CREATED BY GRENZEBACH GLIER + ASSOCIATES. OUR MISSION IS ADVANCING YOURS.
Photo Courtesy of Middlebury College.

You’re on the move, and we want to keep up with you. Our new digital GGQR has the same editorial objective: data-rich insights on topics that matter to philanthropy professionals. If you have feedback or suggestions on future content, we'd love to hear from you.

“Gratitude Can Support Healing”

Grateful patient fundraising programs increasingly essential to advancing research and care

Hospitals and medical centers are increasingly turning to individual gifts – including those generated from grateful patient fundraising programs – to fuel their missions.  The equation is straightforward.  Federal funds that support care and research are decreasing, even as the push for healthcare discovery and innovation is expanding.  The budget of the National Institutes of Health (NIH), which supports 37% of biomedical research conducted at academic medical centers, has declined from a high of $40 billion in 2003 to $34 billion this year.  The uncertainty of federal reimbursements for care is yet another powerful driver in the quest for private support.

During the past several years, grateful patient fundraising programs have grown in both number and scope of philanthropic dollars raised.  “We have seen exponential growth in the formalization of grateful patient programs,” says Patrick Mulvey, Vice President for Development at the University of Texas MD Anderson Cancer Center.  They also have grown in acceptance – not only as an ethical activity, but also one that benefits patients and donors alike.  The days of grateful patient fundraising being viewed as inappropriate have given way to a more enlightened perspective.

The financial calculus is one explanation for growth. Clear guidelines about best practices to safeguard patient privacy is another. Add to that a more informed understanding of the benefits of philanthropy on donors themselves. Several recent academic studies illustrate what we know anecdotally to be true: Philanthropy is a demonstrable component in greater personal contentment and satisfaction, and reduced stress.

Lisa Howley, Assistant Vice President of Advancement Services, Health Sciences, is responsible for implementing the grateful patient program at Keck Medicine of the University of Southern California (USC).  As she says, “Gratitude can support healing.”

To be sure, private giving supports healing by underwriting exceptional care at community hospitals and leading-edge research at academic medical centers. But Howley’s point also reflects the positive, personally empowering action she witnessed in response to the death of a friend.

“I had a dear friend who had a rare cancer twice in her life,” she says.  “In both situations, her family became deeply involved, raising close to a million dollars.”  That philanthropy allowed them to move forward, she explains.  “It’s a way of remembering and giving back.”

Individual giving claiming larger role in healthcare philanthropy

The personal stories and composite figures are compelling. Philanthropy represents a significant budget component of hospitals and medical centers, and individual giving is healthcare’s fastest-growing donor segment. According to the Association for Healthcare Philanthropy (AHP), charitable contributions to healthcare totaled $8.9 billion in 2011, the most recent year for which cumulative giving totals are available.

The maturation of grateful patient programs is bringing philanthropy to all facets of medical research and care. Donors understand the cycle of discovery and the need to invest in the talent pipeline. “We are seeing a keen interest on individuals funding young faculty and providing fungible gifts and developing endowments to support fellowships and lecture series,” says Mulvey at MD Anderson.

Support from individual donors is on an accelerated track.  As illustrated below, in just seven years, individual gifts grew from representing 60% of charitable contributions to 85%.

Five ways to get it right

During the past several decades, GG+A has provided counsel on grateful patient fundraising programs to hundreds of hospitals and medical centers. In 2013, Senior Vice President Dan Lowman, who leads GG+A’s Philanthropic Survey Lab, developed a comprehensive white paper on the topic, based on his extensive experience with patient and family giving programs.

At the center of GG+A’s five Characteristics of Successful Patient Fundraising Programs lies institutional mission. Community hospitals and academic medical centers alike must ensure that their grateful patient programs are driven by and in service to their unique core missions. Arthur J. Ochoa, Senior Vice President, Community Relations and Development at Cedars-Sinai, underscores the point. “Ultimately,” says Ochoa, “our academic enterprise is our client.”

Culture change takes time, investment

Like any change management effort, building a culture of philanthropy requires focused time, attention, support from the top, and development of grassroots support.  “It sounds easy, but sometimes it’s hard to do. You have to think about this on a daily basis,” says Dave Carrera, Vice President of Advancement and Health Sciences Development, University of Southern California.

So, how to begin cracking the nut?

“You can’t do it without the support of the top leadership,” Carrera explains.  “At USC, we have been extremely fortunate to have our University and Medicine leadership behind this effort from the beginning. Once you obtain that, you work with the department-level leadership and the faculty.”

Art Ochoa of Cedars-Sinai describes the backing of CEOs, deans, and others as essential in two ways.  The most obvious demonstration of their support is direct engagement in philanthropy – spending time with prospective donors.  But, he says, “time is a precious commodity, and you have to be careful how you use it.”  More important, in his mind, is leaders’ vocal affirmation of the importance of grateful patient giving programs and, increasingly, the ways in which they set the expectation of participation of physicians and researchers.

With leadership support secured and active, a full-court press is required.  Culture-building, says Lisa Howley, “is internal as well as external.”

There are the customary artifacts of culture.  In the case of grateful patient programs, the signs should be obvious in a care setting:  posters, video messaging, brochures, and pamphlets.  Stories about how philanthropy has improved care and advanced discoveries ought to be front and center on hospital websites and in publications.

Personal stories resonate especially well and are a memorable way to educate patients and families and build affinity for the program. “It’s a way to get to the heart of what we do,” says Maureen Royer, Assistant Vice President, Health Sciences Development, at the University of Southern California.  “We’re providing grateful patients with another opportunity to heal.”

For Art Ochoa, the first principle is about solid relationships. “Ultimately, there’s no substitute for developing a relationship of mutual trust and respect between fundraisers and physicians,” he says. “That doesn’t happen overnight.”

Beyond lip service: true partnerships

In the most successful patient giving programs, development staff fully appreciate that true partnerships with physicians and researchers come from authentic interest, deep knowledge, and mutual respect.  To earn that respect, development staff immerse themselves in the work of researchers and care teams.  Understanding the art and science of healthcare, the process of innovation and discovery, and the pressures of care teams is critical.  “We really need to be seen as part of the larger care experience,” says USC’s Howley.

Trust is gained when development officers are diligent and approachable, and consistently explain the value philanthropy brings to the institution.  “We need to be reasonable, and we should be straightforward in describing philanthropic potential with our faculty,” says MD Anderson’s Mulvey.  “To remain credible, speak to what you know is a reachable philanthropic target and be careful not to over-promise and under-deliver.”

Grateful patient staff facilitate their own work and that of partner physicians and faculty by having a range of quick and easy resources at the ready.  Tip sheets with phrases to listen for, training programs that accommodate physicians’ and nurses’ busy schedules, one-on-one coaching and role-playing, preparation for donor events – all of it supports the efforts of essential giving program partners.

For some scientists and physicians, seeing the whole financial picture advances the partnership and lays the groundwork for a multi-year philanthropic effort.  Maureen Royer works with leadership to create what she calls “financial maps for philanthropy” which outline giving opportunities in a sequential way. These roadmaps are akin to what researchers produce to write NIH grant appeals.  They define the big picture: research and care objectives; processes and milestones; requisite staffing, equipment, and technical assets; and timelines and metrics.  Clearly delineated and agreed upon plans align development officers, physicians and researchers and accelerate the course of philanthropy.

Always wear the white hat

A clear call-out on ethics is merited.  It’s no secret that some community hospitals and academic medical centers have been slow to launch grateful patient fundraising programs, fearing patient or public questioning.  Some worry about an erroneous misperception that philanthropic support equates to a pay-to-play healthcare environment.  Others worry about the difficulty of obtaining useful patient data while maintaining strict and appropriate standards of privacy.

To be plain:  The highest-performing grateful patient programs undertake careful protocols to ensure that their operations not only comply with the letter of the law, but also its ethical spirit.  Successful fundraisers from all nonprofit sectors know that the only way to maintain sustainable growth in philanthropy – and the long-term relationships necessary to achieve it – is to maintain the most principled approach.  Gift officers understand and embrace their roles as advocates on behalf of both the institution they serve and the individuals whose support and engagement they seek.

Confidentiality and trust always matter, though perhaps most keenly in healthcare philanthropy.  Grateful patient programs must adhere to strict HIPAA standards of privacy, established professional ethics of healthcare professionals, and the operating principles of specific hospitals and healthcare organizations.  Asserting values and ethical standards – loudly and frequently – is the responsibility of those who run grateful patient programs.  Doing so helps to ensure that development staff and care providers involved in these fundraising efforts behave in accordance with those standards, and that patients, families, and the public understand the rules of engagement.

The fundamental role of grateful patient programs also must be articulated clearly.  They are about improving lives, plain and simple. “The programs are intended to create something for the future,” says Dave Carrera.

The philanthropic purpose is as noble as it gets. Art Ochoa sums it up this way:  “We’re here for everyone.  We’re going to use those donated resources to help us do all the things we do for everyone.”

Pro Tips for Launching Grateful Patient Programs

“Immerse yourself in the institution’s strategic plan. Identify where philanthropy makes the most sense and can best advance the institution’s mission.”

Patrick B. Mulvey
Vice President for Development
University of Texas MD Anderson Cancer Center

“This is not a process that begins and ends. It’s ongoing. Allow it time to grow and prosper.”

Dave Carrera
Vice President of Advancement and Health Sciences Development
University of Southern California — Keck School of Medicine

“Study the best practices, and figure out what’s going to work in your culture.  It will require customization.”

Arthur J. Ochoa
Senior Vice President, Community Relations and Development
Cedars-Sinai

“Get to know the patient care teams. Get to know what physicians do. Get to know the world of nursing. The more you can demonstrate intellectual curiosity and understand what they do, the better.”

Lisa Howley
Assistant Vice President of Advancement Services
Keck Medicine of USC

“You have to look at it from the perspective of both the staff and the patients. Realize that patients’ treatments and recoveries benefit due to communication and collaboration across departments and specialties, and because of the compassionate and personalized care provided. ”

Maureen Royer
Assistant Vice President, Health Sciences Development
Keck Medicine of USC

“Luck, Hard Work, and a Willingness to Say Yes”

Sara Rubin Vice President for Principal Gifts, The Ohio State University

Sara E. Rubin, Vice President for Principal Gifts at The Ohio State University, credits a whole village of people for her personal and professional success. Over the course of her career, Rubin has taken risks, built a career focused on people, and worked with the “best of the best” in the world of development.

After originally pursuing a career in theater, Rubin took a temporary opportunity at Johns Hopkins’ Wilmer Eye Institute, a position that would lead to a lifelong career in philanthropy. Introduced to development through the lens of grateful patient programs and with the influence of mentors such as the late Dr. Arnall Patz, former director of the Wilmer Institute, Rubin brought an open mind and strong work ethic to her new career. “Luck, hard work, and a willingness to say yes allowed me to learn the business of grateful patient fundraising,” she explains.

“Luck, hard work, and a willingness to say yes allowed me to learn the business of grateful patient fundraising.” – Sara Rubin, Vice President of Principal Gifts, The Ohio State University

When most of her colleagues moved on from annual fund positions to their first development roles, Rubin chose a different direction, accepting a role as Executive Assistant to then-Vice President Bob Lindgren.  “Everyone told me that taking an executive assistant position was too administrative, that I shouldn’t do it, but that position gave me a glimpse into the inner workings of a complex institution and its advancement enterprise.” Not only did Rubin gain extensive insight into the business of development, but she also gained a lifelong mentor in Lindgren. “Bob is a highly strategic thinker, and was an innovative leader in our business at a time when it was becoming a business. His influence on me continues today,” says Rubin of Lindgren, who is now President of Randolph-Macon College.

Lindgren credits Rubin’s “indefatigable high energy” and a “fire in her belly” with her success in this early role, and in her jobs thereafter. “Sara saw the potential of this career and what it means to operate at a really high level,” explains Lindgren. Deeply loyal, Rubin continued to work for Dr. Patz while serving as Lindgren’s executive assistant. “Some might have said that work was below Sara’s pay grade,” says Lindgren,“ but she said she was honored to do it, and that it was the right thing to do.”

Rubin’s strong work ethic led her to a role as Senior Director of Development and Alumni Relations at Johns Hopkins Medicine, her last role at the University – which Rubin playfully calls “the Wharton School of Fundraising.” Patty Hill-Callahan, Vice President of Medical and Health Sciences Advancement, Rubin’s current colleague at Ohio State, adds, “Sara gained different skills with each job she took, beginning with her Executive Assistant job twenty years ago. Today, her vast knowledge and experience puts her a step ahead. She has done great things for really good institutions, and is truly informed about many areas.”

“In this business, it’s all about people. If you let your career be guided by working with great people, you will never go wrong.” – Sara Rubin

At the urging of her former Hopkins colleague Charlie Phlegar, currently the Vice President for Advancement at Virginia Tech, Rubin moved to Cornell University in 2006 as the Assistant Vice President for Alumni Affairs and Development.  There, Rubin oversaw fundraising activities in the Cornell libraries, athletics, the Johnson Museum, and student and academic services. She also managed a range of activities in development services, including donor relations and stewardship, prospect management, research, and special events. Rubin describes this opportunity in her characteristic easygoing manner: “Charlie decided I should become a Cornell Bear instead of a Hopkins Blue Jay. So away I went.” This is the common theme in Rubin’s story: finding great people to work with and trusting that opportunities will follow.  “You have to have the willingness to engage with people who are truly talented, because you’ll come out better for it. In this business, it’s all about people. If you let your career be guided by working with great people, you will never go wrong.” Lindgren highlights why great people, in turn, are drawn to Rubin: “Sara is very respectful and loyal, both to people and to institutions where she works,” he explains. “That is one of her most endearing and important qualities. Sara is a great colleague – someone people can talk to.”

In 2011, Rubin accepted an opportunity at New York University Law School as the Assistant Dean for Development and Alumni Relations, where she focused primarily on alumni and friends fundraising. Although she left New York less than two years later, Rubin believes NYU taught her a great deal about navigating a highly competitive environment. When asked what leadership lessons she learned at NYU and throughout the course of her career, Rubin responds candidly, “Learn to listen in a reflective way. Don’t be the smartest kid in the room, be the chameleon who can play in a team environment.  Learn to listen, and take your daily dose of humble along with your vitamins each morning.”

“Don’t be the smartest kid in the room, be the chameleon who can play in a team environment.  Learn to listen, and take your daily dose of humble along with your vitamins each morning. ” – Sara Rubin

In a move that echoed her Cornell transition, Rubin moved to The Ohio State University in 2013, tempted by an offer from Mike Eicher, Senior Vice President for Advancement and President of The Ohio State University Foundation, who approached Rubin about the principal gifts job. “I went to an Italian dinner in Queens with Mike, we talked about Columbus, about potential, and the opportunity to make a great institution even better…and then I woke up at Ohio State,” she explains. Now Rubin leads Ohio State’s principal gifts program and develops comprehensive gift strategies with University leaders to improve opportunities for engagement.  In this role, she has built a program that is driving record numbers of principal level commitments, and contributed to a culture ever more focused on the development of big ideas. This is consistent with Rubin’s record at all the institutions she has served. Throughout her career, she has embraced the opportunities, challenges, and unique needs of each role, and brought together teams for lasting, positive impact.

“Sara brings a preparedness to her work, which she choreographs as if it were a performance. She consistently looks around corners with the sort of discipline required to manage a large-scale production, which is invaluable for principal gifts.” – Bob Lindgren, President, Randolph-Macon College

Rubin believes that her stage manager background taught her something essential for her career in philanthropy: “As somebody from the theater, we were always prepared for the unprepared. It took me a while to translate that into my development work, but that’s what I would tell someone just starting out in this field. Being prepared matters.” Both Lindgren and Hill-Callahan credit Rubin’s theater background as critical to her success. “Sara brings a preparedness to her work, which she choreographs as if it were a performance,” says Lindgren. “She consistently looks around corners with the sort of discipline required to manage a large-scale production, which is invaluable for principal gifts.” Hill-Callahan agrees. “Sara is like a stage manager in her leadership,” she explains. “She processes complex information quickly, and brings the pieces together, as if she were directing a play.”

“Sara is like a stage manager in her leadership. She processes complex information quickly, and brings the pieces together, as if she were directing a play. ”  – Patty Hill-Callahan, Vice President of Medical and Health Sciences Advancement, The Ohio State University

Rubin’s skills, vision, and dedication have opened doors, but she is quick to emphasize the importance of attitude above all.  When asked for her best career advice, Rubin doesn’t hesitate: “Work hard and focus on your responsibilities – not promotions, money, or title. Do good work and those things will follow.”

A Tale of Two Mail Packs

Adrian Salmon, Vice President, GG+A

“It is a far, far better thing that I do, than I have ever done…”

Except that in this tale, happily, our protagonists aren’t going to the guillotine. They were going to the public with two different direct mail appeals, for different projects and with very different budgets.

For their year-end scholarships appeal, the University of Sheffield created their mailing in-house, with the aid of a local design agency to add the final touches. The University of Southampton, meanwhile, engaged a direct mail agency for their appeal for their innovative Centre for Cancer Immunology.

Both mailings outperformed any mail appeals either university had previously sent. Why? They concentrated on a few key factors that unite all successful appeals, and made sure they executed superbly upon them.

The Envelope

The envelope or “outer” has one job: to get the piece opened.

In keeping with the more traditional nature of Sheffield’s appeal, they chose a traditional branded envelope with an URGENT notice on the front.

Southampton’s CIC appeal already had a tag line and visual identity, which they leveraged by using a poly-wrap.

The Letter

The letter is the heart of every direct mail appeal. It is where the dialogue between the writer and the reader takes place. Neither Sheffield nor Southampton made the mistake of viewing their letters as just a cover letter for a brochure or some other enclosure; both universities drafted an engaging, personal and persuasive message to their reader.

Both universities wrote a two-page letter. It is important to note that longer copy letters have consistently out-performed one-page letters in tests over the entire history of direct mail.

Both also chose a signatory who was relevant to the appeal – Sheffield’s letter was signed by the Scholarships Officer in their financial support team, and Southampton’s was signed by Professor of Medical Oncology Peter Johnson.

Sheffield’s letter employed clever visual devices targeted at those who skim-read. A series of bullet points down the right-hand side of the page (where the eye naturally lands when reading) encapsulated the main points of the case for support. Bolded headlines on the second page highlighted the life-changing nature of the gift and reassured donors that they would have a personal impact on a student.

In keeping with their signatory, Southampton’s letter employed a more formal visual style. But, as Sheffield did, they made sure to make their letter easy to read by using serif font, short paragraphs, and use of visual emphasis (bolding and underlining).

Both letters used the word “you” and spoke to the donor far more than they spoke about the institution.

And, of course, both letters made sure to have a persuasive postscript (PS) that encapsulated the appeal.

The Enclosures

We’re all familiar with brochures, but have you heard of lift notes? In direct mail speak, a lift note is a shorter letter enclosed along with the main appeal letter designed to reinforce the message of the main appeal. The lift note is commonly signed by a direct beneficiary of donors’ gifts, and should increase response rates.

Sheffield decided to interview Megan, one of their scholarship recipients, and designed the lift note as a handwritten message directly from her, describing her time at the University and her gratitude for the scholarship she received.

They made sure to include a photo of Megan at the end to make the personal connection even stronger.

Southampton’s appeal, being for a building, required a bit more by way of enclosures to get the whole scope of the project across. They produced a more high-concept brochure, featuring testimony from academics and clinical trials patients.

They made sure the brochure contained plenty of images of people looking directly at the reader (an old advertising technique!).

The Response Device

None of the wonderful design and copywriting will meet its purpose if donors don’t have an easy and compelling way to respond.

Sheffield’s response device is structured as a mini-appeal, with a picture of Megan to recall the lift note and the main points of the letter recapitulated. That way, even if readers discard the rest of the pack, they’ll still be reminded what their gifts will achieve.

Southampton’s form, although soberer in design on the front (in keeping with the look and feel of the rest of the pack), gave the entire reverse of the form over to the story of Xano, diagnosed with stage four neuroblastoma at the age of four and now happy and healthy thanks to immunology treatment.

The Results

Of course, the proof of the pudding is in the eating. Or, in the case of a mail appeal, the giving.

How did these two very different appeals perform?

Sheffield had always had some element of direct mail in their annual fund programme. On average, each year they would bring in around £45,000 ($56,107) from mail. But this single appeal brought in over £60,000 ($74,810), nearly one and a half times their expected annual total, for a cost of just £10,000 ($12,468). Sent to 10,000 people, it generated an incredibly healthy 6% response.

Southampton had never had sufficient budget to do mail in addition to phone solicitation in any volume. Prior to the CIC appeal, they would only have expected to raise an average of £10,000 ($12,468) per year from mail. The CIC appeal alone generated £95,000 ($117,413) against costs of around £36,000 ($44,886). It generated a very healthy pledge rate of 3.7%.

These are two very different packs with two different purposes. Asking which is “better” in any narrow sense isn’t the right question. Let’s admire the way in which both these institutions have leveraged time-honoured direct marketing wisdom, to achieve outstanding results.

To see more images of the direct mail approaches by Southampton and Sheffield, view Adrian Salmon’s blog on the GG+A website.