(Strategyzer AG, 2017)
This model is an adaption of Osterwelder’s (2004) strategization modelling technique, particularly useful for the application of a lean startup. It has helped our
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firm to better understand our value proposition and given the level of infancy, build on that through our core competancies. However it’s limitations have meant that I have included further industry and internal/external frameworks to compare the company aginst competeitors, both local and international given the globally competitive environment we operate in.
With specific reference to the above business marketing canvas (typically used to explain the business plan and make adaptive changes accordingly) we can begin to understand each of the business elements. The center showing the value position offered and how Operations (Left) and Sales/ Marketing (right) create this. The associated revenues and costs are represented accordingly.
The specifics of each service will be outlined and discussed in detail in proceeding sections, as will the financials in Section 5.
Trading as; “GenderRe” via www.GenderRe.com.
4.1 Service Offering
Concierge Care Services is in essence a service platform that coordinates the activities of its partners to formulate a customized package, tailored to individual needs. The relative partners who provide these individual services are outlined below;
4.1.1 Key Partnerships
These partnerships describe the key relationships that the company has with its related parties. Memorandums of Understanding (MOU’s) and/or associated contracts are located in the appendix as noted.
Bodyline Patient Care (Australia) Limited
o Initial patient/ doctor consultation at hospital
o Care & Custodial Services in Country
§ Attending and arranging meeting with doctors and hospitals
§ Post operative care
• During hospital stay (to ensure that standards and patient comfort is being upheld)
• 2 weeks of monitoring (as needed) following discharge from hospital in Thailand.
§ Assistance in keeping patients local physicians informed of the process (endocrinologists, general practitioners, gynecologists, psychiatrists etc)
o Travel (all as per the level of standard/ budget of the patient)
§ Accommodation
§ Flights
§ Transport
o Staff training in Thailand
§ This particularly concerns the operators of the call center desk that will we be running out of the international department at the hospital.
§ A full time nurse is currently being interviewed to oversee all the care patients will receive.
Trading through;
www.bodyline.com.au
Yahnee International Hospital (Thailand)
• Primary provider of surgical procedures
• Source of international patients through our dedicated staff at their international office and control of their phone lines.
o Australia, New Zealand, USA & Canada
• MTF surgeries performed by Dr Greetchart Poonsirisikit
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Website contact;
www.yahnee.net
Dr Zachariah Turner (Australia)
o Company consultative Physician
o Doctor responsible for providing follow-up with (Australian) patients up to 6 moths from returning to Australia
o Source of publicity and media for the company through existing contacts with the large Australian TV broadcast media
o Bio on
§ https://www.drzac.co/projects/
Dr Diana Hamilton (Australia)
o Psychiatrist responsible for screening patient inquiries using the Harry Benjamin protocol
o Source of patient referrals from,
§ Her practice in Queensland, Australia
§ Her network of professionals globally.
o Advisor on potential areas of liability and best work practices and auditor of surgical providers to ensure compliance with SRS international framework (Harry Benjamin Protocol)
o Support for families before surgery and also following return to Australia.
o Bio on
§ http://www.drdianahamilton.com.au
Ms Yumiko Kigoshi (Japan/ Australia)- (ADACREST Consulting Pty Ltd)
o Well experienced in proving medical (largely cosmetic surgical) concierge procedures to patients both western and in Japan.
o Well connected with Dr Ito in Nagoya, a pioneer in HARG Therapy (Penetrative injection Therapy of Carbonic Acid gas jet), which may prove a popular choice for hair regrowth among interested patients.
o Whilst Ms Kigoshi’s primary input will be in the “Menz” area further along, she is currently referring a second MTF patient.
AVOXI
• Telecom Services for;
o USA o UK o Australia o Canada o New Zealand
Drew Lambert (Australia) (Didcomms Pty LTD)
Consultant publicist. With particular experience with bookings from the Australian Woman’s Day Magazine, SBS News Media Network and Bauer Media.
David Clune (Australia)
Is an experienced social media manager, and advises GenderRe for content creation and html optimization for promotional purposes.
He has kindly offered his services pro-bono.
Partner resumes, profiles and accreditations available via personal website or upon request.
4.1.2 Key Activities
Concierge
The underlying concept behind our business model is the provision of a concierge service that is the linking of our partners and management of the interaction between them to ensure every patients experience is as smooth as possible.
The importance of this service to non-native Thais and those who are less experienced in international travel (let alone medical tourism) is clearer communication with non-native English speakers, access to discount and taking on the burden of scheduling appointments and offering a variety of
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options. This is particularly important in a market where substitutes are available.
Similarly, to have dedicated staff with experience and compassion towards these unique patients aides in the overall customer experience.
Customer Relations
The success of many businesses, especially related to elective surgery and travel can be determined by how the customer views their relationship/ experience with the company. Whilst the day to day care of patients and organizing of hospital visits and accommodation etc is provided by our partner; Bodyline Patient Care Pty LTD.
Through GenderRe’s ERP & CRM system we can check to see if our partners are fulfilling deadlines and following SOP’s to meet the expectations of our company and the patients expected level of service.
The enhancement in the customer relationship and value added by employing patient care specialists is contrasted by the alternative recovery situation had a patient gone directly to a hospital. They would either have to care for themselves in a private hotel or apartment, or incur additional costs by spending an additional two weeks in hospital (non an ideal place to convalesce, particularly when Thailand offer such comfortable lodgings).
Community Engagement
As previously introduced, GenderRe, as being a part of a wider community, commits itself to supporting the LGBTQI community at large, our chosen partners for providing monetary support include;
• Victoria LGBTGI Support Network
• Rainbow Youth (Australia)
• More to be announced
4.1.3 Key Resources
Desk at Yahnee Hospital
Through negotiation with Dr Ismael Naypa, head of the international department of Yahnee Hospital, GenderRe gained unprecedented access to the existing resources of the hospital. Allowing us to choose an existing member of their staff to be trained
by Bodyline for the exclusive purpose of taking calls related to SRS as a representative of GenderRe.
This relationship is currently limited to calls originating from Australia, New Zealand, The UK, USA and Canada. But with the continued success of the relationship and proven increase in throughput (inquiry conversion) due to more well trained staff, our psychiatric network and premium care service along with media publicity we would expect this to be extended to more European locales.
This agreement was reached with Yahnee on Tuesday 11th July 2017, formal MOU just awaiting legal review before final cosigning.
Appendix item 7 is copy of confirmed points.
Human Capital
Janese Ritchie
Of Bodyline (Australia) brings along 15 years of experience in navigating the medical tourism industry in Thailand, having spent this time negotiating with hospitals and providing patient care, along with her sister Judith Remar (a licensed Chaplain).
The knowledge is extremely tacit and is arguably not transferable i.e. is difficult to transfer from one person to another but instead is learnt through experience.
As previously mentioned, Bodyline Patientcare LTD is a partner of GenderRe and their services are contracted.
Dr Zachariah Turner
A registered General Practicing doctor, with a specialization in cosmetic and aesthetic medicine, with regular appearances on Australia’s Channel 10 Morning show he brings a breath of experience and exposure that the company can leverage to its advantage.
Beyond his own personal involvement in medicine in Australia, Dr Zac has been referring patients to for general procedures through Bodyline and can be considered as both an ambassador for and advisor to GenderRe.
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A registered Nurse and trans advocate who underwent her surgery more than 30 years ago is excited to moderate our online forums and also collaborate on future areas such as patient care and liaising with key allies in the LGBT community.
In the future Fran would like to take over all the patient care and initial interaction for customers.
Technical Assets & Infrastructure
The operation of linking all these key partners and organizations is built upon a system consisting of contractual obligations, formalized SOP’s and an interactive (cloud-based) Customer Service & Enterprise Resource planning tool provided by Work (etc), Australia.
The ERP (Enterprise Resource Planning) & CRM (Customer Relationship Management system is cloud based, allowing the users (with appropriate permissions) to follow the input and throughput of customer details and follow the evolving stages of the relationship. Follows patients from the initial inquiry onwards, presenting a system of balances and checks to ensure procedure is followed and customers are always attended to. Similarly from an ERP perspective when patients are being cared for in Thailand the associated careers needed and organization of transfers and relevant travel needs can be monitored and where necessary additional resources deployed.
The technical suite allows for restrictions based access to the data and workflow monitoring between the previously mentioned key partners. This is particularly important, not only given the value of a database as a resource (and the importance of capitalising upon that data) but also given the nature of each partner’s geographical dispersion and the importance of remaining responsive to customer needs and changing working environments.
5.0 Sales, Marketing & Customer Centric Areas
The marketing and sales strategy of the firm is multi-dimensional in relies on multiple channels to reach prospective patients.
5.1 Customer Relationships
Given the long-term relationships we expect to have with patients, customer servicing is a key area we have identified as requiring attention. This can be attributed to anecdotal evidence that patients can take a long time to decide to going ahead with a procedure from there initial point of contact. As such a secure cloud based database has been established to record details of inquiries from all sources and regions.
o This allows to follow with patients and remain in contact so that we can catch them at the moment they are ready
o Also it allows us to continually offer promotions for other related procedures such as facial feminization (Bone sculpting), breast augmentation, hair transplants etc.
5.2 Marketing Channels
In terms of reaching our target audience we rely on a number of channels to communicate our value proposition.
5.2.1 GenderRe Website
Our main point of contact and introduction of services to patients will be via our website, which outlines the services provided as well as the details of our preferred partners & community engagement.
Our key partners have provided a large majority of its content so that the description of services provided is accurate. Furthermore, this content as been optimized for search engine indexing to ensure that results from searches are relevant and lead to our page and not providers/ competitors. The optimization has been conducted in conjunction with Yahnee’s IT team as well as contractors in the Indian sub-continent.
5.2.2 Social Media and Online Promotion
Content on the GenderRe.com homepage has been edited to allow for searches by prospective patients to results optimized (google, yahoo, etc) this maximizes the resulting searches of potential customers towards our page. Fran Hirst, who will also be able to perform the role a source of information, will moderate the forum discussions.
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We are using regular outlets such as Facebook, Instagram to project company information and funnel more leads towards our main information resources. The content/ stories that will be pushed out through these mediums take two forms;
Internally Derived (created in-house)
• Video interviews with
o Doctors at Yahnee Hospital
o Dr Diana Hamilton (our consultative psychiatrist in Australia o Testimonials from our own patients
Externally Derived
• Current events of interest to our target demographic (item below shows such posts in draft to be released on the GenderRe Facebook page
o E.g. ABC & SBS Australia
• Medical news and updates
• Human interest stories
• Hospital promotional material
(GenderRe, 2017)
5.2.3 Media Coverage & Associated Publicity
Patient 1 is currently already signed to a mass-market television show that has followed and will continue to follow her through her transition (along with other similar stories of a human interest nature). This is a continuation of a series from
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one year ago, which is expected to air September 18 2017, hosted by leading Australia Broadcaster, Karl Stefanovic.
New studio entertainment show, This Time Next Year, features everyday Aussies from across the country with extraordinary ambitions, who pledge to change their lives by “this time next year” – whether it’s to overcome a setback, find love, reunite with a relative or achieve a world record.
Hosted by Karl Stefanovic, many of the stories take unexpected turns over the course of the year, with the result of each story revealed in an instant.
- (Nine Entertainment Co (Australia), 2017)
Similarly we are in negotiation with Patient 2 to have Bauer Media (Australia) follow both of their experiences in Thailand (a discount has been offered to each patient to schedule their surgeries at the same time to spread the associated media costs.
Negotiations are underway with “Woman’s Day (Australia)” to report on a 40 year old story of a rural Indigenous Australian girl (Fran Hirst) who decided to undergo surgical transition. The relationship between Fran, Bodyline & Dr Zac has been ongoing for the last 10 years, as she has undergone various facial feminization procedures to complete her desired Aesthetic following the independent gender reassignment surgery she underwent in Singapore (independently).
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Following further discussions, Fran has expressed interest in working with GenderRe, most particularly in the areas of patient care, family support and as a community ambassador.
5.2.4 Yanhee (International) Phone Line
As per the discussed MOU with Yahnee (Full copy to be appendixed), the phone lines listed on Yahnees web site will be all under the control of GenderRe. Whilst this increases the burden on us of initially answering the inquiries, it essentially means we have the bulk of inquiries to the hospital. This means that we can strategically manage the interaction with our customers.
Through our partnership with telecommunications provider AVOXI, we have local telephone numbers for the following markets;
• USA & Canada (0800-029-4622)
• UK (0800-029-4622)
• New Zealand (0800-441-692)
• Australia (1800-870-396)
All calls are diverted to a central line, which will either be to Dominick or Janese at Bodyline (answering on behalf of GenderRe). During after hours calls are managed by an Australian based answering service (Business 1300 Limited)
5.3 Internal Organization and Management
As a concierge service that bundles the particular specialties of our partners the structure is very lean, with management being through the consolidated in the form of the executive director, Dominick Finlayson.
This allows the company to keep overheads low, and exercise a consistent and well-monitored customer experience. This structure is supported via an effective enterprise management system provided by Work (etc) an Australian firm.
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6.0 Financials
The “Strategizer” framework introduced in part 2 introduces some of the revenues and costs associated with the operation of the business as planned. These are simplified below, with detailed Cash flow and Income projections added to the appendix accordingly.
6.1 Costs
Overhead costs of the business are minimal, as the majority of which are outsourced to the experienced partner organizations with whom we engage.
With FC remaining low and VC high, the firm is safe in knowing that the majority of costs that are incurred are done following the successful conversion of an inquiry to customer.
6.1.1 Fixed Overheads
As per appendix item 2 (2017 budget forecast), total fixed costs are estimated to be
$AU 3640 (Less than $AU 303 per month).
Digital ($TBA, ~$200)
• Domain hosting o Godaddy.com
• AVOXI
o Call forwarding and line rental.
• Business 1300
o Messaging service
Thailand (~TBH 20,000)
• Desk at Yahnee (call center)
• Permanent office
• Nurse (Jannine)
6.1.2 Variable Costs Digital
• Google ad-words (TBA)
• Content creation (on-going)
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o Contracted as needed from India (Fiverr.com) o David Clune (Pro-bono until 2018)
• CapitalTV & Bauer Media to film and document individual patients experience
o 10,000TBH per day
Thailand (per patient basis)
• Desk at Yahnee (commission upon successful signing of patient)
• Bodyline (Australia) Limited
o Nurses on a per-patient basis for after care (Polly)
o Attending initial consultation with doctor/ surgeon (Judith/ Polly) o $AU6,500 per-converted patient
Australia (per patient basis)
• Referral fees to partners ( $AU150 for inquiry, 5% for conversion) o Dr Diana Hamilton (consultant psychiatrist)
o Dr Zachariah Turner
• Post-op checkup provided by either (~$AU90, billed to and paid by patient, or Medicare where applicable)
o Dr Zachariah Turner
o Australian Home Doctor Service o GP/ Endocrinologist/ Gynecologist
As per the agreement of all partners, individual travel expenses to/ from Thailand will be individually covered.
6.2 Revenues
Revenue is acquired through a number of streams, which allow for the firm to maintain its operating costs and eventually turn a profit. These are almost entirely variable in nature.
Through whichever entity it is received, it is ultimately realized by Concierge Care Services (Hong Kong) Limited, which provides a stable and well developed financial system along with strategic geographic positioning considering the activities of the firm.
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Thailand
• 25% deposit of medical quotation is required before proceeding,
o If the patient fails to proceed with surgery this can be with held indefinitely or until they are ready to re-start the process.
• Previously mentioned commissions from Hospital for patient conversion o Initially 20%, increasing to 30% as throughput is realized.
Australia
• Commission is received through GenderRe (Australia) Limited on all travel and accommodation booked for patients,
o This can also be in the form of industry discounts given by Airlines &
Hotel chains.
o Approximately 20% of bundled care and travel package will be added.
§ Varies dependent on requirement of patient i.e. economy or business, 4/5 star accommodation.
• Media
o In the case of providing an outlet with a story, generally 10% of the fee paid to the patient is retained by the company.
6.3 Typical Patient Breakdown
Example quotation of patient 1 referenced in appendix item 3 to 5
Typically, 20% of all surgical and non-surgical fees are representative of the margin provided by each patient.
Package total ($30-40,000 AUD)
• ~$8,000 @ 20% Commission
Less Overhead (~$500 Month)
• = ~$7,500
Ongoing royalty from Agency fee
• Variable/ Case by case
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6.4 Forecasting & Budgeting
Using the above figures, we can forecast the expected revenues and expenses for
Given that the business relies on the support of its subcontractors/ partners the strategy of the business centers around the strength of these relationships and continuing to foster and develop them- this would be considered one of the key core competencies of the firm.
As we have already discussed the key partners required to pull the business strategy together it is important to understand the mechanisms behind this.
Given its infancy, it is premature to define the business as operating under one unified strategy. It is fair to say that currently the strategy for future growth revolves around the word of mouth (be this from discussion boards such as theose offered on the “Susans Network’ forum (where we plan to become a corporate donor), publicity and attention garnered from Patient 1s experience. With a specific focus on the Australian transgender community, especially given its contextual proximity to GenderRe (as an Australian firm).
Following the publicity and with the support of our the key partners previously identified, international expansion is not only a locus point, but a priority, given the limited size of the domestic market and exponential potential of markets such as China and Japan that we have existing access to and some limited experience with.
Following the publicity and with the support of our the key partners previously identified, international expansion is not only a locus point, but a priority, given the limited size of the domestic market and exponential potential of markets such as China and Japan that we have existing access to and some limited experience with.