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I finished reading THE E-MYTH REVISITED few months ago; a must read book for entrepreneurs, marketers and business owners. I am not going to type something new, the following masterpiece paragraph quoted from the book. It manifests what marketing and customer experience is all about, enjoy learning!

Your marketing strategy starts, ends, lives, and dies with your customer. So in the development of your marketing strategy, it is absolutely imperative that you forget about dreams, forget about your interests, forget about you want, forget about everything but your customer!

When it comes to marketing , what you want is unimportant. It’s what your customer wants that matters. And what your customer wants is probably significantly different from what you think he wants.

Try to visualize your customer.

He’s standing before you.

He’s not frowning; nor is he smiling. He is perfectly neutral. Yet, there’ s something strange about him.

Coming out of his forehead, reaching up toward the ceiling, is an antenna! And at the end of the antenna is a sensor, beeping away like crazy. And the sensor i staking in all of the sensory data around it-the colors, shapes, sounds, and smells of your store, or your office, or the restaurant where you’re meeting for lunch.

The sensor is also taking in sensory data from you: how you are standing or sitting, the color of your hair, how your hair is combed, the expression on your face, is it tense? Are you looking directly at him or off to the side? The crease in your slacks, the color of your shoes, are they shined? Are they worn? Are the laces tired?

Nothing escapes the sensor as it absorbs the stimuli from the environment. Nothing escapes your customer as he absorbs the information he uses to make his decision to buy or not to buy but this step in the buying process is only the first. It’s what the sensor does with the information that’s of interest here. Because it’s how the sensor processes the information that will determine the decision your customer is about to make. Think of the sensor as your customer’s Conscious Mind. Its job is to gather the information needed for a decision. Most of it does, however, is unconscious; that is automatic, habitual. So even through your customer’s Conscious Mind is actively absorbing all  manner and forms of impressions, it is totally unaware of most of them. It’s not not your conscious mind that has to make the decisions, it’s your customer’s unconscious mind. It’s  in your unconscious mind where the second step of the buying process takes place.  What is your customer’s unconscious mind?

It’s like vast, dark, underground sea in which a multitude of exotic creatures swim about, single and in schools, silently seeking out food, each with entirely different needs and tastes. Those creatures are your customer’s expectations and the sea in which they swim is a truly foreign place to your customer. He has no idea what’s swimming around down there. What’s lurking behind some subterranean rock. What’s lying still and quiet as a stone on the bottom, waiting patiently and deliberately for some sweet morsel to wander by. But you can rest assured that every creatures in that sea, every one of those expectations is a product of your customer’s life!

Of his reactions, perceptions, attitudes, associations, beliefs, opinions, inferences, conclusions. An accumulation of all his experiences since the instant of his birth (and for all his experience since the instant of his birth (and for all we know, before it) to this very moment when he stands before you. And all his expectations are nothing more or less than means through which the sum of them all, your customer’s personality gets fed what it needs. The food it needs comes in the form of sensory input from the conscious mind (the “surface”). And if the food is compatible with the its expectatio0ns, the unconscious mind says “Yes.” and if the food is incompatible with its expectations, the unconscious mind says, “No.”

And that decision, yes or no, is made at the instant it gets a taste! In a television commercial, we’re told, the sale is made or lost in the first three or four seconds. In a print ad, tests have shown, 75 percent of the buying decisions are made at the deadline alone. In a sales presentation, data have shown us, the sale is made or lost in the first three minutes. And all that happens after that psychographic moment of truth, after the buying decision is made, is that the unconscious mind sends its answer up to the conscious mind, which then goes back out into the world to assemble the rational armament it needs to support its already determined emotional commitment. And that’s how buying decisions are made. Irrationally!

If anyone cared to do it, it could probably be proved that no one yet has ever made a rational decision to buy anything! So when no one yet has ever made a rational decision to buy anything! So when your customer says, “I want to think about it,”don’t you believe him. He’s not going to think about it. He doesn’t know how. He’s already done all the “thinking” he’s going to do, he either wants it or not.

What your customer is really saying is one of two things: he is either emotionally incapable of saying no for fear of how you might react if he told you the truth, or you haven’t provided him with the “food” his unconscious mind craves. Either way, little or no thought enters into the transaction. Despite what we would like to believe, the decision was made unconsciously and instantaneously. In fact, it was made long before you every met, but your customer didn’t know it.

The question then becomes: If my customer doesn’t know what he wants, how can I? The answer is, you can’t! Not unless you know more about him than he does about himself. Not unless you know his demographics and his psychgraphics. Demographics and psychographics are the two essential pillars supporting a successful marketing program. If you know who your customer is, -demographics-, you can then determine why he buys -psychographics-. And having done so, you can then begin to construct a prototype to satisfy his unconscious needs, but scientifically rather than arbitrarily.

Again, demographics is the science of marketplace reality. It tells you who buys. Psychgraphics is the science of perceived marketplace reality. It tells you why certain demographics types buy for one reason while other demographic types buy for another.

enough said.


I’m listening to Jim Collins book, Great By Choice, it answers the question: Why do some companies thrive in uncertainty, even chaos, and others do not?

Today, we are living in a chaos with the new Affordable Care Act and the changes happening in the healthcare sector. No physician I met or a speaker I heard know where we are going!

I will discuss few practices that can help you as a healthcare provider formulate your 2014 recipe. The recipe is based on my experience working as a Chief Experience Officer for a primary and urgent care clinics in Maryland.

First, let’s learn what is SMaC? (SMaC not Smaug, the dragon from The Hobbit :))

“SMaC stands for Specific, Methodical, and Consistent.  If you’re in an uncertain, fast-changing, and unforgiving environment, the more you need SMaC.  SMaC is a set of durable operating practices that create a replicable and consistent success formula. It is clear and concrete, enabling the entire enterprise to unify and organize its efforts, giving clear guidance regarding what to do and what not to do.  SMaC recipe reflects empirical validation and insight about what actually works and why.

Great by Choice notes that 10Xers (10X are companies Collins identified as high-performing study cases with the moniker “10X” because they didn’t merely get by or just become successful. They truly thrived. Every 10X case beat its industry index by at least 10 times.) develop a SMaC recipe.”

According to Wikipedia, “A health care provider is an individual or an institution that provides preventive, curative, promotional or rehabilitative health care services in a systematic way to individuals, families or communities.  An individual health care provider may be a health care professional within medicine, nursing, or allied health professions. Health care providers may also be a public/community health professional. Institutions (also known as health facilities) include hospitals, clinics, primary care centres, and other service delivery points.”

The healthcare sector is in constant change so you always need to discuss and answer one important question: How do your medical facility perform well when no one knows what’s coming next?

I will discuss three dimensions of SMaC recipe for healthcare providers; Technology (Mobile, Social Media and Wearable Products), Leadership (Patient Experience) and finally Culture (Team Development). The clarity and specificity of a SMaC recipe helps people keep their bearings and sustain high performance when in extreme conditions.


 Mobile: It is important to be the change and not just react to it

According to ComScore, nearly 148 million Americans age 13 and older own smartphones and 72 million own tablets. The average web user today accesses the internet on multiple platforms and has different value drivers for each platform and access method. Apps are the primary gateway to the mobile internet, so content providers must ensure they’ve not only invested the resources to provide a seamless user experience but also that they’ve effectively marketed the apps to consumers. If consumers don’t make room for your app on their devices, your ability to engage with them on mobile platforms will be significantly limited.

How Mobile is Changing the Way We Experience the Web

Start thinking of developing a mobile app for your hospital in a creative way. For example, if you have many international patients booking to do surgeries at your hospital, start thinking what will make their visit more comfortable? What type of foods they prefer? research their state or country. What type of TV channels or music are their mainstream?

Start building your psychographic database based on your patients demographic. If you just focus on building mobile app that has information others can find it online, just don’t expect anyone to download it. I’m not saying not to include educational contents but think more of just appointment or prescription reminder, instant text or chat with the doctor, or follow-up on things to do after operation.

Do Not just build a mobile app because other healthcare providers did, seek how you will add values to your patients beyond the classic care services, look into your patient’s needs and interests.

Do apply the Customer Development Process – Lean Startup Model to build your next product or service.

Social Media:  All human enterprises require a specific recipe for consistency and change

Everybody needs to remind themselves of two things in 2014:

1. Nothing is private and

2. Anything you do on social media can last forever

It’s commodity to have website and its mobile version, Twitter, Instagram and Facebook will be a commodity also. If you don’t have them then it explain why you are about to be among the physicians looking to sell their practices. 64% Internal medicine subspecialists and 89% of surgeons cited the cost of maintaining a practice as why they wanted to sell. There are many reasons to use these new media tools for your business such as: shown first on search engine results (people in 2014 will trust doing business with companies that has strong online presence and reputation), maintain relationship with your patients and even to help track disease outbreaks and health habits.

Not all of these tools fit the need of your healthcare facility. Recently, one company offered us a marketing package including the use of SnapChat, I was shocked! I started imaging what kind of marketing offers I will do to our patients using this social app.

Do Not create social media accounts if you don’t have the right team to manage them and create contents that suit the audience following you.

Do Five Best Practices to Guide Your Hospital’s Social Media Policy

Wearable Products: Move forward while figuring out what works

ABI Research has projected that by 2016, wearable wireless medical device sales will reach more than 100 million devices annually. The market for wearable sports and fitness-related monitoring devices is projected to grow as well, reaching 80 million device sales by 2016.

Wearable medical technology is becoming a hot commodity. As these devices come to market, they have the potential to help both patients and clinicians monitor vital signs and symptoms.

That’s one side of the wearable products, the other side is patients coming to your medical facility wearing wearable products such as Google Glass recording the whole visit including your hospital, physicians and staff so what you should do?

Do Not complain about the erosion of privacy that these products may engender.

Do be prepared to embrace the watches and glasses and even clothing that lead the wearable technology trend and should proactively be developing policies to weave these products seamlessly into the fabric of their workplace.


Patient Experience: All patients should be treated with professionalism and respect

Everyone in your medical facility is part of your customer service. You should never hope a problem will magically go away, or that someone else will deal with it. Deal with every issue head-on, no matter how small. It’s a tiny detail that separates your urgent care from the rest so give your prospects a reason to try your service.

Everyone should be trained to handle patient’s complaints and provide remarkable experience even physicians.

Do Not build a feedback system that has no human interactions.

Do Patient Satisfactory Service Co-Designed: Map the Gaps in the Human Experience


Team Development: Your company culture is the collective interactions of all your employees

To have a culture, you need a team. Great leaders understand success is built by great teams and they share their success with their teams. To create an emotional bond with your patients, start with your employees.

“In a connected economy, an employee investment is also a company brand investment.” ~ Tom Peters

Do Not hire C players (those with highest aptitude, not attitude) if you are planning for A+ company

Do provide all types of customer service training and updates regarding healthcare trends, your employees are your source to be well prepared for the unknown.

Remember, as the uncertainty, fast-changing, and unforgiving nature of your environment changes, the more SMaC is necessary.

Does your medical facility adhere to the SMaC concept, why or why not?


Over 20 members of the Society for Participatory Medicine weighed in with their own the top three things hospitals could do to be more participatory. They have categorized those answers and grouped them accordingly as a spider graph. The top three suggestions are:

  1. Include and value patients on multidisciplinary teams
  2. Implement a real-time feedback system for both patients and staff
  3. Provide full online, real-time access to medical records

Participatory is about co-designing processes, services and experiences co-created with patients and their families.

Bridget Duffy, MD mentioned in the Four Steps to Improve the Patient Experience and Heal the Art of Medicine that “Integrating the voice of the patient and family into your process improvement efforts can rapidly catalyze your efforts to improve patient satisfaction and clinical outcomes.

Many organizations have created patient and family councils to inform their improvement efforts, but most organizations do not effectively use this information. Organizations need to integrate the voice of patients and families into process improvement efforts, thereby creating new standards of care or “Always Events” for patient experience.  Most process improvement efforts strip out waste, and do very little to restore what matters most to patients and families.”

Many of the marketing companies now days are trying to sell their services especially the online platforms using one general sales tactic to convince bushiness including hospitals and doctors to hire them to attract new patients or improve their online presence. I will address in future blog why this is a wrong strategy for marketing companies and why it’s a waste of time and money for the healthcare institutions. For now, let me make something clear; there will be NO ROI of doing any online marketing campaigns without considering the offline experience

Micah Solomon in Improving The Hospital Patient Customer Experience (It’s About More Than HCAHPS Scores) said: “The biggest obstacle to improving customer service in healthcare is the industry’s insular nature and the way this makes its problems self-reinforcing. In other words, healthcare providers and institutions compare themselves to each other – to the hospital in the next town, the surgeon in the next O.R. – and benchmark their customer service accordingly. And to do so is to set the bar too low. It’s not as if patients stop being consumers – customers – when they put on a hospital gown. And it’s not as if their loved ones surrender their identities as businesspeople, twitterers, Facebook users, either, when they enter your institution. So, it’s time to benchmark healthcare customer service against the best in service-intensive industries, because that’s what your patients and their loved ones will do.”

You should aim to benchmark against the best, hire the marketing company that understand healthcare business, and Integrate  the voice of patients and families to deliver an extraordinary patient experience. That’s what will differentiate you from other healthcare providers in today’s healthcare market.

To validate the point I just said, a study published in 2013 showed that 75% of people search for specific doctors and hospitals when they are in need of the service, that means:

- Doctors and Hospitals with excellent patient experience will be in business and those without will be out of business soon

- Shared experiences will be the new currency of your brand, you could have good products but the overall experience is what will break or keep your brand. Remember, researches shows that people only remember the peak of the experience (good or bad) and the last part of the experience.

How Patient Experience will play a role in business?

Brian Solis in the What’s The Future of Business said: Shared Experiences are more important than products. Products are manifestations of the experience you want people to have and share. Experiences are something we feel and we share what we feel. We share what moves us.

Experiences Customers are sharing experiences about your business now. Why leave them to chance. Define them at every step!

With this introduction, I want to make a point. Your brand is what people have in mind about your service, staff, exam/waiting room cleanness, noise, etc.  and guess what happen when you (healthcare provider) asked your clients (patient and their family) to extract, express  and exude your brand? It’s that simple, you are going to co-design the experience that your patients want.

I will share some satisfaction service surveys including one with over 500 respondents that we collected and used its valuable feedback to improve the patient experience for a primary and urgent care clinics in Maryland. Remember that direct interactions with patients, their family and clients is always better as it gives you direct feedback but in case it’s not available all the time.

1 – Net Promoter Score (NPS)

I used it as an easy and fast method to evaluate the company’s score for few weeks. We got a lot of 10 with less of what we want to hear from patients. For example, it’s not possible to know why the patient get frustrated if we just collect score.


Question: How likely are you to recommend our company to a friend/colleague/relative?

Results: Score: 75

2 – One Question Feedback

One of the best surveys to get patient’s complaints and compliments. We put it near the checkout receptionist and in the waiting room, we also put it in the exam rooms with clip board and pens. You have to understand that the patient is doing a favor for you by filling your surveys so always make sure to make it easy for them to do so.

Question: Help Us Serve You Better!

Results: Very valuable suggestions and most of them read by our staff and physicians during the monthly meetings

3 – Client Insight

The questions below summarize what patients think about our service. We used this survey a lot during the busy hours when there is waiting time. We gave complimentary gifts for patients who complete the two pages such as free Vitamin B12, hand sanitizer, coffee mug, and many more.

Questions: How has your experience/interaction been with our clinic? What’s your favorite doctor/clinic/hospital? In your mind, how do we compare to your favorite? / How can we improve services? / When you talk about our service to others, what do you say? / Describe our service in just three words? / Would you like to be contacted by CXO to discuss your visit?

Results: Among 500 respondents for 1 year, we got:

Positive: 425

Negative: 75

I have to say that I praised my team when we get compliments but my real treasure is the complaints because this is how I improve the service and know our flaws. Most of the solutions to improve the patient experience inspired by the patients and our innovation. I never thought of having mini library for books in the waiting room, real flowers or Sinnamon flavor air spray could cause allergic problem to some patients, never change a TV channel without permission from all patients sitting in the waiting room, etc.

4 – Online

With the rise of mobile and tablet use, you have to make your survey short and touchable. Some ideas:

- Put your Chief Experience Officer phone at the top of the website. Also provide email in case the patient don’t prefer to call but make sure you are replying to anonymous (you can’t identify the person behind the email)

- Twitter is one of the best and fastest growing online platform for customer complaints. Make sure to listen and follow on tweets, Facebook comments, Google and Yelp reviews… well, just be everywhere :)

- Yes, I created a text tab for mobile website visitors to ask questions and send complaints via text messages

5 – Traditional

Few ideas including a hint in your voicemail greeting message about CXO extension number for complaints, answer the clinic phone randomly, and suggestion box in very visible place.

Patient-centered co-design have a vast amount of expertise as it comes from patients experiencing your brand offline and online and your team as the patient experience artist. You have to open all communication channels to patients and include real-time feedback tools whenever possible. Whatever experience you are designing for your patients, please remember:

- Technology changes, humans don’t

- 20% of healing is linked to our technology and tools, the other 80% is something else—it’s the human to human connections, the physical environment, and spirituality ~ Source

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If you search the web for top five HIPAA violations, you will find something similar to the following:

  • Lost or stolen Protected Health Information (PHI) on laptops, back-up disks, and portable drives
  • Inappropriate access of PHI by employees (i.e. snooping into records of family members or co-workers)
  • Improper disposal and storage of PHI
  • Computer Hacking
  • Releasing PHI to patients in a timely manner

You will find after some research that Twitter, YouTube, Instagram and other social media tools are not even mentioned in the list but not anymore. Social Media tools are going to top the HIPPA violations within the next few years unless your healthcare organization and staff are bound by simple, easy to follow, and well protected social media policy. If you haven’t heard about the Woman Sues Chicago Doctor, Hospital For Posting Photos Of Her Drunk In ER To Facebook and you are managing a doctor’s office or urgent care or hospital then this is the time for a must review of your policy and procedure book.

During the past three years, I had the chance to manage a healthcare organization’s brand presence, both offline and online. I can say that managing the offline presence is little easier because most communications are internal while taking the patients online is what makes the whole marketing and branding process a lot harder not just because you are dealing with very sensitive medical information but because their information will become permanent record on the web and you will have no power to remove it later.

My role within the medical center is called Chief Experience Officer, it’s not just a title for another CEO. It is a job that handles the most important responsibility in today’s experience economy, the responsibility to: manage your daily patients’ service problems, contribute to build strong corporate culture, and to full-fill your brand’s promise.

I will share five practices to minimize any threats and exposure your healthcare organization could take. If  these practices work on the medical practices level then you can scale them to work on the hospital level.

1Keep it educational policy.

  • Encourage employees to be ambassadors for your brand than to waste time trying to stop them from using social media. Social media networks are extension to your online brand presence and a place where you connect your fans emotionally to your brand. The patient could visit you one time but if the patient follows you online, the connection will mostly stay forever
  • The policy awareness should start from the interview and goes along the way during meetings and HR/PR updates. Everyone should be educated about the proper way to use their personal social media accounts and not to mix it with hospital’s use
  • Social media is an opportunity to build relationships with patients, the brand naturally is helped by the culture. To have a culture, you need a team, make sure they have real time mindset. Real-time means reacting in real, or near-real time. It’s about relevant action to solve problem that could hurt your brand offline or online and it’s better to manage it offline before it escalated online. Remember, the longer and higher a patient complaint lives in an organization, the more it grows
  • Organize educational events inside the hospital via tweetup and Facebook to arise awareness of the social media by discussing a a new HIPPA violation case and how to prevent it happening at the hospital
  • To make your policy work, you need to make it friendly, simple and short. Include some tips on agenda books, hallways screens, and optional tips via text messages

2Keep a checklist in handy.

  •  You want every member of your organization to know the process of how to ask happy patients for online review, the URLs of your social media networks, and understanding the rules of administering your social media accounts
  • Hospitals have very strict rules regarding patient privacy. Your marketing or patient experience department need to provide a consent specific for patients who don’t mind appearing on YouTube or Facebook for testimonial. The consent must have the patient full name, signature, along with at least one witness. Scan the consent immediately and shred it afterwards
  • Get the patient approval for any picture you take or video you record even if it’s verbal, get the patient to see what you will post online and become permanent record on the web
  • Try to keep patients information shared online anonymous, only first name or nickname
  • Keep your video camera inside a safe place. Make it accessible to limited employees

3Get your IT department involved in crafting your policy. IT personnel understand computer networks, users permission and privileges, and the basic ways to secure your network, prevent hacking and exposing your shared folders to public. Here are some of the best practices I’ve implemented.

  •  Always secure your computer every time you leave your workstation
  •  Use privacy screens on all your hospital computers
  • Do not store PHI on portable devices unless it’s your off-site backup devices
  • Keep your practice management system passwords private
  • Separate your operation network from guest network both wired and Wi-Fi

4Engage your patients offline to motivate them to come online. You don’t need consent for the following:

  • Offer free vitamin B12 (Doctor’s approval needed) for patients who write Facebook recommendation or support a hashtage of your cause
  • Make a tablet accessible in the waiting room to show your patient’s testimonials and successful patient’s treatment stories
  • Offer free lipo-light session for exchange of sharing their visit experience on Yelp.com
  • Make a signage at the gates to offer directions and tips to use hospital’s facilities when they checkin
  • Offer patients exclusive access to educational webinars by registering into the hospital’s email newsletter

5Do not do the following:

  • Do not post patients pictures in your hospital until you get patient’s approval HashTag
  • Do not tweet or comment any medical information that has no trusted source and always make sure to keep your personal opinion away from the hospital, you can RT or mention but use common sense otherwise
  • Do not take any photo or video with your personal mobile, use the hospital’s resources only
  • Do not engage into online conversation with your patients unless you are on HIPAA compliant medium
  • Do not post any before/after pictures of  patient’s procedures without trademark them in way that can’t be replicate

There’s no sense trying to create a social media policy from scratch (Mayo Clinic & Kaiser Permanente‘s social media policy are available online). Many healthcare organizations have already done some of the work already so adapt their work and change as your business and/or culture needs. Remember, the Internet revolution is still ongoing and new media tools are coming to your business whether you like it or not.

A day is coming where patients visiting your practice or hospital will record the whole visit via Google Glass and upload it to YouTube without your knoweldge!


If You Want To Be A Successful Entrepreneur, Be A Phoenician

by Mohammed December 7, 2013 Business

TweetAs many entrepreneurs, I’m a big fan of Shark Tank show. I’m learning a lot about business fundamentals, negotiation, and  how to come-up with the right product or service (not just idea). Kevin O’Leary is one of the sharks and he decided to teach one entrepreneur a lesson by taking him back in time to […]

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How Social Networks Can Manipulate the Millennials in the Arab World

by Mohammed October 19, 2013 Business

TweetIf you are watching TV or scanning your Twitter feeds now, you are watching or reading something about the middle-east. There is no doubt that the Arab Spring has been known to many people and Arab countries that people rarely know where they geographically located are became obvious. New study finds that social media networks […]

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My 3 Predictions for Online Experience

by Mohammed February 4, 2013 Business

TweetIn 2008, IDEA conducted a study about online experiences. The report (download PDF here) outlines key findings from surveys that explored factors that drive online experience which I quoted the following: “Although over 90% of visitors say that they are able to find the information they are looking for, over 50% report that there is […]

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Customer Experience Extension? It’s Almost Your Brand!

by Mohammed December 15, 2012 Business

Tweet“When consumers trust a brand and find it relevant, they may select the offerings associated with that brand over those of competitors, even at a premium price. When a brand’s promise extends beyond a particular product, its owner may leverage it to enter new markets. For all these reasons, a brand can hold tremendous value, […]

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10 #Inbound12 Marketing Takeaways Your Business Need in 2013

by Mohammed September 14, 2012 Business

TweetI was in Boston, MA for Inbound 2012 last week of August. I usually do some research before going to any event. What encourage me to go to #Inbound12 is that my company started using HubSpot to manage its inbound marketing so it was great push for me to pick this conference to be my […]

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Gary Vaynerchuk’s 10 Advices to Small Business Owners #ASBS

by Mohammed June 3, 2012 Business

TweetAfter meeting Seth Godin in Tribeca in NYC, I attended America’s Small Business Summit 2012 in Washington, DC which organized by the U.S. Chamber of Commerce celebrating its 100 year anniversary with more than 700 small business owners from across the nation. The links above have all the details about the event, it was informative […]

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