Future of Physical Therapy 2015 (Part 3)

Welcome to Part 3 of Future of Physical Therapy 2015.

If you wish to look back further, you can find Part 2 HERE!

So what needs to occur to ensure that a great idea isn't snuffed out by the process and organizational values already in play?

Answer: Ambidextrous Design.

Some people call this a parallel process. Regardless the label, it is the ACTION that matters. What occurs in this strategy is the creation of a separate value chain. Some companies will actually reallocate human resources, giving managers a break or incentivizing them with, "You had to downsize anyway, right?"

By hand picking out key players already in favor of an innovative vision, you are creating an all-star team and are setting them up for success. This is very much like the smart data I mentioned earlier. Where smart data is more about strategically using big data with situational, striated, and actionable user-driven perspectives, the Ambidextrous Design similarly attacks the problem by selecting leaders who are already very intune with the tactical circumstances to which an innovation must emerge.

Leaders in this environment must be involved, highly constructive, minimally critical, positive, and visionary. This is NOT where micromanagement needs to be. (Some would argue, micromanagement never needs to be anywhere, ha!)

The separate value chain is critical because it allows for the development process of any innovation to be evaluated through strategic lenses rather than marginal lenses. This becomes extremely important in the early phases since most projects fail to demonstrate financial gains in nascency. However, the exponential gains are made excitingly abundant in the later cycles.

Separate value chains also allow for a co-existence of the old and the new; this is helpful because the visionary leadership at the top intends on converting everything to the new ways for widespread success. However, if leadership were to make sweeping changes right now, there would be an uprising on their hands. This separate value chain allows for a small department to serve as a pilot of sorts, demonstrating to the larger majority who are resistant to change the value of what they now bring to the table. Once their superior metrics are proven, transferring the new values, processes, and resource models become attractive as any manager would be more than happy to take on those benefits now that they are actually proven.

Another HUGE issue in 2015 will be eliminating the middle man. If one examines the study of supply chain management, it is quickly appreciated that "the middle man" or the "distributor" should ONLY exist if they add value to the entire supply chain.

In healthcare, the supply chain exists to give patients access to the content experts, make available technical skills they cannot perform themselves or for themselves(clinicians, technicians, surgeons etc.), and unlock access to products (primarily drugs and DME).

However, the resources of healthcare have been overwhelmed. There's nearly no more water left in the well, so resources are being rationed. However, the industry is looking at this the wrong way.

It isn't that the well is drying out, it is that we keep drawing from the well while ignoring the oasis behind us.

Why see a gatekeeper who knows little about the problem you have, only to have your gatekeeper send you to the expert afterward? Why go in for an office visit when communicating through an app will do? Why go for a follow up when all anyone was waiting for was the results from a lab study? The prescription can be sent in remotely anyway, right? And, why use expensive machines to diagnose when its been plainly demonstrated clinical diagnosis can glean far more useful and actionable pieces of information for both long term and short term benefits?

This eliminating the middle man is really a battle of eliminating redundancies. Redundancies typically serves to waste resources and make processes less efficient. This will be a very big focus in 2015. While this is a great initiative, it is not enough. Reinforcing an agile supply chain for healthcare will emerge as a key partner. When we think about health services, what is really going down?

1. A patient (consumer) has a concern or ailment to be addressed.
2. The patient wants to know if they need to be seen, and if so, to be seen NOW.
3. The patient wants to receive the solution to their concern or ailment directly and ASAP.

The common story of going to the primary provider, waiting for the one specialist only to be referred to another specialist only to be referred to the diagnostic suite, then a follow up with the first specialist -- all of which took 5 months (if they were lucky). Of course, when this person finally sees the first specialist, they will ultimately be referred to the REAL specialist who could do something about their concern.

These kinds of stories will only exist for FAILING health systems.

Instead, the cutting edge systems will employ predictive modeling where beneficiaries will be contacted for emerging risk factors detected by their clinicians, smart data, and  with self reporting.


Finally, the last key strategy I'd like to introduce for physical therapy and healthcare in 2015 is the entrance into emerging markets. Most emerging markets tend to be disruptive. Others, create an entire genre of their own.

While I made mention to this last year, I would still like more PTs to show up in the space of childhood prevention; I've made many mentions to how dentists have done this to prevent cavities. PTs can certainly do this for the many functions of the body. Considering childhood obesity and manner other PHYSICAL concerns on the alarming rise, are not Physical Therapists best suited to address these public concerns?

For healthcare, emerging markets aren't necessarily about treatment of disease and physical ailments. And, it's not even really about keeping the body running in a healthy, fit, and functional way -- in my humble opinion, this has been the goal of healthcare all along.

I think the emerging market we need to carefully and honestly examine is that which involves reimbursement. Reimbursement MUST move beyond billing units and fee for service. If we're honest with ourselves, the more you deliver health services as a system, the more you have sucked in doing your job adequately.

Why would your beneficiaries need more care and more services if you actually did your job to keep them healthy in the first place?

Instead, I suggest to be on the lookout for differential resource management and value added opportunities. These will both help eliminate our problem children and reward our high performers. I mean, really: In acute care, does it REALLY help for a post-op day 3 inpatient to be walked around the hall by PTs or even PTAs? NO! For SNFs, is it really that helpful to boost up a RUG level and have a clinician bat balloons around for minimal gains in Tinetti scores? NO!

However! How incredible would it be for a PT to follow up as a primary care resource to a patient who had a mechanical fall and landed themselves in the emergency department, following them for 2, 3, or even 5 years with regular check ups both physical and digital? Imagine how this would play out for a population of say 5000 people who fell. Imagine the good this would do, the savings that would be made, and the value that would be added by those people staying healthy and actively participating in economy at large!

Feast on the thought that an outpatient office serves as a informatics source and seed site to where a company of several hundred individuals contracts a PT firm to address workplace injury concerns directly. The company already spends over $10 million dollars a year on work injuries. By applying principles of smart data, this PT firm is now able to reduce this company's expenditures on work injuries by $5 million dollars. What of the difference? Well, per the contract, $1.5 million goes to the PT firm! The hiring company saves $3.5 million this year... not to mention the improved productivity throughout.

Toward the end of 2015, I anticipate source and seed processes to take on a social network spirit where like minded allies band together to demonstrate greater value together. This will become powerful on the financial and political front, garnering much momentum to drive legislative changes.

Process and policy changes will occur organically. After all, if Firm A is saving millions because of an innovative process, wouldn't Firm B quickly attempt to adopt it through their own means?


Some Closing Thoughts
For 2015, I anticipate that the large contract model will occur through networks of PTs, attracted to each other in spirit and demonstrating superior solutions to big picture problems that chop shops can't handle. I also sense that PTs will be repeated denied the timid option of billing for clinical services in the near future. I mean really, how much longer before another clinical profession begins to replace what we do for less cost? If you feel absolutely compelled to survive in this space, the network model will still reign supreme when network A demonstrates better outcomes than network B with an average of 10 less visits per case.

Our knowledge base and skill sets demand us to do more. Therefore, we must step out of the box of ONLY clinical care. We need to think on every possible aspect of how we can use our knowledge and skills in meaningful and valuable ways -- not just for patients but entire systems of business.

2015 is the year of healthcare disruption. Roles, accessibilities, and resources never before tapped are going to be mined, trumped and championed. The first few who jump on this opportunity will win out. Wise firms who know that they are behind will seek expert help to seed their success. Those who try to catch up will inherently fail as their organizational structure will refuse to support such initiatives. Some will try so hard that their entire infrastructure will collapse... just watch!

This coming year, I rebuff my encouragement for PT programs to favor clinical affiliations in the space of private practice, acute care hospitals, and out of the box firms who do much more than the day to day workings. There will be plenty of opportunity for that in the working world, now is the time for our students to learn the cutting edge... learning these things after is far too late. Oh and PS. Why not use some of that tuition money during affiliation semesters as financial incentives for clinics of strategic repute and professional integrity? It would only help elevate the profession at large.

The future of Physical Therapy in Healthcare?

• Disruption. Internal and external disruption. PTs entering emerging roles outside of the clinical space, leading the charge for value added models and innovative processes.

The mechanism?

• High impact network models; quality coming together, separating the wheat and the chaff. Small business will become the new source code for "big."

The strategy?

• Ambidextrous, parallel processes -- many will choose a source and seed tactic. Others will separate their value chains to protect and nurture innovative developments.

The winners?

• Those who are taking on the risks now.

Future of Physical Therapy 2015 (Part 2)

Welcome to Part 2 of Future of Physical Therapy 2015.

If you wish to look back further, you can find Part 1 HERE!

So, where do we go from here?

2015 - It's Time To DisruPT!

Well, as with all things when sustainability begins to waver, the inevitable is coming around the corner: DISRUPTION! Disruptive innovation classically occurs when industries can no longer keep up with the pace, volume, costs, and burden of their current patterns of operations. Healthcare is absolutely ripe for disruption.

To accurately approach disruption, we must appreciate that disruption usually occurs as a result of combinations and conveniences. In the 1950's, it wasn't a better vacuum tube that disrupted the television industry. Rather, by offering portability (something TV sets were incapable of doing through vacuum tubes), transistors made it possible for TVs to be more than a fixture -- allowing people to use TV in places, times, and situations never before available. In fact, it also made TVs available to consumers who never before were able to afford them as well!

Healthcare needs to be seen through a similar lense. We can't disrupt healthcare by doing what we've already been doing better. Truth be told, what we've already been doing IS NOT WORKING! Why try to improve on it? It's time to run a different route.

Gone should be the days of healthcare seen as reimbursement, profit, and service based billing. Healthcare should be judged and paid for through cost savings and value added outcomes.

What do I mean by this? If a specific service performed by a firm directly saves $5 million dollars for ten thousand beneficiaries in a health system, a significant segment of those savings should go towards payment of the firm's services. Moreover, the positive consequences of keeping an entire population healthy -- the economic boost, improved productivity, etc., such should also be measured and the firm proportionately rewarded for the value they have returned to society at large.

2015 - Prime Opportunities
So what are the opportunities before us? Resource management, big data, prevention, minimizing risk factors, childhood A-B-C's (getting them living healthy as early as possible), the baby boomers, necessary/unnecessary, population, patterns, primary care, segments and trends... these are the buzzwords for 2015. The reason these are the buzzwords for 2015 is because this is where the accountants and analysts have determined the most financial opportunity for cost saving and change now resides.

While it can be noted that some practices are beginning to mature in this space outside of billing for units in the clinic, I think there's still a general stigma to this shift. It is a stigma that we REALLY need to get over and away from as a profession. Healthcare is a service and this service has evolved far beyond the bedside, operating room, diagnostic suite, and treatment table. It is as if we have 2015 capabilities but are operating out of 1995 mentalities; we need to get beyond this barrier and into a place where we can utilize our skills to the max, bringing all the benefits we offer accessible to the public.

So! Let me say it again: Being a clinician is NOT the ONLY way to be a PT. More importantly, shifting our focus away from hands on clinical should not be seen as abandoning the profession. It is not treason nor betrayal for PTs to serve outside of the clinical realm.

Just as the nursing profession just disrupted healthcare a generation ago by providing adjunct expertise to physicians as a more manageable resource and cost pool, PTs need to be thinking in similar ways relevant to this current generation.

I've observed and strongly suggest that PTs who wish to be part of the disruption look into opportunities where we can be a part of resource management, big data, early intervention, and portal access (ie. telehealth, mobile apps, biometrics, etc). After all, can you REALLY survive by billing units while said units are worth less and less each year? NO! We have got to become more, do more, and seek to bring value outside of our clinical walls. It is here I hope to see PT practices approach big business, big contracts, and large population portals en masse to serve in preventive programs, early intervention, and primary care roles.

It's a good time to pay attention to the forest.

Similar opportunities are present in the inpatient setting. Fall prevention, reduction of employee work related injuries, physical screening for discharge planning, diagnostic support in the emergency department, unskilled labor management, and case management are EXCELLENT areas to which PTs can serve with distinguishment.

Actually, I foresee the most valuable role for PTs (inpatient and outpatient) as a type of primary care case management of musculoskeletal concerns for all settings in both clinical care and resource utilization roles.

To these points, DPT programs need to add to their curriculums business studies, particularly that of marketing, supply chain, operations management, and analytics.

If all our schools do is teach our students to be clinicians, when they graduate that is all they will know to be and feel it is important to be.

If we are to disrupt healthcare; if we are to become more, to evolve into something significant on the largest of scales, we need to empower our students to think outside of the clinical box; we need a generation of leaders in thought... we already know that they will take action.

2015 - Problem Children

When I take a look at the biggest problems in healthcare, I feel that much of it occurs because of the bullwhip effect - a term from supply chain management. Essentially, miniscule errors upstream cause tremendous variabilities and errors downstream. Think about all the missed musculoskeletal diagnoses you've caught; acute PTs, think on all the strokes you've screened out when CT scans said "negative"; consider the sheer number of prescription of drugs and inappropriate referrals to specialists... all these, in my humble opinion, are the result of a process based bullwhip effect -- seeded in outdated practice patterns, poorly applied data, and using a sift rather than going to the source. Keeping to our current path means subjecting ourselves to a masochistic epidemic of inappropriate utilization in healthcare services; drugs, inpatient stays, and redundant office visits are only the tip of the iceberg.

We need to honestly ask ourselves some rather ugly questions:

• Do I really need a physician to educate me on how an antibiotic will be ineffective for the flu symptoms I have?
• Is a physician really the best clinician to perform my PHYSICAL?
• How about prescribing pain meds to... everyone?
• There are problems inward as well: How "skilled" is it to turn on a diathermy machine and leave a patient for 20 minutes? Oh, and don't forget to use that NuStep. After all, your administration told you to do it, right?
• Since we're in the month of December, how ethical is it to scare an assisted living resident to stay for 100 days in the "health center?" After all, they don't want have to go through the trauma of going back to the hospital, now do they? And, even if they do, they still have 100 days come New Year's!
• How much is billing neuro-re-ed really helping our bottom line in the long run?
• Is it really worth fighting for the table scraps of Medicare dollars?
• How about chop shop clinics where aides do all the ther-ex and clinicians do 8 or 23 minutes of whatever else?
• Home health extensions ad nauseum?

Like I said, I'd be bringing up some ugly topics. I also bring solutions. The way I see it, the ugliness exists because people have been brought to the brink of financial disaster in a system that is filled with erroneous processes.

Through all this, many experts and industry leaders are turning to "big data" for clarity. Identifying trends, managing patterns, etc. While I strongly agree with this strategy of digging deeper to find the roots, I challenge some in their methodologies. Personally, I'm not a fan of the term "big data" for healthcare... at least not yet. I think right now, it is the time for SMART DATA. Currently available data in healthcare can get problematic when it is "big" because it can quickly obscure, eclipse, and make murky the commonly obvious, otherwise elucidated by what many have felt (myself included) is best termed as "smart data."

(A topic for another time.)

In any case, for healthcare, data can be quite unclear because no one has truly been honest with the situation and themselves. This has caused the industry to sacrifice clinical excellence, best practice, honest outcomes... betraying the patient experience. Those who have had found the secret, however, they aren't sharing -- not yet, anyway ;)  And that's okay! It is there competitive advantage. Soon, it will be to their best interest to share and stand on the pedestal as industry leaders in disruptive innovation.

I would suggest that clinical excellence with the patient's best interests placed in priority and under the authority of respective content experts will bring truly meaningful and valuable observations to light. Through such analytics, solutions can be synthesized which are applicable in scale and breadth -- these are smart solutions using smart data which will produce satisfied patients, satisfied providers, and favorable finances.

2015 - Key Strategies to Successful Innovation
As we all know, change is inherently met with opposition no matter what, where, or when it occurs. Why? Well, it's not that the any given majority are ignorant, backwards thinking, or archaically minded. The resistance to change on the larger scales occurs because of organizational behavioral factors. Primarily, what has been termed the "innovator's dilemma" causes organizational behavior to favor what has always worked. After all, our core competencies is what made us great to begin with, right? This can quickly lead to a group think of: "Why fix something that isn't broken?"

I know I've said it before on Twitter...(finding it right now):

@SandyHiltonPT @CynicalPT @Cinema_Air When you sample the managers in any industry, we find core capacities define core rigidities. It's not
— Dr. Ben Fung (@DrBenFung) December 17, 2014

So what needs to occur to ensure that a great idea isn't snuffed out by the process and organizational values already in play?

The answer and more, coming up in Future of Physical Therapy 2015 (Part 3)

Future of Physical Therapy 2015 (Part 1)

This is a follow up post from one of my all time, most popular blog posts "Future Thoughts for Private Practice Physical Therapy" from January 2014.

As a one year follow up, I will be comparing my current thoughts to the circumstances from a year ago. Moreover, there will be some discussion on larger issues at hand to where Physical Therapists are very well positioned to disrupt healthcare at large.

PS. This is a long post. Want to skip to the "good stuff?" It starts at "2015 - It's Time To DisruPT!"

PPS. Every once in a while, I diverge from my characteristically positive and constructive presence to delve into some hard, honest topics. There will be some of that in this post. However, as always, I practice what I preach and I bring solutions as well.

Future of Physical Therapy 2015

It has been a very interesting year in physical therapy, in healthcare, and in life. The world has gotten a lot smaller, and sadly, it seems to have also gotten a lot messier. We're doing okay, but people don't seem to be as happy. Many of us want change -- constructive changes. However, it doesn't really seem like anyone really has the answers to be agreed upon.

Yet, for all that we wish to have changed, we can take a look back on 2014 and appreciate that a lot has already changed. For myself, I've finished writing a book and am grinding through the publishing process (P.S. Know of an interested literary agent? Let me know!)

I have also changed employments several times and have officially experienced every segment in healthcare. That's right! Acute care, rehab, skilled, outpatient, home health, wellness, consulting, etc. you name it, I've seen, heard, done it, and moved on. Come April, I will finish an MBA in Marketing from the University of Michigan - Dearborn. From there, who knows!!! Apparently, some people wish for me to go into professional leadership, policy making or even politics... *shudders*

In any case, after some truly inspiring conversations with several leaders in healthcare, I came back to look upon my blog to see what has been the most influential posts, interactions, and concepts in the last year. Sure enough, this exploration into the ideas of THE FUTURE won out. And so, I'm here to give the public what they want with this 2015 follow up.

2014, Year To Date.

To really explore 2014, I had to look back to 2013 to see where we were at. In 2013, the physical therapy world demonstrated a true interest in the external components in the range and scope of the profession. Novel interdisciplinary trends around the world, primarily cooperative and collaborative efforts with the nursing profession were getting traction on the inpatient side of life. On the private practice front, we saw that PTs began to establish independent communities, primarily based on content, products, and schools of thought verified by social proof.

Here is a SWOT analysis in Spring of 2013 that I posted in the month of March. You can find more on this here & here.

I felt that much of the physical therapy world (and healthcare) struggled with the circumstances described in my SWOT analysis through 2013 until things started to get shaken up in early 2014.

This is where things truly got interesting. We've seen that private practice PTs have truly branched out to become owners of businesses. It's not just the clinic hours that PTs are getting income from; there are larger fish to fry including products, new service lines and brand experiences, and some legitimate legal gains in several states.

There exists a growing spirit of unity, particularly amongst the students and new grads. They are interested in finding ways to bring the pieces together. Also, more PTs are getting out there into commercial, retail, and even open market spaces. It also appears the DPT programs are starting to take notice that if they do not facilitate change, there won't be many PT schools left due to reimbursement backflow and cost of loans.

So, all in all, many positive directions were taken in 2014 -- primarily the strategic placement of the many chess pieces involved -- much as a chess master makes before the critical and decisive move.

Unfortunately, while strategic movements was in play, financial decline also occurred. A new wave of audits occurred in a grand and terrifying way. Third party payers were pairing with Medicare dollars in an effort to maximize market share and thus revenue dollars, edging out competition where ever possible under the guise of resource management.

The market responded with another parallel wave of "creative" billing and extension of health services. As there was only so much money in the pot, the powers at be decreased the portions to be divvied out per service in response. This only created a destructive feedback loop. Companies realizing their margins were quickly shrinking continued to push utilization in hopes of demonstrating sustainable growth to senior management and shareholders. Of course, we know what happened... "everyone" did this and "everyone" got hurt as a result.

@CynicalPT @blairgreen @SandyHiltonPT @Jerry_DurhamPT @PTDavidG When money drives, the well dries up quick.
— Dr. Ben Fung (@DrBenFung) December 6, 2014

As an industry, healthcare version 2014 has finally wallowed to a point where we've come face to face with this fact: putting profits before patients has gotten us as close to rock bottom as we can possibly bear.

As dire as that may sound, we also see that opportunities abound. Yet, current processes seem to hinder putting innovative action plans into play.

So, where do we go from here?


The answer and more, coming up in Future of Physical Therapy 2015 (Part 2)

Four Ways To Measure Brand Equity

Brand Equity is defined as:

"Brand equity is a phrase used in the marketing industry which describes the value of having a well-known brand name..." by Wikipedia.

"The value premium that a company realizes from a product with a recognizable name as compared to its generic equivalent." by Investopedia.

As someone who specializes in marketing, I still feel these definitions are highly conceptual, perceptual, and perhaps even theoretical. The general challenge most marketers have in their work is the translation of what we do best (the conceptual) into what the number crunchers want (the measurable).

When we think of the word "equity," must of us probably think about real estate. This is actually quite an accurate perspective. Much as in buying property, intrinsic value is not innate to any particular plot of land - the same goes for company brands. The value is what has been done with the land, what is being done, and what can be done -- it is the utility of real estate which makes it valuable. That is why we always hear: "Location. Location. Location!" If the location is meaningful, then the location is valuable.

Still, I prose: How do you MEASURE it? "The Market" isn't exactly selling brands the way it is selling houses, plots of land, etc.

Therefore, it is with great pleasure that I introduce Four Ways To Measure Brand Equity.

Four Ways To Measure Brand Equity

1. Brand Separation.

Brand separation is the difference in asset exchange one brand needs to subsidize to a consumer to change brands for a single purchase.

"How much of a discount do I need to give you to buy Dunkin' Donuts instead of Starbucks coffee?"

The intriguing thing about brand separation is that it is short term. The average person is more than willing to swap out one brand for another if the it is temporary, and, if it's done at a discount... or even free! Can't say "no" to free, right? Brand separation is the litmus test in seeing how your brand equity compares to a competitor's. Surveying this numerical disparity can be quite enlightening.

2. Brand Conversion.

Brand conversion is the difference in asset exchange one brand needs to subsidize to a consumer for the product loyalty of the competing brand. 

"How much must I pay you for you to switch from an Android phone to an iPhone?"

What I find interesting about brand conversion is the essential difference between this and brand separation; permanence. When people need to commit to something for the long term, things get serious. In fact, things may get so serious that a discount may not be enough to drive someone to convert to a different brand. You may need to end up paying them for them to use your product and brand. What can be seen in brand separation is likened to the cost per unit of market entry any particular product's life cycle. The numerical survey for brand conversion can be interpreted as market repositioning. How much must your firm pay out to elevate your brand above the competition?

3. Lead Time Loyalty.

Lead time loyalty is a two dimensional construct; the length of time for which a customer is willing to wait for their favorite brand before switching to a less favorable competitor, and, the asset subsidy a firm must supply the consumer to switch to a competitor for a single purchase.

"Would you buy Dunkin' Donuts if I could get you your coffee faster? How much of a discount do I need to give you for you to buy Dunkin' Donuts in that time frame?"

Waiting sucks. How many times have you gone into a store to buy something, saw the line was long, gave up, and left? I know I've done that plenty of times. Now as we expand this on thought, lead time is really based on the "time is money" principle. If you need to get into an emergency room and the wait is 4 hours, but, the urgent care down the street has only a 30 minute line, would you drive to that urgent care? More importantly, if you were paying cash, the emergency room may cost you several hundred dollars but the urgent care visit would only be maybe one to two hundred. Does that further tip the scales towards going to urgent care instead?

Lead time loyalty really breaks things down to the heart of the matter. Why should I wait for you? What value does your brand and/or your products bring that makes it so worth it to wait? This parametric measure gives you four basic quadrants of where your brand is either weak or strong when compared to competitors. Where you are strong, that is where you have much brand equity. Where you are weak and quickly abandoned, this is where your brand (or product) doesn't really bring any value to the consumer. Because measuring lead time loyalty is two dimensional, there exists four possibilities to where your brand may currently exist:

1. Valued & high end
2. Unvalued & high end
3. Value & low end
4. Unvalued & low end

It is your job to optimize that space you occupy -- or better yet, to move your brand's trajectory to a more favorable destination.

4. Lifetime Loyalty.

Lifetime loyalty is the asset exchange subsidy which a competing firm must give to a consumer for the consumer to switch from a favorite brand to the competitor for the lifetime of brand use.

"How much must I pay you for you to switch from Android to Apple, FOREVER?"

Similar to brand conversion, lifetime loyalty is all about the long haul. Can you stay with me forever? Will you stray, just for convenience, perhaps? Scandalous! But really, lifetime loyalty measures the long term growth potential and market penetration costs to ousting a competitor's brand and replacing it with yours. The difference between this and brand conversion is the word "forever." Brand conversion may be a swapping dance, back and forth between top end brand products. However, lifetime loyalty is something that dabbles in the space of goodwill. To this point, there's another question you could ask in terms of time, for measurement and comparison:

"How long are you willing to stay with Android if Apple allowed for similar software freedoms starting right now?"

Lifetime loyalty is the most correlative of these four ways to measure brand equity, however, just like brand separation, it gives you a very good initial glimpse at what you're up against -- or perhaps, where you've lucky enough to be situated.

Some Other Considerations Regarding Brand Equity

Market Positioning:
Where on the grocery shelf are you compared to your competitors? Are you on the top shelf, valued and priced the most? Or, are you on the bottom, sold in bulk with a low price point? Doing a SWOT analysis gives you a framework to which you can examine your position. For more on this, please take a look at this post: Consumer Awareness & Access to Physical Therapists (Part 1) with Part 2 linked at the bottom of said post.

Corporate Social Responsibility (CSR):
CSR has become a huge deal these days. Only in the early 2000's the US stock markets saw CSR behaviors by firms as an unnecessary financial burden -- wasting assets which could have been better used turning a profit elsewhere. However, NOW, CSR is seen as standard and expected. Companies who announce or are exposed for mishaps are proportionately rewarded or punished by how socially responsible the market perceives them to have been. Typically, the fluctuation in shareholder wealth is a function of company reputation, CSR ranking by media, and general public exposure.

Which leads us to the last consideration I'd like to discuss today...

Goodwill:
A company's goodwill is pragmatically unmeasurable. Marketers can certainly correlate and estimate the value of a firm's goodwill. However, truth be told, goodwill is simply that... it is the amount of favorable willpower to which the market at large is willing to serve as benefactor toward any given brand.

Sure! In accounting and in law, there are formulas to "calculate"goodwill, estimate really... Here is a popular equation available.

In any case, I think the most honest measure of goodwill is public support of a brand compared to another brand. How many people do you see walking around with Starbucks cups versus Dunkin' Donuts? How many people do you see driving a certain brand of car of care versus another? How many people do you hear casually conversing regarding physical therapy versus chiropractic care? This could go on for a long, long time.


Some Closing Thoughts:
Measuring brand equity is a very important consideration for long term business success. I feel that it is often neglected for attention garnered toward operations, finances, accounting, supply chain, etc. However, a brand is the personage of a firm. As we watch the information age quickly mature several times over, we've appreciated that we have returned how we connect with businesses, brands, networks, collaborations, and each other as individuals in a very social way -- through relationships. For lack of better terms, brand equity is the quality of relationship you have with your consumers. If you want them to value you, you must first demonstrate that you value them.

To use these four measures most effectively, one should use brand separation and lifetime loyalty as the bread to sandwich the juicy center of brand conversion and lead time loyalty. Brand separation and lifetime loyalty demonstrate short term and long term considerations regarding a brand's market mobility. Brand conversion and lead time loyalty describe a brand's leverage within the market itself. More importantly, the center of this sandwich also frames the greatest opportunities for your brand.

I hope you have found these four ways of measuring brand equity both interesting and useful. More importantly, I hope that these will serve as valuable tools -- as solutions for your success.

Engaging Consumers with a Visible Brand

I'm very happy to share with you a guest blog I wrote for StriveLabs™, a firm on the cutting edge of patient-provider platform engagement for musculoskeletal disease.

I encourage you to check out their site and enjoy this guest post to which I had a LOT of fun writing:

Engaging Consumers with a Visible Brand

Building Your Personal Brand

Let's all face it. Resumes and references are mattering less and less these days. Business journals and media outlets are repeatedly publishing articles for how common it is for resumes to lie and for references to actually be imposters. In fact, it has been commonly suggested that traditional  resumes, references, and even curriculum vitaes will soon disappear.

As this is the case, we have moved into an era of personal branding. After all, the job market is a MARKET. And, just as we shop in a store and trust brands, hiring managers have already begun to sift through their applicants in a similar manner. It won't be long before personal branding IS your resume.

This post is all about building your personal brand, how to strengthen key elements of it, and how to protect it.

Building Your Personal Brand

1. Your Image.
The first and perhaps most important thing to any brand is their image. Not the image the brand hopes to present, mind you. It is all about the image which the consumer envisions in their mind before they actually lay eyes upon you. Your image is comprised of physical, social, individual, real, and imagined interactions made visible to anyone and everyone.

This spans between the way you interact with your customers, your colleagues, your co-workers, etc. This also includes your "speech" in social media, the content you share, the links you retweet, and anything else which may comprise your digital footprint. And, while this may be unfair -- this also has to do with the way you physically present yourself. This has to do with something in psychology called the "Halo Effect" which basically states that attractiveness and familiarity gives a favorable bias to your brand. If you look the part, you ARE the part. This only needs confirmation from the fact that you can act the part. After all (unless there are samples!) when in a grocery store, don't we buy first, then bite? This is how we confirm the brand we just bought. If we like how the food tastes, we'll go back for more. If not, we'll move on.

To build your image, be sure you act the part, look the part, and sound the part in everything that you do, in all the media outlets that you have, and, most importantly in how you live your life. Someone is always watching. Give them a show which speaks positively and accurately to who you are.

2. Your Experiences.
Your collective actions, conversations, observations, and collaborations comprise your experiences. The manner in how you have connected with the world constructs the lattice in which your brand is fleshed out. Think of this as the foundation and framework of a building. For a hiring manager, they look at both your work experience and your life experience. I can guarantee you that people will be more willing to hire someone with interesting stories  versus "by the book" blandness.

Your experiences certainly include your past jobs, the brand of your education, where you have traveled, volunteered, and what your hobbies are. Certain experiences can serve as a strong brand multiplier. This can include graduating from top tier programs, interning/working at internationally acclaimed firms, and having meaningful media exposure. These days, hiring managers are being ever so encouraged to make sure the "right stuff" in an applicant is calculated by the sum of their experiences rather than the fact they have a certain amount of experience.

It's no longer about the length of time you've done something. It's about how well you do it. In other words, "It's not what you do, it's HOW you do it." Excellence will elevate your brand.

3. Your Personas.
Everyone has multiple personalities depending on outlet, context, social circles, etc. Sometimes we're the alpha. Other times, we're hanging back. There are moments when we provide the shock value and there are other situations for which we are just the observer. Regardless of who you are personally, how you behave defines the identity of your brand's persona. More importantly, this is ultimately defined by how others PERCEIVE you to be and WHY they wish to (or wish not to) connect with you. This can include sociopolitical postures you present on social media, your physical posturing in person when you interact with co-workers, and the manners in which you serve a customer. It is here that emotional valences are most pronounced. If you come across as a positive person, people will view this favorably. If you come across as a negative and perhaps critical, it may not be so favorable.

Manage your personas carefully as they play an important part in defining your personal brand. Managers hire likeable people. Be likeable. Be kind. Be gracious. Such will grow your brand equity.

4. Your Relationships.
We've all heard it before: "It's not what you know, it's who you know." Who you are and have been associated with plays an important part in branding. Such pairings can serve as a brand multiplier. Other times, it can really hurt you.

Let's just examine the effects with this list:

• Pizza + Beer
• Wine + Cheese
• Baseball + Hot Dogs
• Bar + Wings

(okay I'm a little hungry right now... those are the examples I have, LOL!)

In any case, it's important to safeguard who we allow to be associated with us and who we aim to associate with. It is just as important to pursue meaningful relationships in the same vein. Our relationships all bring with them their own images, their own experiences, and their own personas -- and, all of these facets ultimately paint the finishing strokes upon the artwork of your personal brand.

You can either choose to have smears upon your canvas, or masterful brush strokes. Be favorably relatable and choose good, healthy, meaningful relationships to nurture. This is the final element of building a personal brand. It can just as easily make your brand... or break it.


Some Closing Thoughts
We're heading into a time in human history when information is so rampant we don't even know what to do with it anymore. This transcends our personal, professional, and even the private facets of our lives. Personal branding goes beyond just the business itself. It will certainly impact our relationships, our families, and every possible social and business circle in the future. There are definitely profound implications to the youth of our times in this regard. There are also encouraging strategies to regain control of personal brands so that who you are and who you are known to be eventually become one in the same.