Surely, none of them had ever received much in the way of marketing materials, beyond the standard fruit basket at Christmas. Institutional pharmacies generally touted prices, not prizes, to bring customers in. But not the prices of drugs; because most patients relied on Medicaid to pay for their drugs, pharmacies couldn't charge much beyond the reimbursement rate for the medicine itself. So they competed on the prices of their services: medical carts, forms, in-service training, even software. Given the newness of the industry itself, most of the institutional pharmacies were young, community-oriented, and unsophisticated at marketing. Mostly they relied on sales calls, there being no advertising vehicle that covered each particular area efficiently. Seeing possibilities for glamour where no one else had, Fox brought what one employee refers to as "the dazzle" to every Westhaven service. She markets forms, for instance, under the brand name WINS, an acronym for Westhaven Integrated Nursing System. And her clever brochure ties with a bow. "Mary Lou was, by far, the most marketing-oriented of all the pharmacies," notes Brent Cousino, partner in a nearby accounting firm that specializes in nursing homes.
Fox's marketing focus, however, didn't arise from a sober analysis of the industry's pizzazz shortage. "She used what she knew," says Westphal. "And she knew how to entertain." Having been inside nursing homes, Fox also knew that they were dreary places; anything she could do to distract administrators from the overbearing regulation, or nurses from the low wages, might earn their affection. Around Christmastime, Fox bought 450 poinsettias and sent one off to each resident of the five nursing homes she was servicing in her first year. Even now, serving 140 nursing homes, she sends some sturdier sort of trinket -- for example, a pen that hangs around the neck -- to every nurse. "It says, We are thinking of you," explains Fox. "The best way for us to deliver quality care is for us to be in good communication with the nursing staff." In other words, the nurses might actually pay attention the next time Westhaven bawls them out for ordering incorrectly.
Fox's legendary parties, the icing on Westhaven's marketing effort, grew partially out of her childhood love for birthday parties. At trade shows she earned the nickname "Chocolate Bunny" for her candy-clogged bashes, and she sometimes treated clients to parties at which every element tied into a central theme. "The energy and the elegance she brings to her marketing really sets her apart," admits Phyllis Wilson, president and CEO of Nursing Center Services Inc., a competitor. "Folks call Westhaven 'Mary Lou's pharmacy.' She is very, very visible."
Funding those outings, Fox claims, simply requires shaving Westhaven's bottom line and, to offset it, continually pushing for greater volume. The parties offer tangible payoffs. Any nursing-home administrator thinking of changing drug vendors will undoubtedly find some Westhaven event stored in his or her memory bank. "Because of those parties," says Wilson, "she is known to people." Her clever direct-mail campaigns have also helped her expand beyond Ohio, into Michigan and Indiana. "She just thinks this stuff up," says Westphal. "Every six months she'd come up with a direct-mail piece that was incredibly creative." Westhaven now fills more than 3,000 prescriptions a day.
Fox knew what she wanted her customers to feel, and she used her life experience to design ways to make them feel it. To inspire confidence, she launched daylong seminars not unlike the educational ones she had begun as founder of the Toledo Opera Association. And when she decided to focus on nursing homes in rural areas -- where competition thinned out -- and needed to assure the homes that Westhaven could still provide 24-hour emergency service, she set up a network of drugstores and hospitals modeled on the Red Cross blood-distribution system. In designing Westhaven's computer system, Fox produced a never-ending customer wish list that took more than two years to satisfy. As a result, her customized software checks each incoming prescription against 77 variables: allergies, drug interactions, frequency of orders, and others. She was blessed, she says, in that she "had no preconceived ideas about what people did in business."
So she did whatever she had to do to keep customers. Sometimes, for instance, she'd offer marketing tips to the nursing homes, even sending out banners, table favors, and balloons. Cryan says, "She tried to price each nursing home separately."
Well, something was bringing customers in and keeping them aboard. By the end of year one, Westhaven had amassed sales of some $400,000, with losses near $125,000. By year two Fox had broken the $1-million mark with anemic profits. By 1983 sales had shot over $3 million. There were no losses -- except if you count sleep. Any start-up takes its toll, but hers had been especially painful, given her lack of experience. "I was drained," Fox recalls. "There was so much shock, so much fear, so much emotion in those first two years that I developed a tremendous amount of control. I couldn't cry for a few years. I was trying so hard to just survive."
