THE OLD & THE NEW

Change is neither good or bad. It simply is.

- Don Draper,
Mad Men

Mad Men, one of the most successful dramas in American television history, is set in an advertising agency in New York City. It tells the story of how the world of advertising changed dramatically in the 1960s and 1970s and how consumer habits helped drive
the change.

This may seem far removed from the benign world of ophthalmology but there are parallels. Ophthalmology, like advertising, is a business and it has been subject to dramatic changes in the last 20 years. While the majority of ophthalmologists will feel comfortable with the technical and clinical changes that have driven the profession in the last two decades, for many the biggest challenge has been establishing a business model to sustain their practices.

In a challenging economic environment it is no longer good enough to be the best clinician operating in your locality. You have to be able to communicate this message to your patients to make sure that they will book appointments in
your clinic, rather than with your colleague down the street or in the adjoining neighbourhood.

You can manage your practice successfully with a well-trained and well motivated staff of doctors, nurses and administrators, but if you do not advertise or market the services you provide, you will find it difficult to sustain your practice in the long-term.

DRAMATIC CHANGES

This will be one of the key messages at this year's Practice Management and Development Programme at the XXXIII Congress of the ESCRS in Barcelona, Spain. Mike Malley of the Centre for Refractive Marketing, Houston, Texas, recalls the dramatic changes that have occurred since he started working with ophthalmologists 28 years ago.

“In the early 1980s, when I started out, we were much like the Mad Men in our use of traditional media: newspapers, radio, television, magazines and billboards. During that era of advertising in the US, medical marketing was brand new and was frowned upon by many in the medical profession. So we worked closely with industry professionals and authorities to help establish appropriate guidelines to allow us to discuss and promote medical products. This was before the internet, before cellphones, before email,” he says.

“Now, as marketers, we are shifting a lot of our strategies online. The purchase cycle is also different today compared to what it was in the 1980s. Now, if you are online, it is all about giving people timely information and unique offers. You have to drive inquirers to your website, not necessarily by selling products but by providing unique information that piques the interest of potential patients browsing the web.”

According to Malley, while the majority of ophthalmologists have recognised the advantages of the internet and social media, there are some who are very traditional and still have reservations about its effectiveness as a marketing medium. “What doctors have to realise is that when you are online you are not just competing with people in your own area, you are competing with everyone on the internet who is promoting the same services and products that you provide. And once you have directed them to your website, we strongly believe in re-targeting and event tracking to allow us to properly track them and provide ongoing relevant messaging,” he adds.

This is a message reinforced by David Evans PhD, CEO of Ceatus Media Group, San Diego, California, who will also be presenting at this year’s ESCRS meeting. “The perception of the quality of your practice is directly related to how (and how prominently) people see you online. You cannot disconnect those two things. A highly visible, quality online presence equals (in the minds of potential patients) a highly skilled doctor or clinic. To elevate your brand in the minds of potential patients, you need to create a strong online presence and make it easy for people to find your website and visit your Facebook page,” he says.

Dr Evans agrees that budget can be an issue for some doctors. “You don’t have to spend a lot of money on your website or internet strategy. There are several things you can do to save costs, such as writing the material yourself instead of buying it from a third party. It is important to remember that the quality of the content on your site is critical. It has to be oriented toward what consumers want to learn and not be too technical, while still clearly communicating your unique vision. Other tasks, such as improving your rankings on Google, typically require professional help. And while these costs vary based on several factors, the cost should not be exorbitant.”

Some doctors will express concern that it is difficult to evaluate how much new business their websites actually generate, but Dr Evans says the metrics are improving all the time. “You can now use analytical tools that will show you how many people visit your site, how much time they spend there and specifically what articles they are reading. In addition, to gauge the effectiveness of your online strategy, you should view your website as if you were a potential patient, and objectively assess from a consumer’s perspective what your website says about you and your practice online,” adds Dr Evans.

Dr Evans says that ophthalmologists must not only know their market, they must also be conscious of the fact that they are competing with other service providers.

“We are all buyers when we visit the internet and regardless of the product or service being searched, the process is essentially the same. This means that consumers who visit your site will also visit the websites of other providers in the area in order to make a decision about which procedure they want and who they want to perform their surgery.”

The marketing of medicine is regulated in all countries but every territory has its own regulations, and some are less restrictive than others in decreeing what doctors can say about their individual practices.

“Your content manager must be cognisant of and sensitive to the regulations applying in your area, but in my opinion, this can easily be managed because it is all about patient education. With proper management, an ophthalmologist can have a very compelling and successful website and online image, without being overly promotional,” says Dr Evans.

Is there a bottom line in deciding how much you should spend on your website? “Ultimately, as with all purchases, a website’s cost will depend on many factors including size and features desired. And every web company promises something different,” says Dr Evans.

“There are some basic guidelines that can help determine the appropriate image/size/cost for an individual website. First, you should review the portfolio of the company you are considering and then talk to a few of their clients. Keep in mind that just because you pay more for your website than one of your colleagues, that does not mean that you will get higher quality. And conversely, just because you are quoted a lower price does not mean that it is better value.”

At this time, the need to have an internet presence is well established. However, as with all aspects of an ophthalmologist's practice, it must be done purposefully and professionally to avoid damage to your reputation. “When content is posted on the internet, it is there permanently. If something is placed online that doesn't represent you well, it is often impossible to remove. Research shows that most patients believe what they read online, so it is very important to closely manage, to the greatest extent possible, what appears about you online. You should bear this in mind, especially if you work in a country where patients can post reviews about individual practices,” says Dr Evans.

HANGING ON THE TELEPHONE?

One of the highlights of this year’s Practice Management and Development Programme will be a one-day workshop focusing on how ophthalmologists can convert enquiries into procedures which are paid for by the patient. Rod Solar, of Livesey Solar Practice Builders, London, UK, says if ophthalmologists want to attract more private patients they must understand what their patients want. Solar also argues that, while the internet and social media have revolutionised marketing, the most effective tool for converting enquiries into sales is the telephone, invented in the 19th Century.

“We have done a lot of study into what people actually talk about on the phone. We have audited over 1,000 phone calls and listened to the recordings, where we have been able to glean aggregate data that reveals the kind of questions patients ask and how they respond to targeted questions such as what type of solution they are looking for. We also evaluate how many people they have seen in the past to help them with their problems, how soon they want to fix a problem and how long they wait until they fix that problem,” says Solar.

The mix between new and old marketing platforms is very important, says Solar, but he stresses the primacy of the telephone. “Most conversions will arise from the many website visitors an ophthalmologist might receive. Of the number of patients that actually come in and see you, who are the only people who are actually going to pay an ophthalmologist, 99 per cent of those conversions happen on the telephone. Money exchange rarely occurs online for an ophthalmologist's services. Without the telephone introduction, without the telephone invitation to get someone to walk into you clinic, payment does not materialise and transactions do not happen.”

Solar says that social media is very important to stimulate word of mouth and to give patients a platform on which to communicate, but appointments do not tend to arise via email. “The internet and social media are hugely valuable but the phone conversation is still the most important medium to convert enquiries into visits,” he adds.

PLAN CAREFULLY

Solar also agrees with Mike Malley and David Evans that ophthalmologists need to have a clear vision of what they want to achieve when they market their practices. In the old days, he says, ophthalmologists would ask him: 'Should I have a website?'

“Now we are getting a lot more people who have tried setting up their own websites and who feel somewhat disillusioned with the experience. They may have gone to a marketing specialist with expertise in fast-moving consumer goods or selling cars or electronics. The techniques these marketers use may not work for ophthalmologists. Another complaint is that they have spent a lot of money without satisfactory financial return,” says Solar.

That is why it is important for ophthalmologists to have a plan before they decide which marketing tools they use, says Solar. “As an ophthalmologist,” he says, “you need someone in your practice who understands statistics and how to experiment so you can find out what works best.”

BACK TO THE FUTURE

Every good marketing story has a beginning, middle and an end, but the ophthalmologists who will be ahead of the marketing curve, says Mike Malley, are those who are already looking to the future. The future, he says, will be driven by the generation known as The Millennials, the generation born between the early 1980s and the early 2000s.

“The Millennials are the first group of individuals whose parents had refractive surgery,” says Malley. “All of a sudden we have a group of people who are not afraid of refractive surgery, they just don’t fully understand why their parents are wearing reading glasses, they don’t understand presbyopia. The presbyopic market is wide open online. If ophthalmologists are not online promoting the benefits of presbyopic vision correction, they are falling behind.”

We’re going to sit at our desks and keep typing while the walls fall down around us because we’re creative – the least important, most important thing there is.

- Don Draper, Mad Men

Mike Malley:
mike@refractivemarketing.com

David Evans: devans@ceatus.com

Rod Solar: rod@liveseysolar.com