Article: Hospitals are becoming brands. Now what?

Hospitals are becoming brands. Now what?

Hospitals in the Netherlands are rethinking how they deliver elective care. Waiting lists are growing, commercial clinics are gaining ground, and the national healthcare agreement is pushing for efficiency. More and more hospitals are spinning off focused clinics and care pathways. But when a hospital launches its own specialised unit, an inevitable question arises: who is that, exactly? This piece explores the 'focused factory' model, Dutch and international examples, and the brand strategy decisions that determine whether a new entity thrives or fades into irrelevance.

The hospital is changing; the brand strategy isn't

The hospital as we know it is changing. Not quietly, but visibly and fast. Elective care - a knee replacement, a hip surgery - is increasingly leaving the busy corridors of the general hospital and finding its own home: focused clinics and care pathways where calm, rhythm and predictability take centre stage.

This shift is the answer to a convergence of forces. Waiting lists are growing because emergency admissions keep disrupting planned surgical schedules (ask any operating theatre planner; they'll have stories). Commercial clinics - known in the Netherlands as Independent Treatment Centres (ZBC's) - are filling that gap: small, fast, focused. And the Dutch Integral Care Agreement (IZA) is pushing hospitals towards smarter, more efficient ways of working (Ministry of Health, 2022).

The result: the traditional hospital as a 'one-stop-shop' is under pressure. Healthcare managers are applying logistics principles to care delivery: if you perform one type of procedure repeatedly, with a dedicated team and a standardised process, you get better and faster at it. But while the organisation changes, the brand strategy often lags behind. And that's precisely where it gets interesting.

These questions are not theoretical for us. BR-ND People has spent recent years solving brand and culture challenges for healthcare organisations including St. Antonius Hospital, OLVG, Bernhoven, Santeon and mProve. That experience colours what we share here.

The focused factory model

The term 'focused factory' sounds like you're manufacturing Toyota parts rather than repairing knees. The idea, originally from the manufacturing world (Skinner, 1974), is that focus leads to better performance. A clinic that exclusively performs cataract surgeries does it better, faster and cheaper than a hospital that does everything. Not because the surgeons are better, but because the system around them is optimised.

The Rotterdam Eye Hospital is a Dutch example of the procedure-based model: fully dedicated to ophthalmology, with excellent results on both quality and cost. Internationally, Coxa Hospital in Finland serves as a benchmark: Coxa performs over 4,000 joint replacement surgeries annually and consistently scores above average on patient satisfaction and throughput time (Bredenhoff et al., 2010).

Brand models in practice

When a hospital decides to separate elective care, a fundamental question arises: who are you, then? The answers vary widely.

In the US, elective care has largely moved to Ambulatory Surgery Centers (ASCs). Many hospitals launch these centres through joint ventures and deliberately deploy a sub-brand - as Baptist Health did with Horizon Surgery Center - to capture patients who would otherwise go to an independent clinic. The pattern: a distinct face to the outside world, the trusted parent brand as a safety net behind it. A notable difference with the Netherlands: in the US, hospitals opt for sub-brands more readily, driven by a competitive market that treats patients as consumers. In the Netherlands, the parent brand's reputation carries more weight - public trust in healthcare institutions is greater, and an unfamiliar name is more likely to raise suspicion than curiosity.

In the Netherlands, we recognise the same pattern, but the execution is more diverse.

1. The subsidiary brand

OLVG pursues an autonomous brand strategy through Medical Centre Jan van Goyen. Positioning: "The speed of an independent treatment centre, the medical quality of parent organisation OLVG." Its own identity, but clinical authority borrowed from the parent brand.

2. The specialised joint venture

The Reinier Haga Orthopaedic Centre is a collaboration between three hospitals. Positioned as the largest orthopaedic clinic in the Netherlands, with a hotel-like design to promote recovery. A procedure-based factory in its purest form.

3. The internal focused clinic

• Helene Schweitzer Clinic (Albert Schweitzer Hospital): Elective care physically separated from acute care, resulting in 25% more knee surgeries per day.
• Diak Clinic (Diakonessenhuis): Launched to resolve the tension between 24/7 emergency care and the demand for short waiting times.

The strategic choice: sub-brand or master brand?

This is the question that keeps hospital boards awake at night (or should). Do you create a separate brand, or stay under the wings of the parent hospital? Both routes have sharp pros and cons.

When a sub-brand works:

• You're targeting a new or distinct segment (e.g. patients who prioritise speed and comfort above all else).
• The culture and way of working of the new unit diverge significantly from the parent hospital.
• You want to compete with commercial clinics without 'diluting' your master brand.

When the master brand suffices:

• The new unit delivers the same quality promise as the parent hospital.
• Trust and clinical reputation are the most important decision factors for the patient.
• You lack the resources or buy-in to launch and maintain a separate brand.

The most common mistake? A half-hearted choice. Slapping a new name on a unit that still looks, feels and communicates like the parent hospital in every way. Or the reverse: launching a focused clinic under the master brand when the patient experience is fundamentally different. In both cases, confusion follows - among patients, referrers and staff alike.

A scenario to illustrate. Imagine: a regional hospital opens an eye clinic at a separate location. The waiting area looks like a design hotel, throughput time is three times faster than at the parent hospital, and there is no emergency department in the building. The experience is fundamentally different. A patient who walks in and sees the same logo as the place where last month the A&E was overflowing, gets confused. Conversely: if the clinic carries a completely new name but the surgeons are exactly the same as at the parent hospital, the patient misses the trust that the hospital's reputation provides. Brand strategy must follow the experience - and the experience starts with what the patient sees, feels and remembers.

The lesson from the cases above: brand strategy must follow operational reality, not the other way around. Jan van Goyen works as a separate brand because the experience is fundamentally different from OLVG. Helene Schweitzer works under the parent brand because the difference lies in the process, not the promise.

Lessons from the field

Efficiency gains are measurable

The results speak for themselves. New specialised hubs in England saw a nearly 22% increase in the number of elective procedures in their first year (NHS England, 2023). Albert Schweitzer Hospital reported 25% more knee surgeries per day after opening the Helene Schweitzer Clinic. Focus works - and it's provable.

Talk about care, not factories

Never use the word 'factory' when speaking to patients. Nobody wants their hip replaced in something that sounds like an assembly line. What is internally an efficiency model must be externally translated into what the patient actually experiences: calm, attention, predictability. Leading centres position the benefits of focus without the cold language of business.

Cherry-picking is a real risk

Commercial clinics sometimes face the criticism that they only treat the simplest patients. Integrated units within a hospital are less vulnerable to this: they combine the focus of a clinic with the safety of a full hospital nearby. But it does require transparency: show which patients you do and don't treat, and why.

Culture eats strategy for breakfast

The most beautiful brand strategy fails if the people on the floor don't recognise themselves in it. In every focused clinic we've seen up close, the difference between success and failure wasn't the logo or the positioning - it was whether the team believed in the story. Brand strategy starts from within. Always.

The employee as brand carrier (or brand breaker)

A spin-off doesn't just affect patients. Staff feel it just as strongly. Being selected for the new clinic can spark pride: "I work at the best orthopaedic clinic in the region." But it can also backfire. Those who stay behind at the parent hospital may feel they've been relegated to the B-team. And those who move to the new clinic without understanding why the story is different won't carry that story forward. Employer branding is not a luxury here - it's the foundation. The question "why would I want to work here?" needs a clear answer for both entities.

An uncomfortable truth to close

Hospitals are no longer trusted by default. They are chosen. By patients who google, compare and read reviews - basing their choice on a combination of waiting time, online reputation and the experiences of people they know. By referrers who know where the waiting lists are shortest and where outcomes are best. And by staff who choose where they want to work, increasingly looking at culture and purpose alongside salary.

In that world, "we are a good hospital" is not positioning. It's a platitude. The hospitals that remain relevant in the coming years are the organisations that dare to choose: who they are, who they exist for, and - just as importantly - what they no longer do.

The real question is not whether hospitals are becoming brands. They already are. The question is whether they have the courage to do it deliberately.

Appendix: what we've experienced with healthcare organisations

The challenges in this article are not theoretical for us. Here are four examples of what we encountered and what we solved together.

St. Antonius Hospital: from two cultures to one beating heart

When St. Antonius Hospital merged with Mesos Medical Centre, two different rhythms lived on in the corridors, teams and daily routines. We didn't start with a new logo - we started with the people. Through co-creative sessions we developed a clear purpose, mission and vision as the foundation for a new brand architecture, and translated core values into concrete behaviour. Exactly the challenge that also arises with focused clinics: how do you ensure that two entities with different cultures still beat from the same heart? When another merger came a decade later - with Woerden - St. Antonius found us again.

Bernhoven: a new hospital, a new heart

Bernhoven faced the challenge of translating the feeling of a fresh start into the heartbeat of the organisation. Through the BR-ND Insider platform and energetic co-creation sessions, hundreds of colleagues shared their stories. These became the foundation for an authentic brand narrative carried from within. Proof that a brand strategy only lands when the people on the floor recognise themselves in it - the same lesson that applies to every focused clinic seeking its own identity.

Santeon: stronger together, more visible together

Santeon - the network of seven leading clinical hospitals - needed a clear group strategy. BR-ND People supported the development of that new corporate strategy, complemented by visual tools that made the shared ambition tangible. A classic in brand architecture: how do you let independent brands collaborate without losing their individuality?

mProve: seven hospitals, one story

BR-ND People developed a new corporate brand narrative and a refreshed brand expression together with the brand team and hundreds of ambassadors. The result: a story that makes staff proud, convinces external partners, and shows that mProve is more than the sum of its parts. The parallel with the focused factory model is clear: here too, the challenge is connecting a portfolio of specialised entities under one credible narrative.

Sources

• Ministry of Health, Welfare and Sport (2022). Integral Care Agreement: working together towards healthy care. The Hague.
• NHS England (2023). Elective surgical hubs: one year on. Operational data review.
• Skinner, W. (1974). The Focused Factory. Harvard Business Review, 52(3), 113-121.
• Bredenhoff, E., et al. (2010). Understanding of the concept of focused factories in healthcare. BMC Health Services Research, 10, 90.

Written by: Alexander Koene