Decision-making, despite its importance and prevalence in clinical care, has a hard time fining its way into the business side of healthcare.  Let’s face it, decisions are hard to make for a cohort that cites risk aversion as one of the most common reasons for not starting a private practice in the first place.
And no other place within your profession is decision-making more hard to come by than with healthcare marketing.

In healthcare marketing, identify who you are marketing to.

Get specific with your patients. Who is audience?

It’s not the decision as to whether or not to market that’s so tough (though controversy exists there as well), but rather the decision about who to market to that reminds me of some of the most labor-intensive decisions we have to make in life.  And while deciding on a market for a healthcare practice may rank up there with the other big decisions we make (you know, choosing a color theme for our bathroom linens, deciding whether or not to get the extended warranty for the DVD player), it really doesn’t have to be that hard.
The problem is twofold: (1) We generally think we’ve got one chance to get it right and really don’t want to blow it, and (2) we actually think we can be everything to everyone, so we give it the old college try.
Both of these are myths of course within private practice, and if we can dispel these and bring a healthy level of focus and distinction into our business strategy, odds are the decisions will fall right into place and we’ll not only know who our target market is, but we’ll be able to do a pretty darn good job of serving it.
Myth #1: We’ve got one chance to get it right.  Generally speaking, we actually don’t want to screw up on choosing the right market for a medical, dental, or physical therapy practice – each requires a significant amount of capital, and for the risk averse, this by itself usually lends itself to healthy deliberation.  The thing is, choosing a target market for a practice isn’t like trying to find the one blue marble in a bag of 500 red ones.  Think of the bag as containing every shade in the spectrum from deep red to bright blue.  Yeah, we don’t want to choose brick red, but it’s also OK if we don’t get sky blue the first time around.
If you’re starting a physical therapy practice and aren’t really sure if you want to go after the women’s health market or the general outpatient orthopedic population (as you’re dually trained), realize that there are commonalities to both (yes, women do have general orthopedic conditions that crop up from time to time) and that by choosing a direction, you’re not casting an eternal spell on your practice that will never allow you to change.
Now, there are some considerations that should be made when making this decision, including how to back out if indeed it doesn’t pan out for the long term, but these are well handled through a sound branding and healthcare marketing strategy that builds into it a flexible architecture and messaging strategy that can unfold in a couple of different ways depending on the direction the wind ends up blowing.
What generally doesn’t work however, is making the decision (not much of a decision actually) to do it all.  Why wouldn’t you want to do it all you ask?  Doesn’t that open up many more doors by casting a wider net?  Well, yes, but in theory only.  The reason you don’t want to do it all is because you likely can’t, which brings us to myth #2.
Myth #2: We can be everything to everyone.  We’re not designed to think of ourselves as incapable of doing what we set out to do.  In healthcare especially, the level of intellect and drive is of the highest around, so why wouldn’t we be able to go in multiple directions at once; be kind of a one-stop-shop to all who need us?
We can’t do it because like any other mortal, when spread too thin we can only scratch the surface in terms of quality, time, and energy (sort of important in healthcare), and even if we could do a great job at it, the lack of focus wouldn’t communicate to the marketplace that we are distinctly different from our competitors.
Surprisingly, being good – or being different, is just as important as communicating that we’re good – or different.  Certainly an argument exists that many of us would rather be good than have others think we’re good – the problem is, that if nobody knows we’re good we can’t really help those that need us anyway.  This is precisely what happens when we lack a defined focus in our selection of a target market and/or specialty for our practice.
Now, it’s important to understand that the takeaway here is not that one can’t be a generalist and survive in today’s healthcare marketplace – on the contrary, generalists are one of the most critical components of the system as a whole.  What should be conveyed is that even a generalist who has selected her specialty (general practice) has many decisions to make about how to focus her practice around other elements that will influence the level of focus and distinction the practice holds in the market.  Decisions regarding which insurance contracts to solicit (drives patient mix and revenue diversity), which age group to target, and which referral sources will provide the best partnerships for the life of the practice, will have longstanding effects on the practice, and aren’t amenable to a “straddle-the-fence” kind of approach.
By making decisions that limit the need for the practice owner to be everything to everyone, the quality, enjoyment, and overall experience within the practice is elevated significantly for those receiving the focus of the marketing and operational efforts; a big win for all involved.
Here is a post on the Entrepreneurial MD blog that speaks to this very point, and I recommend it as a succinct, quick read on the benefits of focusing on a target market.

In order to immunize your business against recession, you need to discriminate. While this is not a comfortable word for the politically correct amongst us, one of  Webster’s definition of discrimination is “the quality or power of finely distinguishing”.