I think consumers' use of the internet including social media has changed marketing. Tapscott (2000) noted that the internet has brought about significant changes to marketing. Online, communication flows in multiple directions, and marketers can no longer exert full control over the four P's. Customers now hold the power as they can access more comprehensive product information and engage in personalized, one-to-one communication. As a result, they determine the marketing mix by selecting the medium and message that suits their preferences. The consumer takes charge of the communication process. I believe this makes it harder for healthcare organizations to differentiate themselves and reach their target market.

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