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.