Tony Mork, MD.

AAOS Now

Published 11/1/2015
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Eeric Truumees, MD

Doctor, Market Thyself

A few months ago, I received a copy of "Medical Marketing Demystified: Leverage the Internet to Grow Your Practice in 5 Easy Steps" by Dr. Mork is an orthopaedic spine surgeon and AAOS member. His book, published in 2014 by Krome Publishing, seeks to educate orthopaedic surgeons on the importance of a sophisticated online presence and offers some tools to help them get there.

I came to the subject a relative novice; although my current and previous practices have used online and marketing consultants, I was not deeply engaged in the process. Also, admitting my biases up front, I am of two minds with this material. On the one hand, my mentors were "old school" surgeons who expressed some distaste for aggressive marketing and self-promotion. Their view was that your clinical and academic reputations should speak for you.

On the other hand, I recognize that times have changed and health care is rapidly evolving. In a highly mobile society with narrower provider networks, word of mouth does not seem to carry the same weight. Still, I've always, and probably inappropriately, seen aggressive marketing as a little "cheesy." Dr. Mork sees things differently when it comes to marketing: "You must take action ... the life of your practice depends on it." Depending on your practice situation, he may be right.

Medical marketing demystified
Dr. Mork's concise book offers 90 pages of large type. It has lists of services that can help an Internet novice pursue more visibility. The six chapters align with the course modules on Dr. Mork's website (MedicalWebsiteAcademy.Com). However, I was not able to sign up for individual course modules and did not purchase the course itself. A "Medical Marketing Demystified Live Workshop" sells for $1,595.

The first chapter, "Your Website—The Game Leveler," walks readers through the purpose of a medical website. According to Dr. Mork, even solo practitioners can have the web presence and appearance of huge institutions like the Mayo Clinic. He decries the vanity or brochure website that merely shows a picture of the office and lists the doctors and their credentials. He suggests that offering free education to the prospective patient is a better way of introducing yourself and gaining the potential patient's trust. He notes that many excellent website developers do not know much about medical marketing, so their "slick" websites rarely generate measurable results.

The chapter also includes a discussion of website front-end and back-end mechanics, the impact on potential patients' ability to find you on the web, and the likelihood of patients' staying on the site once they land there. Critical issues include layout and the use of plain English to address patient problems before delivering your solutions, credentials, or expertise. This chapter, as do all the others, ends with a short list of practical "action steps."

The second chapter, "Medical Website Components," contends that the best marketing lies in patient education. He discusses the importance of video, noting that production and upload costs are negligible. Dr. Mork exhorts readers to keep website material fresh with blogs or newsletters. Excellent advice, no doubt, but possibly too much for the busy orthopaedic surgeon. Even the suggested team approach may not be sufficient, as Dr. Mork's own websites show. For example, the most recent newsletter on his website (EndoscopicSpineNewsletter.com) is dated March 2014.

Chapter 3, "Acquiring New Customers," shows readers how to drive traffic to a practice's website and then to the practice. According to Dr. Mork, two basic strategies to attract visitors are paid advertisements (on search engines and other sites) and organic growth through search engine optimization.

He emphasizes the selection of proper keywords to drive the right kinds of patients to the practice. Dr. Mork offers very practical advice on this process and recommends some helpful online tools (Google AdWords, for example). He urges readers to measure the impact of on- and offline marketing efforts by asking patients how they found the practice. He also discusses the importance of linking the practice website to other online activities, such as YouTube and Facebook.

In chapter 4, "My $1.8 Million Mistake," Dr. Mork discusses ways to monetize a list of previous patients and online contacts. He uses the example of his 3-hour, multimedia back pain relief educational product ($147). He notes that if he could sell this product to even 1 percent of the people on his list, he could make more than $1.7 million. The chapter discusses how to build such a list and to keep patients and contacts abreast of the practice and its products through email marketing platforms.

In chapter 5, Dr. Mork teaches readers how to "Use Your Website to Generate Sales." He points out that, although tremendous resources can be found on the web, we, as orthopaedic surgeons, have expertise that enables us to digest and package musculoskeletal health information in ways that can be sold online. This chapter includes examples of these products as well as the idea of adding a "shopping cart" to the website.

The last chapter, "Benefits without Headaches," iterates the importance of having an interactive, "live" web presence and using web specialists who can assist with the technical aspects of this endeavor. It's followed by a glossary and list of useful online services.

How far should we go?
Although this book focuses on web marketing, it did get me thinking about marketing more generally.

First, I am still a bit in the dark about how to develop an overall market strategy. In addition to online tools, medical marketing may include ads in phonebooks, magazines, and newspapers; radio and television spots; direct mail; flyers; billboards; and paid physician directory entries. A marketing strategy, I'm told, should include attention to a logo and common design elements in letterhead, envelopes, business cards, referral forms, office forms, appointment cards, brochures, pamphlets, and signage.

I have also reflected on how far we should go in marketing our practices to the general public. Some practice websites, including Dr. Mork's, adopt an aggressive stance toward certain procedures. Others tout the benefits of questionable treatments. Some make unfounded claims—both positive and negative—about the results of various surgeries.

To me, this is negative campaigning. I am certainly not the arbiter of what's true and correct in spine surgery (or anything else), but I am concerned about marketing efforts that actively denigrate accepted clinical practices. This type of medical marketing can simply confuse patients, especially when it comes from a board-certified orthopaedic surgeon.

I recently spoke with Andrew Glassman, MD, chair of the Ohio State University department of orthopaedic surgery. Dr. Glassman noted that the way outpatient total joint arthroplasty is promoted often leaves potential patients with an unrealistic set of expectations regarding their own postoperative recovery and need for rehabilitation. Many spine surgeons are frequently asked about "laser surgery," which patients have read about or seen on the web and in other media outlets.

A more prominent example may be Columbia University cardiothoracic surgeon and television personality Mehmet Oz, MD. In a recent Medscape video, Arthur L. Caplan, PhD, director of the Division of Medical Ethics at New York University's Langone Medical Center, discussed the pushback Dr. Oz has faced from the medical community for endorsing "many 'magic' remedies and 'miracle' cures for which there isn't much or any medical evidence."

On one hand, Dr. Oz is a surgeon in good standing at a prestigious medical school. On the other hand, his endorsements put physicians in a difficult position when they are questioned about his recommendations by their patients. Ultimately, in a letter to Columbia, 10 prominent physicians demanded Dr. Oz be fired.

Dr. Caplan concluded that "it's a fine line, but [Oz] has to walk it more closely." He added, "So, Dr. Oz, I say keep your job, keep your platform, and keep communicating, but let's rein in the message."

I was surprised by the online comments on Dr. Caplan's presentation. A number of physicians from across the spectrum of modern specialty care weighed in with opinions ranging from "Oz is a hero" to "Oz should be shot."

Many of these doctors emphasized the many areas in which the evidence is both limited and poor. In spine care in particular, many questions and problems have a limited and conflicted evidence base. For example, vertebroplasty, routine interbody cage placement, and discography remain popular, despite the poor evidence base supporting these treatments.

How we, as orthopaedic surgeons, present these controversies to our patients and the public is critical. We need innovators, certainly. We also need to set ourselves apart from the competition to effectively market our practices. The 2007 AAOS Standards of Professionalism (SOPs) in Advertising state that "Advertising of services, as well as competition between and among orthopaedic surgeons and other health care practitioners, is ethical and acceptable."

But those same SOPs emphasize trust as the cornerstone of the patient-physician relationship. Burying ourselves behind electronic medical record screens or aggressively distinguishing our practices from others by denigrating acceptable treatment modalities will only serve to erode that trust.

As medical marketing efforts evolve, I would hope that our messages reflect the evidence base, are less divisive, and support realistic expectations for patients. I welcome your comments.

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