Marketing Director Discusses ‘Ethics’ Article

DISCLAIMER: This article directly references the Rocket Miner, Green River Star and other businesses who are our direct competitors.


Mrs. Jantz:

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In answering your questions (see Ann Jantz orginal email here) I will also be referencing the GR Star article from which they arose. (GR Star article – 02/08/17)

In Mr. Martin’s article he states that Commissioner John Kolb has known about my involvement with SweetwaterNOW since at least summer of 2016. I don’t believe the timing on the release of this information is lost on anyone, especially with the current situation involving the hospital board and CEO position. I had not spoken to Mr. Harryman about his 2016 conversation with the commissioner until just recently, but reading about his response and knowing Carlo’s ethics, I can say that he answered the question just as he would to anyone who asks – with honesty. My involvement is not a secret and I think you will find that many people openly know, including business owners, public officials and more.

Following is more information about the hospital’s advertising than you’ll ever want to know. I do not plan to volley this subject back and forth in the Rocket, so will be copying this statement to all other local media sources.


(I apologize upfront to those who will read this and be bored to tears, but I believe the more information provided, the best. Transparency is key.)



The distribution of advertising dollars starts with market research, analyzing the demographic of the audience we are trying to reach (which differs between each clinic, service, etc.) and also looking at the reach available from the vendor (in this case, the vendors in the categories of digital, newspaper, radio, outdoor, etc.). In the simplest terms, “how can I reach the highest number of potential and current patients of the hospital per dollar spent on advertising?”

Once that is decided, a line item suggestion is provided to a committee made up of the CEO, CFO and a few others from the purchasing and business department. They review, edit and make suggestions and send back an approved fiscal year budget. That budget is then voted and approved by the Board of Trustees.

In my capacity, I do not have the decision-making authority to spend more than $250 without signatures from the aforementioned. Even below that threshold I have always taken the extra step of having all check requests signed by CEO/CFO that leave my department.

Occasionally, over the 10 years that I’ve been here, there have been items added into the advertising budget after initial approval (for example, we might have hired a new physician or started a new service line), but that is all approved by the CEO. At the same time, there have also been periods over that duration where advertising was slowed down or discontinued with a vendor per request by someone above me in the chain of command.

It may also be of importance to note that spending with SweetwaterNOW outside of my department is not under my purview or suggestion. For example, the HR Department saved over $1000/mo. by moving from newspaper classifieds to online recruitment ads. A handful of departments do have their own small ad budgets to spend as they wish.



I believe this question to be quite leading, so will start with the glaring words of “government money.” You probably have a better understanding of the hospital financials than the general public due to your assignment of covering the hospital, so I won’t be telling you anything new. An opportunity to teach the public more about how the hospital is financed is one I always enjoy. The complexity of healthcare finance is different than any other industry.


1) Although the hospital is extremely grateful for any funds received by the County, those monies are used for very specific things, none of which include advertising.

2) Those very specific things are for what has been termed the “maintenance fund” and also Title 25 care.

3) The hospital’s budget varies each year, but one thing you will find consistent is that less than 1% of the hospital budget comes from the County. That means the hospital is at least 99% self-sufficient and is funded through the services provided to patients. In our FY17 budget of $155M in revenue, the county is budgeted to reimburse the hospital for $1.35M. That is right around .087% of our total budget.

Is this a county (government) hospital in name and by statute, yes.

Are “government” dollars being used to advertise the hospital services, as the question from your Editor suggests? No. Absolutely zero “government” dollars have ever been used for advertising at the hospital in my tenure here.

As with any other business, locally or otherwise, the operations are funded by the users and purchasers of the service.

4) The only other source of funding that might be referenced as “government money” is the 6th penny (or Special Purpose Tax) that the voters graciously supported to help fund a large portion of the cost the medical office building ($18.85M). Again, those monies are for very specific purchases for the construction of the building, not one of them includes advertising.

As for ethics, I did my due diligence through research and recommendation long before ownership. I disclosed my potential interest and discussed at length with my superiors and counsel.

I went above and beyond ethically to make sure the hospital was protected and that I was not in violation of policy. At that time, and since, I have followed the instruction of my superiors to include a written conflict of interest disclaimer each year during my annual evaluation and have gone beyond reproach to maintain the integrity of my position.



In Mr. Martin’s article he has either misread the financials that were provided to him or in his attempt to create a narrative of increased spending with one vendor correlating to a decrease in spending with another vendor, his ‘sampling’ was incorrect. I have attached the advertising spending directly from our finance department for FY2012-FY2016 (AdvertisingDetailFY12-16.pdf) as well as a visual graph showing the trend of the bulk of that budget below:

MHSC Advertising Spending from FY12-FY16


National Digital Advertising Spending

(Pew Research Center – – Digital News Revenue Fact Sheet)


As you can see, the way our advertising budget has been spent has followed national advertising trends and more specifically, national health care marketing trends.

      • In 2014, it was noted that 77% of patients were using search engines to choose their health services, 76% of patients were using hospital websites to make a decision and 52% of patients were referencing health care content online. Comparatively, the same report showed that only 18% of patients were using newspapers. (Obelis Media, Healthcare Marketing Trends 2014.)


      • Also in 2014, it was stated that Search and Paid Search were the most integral part of inbound health care marketing strategy, bolstering direct traffic and drive for patients to their providers.


      • Also to note, FY12-13 was a time when Facebook for Business and Facebook Ads were not yet mainstream for health care marketing. MHSC also did not have a Cancer Center or a large group of employed physicians, whose growth follows the graph, who now currently need online search optimization and their own digital structure of paid search so that they can be found by potential patients looking for an appointment.


      • I understand that Mr. Martin’s article leaves out any vendors that he doesn’t see as being “local”, but that is an inaccurate portrayal of how advertising and marketing works. The majority of the digital ad spend is just like any other marketing director – Facebook & Google and in our market, Comcast.


Last, but not least – the average age in Sweetwater County is 32.6 years old. The majority of our demographic is online. (Sweetwater Economic Development Coalition – FebDemos.pdf)

According to Pew Research Center, in 2016, “about four-in-ten Americans often get news online.” Here is that breakdown by age:

(PewResearchCenter – – Pathway to News)



A few quick things to point out that were insinuated or referenced in the GR Star article.

      • The source used by Mr. Martin is a former employee of at least 3 of the local businesses mentioned in his article, among others.


      • There is zero correlation between increased spending on SweetwaterNOW and decreased spending with WyoRadio. There are very good people that work at all of the radio stations in Sweetwater County.


      • The spend to SweewaterNOW from the advertising budget is minimal when compared to all vendors, not just the few called out in the article. The percentage of budget spent towards advertising on SweetwaterNOW is shown below:



      • As for newspaper, traditional print advertising has been on a steady decline. It has been very hard to receive direct numbers from both local newspapers since papers printed (circulation) does not count as readership, but the Rocket Miner is estimated around 3,500 subscribers and the GR Star around 1,500. SweetwaterNOW has 140,000 active readers, (80,000 in Wyoming – Google Analytics) and as of today I do not have the audience numbers for Wyo4News.


      • At the same time, the Rocket Miner just increased their advertising rates by 10% and increased the price of their paper by 25%.


      • Newspaper advertising in Sweewater County is the most expensive form of advertising for the least amount of people reached. An example of a current campaign I reached out on:  a one-day ad in the newspaper was priced at the equivalent of 40 radio spots (:30 seconds) or the equivalent of a full-month of online advertising. These are the options that I have to analyze and choose from when deciding the absolute best way to get the word out about the hospital within our budget. These are also the options that every local business or marketing director is faced with.


      • The GR Star and Rocket Miner are the two media companies in Sweetwater County that are not locally-owned or managed.


      • The County is one of the Rocket Miner’s largest advertisers, if not the largest. Tens of thousands of dollars per year.




I will proceed just as I have for over 10 years, by following hospital policy and guidelines set forth by my superiors. The allocation of the hospital budget is ultimately up to those above me in the chain of command. I will also proceed in being a champion for this community and an impassioned ambassador for our community hospital.

I will continue to use statistical proof and keep my finger on the pulse of national and regional health care marketing trends to effectively and efficiently make suggestions for how the hospital should target its advertising. When I walk through the doors here I only wear one hat. I have done a great job in this role and it is a very public responsibility. I have taken that head-on with honesty and integrity from day one. We have won a number of marketing awards during my career here. They sit in the corner on my office floor. This has never been about me; this has been about getting the positive word out about the great things that go on at Memorial Hospital.

I will say that after Mr. Martin’s article I have had hundreds of texts, calls and emails offering support and encouragement – that includes each of the local competitors of SweetwaterNOW. I think that says a lot for itself.

Mr. Martin’s article raised good concerns that the public should be aware of, and through this discussion I hope that it will clear up any confusion. I have worked with David for many years and I think he did a good job with what he had available and the task put before him.

I encourage transparency and appreciate this opportunity to discuss this matter with the few people who did not know my personal business. If anyone would like to discuss the numbers provided or has questions, I gladly offer my email (

I was the first to share the GR Star article and I hope to be the first to share yours.


Gary L Collins