Medical director and hospital marketing: how it works

There is one person in a hospital group whose “no” ends a growth initiative outright, and whose “yes” is necessary but never sufficient. That is the medical director. Every growth leader learns this, usually in the meeting where a campaign that has been approved by the CEO, funded by the CFO and briefed to the agency is stopped by a single sentence about credentialing.

I worked alongside medical directors for years across a multi-unit group, at the flagship and at units in smaller cities, and the relationship was the most consequential one I had that did not appear on any organisation chart. When it worked, growth and clinical governance pulled the same way and the group grew without an incident. When it did not, we lost quarters to campaigns that were withdrawn, launches that were delayed and doctors who left because they felt sold.

This is where the two roles collide, what a working partnership actually looks like, and the lines that growth must never cross in an organisation whose product is clinical.

Where the two roles collide

The collisions are structural, not personal. They will happen with any two competent people in these seats.

Capacity. Growth wants to fill OT slots, ICU beds and consultant diaries. The medical director is protecting elective schedules from being overrun, keeping emergency and ICU buffer free, and refusing to let a surgeon operate at a rate that compromises outcomes. A campaign that succeeds in filling a schedule that was deliberately kept short of full is not a success. It is a safety problem with a marketing invoice attached.

Case mix. Growth measures volume; the medical director sees what the volume is. A tertiary unit flooded with low-acuity cases from a successful health-check campaign is a unit whose beds and consultant time are being used on work that should be at a primary clinic — and whose complex cases, the ones the unit was built for, are now waiting.

Doctor recruitment. Growth wants names for the launch, ideally with regional recognition. The medical director wants credentialing done properly, references verified, privileging matched to what the unit can actually support, and no doctor announced before the paperwork is finished. Those timelines do not agree, and the agency’s deadline is on growth’s side of the table.

Pricing of clinical work. Growth wants a package — a knee replacement, a delivery, a cardiac procedure — with a single price that can be advertised and sold through the contact centre. The medical director knows that clinical variance is real, that a package which excludes complications invites a billing dispute at discharge, and that a package which includes them is priced by someone who understands the variance, not by the marketer.

Promotion of specific services. The robotics launch, the new transplant programme, the “first in the region” claim. Growth wants to promote what will draw demand; the medical director wants to promote what the unit can consistently deliver. And the doctor who most wants to be promoted is rarely the doctor the medical director would choose.

What the medical director is actually accountable for

Understanding this reframed the relationship for me more than anything else. The medical director is accountable for outcomes, credentialing and privileging, NABH compliance, infection control, mortality and morbidity review, consent, the state medical council’s view of the unit, and the courts. When something goes wrong clinically, the medical director is named. The growth leader is not.

Once you see the asymmetry, the “no” stops looking like obstruction. It looks like someone declining to carry a risk that you would not be carrying with them. The right response is not to escalate to the CEO. It is to ask what would make the risk acceptable, and to do that.

What a working partnership looks like

The partnership that worked had four parts, none of them complicated.

A standing monthly forum — the two of us, the unit heads concerned, and the person who owns scheduling — on capacity and mix. Growth brought demand by specialty: what the city was searching for, what the contact centre was being asked for, where enquiries were being lost for want of an appointment. The medical director brought capacity by consultant and the constraint behind it: the surgeon at the limit, the ICU nurses short, the OT going down for a month. Out of that came a demand plan that the medical director had shaped, which is the only kind that survives contact with a real quarter.

A shared, written list of services approved for promotion, owned by the medical director. If a service was not on the list, it was not in a campaign, on a hoarding or in the contact centre script. Getting a service onto the list was a conversation about readiness, not a marketing approval.

A view for growth of clinical incident and complaint trends — not the details, the trends — before a campaign was planned for a specialty. If a unit’s orthopaedic programme had two open incident reviews, we did not launch a knee campaign that month, and the medical director did not have to fight for that.

And a rule that growth met the medical director before any new doctor was announced, any new package priced or any new claim made. Not to ask permission. To ask what could go wrong.

The contact centre is where this partnership is tested every day, because it is where growth’s demand meets clinical judgement in the mouth of an agent with a script. The medical director should own the triage rules in that script — which symptoms go straight to emergency, which specialties an agent may book directly, when a call is handed to a nurse — and growth should own everything else. When we got that division wrong, agents booked patients into the wrong specialty to hit a booking target, and the consultants who received them told the medical director, not me. When we got it right, the script was reviewed by the medical director’s office every quarter and bookings went up anyway, because patients who were routed correctly turned up.

Doctor recruitment: what growth can contribute

Growth cannot choose doctors and should not try. What it can do is bring the market. Search demand by specialty in a city. Which competitor has just recruited whom, visible from their listings and the aggregators. Where enquiries are going unanswered for lack of a consultant. What the referring doctors in a district say they need and cannot find locally. A medical director who wants to open a specialty in a Tier 2 unit can make a far better case to the CEO with that data than without it, and the growth leader who supplies it becomes a partner in recruitment rather than the person who wants a name for the launch.

What growth does not do is promise a doctor volume in order to recruit them. That promise gets made in a recruiting conversation, it gets remembered, and when the volume does not arrive the doctor holds growth responsible and the medical director holds growth responsible for the doctor. I have watched a consultant leave a unit eleven months after joining on exactly that grievance.

Pricing: who decides what

Growth can propose that a package exists, what price the market will bear and how it should be sold. The medical director decides what is in it, what is excluded, how clinical variance is handled and what happens at discharge when the case did not go to plan. A package agreed this way can be advertised without a billing dispute following every third patient. A package that growth priced from competitor hoardings and the medical director saw afterwards is a complaint waiting for a patient.

The same division holds for discounts and camps. Growth can propose them. The medical director’s view on whether a discounted procedure changes the case mix — whether it brings the unit patients it is not built for, or brings them at a rate the consultants cannot safely absorb — belongs in the decision, not in the review after.

One practical point that causes more friction than any principle: the price list the contact centre quotes must be the price list the billing desk uses. Growth owns the first, finance the second, and the medical director is the one who hears about the gap from a patient’s family at discharge.

The lines growth must never cross

Never make or imply a clinical claim the medical director has not approved. “Best”, “safest”, “highest success rate” are not marketing adjectives in a hospital. They are outcome claims with legal consequences, and the regulator’s view of advertising by medical establishments is not lenient.
Never route a patient to a specific doctor for a commercial reason. Referral within a group must follow clinical logic, and the moment the contact centre steers by revenue, the medical director cannot defend the unit.
Never pressure a consultant, directly or through a dashboard, on converting consultations into procedures. The number will move, and the wrong patients will be operated on.
Never use outcome data selectively. If the group publishes a figure it publishes the method, the denominator and the period, and the medical director signs it.
Never go around the medical director to a star doctor who wants to be promoted. The doctor may be willing. The medical director is the one who answers for it.
Never announce a doctor before credentialing is complete. Not on a hoarding, not on a listing, not in a WhatsApp forward to the referral network.

These are not policies to negotiate. They are the conditions under which a growth function is allowed to exist in a clinical organisation.

What I got wrong

Early on, a campaign for a specialty went live with the second consultant’s name on it while his privileging was still with the credentials committee. The paperwork was days from done; the agency had a deadline; the unit head was keen. The medical director found out from a hoarding on the way to work.

The campaign came down that day. What took months to recover was not the campaign. It was the medical director’s willingness to take my call about anything else — to believe that when I said a service was ready, I had checked. I would rather have missed the launch by three weeks. It is the mistake I tell every growth leader about, because every one of them is one agency deadline away from making it.

If you are starting the relationship

Ask the medical director for an hour and use it to understand what they are accountable for. Say nothing about your plans.
Bring demand data by specialty to the second meeting, against their capacity view. Let them see what you can see.
Propose the shared list of promotable services and offer them ownership of it.
Set up the monthly capacity-and-mix forum with the unit heads present.
Show them every claim, package and doctor announcement before it goes anywhere, for the first year, without being asked.
Write the lines above into your team’s operating rules and tell the medical director you have done so.

Growth brings the patient to the door. The medical director is the reason the patient can walk back out. Forget which of those matters more and the group will remind you.

Questions people ask

Why can a medical director stop a hospital marketing initiative outright?

Because the medical director is accountable for outcomes, credentialing and privileging, NABH compliance, infection control, mortality review, consent, the state medical council’s view of the unit and the courts. When something goes wrong clinically, the medical director is named; the growth leader is not. Once you see that asymmetry, the no stops looking like obstruction and starts looking like someone declining to carry a risk you would not share. The right response is not to escalate but to ask what would make the risk acceptable.

Where do hospital marketing and the medical director collide?

Five places, structurally, with any two competent people in the seats. Capacity: growth wants to fill OT slots and diaries; the medical director is protecting buffer and outcomes. Case mix: a health-check campaign that floods a tertiary unit with low-acuity work. Doctor recruitment: names for the launch versus credentialing done properly. Package pricing: a single advertisable price versus real clinical variance. And promotion of specific services, where the doctor who most wants promoting is rarely the one the medical director would choose.

What does a working partnership between growth and the medical director look like?

Four parts. A monthly forum on capacity and mix with the unit heads, where growth brings demand by specialty and the medical director brings capacity by consultant and the constraint behind it. A shared written list of services approved for promotion, owned by the medical director — not on the list, not in a campaign or script. A view for growth of incident and complaint trends before a campaign is planned. And a rule that growth meets the medical director before any doctor is announced, package priced or claim made.

Who should own the triage rules in a hospital contact centre script?

The medical director. Which symptoms go straight to emergency, which specialties an agent may book directly, when a call is handed to a nurse — those are clinical judgements in the mouth of an agent with a booking target. Growth owns everything else in the script. When we got the division wrong, agents booked patients into the wrong specialty to hit targets, and the consultants who received them told the medical director, not me. When we got it right, the script was reviewed quarterly and bookings went up anyway.

Can hospital marketing in India say best, safest or highest success rate?

No. Those are not marketing adjectives in a hospital; they are outcome claims with legal consequences, and the regulator’s view of advertising by medical establishments is not lenient. If the group publishes a figure, it publishes the method, the denominator and the period, and the medical director signs it. Never make or imply a clinical claim the medical director has not approved, and never use outcome data selectively. These are not policies to negotiate. They are the conditions under which a growth function is allowed to exist.

Who decides the price of a hospital package — marketing or the medical director?

Growth proposes that a package exists, what price the market will bear and how it should be sold. The medical director decides what is in it, what is excluded, how clinical variance is handled and what happens at discharge when the case did not go to plan. A package agreed that way can be advertised without a billing dispute following every third patient. One that growth priced from competitor hoardings and the medical director saw afterwards is a complaint waiting for a patient.

What can hospital marketing contribute to doctor recruitment?

The market, not the choice. Search demand by specialty in a city. Which competitor has just recruited whom, visible from listings and aggregators. Where enquiries go unanswered for lack of a consultant. What referring doctors in a district say they cannot find locally. A medical director opening a specialty in a Tier 2 unit makes a far better case with that data. What growth must never do is promise a doctor volume to recruit them. I watched a consultant leave eleven months after joining on exactly that grievance.

What did you get wrong with a medical director?

A campaign went live with the second consultant’s name on it while his privileging was still with the credentials committee. The paperwork was days from done, the agency had a deadline, the unit head was keen. The medical director found out from a hoarding on the way to work. The campaign came down that day. What took months to recover was his willingness to believe that when I said a service was ready, I had checked. I would rather have missed the launch by three weeks.

What are the lines hospital marketing must never cross?

Never make a clinical claim the medical director has not approved. Never route a patient to a specific doctor for a commercial reason — the moment the contact centre steers by revenue, the medical director cannot defend the unit. Never pressure a consultant, directly or through a dashboard, on converting consultations into procedures. Never use outcome data selectively. Never go around the medical director to a star doctor who wants promoting. And never announce a doctor before credentialing is complete — not on a hoarding, a listing or a forward.

How long does it take to build trust with a medical director?

Plan on a year of showing them every claim, package and doctor announcement before it goes anywhere, without being asked. Start by asking for an hour to understand what they are accountable for and saying nothing about your plans. Bring demand data by specialty to the second meeting against their capacity view. Propose the shared list of promotable services and offer them ownership. Trust is built in the monthly forum, meeting after meeting, and it can be lost in one hoarding.

What should a CEO do when growth and the medical director disagree?

Not adjudicate. A CEO who overrules the medical director on a clinical readiness question has taken on a risk the medical director was declining to carry, and has taught growth that escalation works. The better structure is the monthly capacity-and-mix forum with unit heads present, where the demand plan is shaped by the medical director and therefore survives contact with a real quarter. A CEO should insist that forum exists and that the promotable-services list is owned by the medical director, and then stay out of it.

Why must the price list the contact centre quotes match the billing desk?

Because growth owns the first, finance owns the second, and the medical director is the one who hears about the gap from a patient’s family at discharge. It causes more friction than any principle. The same applies to discounts and camps: growth can propose them, but the medical director’s view on whether a discounted procedure changes the case mix or brings patients at a rate consultants cannot safely absorb belongs in the decision, not in the review afterwards.

Why does a successful campaign that fills every slot count as a failure?

Because some schedules are deliberately kept short of full. The medical director is protecting elective lists from being overrun, keeping emergency and ICU buffer free, and holding a surgeon below the rate at which outcomes suffer. A campaign that fills a schedule kept short on purpose is a safety problem with a marketing invoice attached. Growth measures volume; the medical director sees what the volume is. That is why demand by specialty has to be planned against capacity by consultant, monthly, before the media goes out.

Does the medical director relationship matter in a single Tier 2 hospital as much as in a group?

More, because there is no group medical affairs function to absorb the friction and the medical director is often also a practising senior consultant. The same four mechanisms apply — the monthly forum, the promotable-services list, the incident-trend view and the pre-announcement rule — but run faster and more personally. In a smaller city the referral network hears about a mis-announced doctor within days, so the credentialing line is even less negotiable. Growth brings the patient to the door; the medical director is why the patient can walk back out.