AAOS Now

Published 6/1/2013
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Bill Champion

The Average Return on “Marketing” Is Negative

Focus on internal, external communications, not promotion

Why does a profession that relies on research and data to correctly diagnose, treat, and manage patients so rarely use research and data to plan, execute, and grow the practice? Consider the following studies.

The first study looked at market research for 137 orthopaedic practices over a 12-month period. Practices had from 3 to 38 doctors, in all practice settings from all regions of the country. The study evaluated awareness levels of the general population with regard to a specific orthopaedist as well as how likely people were to prefer or choose a specific orthopaedist.

Although market size affected awareness and preference levels, the study found that, for every four and a half people who either knew an orthopaedist by name and/or had heard of a specific orthopaedist, only one person indicated a preference for that doctor.

This study shows that patients don’t need more choices, nor do practices need increased awareness levels. What patients need—and what practices need to give them—is help choosing. It isn’t about being louder or reaching more people; it’s about being more compelling to the right ones.

The second study involved 27 orthopaedic practices and more than 4,000 patients. Each patient was asked who or what influenced his or her decision to seek care, and each practice was asked how it allocated financial resources to influence patient choice. Researchers found that practices were allocating 68 percent of their financial resources to advertising and sponsorships—but less than 1 percent of patients identified advertising and sponsorships as having any influence on their choice. On the other hand, practices spent 18 percent of their financial resources on current patients, primary care, sports medicine, and workers’ compensation combined—areas that influenced 91 percent of new patients.

Target and deliver
What most practices don’t understand is that communicating effectively to select target audiences with the appropriate message is more effective than broad appeals. Less than 1 percent of the population will need musculoskeletal care this month, and no newspaper, radio, or television station will reach them effectively and economically.

Unfortunately, each year, practices get hundreds of proposals to advertise and sponsor. A practice that says “yes” to even a quarter of these “opportunities” will need a dedicated staff person just to manage the requests and the subsequent details. What is being sold is almost never what a practice needs; even worse, these activities distract both time and attention from what might actually help.

For example, even though they are the least clinically qualified to make a referral, current patients are (or should be) a practice’s largest referral source. So how can the practice persuade them to recommend future patients?

In almost all cases, patients are influenced more by their experience and perception of soft skills throughout their experience than by the hard technical skills of the surgeon. Patients don’t go home and praise a wonderful shoulder exam. What they do remember is how they were treated, whether they felt respected, and how the service ranked in comparison to their expectations.

An average orthopaedic practice generates roughly 40 percent of its new patients from previous patients, yet some practices generate more than 65 percent of new patients from this group. The value of running a practice that engages patients at this higher level is critical. The practice spends less to grow because current patients are already doing that, and is less vulnerable to the whims of primary care and carries a bigger stick when it comes to negotiating payer contracts.

Similarly, the number-one visitor to a practice’s website is a current patient. Current patients, having gained an understanding of their condition and treatment options, are now far more motivated to learn more about the problem and the necessary steps to heal.

But new patients may go online only to perceive that their procedure would be best performed elsewhere. It is not uncommon for a surgery candidate to go online and be influenced by better-positioned practices, online rating sites, or other online resources that more closely align with the patient’s expectations. If a practice is not involved in effectively communicating and managing the right messages online, it is vulnerable. The practice website doesn’t have to be the nation’s best, just better than any other one in the market.

Communication is harder
Practices need to focus less time, talent, and money on advertising or sponsorships and significantly more on communicating effectively. Effective communication requires thinking and acting differently. Communication starts with the very first impression, such as how the phone is answered, and involves every aspect of the practice and the patient experience until well after the last postoperative visit. It involves everything that everyone in the practice does and will affect everything a patient will say.

From the moment a patient walks into the office, he or she will get a message about the practice from the perception of the space, the employees’ demeanor, even the furniture. When a patient waits an hour with no update from the front desk, he or she gets the message “you’re not important.” When a patient has a great clinical outcome but never receives any follow-up, the patient gets the same message. The entirety of these messages creates an experience that the patient will communicate to friends, family members, and coworkers.

The very best practices look at every possible communication opportunity and find ways to ensure that effective messages are being communicated to the appropriate people and in the right manner.

Orthopaedic practices need to stop selling and start helping patients and referral sources find them as the right choice for care. More effective communication means differentiating the practice in the market by communicating what the practice does and how it is done in ways that are meaningful and memorable to potential patients. A practice becomes just another commodity only if it acts and communicates like everyone else.

Effort and talent have provided you with the opportunity to work in an admirable occupation that is as honorable as any. Don’t diminish your work or your profession by selling yourself like a candy bar—especially when the research and data prove that it rarely pays off.

Bill Champion is the president of Venel, a research and communication firm founded in 1989 that focuses exclusively on orthopaedics. He can be reached at Bill@Venel.com