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Marketing EOLD 101

How to Promote the Profession Without Forgetting the Purpose

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by Karen Reppen

As dedicated gardeners know, it takes time, right conditions, and continued labor and nurturance to grow a bountiful crop. Seems this holds true for end-of-life doula (EOLD) work, too. Success in the garden and in the EOLD field depends on many 
factors. Unlike garden peas, there are also “Ps” in the parlance of business theory that identify key factors which form a framework for marketing decision-making. All are necessary to when presenting your work to referral sources and direct prospects.

The “Ps of the Services Marketing Mix” are commonly used as a framework for making marketing decisions in business. Eleven key factors need to be considered when presenting a service to prospective clients in ways that stimulate interest, understanding, and ultimately buy-in and transaction (paid or not), listed below.  We’ll explore each of them in depth, starting with Product, which not surprisingly, is the most important. Without it, none of the others really matter.

Commonly referred to as the “
11 P’s of the Services Marketing Mix”, they include:
  1. Product: What is being provided?
  2. Price: How much do services cost?
  3. Place: Where are services provided?
  4. Promotion: How does one learn of, or know about them?
  5. People: Who’s involved in any transaction/interaction?
  6. Processes: How are services provided?
  7. Physical evidence: What outcomes are expected when services are rendered?
  8. Productivity & Quality: How does one measure value of the services?
  9. Performance: What are the results? What is the return on investment?
  10. Perspective/Point of View: From whose eyes do we see what is happening? What is the best angle for considering things? (Hint: it’s not the provider’s PoV)!
  11. Purpose: What’s the underlying need? What are the reasons for what we’re doing?

Prospect to Patron
To successfully convert a prospect into a patron, one must create a clear and compelling connection between provider and receiver. People will not recognize and understand EOLD work until they know unequivocally that we recognize and understand them. To do that, we must awaken a prospect’s understanding of their own needs and then establish a sense of trust that we can help address those needs. You’re encouraged to go out, put your hands in the dirt and see what you find growing in your own marketing mix.

Product
One of the first steps in any successful business endeavor is to ensure that the product being offered has the right features and functions to attract people to it. It must be perceived as something of value, quality, and benefit. For many goods and services this is already done, with supply and demand already proven, but the role end-of-life doulas (EOLDs) play in our culture is still relatively new and unknown to most people. We need to consider that EOLDs operate without credentialling or regulation by a governing agency that establishes and monitors standards like other positions in the health- and death-care system. We must also consider that what we do collectively and individually includes a broad range of goods and services and involves people with many different interests, experience, philosophies, and skill sets resulting in huge diversity in the field.

What then, does product mean in terms of EOLD practice? It’s not enough to say our product is to provide “much-needed non-medical support to those who are dying and their loved ones.” Although that is true, the products EOLDs provide depend on so many variables, we need to be more specific. Tangible outcomes like advance directive documents, or legacy/life review video or memory book that result in physical evidence may be easy for people to grasp and connect with, but much of our work involves intangibles like“education, assistance, collaboration, holding space, bearing witness, guidance, problem solving” which are better interpreted as processes that are harder to quantify.

When providing EOLD services, it seems what clients need most is respect, understanding, encouragement, willingness, open-mindedness, cultural sensitivity, reliability, responsiveness, integrity, honesty, compassion--all wrapped up in a base of core knowledge and navigational skill that allows the product to be delivered effectively.
As obvious as it is that illness, aging, death, and grief are universal, most people don’t usually approach them eagerly. Clearly, we are wrestling with bigger challenges than those selling pizza or chocolate bars. We’ll explore how we can use the other “Ps” in the marketing mix to make our product something people actually desire.

Price
Consider various factors when presenting a service to prospective clients to stimulate interest, understanding, buy-in, and ultimately, a transactional exchange. How does one put a price on quality end-of-life doula (EOLD) support? There are many opinions about how people should be compensated for EOLD work or whether this should be monetized at all. These are important questions in the larger picture but will not be the focus of this article. Here, remuneration in exchange for services is assumed.

For our purposes, price is defined as the amount of money people are asked or willing to pay for a product or service. It is used to determine the actual worth and perceived value of what is being offered. Pricing a customized service is not as easy as pricing hard goods/tangible products—it’s more of an art rather than science. Each engagement starts with a huge range of possibilities, many of which can be unknown or unexpected.

Whether you charge a fee for services or not, it is helpful to understand the following steps commonly used in price setting.

1. Determine Pricing Objectives
The first step in pricing is to determine goals and objectives, e.g., return on investment, increasing market share, discouraging competition; increasing visibility; enhancing image; maximizing profits; growing (or even saving) your company, etc. Beyond financial, marketing, and strategic objectives—social, ethical, or ideological objectives must also be considered as well. This requires a clear understanding of what motivates you to do this work and how monetary reimbursement fits into the big picture.

2. Calculate your costs
It takes money to make money—it’s important to understand the cost of doing business—including material, overhead, and labor expenses (fixed and variable) and other resources you’ll need—office space, supplies and equipment, promotional materials, salaries and benefits, licensing, taxes, travel, training and education, membership fees, and so much more.

3. Look at the market
Next, consider demographics in terms of supply and demand. Where will you find your customers--in a large city, small town, or expansive rural area? How many people might want or need your services? Is the community growing or shrinking? Is most of the population aging and nearing the end of life, or still young and healthy? Is it comprised of college students or highly paid professionals who leave town after a few years, or tight-knit multi-generational blue-collar families? How many share similar cultural and ethnic backgrounds?

4. Know your customers
Drill down to the specific market segments you hope to serve. How does gender, age, race, financial position, social status, communication methods, support systems, and attitudes towards death impact price? Do you focus on the general public or specific organizations or institutions? Will your services need to be customized for each individual client, or do you expect to work with groups of people with similar needs and interests?

5. Consider your time investment
How much time will you need to do the work? Is it a part-time, full-time, or overtime commitment? Preparing for and facilitating a 12-hour/two-day weekend workshop with 30 participants is different from 12 separate hour-long meetings over the course of three weeks with different family members who live 40 miles apart.

6. Come up with a fair profit margin
This is where factoring in a percentage above and beyond your costs and time investment comes in. How far beyond “break even” do you want to go? If you underestimate your costs and set too low a profit margin, the result will be a loss on your end. If you set your margin too high, you may not get the job—especially if you are located where potential customers have various options for similar service. Bottom line—if earning a profit is one of your primary goals, consider different scenarios, and carefully monitor your time and expenses relative to revenue and income.

7. Decide whether to charge an hourly or per-project rate
How will you structure your fees? Will you ask everyone to pay the same amount regardless of their ability to pay? Will you charge for certain services and not for others? Offering a one-size-fits-all price might not work best for EOLDs because needs and desires differ in nature and scope from one customer to another. As a result, service-based businesses need a model that is flexible enough to solve customers’ problems. At the same time, offering 100% custom pricing can limit growth because of the time required to quote every facet of your services.
Establishing the right pricing for a service business is never easy. This is especially so when the service relates to illness, aging, death, and grief—things on which most people aren’t eager to spend their hard- earned money. In future articles, we’ll talk more about how to communicate the actual value that your price represents and how to help people become more comfortable investing in EOLD services.

People and Place
When exploring the particulars of People and Place, a good place to start is by creating a three-column chart or spreadsheet that allows you to consider different variables that will impact how you market and operate your business. You’ll quickly see that there are many variables in each of the columns for people and place—so in addition to simply listing people and place, you’ll want to ask yourself questions like the following:
  1. List the specific product or service you wish to provide (e.g., teaching workshops, hosting death cafes, helping with household chores, assisting with advance directives, legacy work, sitting vigil).
  2. List all those involved in the transaction. This not only includes your target markets (preferred customers), but everyone else who might be involved in developing, creating, and distributing or providing the product or service being offered.
    1. ​Who provides the service? Is it you alone, or will you have teammates or other partners with whom you will collaborate?
    2. If you are working independently, who will cover for you if you aren’t available? What will need to be done to make a smooth transition from one provider to another? Who will you turn to if you need help? Will you need to supervise others, or will you be supervised by someone else?
    3. If you’re part of a larger collective, where do people’s skills differ and/or overlap? Will this help you to be more flexible or will it complicate matters? Who will be responsible for the scheduling, financial management, and other administrative duties?
    4. Will you work 1:1 with individuals or in a larger group? If a group, will they have some common affiliation or specific need? How many clients can you serve at once?
    5. Will your clients share similar cultural traits like age, race, ethnicity, gender, sexual orientation, language, financial position, etc.? How might differences in each of these areas affect your approach?
    6. How will your client’s personal health condition, cognitive capabilities, and past lived experience affect how you work? If they themselves are terminally ill, what do you need to know about their disease progression? What about people with dementia, or ALS, or suffering gross disfigurement or malodorous wounds resulting from cancerous tumors? How about those who are military veterans, or survivors of major trauma?
    7. Will you operate face-to-face, or in a virtual setting? What personal protective equipment, supplies, and technological tools and skills will you need? Where will you obtain these things?
    8. Who are your potential referral sources? Who will help you spread the word and connect you with prospective clients? Family, neighbors, faith community leaders, hospice volunteer coordinators, etc., hospital discharge planners?
  3. Determine where all the above will take place?
    • Will you have an on office where people come to you or will you meet them in a café or coffee shop, address them from a church pulpit, or gather in a classroom or event venue? If so, what do you need to have access to all these places? Will your clients have easy access to these places?
    • Or, will most of your work be done where a person resides--such as their own private home/apartment, a long-term care facility, or inpatient hospice setting? How does this affect schedule, the way you’ll dress, the materials you take along, the language you use, the way you deliver the support you give?
    • What is the extent of your service territory--will you be operating locally, regionally, or nationally? Are you limited by geographical distance, methods or transportation, weather?
    • Where will you find your referral sources, suppliers, etc.?

The answers to these and other questions will help you to illuminate issues and opportunities that need to be addressed as you move forward. The more thorough you can be, the more likely you’ll avoid stumbling blocks along the way. These are all points that should not only influence who you are marketing to, but how you market to them--which will be covered in the next installment of this series. The more you ask and answer questions like those above, the closer you’ll be to finding a clear path to achieving your objectives.

Process and Promotion
As we move further down the list of the “11 Ps of the Service Marketing Mix”, the focus is on Process and Promotion—which concentrate on the methodology that you might use to deliver services to clients, as well as how get the word out about those offerings.

We need to break things down by identifying the specific items you’ll need and steps you’ll take to do the work effectively, efficiently, and economically. For example, if you plan to do life-review or legacy work (creating a video, memory books, etc.), you may need to obtaining audio/visual recording equipment, computer hardware and software, interview templates, and other creative materials to ensure a quality end-product. If your focus is more on educating, problem solving, and helping your clients navigate the myriad challenges they encounter as things evolve, you may need to research and develop reliable lists of resources and build a network of collaborative relationships with others who might be involved along the way. Even activities like providing respite to anxious family members or sitting vigil with non-responsive individuals requires advance preparation. And don’t forget all the administrative and procedural processes and materials you’ll need like contracts, time records, travel logs, info sheets, client notes, invoices, expense reports, etc.

Once you have developed a good understanding of the processes involved in providing your products/services, you’ll be ready to actually start the work of promoting them. The objective here is to build buzz, inspire interest, and ultimately to gain clients that you can serve. But this factor also requires careful thinking through the myriad steps and materials included in each approach. Only then will you be able to determine which of the following methods are best suited for you and the target audiences you wish to reach:
  • Personal selling, direct face-to-face contact: Do you have your elevator speech ready, business card, handouts? Have you practiced? How do you show your personality and passion?
  • Word of mouth referrals by others: Who knows what you do well enough to champion for you (family, friends, co-workers)? Do they have all they need to accurately convey your message?
  • Networking through affiliations and association memberships, and volunteer activities: NEDA is a great place to start; what other local civic or social groups, professional organizations might be a good fit?
  • Website: Do you have the skills to build and maintain your own? If not, what will you need to create one? How are you driving people to your site? How’s your Search Engine Optimization?
  • Blogs: Are you a writer? What do you have to say? Who will read what you write?
  • Social Media (Facebook, LinkedIn, Instagram, Twitter): How often can you post; what content
    do you have to offer? Are you aware of the different audiences reached by each platform?
  • Print Collateral (business cards, brochures, information sheets, etc.): Consider not only the message, but the cost of design, printing, and distribution.
  • Direct Mail: Who’s on your mailing list? Is it up to date? Do you know the price paper of a stamp these days?
  • E-mail correspondence and Electronic Newsletters: Do you need to invest in special program like MailChimp or Constant Contact? How are you collecting and maintaining contact information; do you know the legal constraints around permissions (opt-in/opt-out) to send?
  • Presentations: Do you have an outline and list of talking points? Do you need A/V equipment and PowerPoint slides? Who might benefit from hearing your story? What healthcare and hospice providers, church congregations, senior centers, civic, social, and professional organizations, students and teachers, neighborhood associations, or members of the general public might be interested in what you have to say?
  • Events, Sponsorships, and Exhibits: Are you prepared to create your own events (in person or online) or participate as a sponsor or exhibitor?
  • Directory listings: Does your community publish service directories? Is there a fee or are free listings available? Are you taking advantage of directories associated with memberships you hold?
  • Publicity/Earned Media: press releases, photos, PSAs, radio interviews, feature articles, etc.: What’s your pitch? Do you have a good hook? What is unique and newsworthy about your message? What media outlets (Print [newspapers, magazines], Online, TV, Radio) are going to reach your target markets?
  • Paid advertising: Are there media opportunities that provide cost-effective ways to reach your desired audience? Is design and production included in the price of your ads? Can you negotiate a volume discount or trade for writing an article? Do you read ads?
​
Remember, every promotional channel has a cost associated with it—even if there’s not a monetary transaction involved. Your time, knowledge, and effort are all valuable assets and not to be squandered; scrutiny is recommended here when choosing a course of action—remember to consider ROI—Return on Investment. To achieve your goals requires more than choosing how, when, where, and to whom you target with your promotion. Just as important is the way you convey your messages through visual and verbal branding.

Physical Evidence, Productivity and Quality, Performance, Perspective/Point of View, and Purpose
We're planting our final row of "Ps" for the season, with a very brief discussion of five more factors that form a framework for marketing decision making. We've already explored product, price, place, promotion, people, and processes in depth. We will finish up with those elements that help us to evaluate whether our efforts are successful or not.

Physical Evidence: What tangible outcomes are expected when services are rendered?
Productivity and Quality: How does one perceive the value of services?
Performance: What are the results and the return on investment?

Since most of what is offered by EOLDs is "intangible" in nature, knowing if we meet our objectives will rely on gathering responses from our clients. Ideally, this will come naturally during the process of working together, but it doesn't hurt to ask whether you are meeting expectations or not. It may also be helpful to incorporate some sort of evaluation tool after your work is finished—being sensitive to what, when, and how you ask for feedback. Satisfaction around terminal illness and death is hard to measure. The goal here is not to look for personal praise, but to ensure that your clients have received something of value to them.

Perspective/point of view: As you reflect on the three factors above, it is helpful to look at them from different angles—what you see as success may not be the same as what your clients see. When you go about measuring the results of your efforts, be sure to consider the opinions and feelings of all those involved in what you're doing. Remember the difference between intent and impact too--stay objective and don't allow your biases to obscure reality.

Purpose: Throughout the marketing process, we need to keep our reason for being in mind every step of the way. If we lose sight of our purpose, all the planning and preparation will be meaningless when we try to put everything together. Providing support to people who are preparing for, or experiencing the end of life, is truly a privilege. The potential good that can be accomplished is limitless. If we leave our egos out of things and keep the Doula Model of Care in mind as we plan and proceed, we shouldn't have much trouble fulfilling our purpose.

Well, there you have it. Time to tamp down the dirt, brush off your hands, and let nature take her course. If you've done your planting properly, you can probably expect a bumper harvest for all your efforts.


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Ferns are traditional symbols of humility and sincerity, both chief qualities of end-of-life doulas

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  • Home
  • About
    • Who We Are >
      • Our Mission
      • Scope of Practice
      • Code of Ethics >
        • Research Best Practices
      • The Doula Model of Care
    • Board of Directors
    • Anti-Racism and Inclusivity Statements
    • 2021 - 2024 Strategic Plan
    • Q&A
  • Directories
    • Members by Name
    • Doulas by State A - M
    • Doulas by State N - Z
    • Doulas International
    • Trainer Directory >
      • 2019 Trainer Survey Results
    • Friends of NEDA Directory
    • Corporations & Organizations Directory
    • Tips for Choosing an EOLD
    • Suggestions for Selecting an EOLD Training
  • Membership
    • Membership Applications
    • Who Are Our Members?
    • Get Involved
  • Credentials
    • Certification
    • EOL Doula Core Competencies >
      • EOL Doula Proficiency Badge
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      • Selected Medicare CoPs
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    • After-Death Care Educator Core Competencies >
      • NEDA ADCE Proficiency Badge
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  • Resources
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    • NEDA Tips and Guidelines >
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      • Tips for Choosing an EOLD
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    • Tools of the Trade
  • Events
    • Doulapalooza 2023
    • All Events
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