Like so many other business processes, marketing implementation is far more successful when a practice executes a solid marketing plan with the support of a structured system.
"If you fail to plan, plan to fail." Everyone's heard this saying, yet so few healthcare practices follow this sound advice when it comes to marketing.
Everything begins with a well-conceived strategic marketing plan. If you don't already have a marketing plan or it isn't current, this is where you begin to build your marketing system.
See What Is a Marketing Plan? for extensive details on best practices for developing a powerful plan.
The quality of implementation of a marketing plan is certainly as critical as the quality of the plan itself to the chances for a successful outcome.
While the success formula here may not exactly correspond to the Thomas Edison quote that "Genius is 1% inspiration and 99% perspiration," it is clear that effective implementation of a well conceived marketing plan is at least half the battle. Dramatic differences in the outcome of similar or identical marketing strategies and plans, executed in similar or identical situations, reinforces this reality.
If a practice has not previously developed a marketing plan, it's very likely that no implementation system exists. If you are instituting your first such implementation system, you first want to develop a checklist to account for everything you will need.
A checklist for marketing implementation will usually include:
- Identification and assignment of internal and external resources, including tasks and responsibilities
- Design of the marketing calendar, including critical deadlines and milestones
- Development of campaign concept or theme, positioning, and, for some practices,
even core brand identity and unique value proposition
- Media plan development (if external media is part of the plan)
- Development of marketing materials, ads, etc.
- Development of testing model
- Development of tracking protocols and forms
- Staff orientation and training (as necessary to support the marketing plan and implementation plan)
- Evaluation and adjustment protocols and timelines
Resources include internal resources that can be identified within the practice as well as external resources that must be found outside of the practice.
• Personnel (providers and staff)
• Computers and software owned by the practice
• Applicable or adaptable forms and materials
• Funding from within the practice
• Printing Vendors
• Supplies Vendors
• Media sources and companies
• Marketing Consultants
• Management Consultants
• Public relations Consultants
• Financial advisors
• Advertising Agencies
• Graphic Designers
• Web designers and/or webmasters
• Media planners and/or media buyers
•External funding sources
Once you have researched and identified your resource options, you will need to select and assign various marketing implementation tasks and responsibilities among a group of these resources. In some situations, one internal or external source may be able to provide multiple resources that are required for successful implementation.
While each practice needs to assign a primary internal oversight and management responsibility for the successful implementation of the marketing plan, this does not mean that one person should be expected to individually perform all of the necessary tasks and functions required to support the plan. Successful marketing is a coordinated and well-organized team effort, consisting of internal leaders and supporters as well as external resources, guides and experts as required for each individual plan.
The marketing calendar includes the organizational deadlines and milestones that must be met in order for the marketing plan to stay on schedule and on course. If you are working with external resources to help you with your implementation plan, you will find that one or several of these sources will be able to help you develop, define and organize your marketing calendar.
The marketing calendar may be co-managed by internal and external practice resources and people, but there should always be one person internal to the practice that holds the primary management oversight responsibility for maintaining and updating the marketing calendar on an ongoing basis.
A marketing plan is designed as a synergistic and complementary combination of strategies and tactics that are intended to work together for exponential positive effect. Therefore, when a marketing plan is executed, it is common for one of the early activities to be the development of the central unifying theme or concept of at least the initial marketing campaign.
For example, the famous, award-winning and long-lasting "Got Milk?" campaign is an ideal example of a marketing and advertising campaign concept/theme that became so successful that it evolved into an actual trademarked brand for the entire dairy industry.
Initially launched in 1994 by the California Milk Processor Board, this simple yet incredibly creative concept has permeated the consciousness of milk-drinkers and non-milk-drinkers alike. The print ad and billboard campaigns featuring celebrities with milk mustaches has been an ongoing success for many years, and their hilarious television commercials have won numerous industry awards while contributing to a 90%+ awareness rating.
While most campaign concepts or themes will perhaps not be as unique, creative or effective as the "Got Milk?" campaign, this is a great illustration of how a marketing campaign can create powerful market awareness and, in some cases, even be the basis for a brand identity.
Of course, small businesses don't have the advertising budget of the dairy industry or even the California Milk Processor Board, but that is even more reason to define a strong and unique campaign theme that has a better chance to be noticed among the clutter of marketing information that we all experience.
A marketing campaign should not be confused with a practice branding strategy or positioning niche, but these concepts all need to be well defined and working together in a complementary fashion.
Media plans and Media Buyers
If your marketing plan includes the use of one or more external media channels - including newspaper advertising, radio advertising, television advertising, Internet advertising, billboard advertising and more - you will benefit greatly from the development of a professional developed media plan.
Here's how many practices handle their media expenses. The person in charge of the budget starts saying yes to the salespeople who call. Advertising appears here and there as a result. When the budget's gone, the person in charge starts saying no, and the ad campaign is over. It's a method, but you wouldn't call it a media plan. And if that approach sounds familiar, you can bet you're passing up opportunities to maximize your return on investment.
Media planning is the process of choosing a course of action. The media plan guides the execution of the media activities throughout the plan period. Based on the marketing plan, a media planner will typically develop an annual plan that lists each media outlet- print, broadcast, outdoor and more recently, Internet. In some cases, the media plan will be developed for one specific campaign. Planning then gives way to buying, as each separate contract is negotiated, then finalized.
In developing your media plan, the following steps should occur:
- Review of your marketing objectives within the specific context of media planning
- Review of the available media options
- Evaluation of media options against your objectives
- Setting minimum and maximum budget constraints
- Creation of alternative scenarios until the best strategy is determined that accomplishes your objectives within the defined media budget parameters
- Development of a schedule describing ad appearances in each medium
- Plan summary in the form of a calendar and a budget
- Negotiation with media representatives to execute your plan
A media plan is generally organized as a document in sections. The sections of a typical media plan may include:
- Media outlets (newspapers, magazines, radio stations, TV stations, outdoor sign companies, Internet advertising channels, etc.). This section lists all of the media in which advertising will be placed.
- Goals. This section describes the goals of the advertising (a subset of the marketing plan), and explains why and how this plan meets these goals.
- Target Audience. In this section, target audience information is presented. Information in this section might include statistics by demographics or lifestyle.
For more information on this subject, see Target Marketing - Establishing Target Customers.
- Media strategy. The media plan will include a statement of strategy backed up by a rationale. The action steps described here will guide a year's activity.
- Media budget and calendar. Your media plan will outline what money is to be spent where, and when. Over time, media plans provide a history of your advertising. If alterations are made to the media schedule in the course of the year, those changes are recorded in the media plan.
Media Planners and Buyers
There are both large and small media buying companies and prices seem to range pretty significantly. Media buyers can often help to provide good exposure results for your business. If you can afford it and can locate a media planning or buying company who is willing to work with a small business, this approach is well worth investigating.
Unfortunately, most media companies prefer to work primarily or exclusively with large businesses that have large media budgets. However, even if you have difficulty locating a media planner or buyer who is willing to take you as a client, it is valuable to have the insights on the media buying process, even if you have to manage the process yourself.
Media Advertising Costs
Advertising prices are usually based on the number of readers, viewers, listeners or online visitors that can be delivered by the media source in question.
For example, many publications will quote you a circulation figure based on paid subscribers. The audited circulation figures are verified by monitoring organizations. The publications will try to convince you that actual circulation is higher by including the free copies they distribute and the pass-along readership they claim. Sometimes these claims of "bonus" circulation are valid--for example, magazines distributed on airlines get at least eight readers per copy. Still, you should be wary of inflated circulation figures.
Audience is the equivalent of circulation when you're talking about broadcast media. Audience size varies throughout the day as people tune in and tune out. Therefore, the price for advertising at different times of day will vary, based on the audience size that the day-part delivers.
Penetration is generally related to circulation. Penetration describes how much of the total available market you are reaching. If you are in a town with a demographic count of 200,000 households, and you buy an ad in a publication that states a circulation of 140,000, you're reaching 70 percent of the possible market--high penetration. What degree of penetration is necessary for you depends on whether your strategy is to dominate the market or to reach a certain niche within that market.
Reach and frequency are key media terms used more in broadcast than in print. Reach is the total number of people exposed to a message at least once in a set time period, usually four weeks. (Reach is the broadcast equivalent of circulation, for print advertising.) Frequency is the average number of times those people are exposed during that time period.
To make reach go up, you buy a wider market area. To make frequency go up, you buy more ads during the time period. Usually, when reach goes up, you have to compromise and let frequency go down. You could spend a lot of money trying to achieve a high reach and a high frequency. The creative part of media planning comes in balancing reach, frequency, and budget constraints to find the best combination in view of your marketing goals.
In the world of Internet marketing, media advertising costs are most commonly determined by CPC or "cost per click" where the advertiser pays only if an Internet viewer clicks on their ad. However, the cost that an advertiser will pay "per click" can be determined by a variety of factors.
For example, most Internet advertising goes to and through Yahoo! and Google www.google.com, the most commonly used and visited search engines.
Google offers a program called AdWords, where the cost of your Internet ads and campaigns depends on how much you're willing to pay and how well you know your audience. There is a nominal, one-time activation fee, after which you pay for clicks on your keyword-targeted AdWords ads, which you control by telling Google how much you're willing to pay per click and per day.
Google also offers a program where you can place ads on other web sites that are part of Google's AdSense program. How much you pay "per click" to advertise on another site depends on CPM (cost per thousand impressions) delivered through that site.
Yahoo! offers a program called Sponsored Search. This is essentially an online auction model, where you set the price you're willing to pay for each customer who clicks on your listing. You pay only for the interested customers who actually click through to your site, but your site will come up in the Yahoo! search result rankings based on your price-per-click offer compared against other advertisers who bid for the same search keywords.
Regarding web site popularity, there are various ways to measure exposure. One of the ways that Internet exposure if measured is by "opportunities to see" (the equivalent of circulation figures in print publications and Nielsen viewership data for TV broadcasts). Many press clipping and news monitoring services provide media measurement data on Internet sites.
Additionally, web sites such as Alexa www.alexa.com (owned by Amazon.com) www.amazon.com provides traffic rankings of sites visited.
Alexa statistics are generated based on visits from Alexa users (people who have installed the Alexa plug-in in their system) and are useful for comparative study, but because Alexa's user base is very large, this site is still a very good representation of relative web traffic.
Alexa's traffic rankings are based on the usage patterns of Alexa Toolbar users over a rolling 3 month period. A site's ranking is based on a combined measure of reach and pageviews.
Reach is determined by the number of unique Alexa users who visit a site on a given day. Pageviews are the total number of Alexa user URL requests for a site. The site with the highest combination of users and pageviews is ranked #1. (In case you're curious, the #1 ranked site on Alexa is Yahoo! www.yahoo.com.)
CPM stands for Cost Per Thousand (M is the Roman Numeral for thousand). This is the term you will probably hear most often in reference to measurement of media buying power.
CPM analysis is the method media buyers often use to convert various rate and circulation options to relative terms. CPM represents the cost of reaching one thousand people via different types of media. For example, in television advertising, CPM measures cost per thousand viewers, in radio advertising, CPM measures cost to reach one thousand listeners, while in Internet advertising, CPM refers to cost per thousand "impressions" (i.e., "sets of eyeballs") on an Internet ad.
To calculate CPM, you find the cost for an ad, then divide it by the total circulation the ad reaches (in thousands). By finding this information and calculating this cost for each of your options, you can give them a numerical ranking for comparison. CPM is a basic media concept.
CPL stands for Cost Per Lead. This measurement is the calculation of cost of advertising divided by the number of leads generated. Some businesses and media buyers believe that cost per lead or cost per sale are more meaningful measurement criteria than CPM.
In Internet advertising, for example, a lead is defined as the successful completion of the advertisers Lead form (hosted on advertiser's or publisher's site).
PPL stands for Pay Per Lead - This term is interchangeable with CPL.
CPA stands for Cost Per Action or Cost Per Acquisition. This is essentially the same as CPL/PPL. The advertiser only pays when a desired action is achieved or acquisition is achieved.
CPC stands for Cost Per Click. CPC is exclusively an Internet advertising term. In this model, web site publishers are paid for every unique click that delivers a consumer to the advertiser's site. Regardless of what that consumer does on the advertiser's site, the click is still paid.
CPS stands for Cost Per Sale. Media plans won't use CPS as a planning tool because the media planner has no control over sales performance or predictability of sales that will be generated.
However, to the degree that it can be accurately measured by a specific business, CPS is probably most meaningful tool for the business owner to evaluate advertising effectiveness because the advertising costs are measured against bottom line sales results. This method allows for a more accurate calculation of gross return-on-investment ROI for the advertising (prior to subtracting the cost of providing the product and/or service sold).
Of course, if the advertising is delivering plenty of qualified leads that are not being successfully converted into enough sales, new patients, etc., then the practice owner needs to evaluate internal sales and/or case presentation effectiveness and possibly devote additional time, attention and marketing budget toward sales training, case presentation training or customer service training.
Marketing materials should always be developed with a focus on the specific practice branding strategy and positioning. You don't successfully differentiate your practice by marketing your profession, your specialty, your products or your services in a generic manner. You win the marketing game by promoting your specific practice and your uniquely branded programs, services and products.
Some of the tangible marketing materials required to support a new marketing plan may already exist in the practice. However, in most cases, new marketing materials will need to be conceived, developed, written and designed (and sometimes printed) to support the new plan and campaign concept.
Depending on the specific plan, marketing materials may include:
• Other promotional literature
• Web sites
• Stationery Systems
• Marketing Bios
• In-Office Branded Marketing Posters
• Direct mail advertising
• Newspaper ads and magazine ads
• Yellow Pages ads
• Radio commercials
• TV commercials
• Movie theater advertising
• Internet ads and banners
Marketing is an ongoing process of testing new concepts, ideas and campaigns in order to keep improving your marketing system, maintain a current and fresh appeal to your audience and stay ahead of your competition and market changes.
The process of testing new marketing usually includes establishing a testing model. Depending on the strategy and media being tested, the testing model may be constructed as a matrix.
Example: Direct Mail Testing Model
Proven direct mail models consistently indicate that the fastest and most cost-efficient way to determine an optimal direct mail strategy is to conduct comparative tests as quickly as possible of the three elements that impact direct mail results:
3) Creative approach
The number of "splits" built into your direct mail matrix determines how quickly you learn and apply results from your testing model to greater effect in the rollouts of successful tests.
In an ongoing, consistent direct mail program, there is always a "control" package to which new tests are compared. In the case where direct mail has not been implemented with enough consistency or comparative testing to develop a credible control package, the initial tests would serve the dual purposes of generating leads while hopefully allowing a control package to emerge from the initial tests, based on which test cell achieves the best results.
Testing can be conducted to test one element at a time (such as list or offer) or multiple elements simultaneously. If there is no control to test against, it would be ideal if multiple elements are simultaneously tested to allow a strong control package to emerge more quickly (while also generating more leads early on in the process).
Note: It is a generally accepted direct mail principle that 5,000 pieces of mail is the minimum to test for any specific test cell. This number is based on both the minimum purchase that many list companies require as well as a number high enough to yield meaningful results that can be utilized for establishing a rollout (expansion) mailing schedule based on results of the tests.
For example, if you send out one creative piece from one list and divide it into three groups to test 3 different offers, the test cell matrix might look like this:
List Offer Creative Results
Test Cell 1 (5,000) A 1 A
Test Cell 2 (5,000) A 2 A
Test Cell 3 (5,000) A 3 A
The limitations and challenges of this limited type of test emerge from a limited amount that you learn from the results. For example, you may learn that Offer 2 generates more leads than Offer 3 but less than Offer 1. However, you will not learn whether a different list or different creative approach might have yielded a higher response for ALL the tested offers.
What if all the offers in the above matrix tested poorly? Does it mean that the offers are all invalid or could the problem be that the tested list is not very good? Or maybe the list and offers are valid, but the creative approach doesn't test well, thereby skewing the results of the offers and list being tested.
Assuming that there are 3 initial offers to be tested (which would require a larger budget commitment), a much better initial testing matrix would be to test the three offers against two different lists and utilizing two different creative approaches - all tested simultaneously.
The test cell matrix in this recommended model would look like this:
List Offer Creative Results
Test Cell 1 (5,000) A 1 A
Test Cell 2 (5,000) A 1 B
Test Cell 3 (5,000) A 2 A
Test Cell 4 (5,000) A 2 B
Test Cell 5 (5,000) A 3 A
Test Cell 6 (5,000) A 3 B
Test Cell 7 (5,000) B 1 A
Test Cell 8 (5,000) B 1 B
Test Cell 9 (5,000) B 2 A
Test Cell 10 (5,000) B 2 B
Test Cell 11 (5,000) B 3 A
Test Cell 12 (5,000) B 3 B
Each test cell is coded with a differentiating source/response code so that results can be easily and accurately measured (assuming that your call center is capturing source/response codes from all respondents).
Tracking and measuring success
Your marketing plan will only be as effective as your process for tracking results and measuring success.
A good tracking system for your practice would include:
- Tracking codes (sometimes referred to as source codes) assigned to each ad or marketing activity that could generate a tracked response
- A customized tracking form based on your marketing campaign activities
- A communications model and training for employees or outside call center assigned to capture tracking information from respondents
Tracking codes - Source codes
A tracking code or source code is a way of helping you more easily identify the specific source of marketing that produces each specific response. Obviously, the more accurate your tracking information, the more accurate your profitability analysis will be for each marketing expense.
In some cases, you will not need specific tracking or source codes. For example, if you are only running one newspaper ad and the caller says they are calling because they saw your ad in the newspaper, you know which ad they saw.
However, if you are running a newspaper ad series with different ads at different times (and maybe in different newspapers) presenting different subjects or aspects of your practice, it is easier to ask the caller for the tracking code at the bottom of the ad than to go through a more extensive Q&A to determine which ad they saw in which publication on which day.
For example, you may have a 3-ad series, in which you code the ads as simply as "1," "2" and "3" in small print in a lower corner of each ad. The source code could be made even more specific if the ads are running in more than one newspaper. If you run ads in both the Gazette and the Times, you could code the ads appearing in the Gazette as "G1," "G2" and "G3" while coding the ads in the Times as "T1," "T2" and "T3."
Sometimes the tracking or source "code" is actually a specific phone number that is promoted exclusively in conjunction with a particular medium, ad or campaign. If you don't have enough phone lines in your office to assign or add a phone number specifically for this purpose, you can buy an inexpensive cell phone with a "pay as you go" plan that will accomplish this purpose. When that phone rings, you know the source.
The tracking form could be a direct output from your computer software records system if you create new patient records at the time of the initial phone call. Some software programs include customized data fields for tracking new customers as well as customizable report formats that organize the data by whatever means you wish to review it. Most programs have customizable fields that can be adapted for this purpose if they don't already exist.
However, most practices don't create a new record until a new patient either makes an appointment or (in most cases) not until the new patient's initial office visit. This process can leave a gaping hole in an accurate tracking model. Here's why.
In an optimal tracking process, you want to capture all responses, not just those who made and kept appointments. Why? Because the callers who did not make appointments still called you. And they wouldn't have called if they weren't interested in what you have to offer.
If a caller doesn't make an appointment, it could be an indicator (at least to some degree) that your phone staff may need better scripting and/or training on how to respond to the caller's questions and issues.
If you only track the callers who make appointments, you don't necessarily learn how many people really responded unless they all made appointments - which is rare, particularly if you are doing any external advertising.
A comprehensive tracking form allows for capture of all calls, not just appointments. It also allows for recording of the source of each new caller, including tracking code or source code if applicable.
If necessary to achieve the highest degree of accuracy or if your staff does not open a new record at the time of an initial call, the tracking form can be created as a manual form kept near the phone(s) in the practice. The tracking data can be transferred at a later time into your practice software program.
Depending on the marketing strategy and approach, some responses might be received in other forms than by phone. If you give your audience the option to fax or email a response, you may receive some responses through these channels. Depending on the type of practice, you might even get some walk-in responses. ("I saw your sign and I just decided to drop in.")
All of the data still needs to be incorporated into your tracking system, no matter how it arrives.
Important information to capture includes:
- Name of caller
- Date of call
- Tracking source (including source code, if applicable)
- Appointment made (yes or no)
- Reason for call (problem, need or desired product or service)
If you have either created a column for each category on your manual form or a field for each category in your software program, your staff will be much more efficient in quickly and accurately recording the information.
Prior to the launch of any marketing campaign or program, your office staff should be fully informed and trained on how to anticipate and respond to frequently asked questions that are most likely to be raised by people who are responding to your marketing.
The staff should be given copies of any and all ads, new marketing materials and any other relevant information that they need in order to know what is being communicated through the marketing campaign and how to best handle responses.
The training process might include a special phone script that includes the important benefits of your practice and/or program as it relates to the marketing campaign. The script would also include best answers for anticipated questions that callers might raise.
In order to have staff feel comfortable working with such a script, you may want to engage is some role playing through simulated "rehearsal" calls prior to the launch of the campaign.
Basic construct of the phone script sequence should include:
Don't overcomplicate the conversation. Answer questions in a friendly, helpful, positive manner and tone of voice.
Keep steering the conversation back to taking an action (making an appointment) so the patient can have their problem solved, need addressed or desire fulfilled.
If a caller doesn't make an appointment, it could be an indicator (at least to some degree) that your phone staff may need better scripting and/or training on how to respond to the caller's questions and issues.
This is not uncommon among practices that do not have much marketing experience because the office staff of these practices is used to new patient callers making appointments without questions because they have already been referred by someone they trust. The most common question that these "pre-sold" callers usually have is "When can I get an appointment?"
Callers who respond to advertising are not "pre-sold." Yes, they are interested or they would not have called. But they are also somewhat guarded, even skeptical that you are as good as your advertising makes you appear. That is because we have all had too many disappointing experiences with inflated advertising claims from companies and products that don't deliver on their promises.
Callers responding to advertising often have a series of questions that office staff may not be experienced in receiving or handling. These callers want to be convinced but they also need to be convinced that you are the "real deal" and that you are as good as your advertising claims. You have to work a bit harder to earn the caller's trust.
Compile a list for of the most frequently asked questions and sales "objections" raised in conversations with prospective patients. Then write up the best responses, using simple, easy-to-understand benefit-oriented language.
Some sales objections are obvious. If the caller is responding to a cash service that is not covered by their insurance, you might get a response such as "Gee, it sounds really expensive..."
Your script should be able to have an anticipated pre-scripted and practiced response, such as...
"I understand how you might feel that way. In fact, that's what some of our happiest patients felt at first. Of course, many of them are now (fill in desired outcome), so in hindsight, I'm sure they found it was well worth it to invest in themselves. Besides, we offer a host of different payment options to fit different budgets because we're committed to helping patients achieve their goals and their dreams. Maybe we should discuss those options right now. Would that be helpful?"
Make sure you can distinguish questions from objections. Some objections may be expressed as questions or requests, so you have to be able to read "between the lines" to sense if it is really a question or an objection.
For example, someone might ask,
"Can you mail me a brochure or some information on your practice?"
This sounds like a legitimate question, but it's usually really just a delaying tactic from someone who doesn't really want to make a decision or commitment. What they really want to do is get off the phone.
To determine if this is a legitimate question or a hidden objection, you could follow up this request in the following manner:
"Of course I can send you information, but since we are on the phone together now, I would be happy to answer any question you might have. What specific information are you hoping to learn from our brochure?"
If they hem and haw and say, "Well, it's not one thing in particular blah blah blah," then you can reasonable assume you are dealing with a hidden objection. One possible follow up question at this point could be...
"By the way, have you visited our website yet?"
Regardless of whether the prospect responds with "yes" or "no", you have opened a new path of discussion.
If they say "no", you can invite them to go online right now while you are on the phone with them and you can talk them through a visual and verbal "virtual tour" of your practice. If they decline or make an excuse about not being near a computer, you can still invite them to visit the site on their own, but you can probably assume they just want to get off the phone.
If the prospect says "yes" to having visited your website, you can ask them what questions they hope to learn from your brochure that they couldn't find answers from visiting your website. If they say they "can't remember", you could invite them to revisit the site with you now, and give them the verbal virtual tour if they like.
Again, depending on their response, you will know if they are seriously interested in understanding more in order to make a good decision, or if they just want off the phone.
Marketing is a dynamic process that is constantly evolving. Increasing marketing success and profitability over time comes from constant adjustments in the plan, based on "pushing" your marketing "winners" and "cutting" your marketing "losers."
It is difficult or sometimes impossible to differentiate your marketing winners from losers if you don't have a good system for tracking and measuring success of your marketing plan and activities.
A review of marketing plan performance should be conducted at least quarterly throughout the year. Marketing results may be reviewed even more frequently (usually monthly) for decisions that may require a more real-time evaluation.