INTERNET MARKETING FOR WEIGHT LOSS SURGERY
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1 INTERNET MARKETING FOR WEIGHT LOSS SURGERY Hsin-Chih Kuo, I-Shou University, No. 8, Yida Rd., Yanchao Township, Kaohsiung County 824, Taiwan, R.O.C ext Chi-Hsing Tseng, National Pingtung Institute of Commerce, No. 51, Min Sheng E. Rd., Pingtung 900, Taiwan, R.O.C ext ABSTRACT In order to provide the medical information of bariatric surgery for obesity patients, the bariatric center in a hospital pay attention to do internet marketing from the customers view. When customers search the information for bariatric surgery, they are usually confused by the message on the website which demonstrates usually from the providers view. This research used the focus group to integrate the message which needed to be showed on the internet and to rearrange the topic for the convenience and precise in a reasonable way. The result showed that the topic of information for bariatric surgery would be rearranged by the indication of the surgeries, the process of hospitalization, and the related interactive communication for the surgeries. Moreover, the supporting groups or some blogs which were established by the operated patients could persuade and help the potential patients to make the decision. The conclusions of this study is that the website information should provide the options of bariatric surgery, show the hospitalization process, and encourage the interactive communication among the blogs which are established by the patients who had ever received bariatric surgery. Keyword: internet marketing, obesity, bariatric surgery, INTRODUCTION In order to provide the medical information of weight loss surgery for obese patients, the bariatric centers pay a lot of attention to do effective Internet marketing. When customers search for weight loss surgery information, they are usually confused by the message on the web. Because many searchers dissatisfied with the content on the internet, bariatric centers need to rethink the following questions. What does the information is available for target customers? How do the target customers look for the information of weight loss surgery through the internet? The issue would be discussed in the following section.
2 THEORETICAL BACKGROUND The disease related to obesity may be substantial, e.g., diabetes, hypertension, heart disease and high serum cholesterol (Paeratakul, Lovejoy, Ryan, & Bray, 2002). There s several method to improve body weight, e.g., diet, exercise, medication, or even surgery. Especially the morbid obesity would be the indication for weight loss surgery, also called bariatric surgery. Weight loss surgery could decrease patient s mortality in morbid obesity (Christou et al., 2004). When obese adults receive bariatric surgery, their glycemic control would also be improved (Michael, 2008). Bariatric surgery also could reduce medication use for major disease categories (Cremieux, Ledoux, Clerici, Cremieux, & Buessing, 2010). Therefore, the bariatric surgery has become the option for weight loss. The quality of health-related information on the internet is highly variable (Purcell, Wilson, & Delamothe, 2002). Many people use the internet to find health-related information (Bansil, Keenan, Zlot, & Gilliland, 2006). Although doctors think the information on the internet may mislead patient s perception and behavior, doctors still need to face the questions which patients search for on the internet. If doctors could distinguish the quality of information, they could pursue patients to select the good quality information. Moreover searching with Google may also help doctors to diagnose difficult cases (Tang & Jennifer Hwee Kwoon, 2006). Not all information on the internet could offer the same level of advantage. It needs careful design to ensure that key messages could clearly communicate to their users (Hurling, Fairley, & Dias, 2006). Finding the proper colorectal cancer information resources would be useful to healthcare professional (John, 2006). Good quality information with familial adenomatous polyposis is difficult to obtain on the internet (Soobrah & Clark, 2012). Grewal, Williams, Alagaratnam, Neffendorf, and Soobrah (2012) indicated that internet information on vascular surgical conditions and procedures is poorly written and unreliable. Health professionals should make the information on the internet easy to read, access, and use. The aim of this study is to provide high quality information for those who search on the internet to solve overweigh and obesity problems. METHODOLOGY This study adopted a focus group design and attempted to find the information which is appropriate or not from the customer s view. The seven members of the focus group are patients who had received bariatric surgery before within a bariatric center. The bariatric center is a division of a hospital which is a large scale hospital and has more than 1000 beds in Taiwan. Moreover, this study also invited one member of medical staff to join the focus group because the member could promote the discussion in the focus group. The researchers thought the interactive dialogue would be helpful to explore the necessary information from both medical staff and patients.
3 Multiple sources which come from both medical staff and patients will help researchers to clarify the focus of attention. FINDING Generally speaking, the medical information on the internet should all the information which patients need to make their decision making and decrease their anxiety. Although medical staff will provide the information from their professional view, it s better to describe the process which patients would experience. Researchers just want to know the perception of patients both before and after their operations. The related suggestion could be divided into three parts: original arrangement of information on the internet, searching experience of patients, and rearrangement of information on the internet. Original arrangement of information on the internet The content arranged by functional division. The concerned focus of information for patients may be quite different from that for medical staff. Original arrangement on the internet was showed by medical specialty which the health assessment, internal medicine, surgery, nutrition, and fitness provided their information separately. The original arrangement on the internet was hard to understand by patients. The reason may come from medical specialty according to functional division in a bariatric center. For example, the suggestion of nutrition on the internet may be as follows: Nutrition needs to be adjusted according to different days after bariatric surgery. The detail of nutrition would be different during different stages after bariatric surgery. The nutrition during maintain stage should be the part of patient s life and become their eating habit. In addition to the information of nutrition, patients could hardly understand the whole process after bariatric surgery. Because patients didn t have a whole picture for the process, they couldn t catch the proper time to follow the instruction which included internal medicine, wound care, nutrition, fitness, and so forth. Much separate information may confuse patient s perception and behavior and result in some conflicted instructions among the specialties. The proper information hard to find. If all information was provided separately, patients need to think the way to integrate by themselves. Because the original arrangement is designed by separate specialty, patients can t find the necessary information easily. If patients want to know the wound care, nutrition, fitness, immediate or late following process after bariatric surgery, they would spend a lot of
4 time to search for the necessary information on the internet. Patients must have done the hard work to coordinate different information by themselves. This will make patients anxious and uncertain. If the medical staff didn t think the whole process for their coordination, there would be more or less deviation between the planned procedure and real procedure. So even if patients had finished the integration of information on the internet, the integrated information may be different from the real procedure operated by medical staff. The whole process hard to understand for the bariatric surgery. Compared to the medical staff, patients usually owned less information. If the information must be collected or organized by patients, the whole process may be misunderstood during the integration. Therefore, the result will be the uncontrollable perception and quality evaluation about the process of bariatric center. The information on the internet is not user-friendly. In other words, the necessary information didn t be given comprehensively on the internet and patient would feel uncertain about the process. This study indicated that the useful bariatric information on the internet should be focused on the needs of customers which the information should be integrated. Searching experience of patients According to the thought of patients, information on the internet should let patients know the facility and faculty, especially the team work for weight loss. Next, patients need information to help their decisions which contain the advantage and disadvantage about the different type of treatment. Consequently, the details which contain preoperative, intraoperative, and postoperative procedure could decrease the anxiety of patients. In addition to the information provided by medical staff, patient will want to know the positive or negative experience that other patients had undergone the operations. But there s still a problem: How detail should be demonstrated? Some patients told that they wanted to know the detail about the procedure of sending patients to operation room, but not the detail like the operation instrument used during operation. They concerned the complication and any other changes that would cause inconvenience of her life after bariatric surgery. To reduce the uncertainty, the information on the internet should demonstrate at least the whole process which contains preoperative, intraoperative, and postoperative procedure. Rearrangement of information on the internet According to above opinions, the item on the internet will be demonstrated as
5 following: tangible facility, professional faculty, treatment option, whole procedures in the bariatric center, news and activities, related connection, and contact us. Tangible facility. Tangible facility demonstrated the facility which included the ward, equipment, instrument, and operation room. Professional faculty. Professional faculty showed the complementary task of professional team which contains doctors for internal medicine, surgery, psychology, urology, gynecology, plastic, metabolism, and other medical staff like case manager, professional nurse, research assistant, and so forth. Treatment option. The severity of overweigh or obesity begins from calculation of BMI, the consumption of diet and exercise. If the overweigh needs to be fixed, medical option priority should be diet and exercise, internal medicine. Morbid obesity should be considered by bariatric surgery consequently. The surgical types would provide sufficient information for patient s option which would contain surgical principle, surgical type, effectiveness, duration for the prognosis, vitamin deficiency, surgical risk, surgical time, and length of stay in a hospital. Whole procedures in the bariatric center. Patient needs know the information about the outpatient, inpatient, and discharge. The inpatient procedures contain the preoperative, intraoperative, postoperative procedures. Patients will concern about the detail of these procedures. News and activities. Bariatric center could show patients the evidence for their treatment result. News and activities will be helpful. Besides, video from TV or successful story would be persuasive for the decision making of patients. Related connection. Even after surgery, the social support would still be the important factors for the success after bariatric surgery. To decrease the uncertainty and negative imagination, opinion leaders play an important role for the decision making and taking the action. Some opinion leaders will have their own blog, facebook, or other discussion forum on the internet which could provide the customer s view to decrease the uncertainty and to help continuous weigh maintain after bariatric surgery. Moreover, bariatric center also have established the obesity support association to support the patients and to maintain the effect after bariatric surgery. Contact us. If there s any problems, patients need to know the telephone, address, and clinic hours for connection. The special-purpose phone line will be suitable for those potential customers and even for those patients who will receive the operation or will need more information after bariatric surgery. After rearrangement of information on the internet, the website of bariatric center is
6 widely spread by word-of-mouth. Other patients who need to know the comprehensive process will search the information provided by the bariatric center in Taiwan. The website becomes an important source of bariatric surgery information. The result is unexpected and the web had become the reference for most patients who want to understand the whole process. CONCLUSION To describe the information of web separately by specialty is easy for the medical staff. But the information which had not been integrated would confuse the users. To describe the information on the internet should be the integrated information which must be integrated by specialty previously and put into customer s consideration. This study shows that a better way is to describe the process which follow the decision making, preoperative procedure, intraoperative procedure, postoperative procedure, and discharge process. REFERENCES Bansil, P., Keenan, N. L., Zlot, A. I., & Gilliland, J. C. (2006). Health-related Information on the Web: Results From the HealthStyles Survey, Preventing chronic disease, 3(2), A36. Christou, N. V., Sampalis, J. S., Liberman, M., Look, D., Auger, S., McLean, A. P. H., & MacLean, L. D. (2004). Surgery decreases long-term mortality, morbidity, and health care use in morbidly obese patients. Annals of surgery, 240(3), Cremieux, P. Y., Ledoux, S., Clerici, C., Cremieux, F., & Buessing, M. (2010). The impact of bariatric surgery on comorbidities and medication use among obese patients. Obes Surg, 20(7), doi: /s Grewal, P., Williams, B., Alagaratnam, S., Neffendorf, J., & Soobrah, R. (2012). Quality of vascular surgery Web sites on the Internet. Journal of Vascular Surgery, 56(5), Hurling, R., Fairley, B. W., & Dias, M. B. (2006). Internet-based exercise intervention systems: Are more interactive designs better? Psychology & Health, 21(6), doi: / John, A. K. (2006). A critical appraisal of internet resources on colorectal cancer. Colorectal Disease, 8(3), doi: /j x Michael, P. (2008). Bariatric Surgery Improves Glycemic Control. Clinical Diabetes, 26(3), Paeratakul, S., Lovejoy, J. C., Ryan, D. H., & Bray, G. A. (2002). The relation of gender, race and socioeconomic status to obesity and obesity comorbidities in a sample of US adults. International Journal of Obesity, 26(9), doi:
7 /sj.ijo Purcell, G. P., Wilson, P., & Delamothe, T. (2002). The Quality Of Health Information On The Internet: As For Any Other Medium It Varies Widely; Regulation Is Not The Answer. BMJ: British Medical Journal, 324(7337), doi: / Soobrah, R., & Clark, S. K. (2012). Your patient information website: how good is it? Colorectal Disease, 14(3), e90-e94. doi: /j x Tang, H., & Jennifer Hwee Kwoon, N. (2006). Googling for a diagnosis use of Google as a diagnostic aid: internet based study. BMJ: British Medical Journal, 333(7579), doi: /
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