When a company is small, its marketing may consist only of a logo and delivering what is asked and required on initial personal relationships. As the company grows, the more it needs focused expertise and marketing initiatives to reach customers, manage message, programs and costs and deliver performance — but that usually doesn't happen.

Some companies get so large that their marketing becomes more corporately professional, disassociated from sales and the customer, and they need those initial personal relationships to remember how it all works.

Marketing is all about finding, engaging and satisfying the customer, profitably. Over and over and over again.

So if we are going to discuss an HME makeover in marketing, let's make sure we're talking the same language. Marketing is the process and battle plan of why, how, when and what you do to interest, engage and profitably satisfy your target markets' wants and needs. The result must have value for both your targets and you.

Marketing strategies and tactics build your distinctive brand among stakeholders (consumers, referral sources, patients, payers, employees, local government, bankers, strategic alliances, etc.). The strategies and tactics are the unique combination of your offering decisions in products and services, pricing, sales, promotion, distribution and communications. They must be different and/or better than that of your competition.

Remember that there really is no “typical” HME. Every company is different. Each has different strengths, weaknesses, service and product offerings, customers, patient and referral mix, pricing strategy, human capital, ingenuity and financial strength. Each company faces different challenges in geography, competition and media.

Some companies have grown inch-by-inch over years to establish their market position. Others started with a master plan and grew their business in stages through outside funding or personal financing. Yet others acquired existing HMEs and went on to refine the company with their imprint. Many firms have two and three generations of family driving the community, region or statewide business.

But in working with all types of companies, I find there are some common issues that arise in HME marketing and execution. Frequently the issues are ignored, sometimes for years. Growth is good, profits are good. But then roadblocks start showing up, a competitor makes swift inroads, a piece of business is lost and the profit winds and momentum seem to shift overnight.

All too often, the attention to a firm's marketing strategy and brand value comes too late.

• What's Wrong with Current Marketing

  What's the direction, and what are the critical priorities? Most HME businesses that have grown organically, adding new facets to old, have done so without modifying the old. Critical to any marketing investment is the detailed understanding of where the business and profits come from by product, category, payer, diagnosis and referral source.

  Equally important is an assessment of the growth potential and potential of likely aligning products, services and businesses. No product/service or referral source should be capturing a portion of the business that if lost, will jeopardize the business solvency. The critical priorities drive the marketing strategy and investment.

• Who's driving the marketing momentum? Typically in HME firms, bits and pieces of marketing, strategy development and execution are handled by lots of hands. It has had to be that way to get the job done. No one person really knows marketing but learns along the road.

  One person leads sales call planning, lead development and account maintenance. The CEO handles contracts and cable advertising. Another does newspaper advertising and promotions work with manufacturers. And another handles brochures, showroom maintenance and maybe the Web site. Still another puts together in-services, health fairs and newsletter mailings as inside customer service/sales. Sometimes the result works.

  But no one is the driver and communicator of marketing strategy and the pieces that will be rolled out. In most cases, employees don't know the critical initiatives, the plans and how they fit into company efforts to achieve the goals. Frequently each employee is telling a different story. Each salesperson creates their own story.

  When a competitor enters the market with a laser-like marketing program attacking a specific piece of business, valuable time is lost as a company scrambles to understand how to defend its turf. A unifying driver of the marketing strategy and the company's plans knows the power of brand and messaging and recommends components of an integrated counter-attack.

• Sporadic marketing. Usually because marketing strategy and implementation are handled by many hands, or results of short-term efforts are difficult to measure, HME firms fall into the trap of pulling back for long periods of time in investing in marketing and follow-through on their initiatives.

  Referral calls by sales staff continue to be made, but new products or program launches become as ho-hum as a manufacturer brochure or announcement on colored copy paper. Showroom changes, educational programs and merchandising promotions come to a dusty six-month stand still. What other business can afford these lapses and expect strong growth?

  Just dealing with the challenges of government regulation and reimbursement are all-consuming. But companies need specific programs in place that describe and reinforce their professional image and services in the community-at-large in tough, budget-slashing times. Not just yellow pages advertising, professional truck signs, logos on company shirts or a couple of discount tables in the showroom, but modest, ongoing guerrilla tactics that maintain your presence, provide a return on investment and keep your name and services in front of target audiences.

  No matter what type of HME company or product/service/payer emphasis, regular, consistent marketing efforts are essential to build brand, prestige, additional business, future contacts and referrals.