January 2017




To the point: Simple practice tune-ups for complex times
A marketing check-up list

by Maxine Lipner EyeWorld Senior Contributing Writer


“While ignoring marketing won’t kill your practice today (the way clinical neglect would), over time, marketing deficiencies will sap your practice’s potential.”

“The aim of marketing is to know and understand the customer so well the product or service fits him and sells itself.” –Peter Drucker

A lot of practices see marketing as a mysterious, expensive administrative afterthought. This is especially true in the present environment where growing regulatory burdens and clinical innovations leave precious little time to devote to marketing. But marketing communications is one of the most basic pillars of any successful practice business. While ignoring marketing won’t kill your practice today (the way clinical neglect would), over time, marketing deficiencies will sap your practice’s potential. Let’s demystify marketing: Marketing is nothing more than establishing and then maintaining an exchange relationship with a customer base. An exchange relationship is just fancy biz-speak for, “I treat your eye problem, you and your insurance company reimburse us.” Effective marketing is generally multi-pronged. Marketing executives have a term for this, the “marketing mix,” the appropriate ratio of tactics assembled to achieve desired growth rates. Although “selling,” “advertising,” “outreach,” and the like are tools in the marketing tool box, none of them alone is sufficient. Here is a six-point marketing check-up list. By the time you get to the end of this list you’ll have a good sense of where you may be falling short. The first three are internal; the last three are external.

1. Marketing needs forethought. You can’t draw up a sensible, relevant marketing plan without the underpinning of a clear view of your broader goals. What’s your service area? Desired growth pace? Service mix? Provider mix? Answering these questions first will make writing a brief, formal marketing plan much easier.

Check to make sure you are doing these things:

• Write a 5+ year strategic plan, even if it does little more than answer the questions above.

• Hone in on your desired percentile growth rate. If you want to grow faster than the baseline pace in most markets —about 4% per year—you will have to add proportionately more resources to your marketing mix.

• Decide on a budget, which should be proportional to several factors:

• Your desired growth pace

• Level of local competition

• The scale of your local market—small rural and suburban markets are much less expensive to market in than urban hubs The typical budget today is 2% to 4% of net practice collections, but can readily exceed 10% for a refractive or cosmetic surgery practice.

2. Recall and continuity of care are marketing job #1. There is little point in expensively directing new patients to your clinic through paid advertising and other external efforts without having systems in place internally to ensure that the patients actually stick around. It can cost $500 or more in paid advertising to generate a new patient; this only pays off if the patient stays in your practice for many years and refers others to you.

Make sure you are doing these things:

• Measuring patient satisfaction formally at least annually; this should be live phone surveys, not written surveys, which are notoriously useless

• Using the results of your patient survey work, make sure customer service is optimized; this includes things like ensuring that the average total appointment time is 70 minutes or less in the typical setting

• Auditing each provider’s return- to-clinic patterns, and making sure that every appropriate patient is being given a follow-up appointment at checkout

• Applying whatever level of appointment reminder intensity is needed in your unique practice; pediatric practices often need to combine texts and emails with automated and personal calls and still never get below a 15% no-show rate

• Keeping no-show rates as low as possible and following up with every absent patient

3. More than 50% of new patients in the typical clinic are derived from patient-to-patient or so-called “alumni” referrals. Such referrals are inexpensive to generate and are generally proportionate to the kind of global customer care your practice supplies.

Make sure you are doing these things:

• The provider should directly and personally ask each patient to refer; what works best is a simple public health message, “Please tell your friends about the importance of regular eyecare.”

• Have business cards at the ready to hand out to patients who respond positively to this message (or simply hand out the cards when you say this to the patient).

• Don’t stop asking for referrals just because the occasional patient pushes back and says, “Oh sure, so I can wait for an hour next time!” Roll with the punches and keep delivering the message that you are still accepting new patients.

• Set up a referral acknowledgment system; this might be as little as a thank you card or as much as a personal phone call from the provider placed to his or her most active referral sources.

You should not launch external marketing until you have nailed these first three basic, inexpensive internal marketing efforts. If these are still not generating enough new patients, consider these final three.

4. The largest external source of new patients in the average general ophthalmology practice is optometric referrals. Whether you have the lower/average support levels (plus or minus 15% of new patients) or exceptional “comanagement center” levels (70+%), this is the most cost-effective external source of new patients—and some would say the most professionally gratifying.

Make sure you are doing these things:

• Keep a database of optometrists who refer to you (the “A” list), and docs who might (the “B” list); include in this database their contact information, referral and consult letter preferences, favorite pastimes, and the names of key staff and family members, as you come to know these.

• Commit a fixed number of hours each week to outreach; it may be just an hour, or it could be a full day if you are still building a practice. Spend 75% of your efforts on the “As” and the rest of your time on the “Bs.”

• Broaden your efforts proportionate to your goals in this area; this may include:

• Both providers and lay surrogates doing the outreach

• Personal time together (golf, socializing, etc.)

• Large CE sessions for the community and “mini CE” sessions in your office

• Lunch-and-learns in the optometrist’s office

5. Next in line, at least in terms of cost-effectiveness, is to provide community talks and screenings. This can be as simple as giving talks through your hospital’s speaker’s bureau or be built up to a full-scale regional vision screening program with vans. Make sure you are doing these things:

• Scan the environment; if others are not using this patient channel, this could be a niche for you to successfully occupy.

• Senior activity centers are classically the most productive outlets; meet with the directors of such centers and simply ask, “Would senior vision talks/screenings be welcome here?”

6. Finally on our checklist, we have what you probably thought was going to be higher up on this list: paid advertising. Whether this is “old media” like radio and newspapers or “new media” like social marketing and website development, the principles are the same: You are seeking one or more cost-effective channels to reach a targeted audience. All but the largest practices have to outsource support for these areas.

Make sure you are doing these things:

• The consensus view is that your external advertising budget should be cut down the middle between new and old media. A 100% new media play is probably not reaching all of your potential audience. Don’t abandon old media.

• For new and old media efforts alike, get professional help. The sophistication of this help should be proportional to your location, budget and objectives.

• Practices in less-competitive rural settings can get by with a local kitchen-table web developer or one of the national providers of web marketing services.

• Practices in competitive markets may need to roll out heavier artillery.

• An increasing number of advertising agencies develop programs on both sides of the aisle, and if you work in a larger market with a choice of agencies—including specialists in medical services—you may be better served taking this route.

About the authors

Mr. Pinto is president of J. Pinto & Associates, Inc., an ophthalmic practice management consulting firm established in 1979, with offices in San Diego. His latest ASCRS•ASOA book, Simple: The Inner Game of Ophthalmic Practice Success, is now available at www.asoa.org. He can be contacted at pintoinc@aol.com or 619-223-2233.

Ms. Wohl is president of C. Wohl & Associates, a practice management consulting firm. She earned her Masters of Health Services Administration degree at George Washington University and has more than 30 years of hospital and physician practice management expertise. She can be contacted at czwohl@gmail.com or 609-410-2932.

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