My Favorite Software

So I was surprised today when one of my clients asked what my favorite piece of software was. I had to think for a moment...not Word, not Excel, not PhotoShop or anything fancy...no, my favorite little piece of software is RoboForm.

It's a great little application that stores all my logins and passwords in a secure little locker. I'm able to log in to one program and then it will automatically log me in anywhere I have an online account.

But wait...there's more. It will auto-fill forms for me too. I remembers my personal and work profiles; shipping address, billing address, and CC info. So ordering online or creating new accounts, takes just seconds.

And my favorite bit...RoboForm To Go runs from a Zip drive that I can use whenever I travel to quickly access all of my favorite online resources. RoboForm is simple and functional...just what software should be.

No Wait, That's 3 Ws

It seems every day we hear at least one thing from a practice that makes us giggle. We're calling prospective clients in a few key cities to verify their practice Web site address. The responses we're getting range from horrifying to silly. Our favorite today was, "Oh, wait, let me find that...it's written down here somewhere. Found it! Our web site address is ww.[practicename].com. No wait, that's 3 ws."

You probably had to be there to appreciate the humor.

What we're finding is startling. Fully 50% of the board certified plastic surgeons we are surveying in major metro markets do not yet have a site. And WORSE, the staff for more than half of the ones that do have a site don't know the address.

Give me a second to jump up on the soap box...get my balance and my bullhorn...

• Everyone on your staff who interacts with patients MUST know your Web site address, be able to spell it, and know what is on the site and why someone would want to go there
• The recall should be instant, no searching or hunting should be required to rattle it off
• The site should be OFFERED at the end of every casual interaction as a way to learn more about the practice, view before and after photos, subscribe to a newsletter...whatever your site does...as a way to extend your interaction with that patient, build your brand and reputation, and increase the value of the site to your practice

Stepping back...no wait...give me that bull horn back. We noticed while making the calls, when we are just asking for the Web address, even the practices who can provide it aren't asking if they can help us in any other way. Not one has said, "You really should go to the site to read about the doctor's experience and training and to see samples of our work...but while we're on the phone there must be some questions I can answer for you. I'm Ryan, what was your name?"

If ever there was a time to start a dialogue with a patient...it's when you are already talking to the patient! So, clearing my throat...

• If you have a prospect on the phone, introduce yourself, ask for the patient's name, and offer help. Better yet, ask if the caller would like to come in for a consultation!

Granted we're not real prospects, but the receptionists didn't know that. My advice for any plastic surgeon who is listening today, invest a bit more time and energy training your front office staff to make the most out of every interaction...that may mean making sure there is enough help in the front office to allow them to engage each caller, rather than just processing them!

Search Engine Optimization in a Nutshell

Over the weekend I got a call from a surgeon that we've worked with for over 3 years. This surgeon has attended at least one of our webinars and had untold number of conversations about search engine optimization (SEO). In this call he asked me to sum up SEO, "in a nutshell."

Here's how I would sum it up...

Search Engines Scrutinize You, and Check Your References

Search engines look at both "on page" and "off page" factors. This means they look at each of your pages (they look "on page") for how they are designed, programmed and authored. They look at how the pages of your site connect together. And mostly they are looking for which keywords are located where on each page.

They also look "off page" at other sites to see both how many sites link to you, and how those sites relate to your topic and keywords.

Search Engines Optimization Begins with the Right Keywords

Everything about your online marketing, from the topics you cover, to the names of your files, to the text you write, should all be based upon your list of target keywords. At first you should focus on the most actively searched keywords that relate to what you do in your market. Over time, a good SEO firm will help you refine the list to the terms that are most likely to attract a new patient.

SEO in a Nutshell

So, in a nutshell, SEO is about first choosing the right keywords, using them judiciously in well written text, on a well built site, and then working to secure lots of high quality inbound links from related sites.

Any questions?

What do Tasers and Flash Animation Have in Common?

I was away on vacation last week, so I missed the news about the kid that was tasered at the Kerry speech in Florida. Like the good nerd I am, I ran to Google News to get the full story. Searching for "taser" I figured there could only be the one big story. Wrong.

As it turns out, there has been at least one big taser story each day for the last few months. In the last two weeks alone, an autistic child was tasered in California, a retired New York police officer accused cops of unwarranted taser use on his son, a mentally ill Florida woman in a wheelchair was tasered 10 times by police and killed. So what do tasers and Flash animation have in common? Both were invented with the best intentions, and both serve an important purpose. But with both, irresponsible or aggressive use is harmful.

On three separate occasions last week I found myself in conference with clients who were determined to use Flash to their Detriment.

1. One wanted a Flash “splash page” a mini commercial that would run before a visitor could access any part of the site.
2. The other presented with a site made entirely of Flash and could not understand why her site had no search engine rankings.
3. The third, enamored by a twinkling firefly effect wanted moving lights behind his text.

There are some fantastic examples of Flash out there…like the animated procedure tutorials from Understand.com or Candace Crowe. A little Flash on your home page can also go a long way, as long as it does not impede your visitors.

Here’s what I encourage any cosmetic and plastic surgeons to consider before adding Flash to their Web sites:

1. Your visitors came to your site for a reason, and it was not to watch a commercial;
2. Search engines still struggle to see text inside of Flash movies…so Flash sites rank poorly; and
3. Flash is just as likely to distract as attract. Continuous movement on a page impedes reading.

So before you move to “stun” visitors with the bells and whistles, step away from the Flash and carefully consider your next move.

FROM THE RANKS PART 4: Web Marketing For Cosmetic Plastic Surgeons Isn’t Important…

It's my own damn fault...I got the writing team thinking about the relationship between eye tracking studies and Google's recent infatuation with shorter pages that happen to have keywords in the areas most users look first when "scanning" a page. It seems we just can't get away from the topic. But in the next post, copywriter Mike Roe takes a stab explaining how to satisfy both search engines and scanners...

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Web Marketing For Cosmetic Plastic Surgeons Isn’t Important…
It’s imperative. In fact, studies show that 80% of computer owners use search engines to find physicians and research procedures. And studies suggest that once they’ve found your medical Web site, you have but a few moments to prove to them they’ve come to the right place, to show them what they’re looking for – “show” rather than “tell” being the key word here.

How Can You Show Them Your Page Is Worthy of Being Read?By writing it in such a way that ensures it isn’t. Wait. What? Studies conducted by Jakob Nielsen (“The Guru of Web Page Usability”) and Kara Pernice Coyne – both of the Nielsen Norman Group – bear out that Web readers are in reality “scanners.” They scan pages, often tabbing back-and-forth between your page and your competitor’s. What are they looking for? Answers. What do they ignore? Details (at least in the beginning).

So, how can you help them to find the answers – “the main points” – they’re scanning for? Mr. Nielsen and Ms. Coyne recommend bulleting items, as well as...

• offering straightforward page titles
• increasing white space
• front-loading keywords
• making headlines simple and direct
• guiding the scanner with subheads, and
• bolding or linking from information-bearing words

For Effective Web Marketing, Cosmetic Plastic Surgeons Should Keep In Mind...
Less copy is more – by decreasing the time it takes for the scanner to “read” your page, you actually increase both comprehension and retention. So, try to keep your search engine optimized copy between 250 and 300 words, like this blog.

For more information about how people use the Web, check out Steve Krug’s book, “Don’t Make Me Think! A Common Sense Approach to Web Usability.”

FROM THE RANKS PART 3: Death by Jargon

Our lead copywriter Cathy has a few words for people with big brains who write their Web sites without thought of their audience.

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Picture this. You’re roaming the Web one evening after a light day of patient consults. You decide to look for some extra help getting your brand new PDA to synch up properly with your old computer. You’re getting close; you think you may have found the right site…eureka! Here’s your advice:

Microsoft Windows Installer can be used to install signed driver packages that are associated with applications in a Windows Installer installation package.

You heave a big sigh and abandon that quest in favor of checking out the classes your college student daughter has signed up for this term. You locate her university’s Web site and here’s the scoop:

This symposium aims to provide ethnographic and anthropological substance to the political philosophy of publicization. We hope to elucidate the ethnographic forms that the new public forums (Helga Nowotny et. al. call them agora) are taking in our anthropological contemporary.

“Whoa, whoa, whoa,” you say. “Wait just a minute. I know where you’re going with this. I’m smarter about medical Web marketing than you think. My site’s nothing like that.”

Is that right? You’re sure?

Just as doctors aren’t usually skilled in geek-speak or university blather, most prospective plastic surgery patients aren’t experts in medical terminology. Think how they may react to gobbledegook like these gems from real Web sites:

There is no blind dissection of the space for the implant. The fold below the breast (inframammary fold) as well as the medial aspect of the pocket (the cleavage area) is precisely created.

Dr. X prefers the small 3 mm,triple lumen Mercedes cannulas to 1 atmosphere of vacuum suction pressure.

External Ultrasound Assist is a method of preparing tissue for surgery by infusing fluid followed by high frequency ultrasound using a special device
designed especially for this procedure.

Not only will most searchers fail to understand what these passages are trying to say, the average patient does not want to be talked to this way. They are real people seeking understanding, support and expertise in their pursuit of self improvement—they want to connect with a physician, not receive a lecture.

An early study of the behavior of Web site visitors revealed that over 75% of them look at text first (rather than photos or other graphics). What will happen when their eyes land on “1 atmosphere of vacuum suction pressure?”

Sure you don’t want to take another look at your Web site?

Together We Are

Friday afternoon is still with me. Two days later I still can't let it go. I've been reluctant to blog about it, mostly because all of my thoughts come out as, well...corny and cliche.

You see we're hiring...and right off the bat you should know that our hiring process is a bit out of the ordinary. Everyone who gets hired must complete a complicated skills assessment to win a chance to interview. The interview is a conducted panel of our senior staff; four on one. The office is open format, meaning everyone can hear, so it's more like 15 on one.

On Thursday we thought we had found the perfect candidate...but something wasn't sitting right. We scheduled a second interview, bringing in different members from our team to sit on the panel. The young lady in the hot seat was smart, skilled, and a prime contender...but the new questions from the new panel revealed that the fit just wasn't right.

The debate was intense, but the post-interview discussion grew from the panel, to the panel and senior staff, to the panel, senior staff and pretty much everyone else.

I was certain this young lady would master the job, make our clients happy, I even denied my feelings that something about her personality might abrade the rest of the team.

But, when I set my ego aside, and trusted my team, listened to my team, I heard reflected back at me the truth about the candidate. Her ambition and approach to conflict were certain to pit her against the production staff in short order.

It was a moment for me, a moment when I realized that sometimes I manage best by getting out of the way. I think it may have been a moment of for my team, a moment when they realized I trust them implicitly. It was golden. We had invested a ton of time and energy in the wrong candidate, but I think we walked away feeling successful, and closer.

Like the candidate, I have a history of trying too hard to always have thins my way. It seems that together we are smarter, better, and more successful.

FROM THE RANKS PART 2: Matt Gets Write to the Point

Staff copywriter Matt had a few choice words to share about the risks of do-it-yourself copywriting...and the rewards of turning to our professional team for help. The stage is yours Matt...

"Imagine this: you’re a cosmetic surgeon, and you want to do some medical marketing of your services over the Web. Seems simple enough—just write up what procedures you offer and a little bit about your office, your staff, and your treatment philosophy, right?"

"In fact, many of the surgeons we work with do believe they can do all this writing on their own, and in a few hours at that. Writing may not be rocket science (though a recent study gave corporate employees a D in their grammar skills), but I’m a big fan of trusting a professional to do the job right. I don’t pretend to know how to rebuild a transmission or administer an IV drip. I haven’t been trained in those things. But I did graduate from Carnegie-Mellon with a degree in Creative Writing, and I refined my skills writing proposals, memos, letters, and case studies before heading back to law school at UCLA, where you bet I got a healthy dose of readin’ and writin’. I have to admit that I take a little offense at those who think anyone can write—it’s a skill I’ve worked hard to develop and refine for over a decade. "

"But enough with me being grouchy. Getting back to that surgeon, how’s the Web site writing really going to go? Think traffic jams. Think molasses. Think three-toed sloth. In my experience, our clients who choose to do their own writing have a very slow go of it. That’s not to criticize the doctors in any way—they always start out with the best intentions. But the strains and pressures of their practice mean that Web site writing has to take a back burner. Many think they’ll find time for the writing over the weekend. In all but the rarest case, they won’t."

"Most of our sites require 50 to 100 hours of copywriting, when a pro does it. Figure probably twice as much time for a surgeon to get in the swing of things: thinking about what to say, integrating keywords, developing a page model, researching the marketing of the products they use, optimizing the copy, and having someone proof it. So even if a surgeon, who mind you is more than likely slammed with consultations, scheduled surgeries, and practice administration, can devote 2 hours per week to writing their site, they’ll be finished in about one to two years. Think that’s exaggerating things? We are currently working with a surgeon who has spent over a year drafting copy, and is not all that close to completing it. Meanwhile, the surgeon has no Web presence and is missing growth opportunities."

"Here’s the moral of this medical marketing story: do what you do best. Leave the writing to us."

Not sure if you can trust our team to get the writing, well, right? Ask our clients. They routinely report that we convey their personality, voice, mission, and the essential clinical details of their procedures with resounding success.

FROM THE RANKS, PART 1: The Client Who Cried Urgent

I recently sent an email out to the entire Etna Interactive staff, asking the team to weigh in on what they would share with a client if they had no fear of causing offense. It's not too surprising that most of the comments I've received from the team relate to communication and vendor management.

One of our Senior Project Manager's, Kristin Bertsch, commented on one of my favorite (or least favorite) topics...the client who cries URGENT!!!!!

Kristin wrote, "We understand that things come up at the last minute and that most edits need to be made to a web site as soon as possible. I would want our clients to understand that urgent and last minute requests impact our production schedule, delay other projects, and cause unnecessary stress on the production team."

"Our best clients let us know when important events are approaching, plan for updates and direct marketing efforts, and reserve URGENT requests for real emergencies. When those things happen it feels good to come to the rescue."

What Kristin was too polite to bring up was the other side of that coin. If you're a doctor, you know what you feel, and what the front office says, about that one patient that insists she's having a "Botox emergency" and simply must have her next treatment today. The one that calls at the last minute and insists that the doctor drop everything for her consultation. Need I say more?

So when it comes to working with my team, and really any of your vendors, a little planning, and a little respect, goes a long way

Why Original Content Matters

So a medical web site assessment I performed this morning landed me on yet another site with 100% duplicated content. The ensuing call left me explaining again why original content matters. Some things are better explained in person, so I invite you to sit back, relax, and listen to me rant on why original content matters...

My Favorite Sales Pitch of All Time

Ok, are you ready for it? "The technology is so unique I can't describe it in words. You have to see it."

No kidding, a woman calling to sell me an online advertising vehicle just said that. What an idiot.

I had a pretty good sense what her product was, so I humored her for 5 minutes. Humored her in that grumpy and impatient way I have when I know another silly person is wasting my time.

She embarked on a long-winded presentation that I forcibly cut short, and by the end I asked her to pull out a pen and take some dictation. I wanted to arm her with some actual words to explain what she was selling the next time a prospect asked, "Can you describe it to me?"

1. We developed some software that helps parents of myspace.com users protect their children from sexual predators. It is free to the parents, that's why 12.5 million have already downloaded our tool.
   
2. Once installed, that same software allows us to spy on their search behavior. When they type a phrase in any of the top search engines, we see it.


3. In response to what they type, we can hijack their browser and place an ad (your website) above the search results page.


4. You can actually buy a keyword! Own a keyword! And have your site appear above the search results whenever that keyword is used by someone in our network at any of the major search engines.

See now, that wasn't so hard.

Here's the part they left out. As soon as you subscribe, expect more hate mail than new customers. It's not clear to these 12.5 million parents of myspace users that the price they pay for the free software is having their search activity spied upon and their browser hijacked by massive 1/3 page ads.

We've run a few test campaigns on different networks with this same platform in the past...the results were beyond horrible. What resulted was a backlash against the advertisers, phones ringing off the hook accusing them of putting a virus on people's computers. It was a huge mess.

So, when your phone rings and the sales person says, "The technology is so unique I can't describe it in words. You have to see it." Just hang up, it's Portal Response Technology calling.

Kung Fu Carradine Pimps for Yellow Book

OK I'll admit it...I was a big fan of Kung Fu as a kid. Seriously, who didn't want to walk across rice paper without leaving a print.

But I have to challenge the master with his recent celebrity endorsement of Yellow Book and http://www.yellowbook.com/. The commercial makes three claims that basically amount to, "Yellow Book is your one stop shop for yellow page, online, and search engine marketing." I say, "Pshaw."

Let's break it down:

1. Yellow Book Yellow Page Directory
   While yellow page advertising will remain an important way to reach new and existing customers for a good time, we all have to concede that the value of big books is diminishing.
   


2. YellowBook.com
   I've heard amazing claims from all of the online yellow page sites about their huge traffic, dramatic referrals, large visitor count, etc. On close inspection we usually find that the numbers quoted are for general metrics, like all searches in your city, or nationwide searches for plastic surgery. More importantly, in each of the five major test listings we've run over the last few years there has not been sufficient, demonstrable return on investment to even cover the cost of the listing.
   


3. Yellow Book Search Engine Marketing
   To look at their program, they are reselling pay-per-click advertising at a markup. This is something you can do for yourself, or find for less.

So, to summarize, what you can find with Yellow Book are products that are over valued, over priced, and over the hill.

Spa Medical Directors, Marketing, And a Fish Sandwich

Lunch today was a fish sandwich and the July/August 2007 issue of Medesthetics Magazine. The sandwich was good, but Scott Blair's article covering medico-legal considerations for spa medical directors was juicier.

He's covered different aspects of this same topic in the past. I especially appreciate the practical approach he takes to outlining the issues as they affect doctors.

One aspect I have yet to see covered, although it is quite likely Mr. Blair has touched on this in past writings or one of his lectures, is the inherent risk and potential for disciplinary action with medical spa marketing.

I'm not a JD (nor do I play one on TV), but I do like playing at junior detective and harbinger for ethical approaches to medical marketing. The most common marketing violations we encounter, violations that we have seen trigger disciplinary action on unsuspecting physicians, are related to medical spa services.

If you own, or serve as medical director in a spa, keep in mind that it is your medical license on the line, and that most, if not all of the spa's marketing activities will be measured against your state's business and professions code.

So, following Mr. Blair's excellent example of actionable authoring, here are the issues as I see them:

1. Insist on the right to review and refuse
   Any unsolicited communication coming out of your medical spa, aka your marketing, is subject to the restrictions of your state's business and professions code, in addition to the codes set by any of your licensing boards and professional societies. Reserve the right to review all brochure content, web page text, and advertising to ensure clinical accuracy, absence of hyperbole, and adherence to your state's requirements as they relate to the display of testimonials, price based advertising, and the use of model photography.
   
   In general you will want to make sure that there are no false or misleading claims and that all price based advertising (offers of discount, etc) include all material facts about the offer (such as original price of the service, related costs, restrictions). Several states, such as NY prohibit the use of testimonials in advertising. Most states require you to disclose when an ad contains a model or stock photo.
   
2. Educate your staff
   Make sure that the medical spa manager and staff understand just how important it is that you review all marketing communications. Business managers and aestheticians may not appreciate the cost and consequence of disciplinary action if they act alone and distribute an advertisement that violates state law or another code to which you are subject.
   
3. Know the law
   I'm startled almost daily by how many of our physician clients know little to nothing about the restrictions set by their state on marketing communications. Mr. Blair said it best, "The burden is always on a physician to establish that his or her practice is compliant with applicable medical laws and regulations."
   
   And that does not just mean state code. You must understand what your medical boards and societies expect as well.
   
4. Market like the guy down the street was gunning for you
   I was surprised when I first started working in medical marketing how quick competing practices were to report one another to their state medical licensing board or societies. I have also been startled by painful demonstrations of societies singling out small groups of young doctors for even minor, unintentional marketing violations. I think you are safest to assume that your ad will end up in front of the medical board and then ask yourself, "Can I defend the design, content, claims and offers made in this piece?"

Thanks again to Scott Blair, JD, MIM, for his continuing coverage of medical spa legal issues.

Ambitious Aesthetician

So earlier in the week an ambitious aesthetician in one of our client’s offices decided to execute a small marketing campaign to help boost monthly numbers for the medical spa. And I’m sure it’s right about now that some of you are gasping in disbelief, others are cheering, and still others are wondering how to motivate your own staff to take such bold initiative. Hold on, the story goes downhill from here.

So said aesthetician decides to grab all of the email address in her Outlook and compose a special offer designed to encourage past patients to come in for a touch up treatment. She dumps every name in her contacts folder in to the “To…” line of a message, composes a very short offer that blends text and images in Outlook, and hits send.

Quick, before you read any more, write down at least three laws she just broke, three ways she could harm the practice, and three technical problems with this approach.

I had the benefit of seeing the message, so it was a bit easier for me, but here goes:

1. By including names and email of patients in the “To…” line she revealed the identity of those patients to one another, violating HIPAA


2. Sending unsolicited mail to individuals who had not asked to receive marketing communications violated the Federal Can-SPAM Act of 2003


3. By extending a discount offer for medical services without disclosing all material facts related to the procedure pricing she violated the Medical board of California’s Business and professions code

How could this harm the practice?

1. Clear privacy violations are a great way to hurt your reputation with patients


2. The fines associated with HIPAA violations could run you up to $25,000 per year


3. In the message, she failed to set any restrictions to the offer, so anyone who received the message could demand the offer as many times as they like and for as often as they want

And the technical stuff?

1. Well, she failed to test the message in gMail and Hotmail, so the message actually looked poor and unprofessional in several different email readers


2. Because the marketing communication was not sent in a subscription system, it failed to include the requisite unsubscribe instructions, which both creates a logistics problem and is another violation of the Federal Can-SPAM act


3. By sending a mass, unsolicited marketing message out through the office Internet account, she is likely have the email access for the practice suspended

There are actually many more issues, but I think I’ve made my point. How did you do…were you able to anticipate some of the problems that can be caused by allowing your staff to develop and distribute their own email promotions?

Here are some quick suggestions for an email marketing policy in your practice:

1. Create a written policy that prohibits staff from sending mass email


2. Explain the basic principles of the Federal Can-SPAM act with those staff involved in marketing The message must be labeled as commercial


1. You must include clear instructions on how to opt-out of future mailings


2. You must include your physical address and phone number


3. You may not use deceptive subject lines


3. Review how HIPAA impacts your practice communications, and specifically email




1. You must never reveal personally identifiable patient information (like names and email)


2. You may only send unsolicited marketing messages to people who have expressly requested them


3. You should include a link to your privacy policy in your messages


4. Manage your subscription list carefully, making sure there is no chance you might re-add someone after they have indicated their desire to unsubscribe

Proponderance of Pay Per Lead Programs Popping Up

One of our clients in San Francisco, a facial plastic surgeon found a fantastic new scheduling utility that would be perfect for his practice if using it weren't illegal in California.

The service, found at Genbook.com, is a very slick tool to add a "Schedule an Appointment Now" button to your Web site and your various online advertisements. It does everything you would want from an online scheduling utility. I'll be the first to admit it is one of the cleanest interfaces of its kind (there are several other companies offering similar scheduling services).

Where California physicians need to beware is their pay-per-lead, lead generation model. According to their Web site, participating physicians pay $2 per appointment when the booking is initiated from the physician's own marketing efforts (say from a Web site visitor or existing patient) but as much as $40 per lead when Genbook finds the lead for you.

We've written extensively on the dangers of pay-per-lead programs for California physicians in the past. I've submitted an inquiry to Genbook and I am waiting for their feedback.

PPC - Do it Yourself?

Many of our clients current, or have in the past, run pay-per-click campaigns. It's pretty common that we hear from new clients, "I tried that before, it was a huge waste of money." I agree that when someone without a clear understanding of how the big PPC programs work, and how much they should spend per click without losing money, tries to run their own account, then the obvious outcome is a big goose egg.

So if you are considering pay-per-click advertising as a part of your overall medical marketing plan, should you try to do it yourself? As much as I would like my company to do it for you, you can be successful mananging your own PPC account if you:

1. Check your ego at the door. Ego bidding, insisting on being in the top spot even if that means paying $12 per click, will bankrupt your practice. Know what you can afford to spend to acquire a new patient, figure out about how many clicks it takes to get that new patient, and then don't bid any higher. My recommendation, if you average $5000 per procedure, is to not bid more than $4 per click for REGIONALLY QUALIFIED traffic.
2. Target your region tightly. Sure, people will fly for a procedure with a great surgeon. But those people are few and far between. Spend your precious PPC dollars to target patients in your immediate market. All three of the top search engines, Google, Yahoo, and MSN, can help you only display your ads to people sitting near your practice.
3. Focus tight, scope broad. Start by focusing on a smaller set of procedures and bid on the largest possible set of related keyword phrases. Often you will find you can get away with bidding less for very detail phrases.
4. Take time with the writing. Google in particular will rank your ads higher than someone who is bidding more than you if your ads are clicked more often. Why would someone click your ads over another? If they are well written or suggest an incentive to click, that's one reason. Or, if your name is locally recognized, that's another.
5. Track track track. Make sure your site and lead capture forms are going to signal you when you get new inquiries from your PPC activities. Google offers a free tool that you can add to your lead capture pages to measure conversions!

Of course there is a lot more to it, but if you can master these 5 points you will be off to a great start.

Have a great weekend,

Ryan

Plastic Surgery as Porn

It's a little known fact, but Google thinks most plastic surgery sites are pornographic.

It's true. They haven't talked about it much, but sites that display nude images, even clinical before and after photos, without a warning, may be classified as having "adult content." If your site is assigned this classification, YOUR SEARCH ENGINE RANKINGS WILL SUFFER. It appears that at least Google and AOL are limiting how sites with adult content will appear among their search rankings. If your site is givent his label, it may only, or primarily, be returned when the search is pornographic in nature.

You'd think there would be more talk about this, since Google's adult content filtering has been a problem since early 2003 (see this searchday article).

We originally uncovered the problem with Google's pay-per-click program, adwords. The had assigned the adult content classification to a plastic surgeon we work with, and as a result their ads only appeared when the searches were largely pornographic. As you can imagine, it burned through a lot of money and delivered few high quality leads.

That's why we recommend:

1. Refrain from using nude stock images in your design;
2. If you are showing before and after photos on your home page or procedure pages, discretely place a bar over breasts and genitals; and
3. When you are about to deliver someone to a page that contains nudity or graphical content (such as intra-operative photos) display a polite warning, giving people the opportunity to back out before you fill their screen with nipples or gore.

The idea is actually polite. It allows you to split your site between the content for general audiences, and the content that is best left to adults. In that way you can work with filters that are trying to discourage access to adult imagery, rather than having them work against you.

I Can Still Remember When...

I can still remember when the doctors I spoke with argued with me over the value of the Internet and whether they should be online. While those days are long gone (ok, true, I did have a doc question the value of web sites in general yesterday), some people still don't know how to quantify just how important a web site is in their medical marketing efforts.

Check out this great bit of research from PEW Research Center. Titled Seeking Health Online, author Susannah Fox discusses the extent of Internet users who rely on the Web to research medical information, and the problems associated with the credibility of online health assets.

My favorite quote:

"On a typical day some 10 million Americans now turn to the web for health information - about as many as those who pay bills online, read blogs or look up a phone number or address."

Check out the report for yourself, it is rife with inspiring insights.

Medical Marketing ROI - A No Brainer

So it was a few days back that we had a conversation with one of our clients that went a little like this:

ETNA: "Your online directory listing with [popularplasticsurgerysite.com] is up for renewal. Working with your staff we audited all of the leads generated through the listing, and found that there were 4 confirmed surgical cases. Your confirmed revenue was just over $20,000. The listing cost $7,500 last year."

CLIENT: "That seems like a no-brainer, we should renew."

A no-brainer? [Insert sound of me swallowing my uvula here]

While paying a fee for a referral is illegal in almost every state, return on investment (ROI) analysis for medical marketing is a bit like calculating how much you paid to put a patient on the table. In this case, the math is easy, $7500 resulted in 4 patients, $7500/4 is $1875 per patient.

I know, you're thinking, hold on Ryan, there are the intangible benefits of name and brand exposure and all those leads you can't track, like the people who call the practice rather than using a lead capture form...I'm with you...and we'll get back to that.

Stay with me. My guess is that I would get a very different response than, "it's a no-brainer" from a client if I recommended a new directory service that guaranteed perfect candidates on the table, each willing to pay an average of $5000, for the low low cost of just $1875. For those of you that like the numbers, that's a 37.5% cost to acquire.

So if you're reading this, and you're a doctor, ask yourself now, what would I be willing to pay for a new patient? It's a scary idea, but it's just an exercise in good business. You MUST know that number in order to determine which investments are really no-brainers, and which investments are going to break the bank.

My feeling is that most plastic surgeons who average $5000 in total revenue per case, would be willing to part with about $800 per case (about 15% of that revenue). Does that feel right to you?

So back to our real world example...I promised to return to those unknowns and intangibles. When evaluating directories, we will often give them 100% benefit of the doubt. So if we were able to track 4 cases (and we work hard at tracking lead capture), then we assume there were probably 8 cases in total. That $20,000 in confirmed revenue, we'll take the leap and call it $40,000. But even in that case, we're still talking about $938 per referral...not bad, but when we know there are alternate programs out there that are driving procedures at less than $200 per case...certainly not our first choice.

And as for the "brand marketing" benefits...I can't quantify them (most of our clients don't have the resources for expensive campaign impact research) and therefore I cannot defend their value. For small practice marketing, when your budget is finite, I say go with what you can measure.

Said another way, go with what you can wrap your brain around. I feel strongly that every online marketing decision should be a brainer; carefully considered at first and carefully evaluated when due for renewal.

Using Testimonials in Medical Marketing in NY

It's not often I can get a straight answer from medical boards in various states about their professional codes as they relate to medical marketing, but New York has proven a helpful exception. Despite the fact that is common to see testimonials in medical website design for New York plastic surgeons, it is not allowed.

In New York state, physicians are governed the New York State Education Department's Office of the Professions. And when it comes to marketing, the code to be concerned about is Article 131-A, Section 6530.27. You can see the full text on at http://www.op.nysed.gov/article131-a.htm. Unlike California's business and professions code (which reads like VCR instructions back in the day when technology was confusing), the language is plain: "Advertising or soliciting not in the public interest shall include, but not be limited to, advertising or soliciting that:
uses testimonials."

So, if you are a physician, physicians assistant or medical specialist in NY, bottom line, no testimonials should appear in any advertising. And while I am reaching out on a limb here, I would also guess that real patient stories that quote a patient are frowned upon.

Inaugural Post

I'll make this first post a quick one. It's 1:30 in the morning and I'm all hopped up on green tea. For those of you who aren't yet acquainted with my obsessive habits, here's one of them. I read like a fiend, and when I'm reading magazines (my favorites include Business 2.0, Entrepreneur, Cosmetic Surgery Times, and anything left in the pocket of the seat in front of me on an airplane) I tear out pages.

It may be an idea for business innovation, new staff benefits, marketing tactics, or whatever catches my eye.

Then, when I happen on a sleepless night or a quiet moment, I'll pull together all those piles of torn out pages and start re-reading them. Going through the stack tonight I happened on an old article by Paul Sloan in Business 2.0 on blogging tips.

His list of seven recommendations, and I think this would be helpful for any doctor considering a blog of their own, was:

1. Focus on a narrow niche
   My focus is online marketing for the medical industry
2. Set up the blog so that each post gets a permaent URL
   blogger does that automatically for me
3. Think of the blog as a database
   My goal will be to make 3 posts a week, drawing inspiration from my daily calls with my surgeon-clients
4. Blog frequently and regularly
   See point 3
5. Using striking images
   That may be tough given the less than visual nature of most of my craft
6. Enable comments
   Check
7. Make friends with other bloggers
   I guess that would be better than making enemies

That's all for tonight. Sweet dreams everyone.

Ryan

http://www.etnainteractive.com