To Market to Market: Marketing Your Podiatric Practice.
An effective program involves both internal and external techniques.

By Mark Terry

No matter where you are in your podiatric practice, there are likely to be marketing concerns. Just starting out, you need to build up your customer base. If you’ve been in practice for a while, you still need to keep your name out there, bring in referrals and assure a steady stream of patients. It’s possible that you’re not happy with the number of patients you have, the types of patients you have, or the insurance base of your patients. Perhaps you hope to bring on a partner and want to increase your numbers, or maybe you’re thinking of retiring and want to have a strong client base in order to bolster the value of your practice. Whatever the reason and exact nature of your marketing requirements, there are some things to consider.

Internal Marketing—Focus on Referrals
Internal marketing is the things you do within your practice that are a way to promote your practice. Being a warm, professional, genial podiatrist with an excellent service record is all a part of that. Jason Kraus, a partner with SOS Healthcare Management Solutions, LLC, says, “I try to focus marketing first internally before I go outside the practice. There are many things that can be done within the existing framework of referral sources and the existing patient population that can drive additional revenues to the practice. And it tends to be the least expensive marketing programs that you can incorporate into your practice.” He lists several:
• Proper signage
• Patient education materials within the practice
• Systematic thanks to referral sources, both physicians and patients
• Asking patients for referrals upon discharge visits

Dr. Marlene Reid, DPM, in Westmont, IL, says, “I’m a firm believer that patients don’t know what you do unless you tell them. So I do a lot of internal marketing at the time I’m with the patients. I’ll tell them something about ankle sprains, or say, ‘Sorry I’m late, I had to put a cast on someone.’” Reid also says they try to be consistent in terms of follow-up with referral physicians. “When we have one of their patients, we inform them that we’re seeing the patient and we’re taking care of the problem. We have a letter that goes out and at the end it will say: ‘Feel free to contact me in the future for this patient or any other patients that might need podiatric or other surgical care.’”

Dr. Jane Andersen, DPM, in Chapel Hill, NC, agrees. “Some of the best advertising you can get for yourself, some of your best marketing, is your followup. When a doctor sends me a patient, now I have the letter dictated and faxed back to the doctor within 24 hours. That speaks volumes about our follow-up and doctors really appreciate that and so they send us more patients.”

Glenn Lombardi, with the medical marketing firm Officite (Oak Brook, IL), says, “Doctor referrals are huge. In fact, what most doctors aren’t doing is both recruiting and nurturing those relationships. That can be as simple as sending notes to them every quarter, sending them office brochures—or five or six office brochures—so that when they do refer patients, the patients are given an office brochure so they feel more comfortable coming to a referral doctor.”

Although Lombardi suggests sending somebody out to chat up the referral physicians about once a quarter to keep the relationship alive, Andersen says in an earlier practice, “We took lunches to doctors sometimes. I’m not sure that worked.”

It’s possible, of course, that the physicians themselves aren’t the people to target for physician referrals. Kraus says, “I think not enough attention is paid to referral coordinators for referring physicians.” In many cases, it is a member of the staff that actually decides which specialist to refer a patient to. “The MD,” says Kraus, “might simply say to a patient, ‘You need to see a podiatrist for this condition; go up to the front desk on the way out and they’ll give you somebody’s name.’ It’s the referral coordinator on the way out that may simply select from a Rolodex, so I think as part of a marketing program, you include referral coordinators from referring physicians as a target audience. You’ll get a nice response to that.”

S.W.O.T.—Analyze Your Situation
Jeffrey Denning of Practice Performance Group (La Jolla, CA), says, “The first question anybody who’s doing a marketing effort has to ask is: ‘Whom am I trying to convince?’” For many physicians who get their referrals from other physicians, the approach is significantly different from those trying to get their referrals directly from patients.

Rebecca A.H. Anwar, PhD, senior consultant with The Sage Group (Philadelphia, PA), says, “What they want to do is first look at their own practice and do a S.W.O.T. Analysis.”
S = Strengths
W = Weaknesses
O = Opportunities
T = Threats

“Strengths,” says Anwar, “may be you’ve been in the community for ten years, you’re well-known, you’ve never had a malpractice lawsuit, you have excellent credentials, etc.”

Weaknesses may be limited parking, or no evening or weekend office hours; in other words, accessibility.

“O is for opportunities,” says Anwar. “Maybe you need to open the practice on Saturday mornings and have evening hours or you may want to specialize in hammertoe or some sort of specialization and have clinics for that. Diabetes, let’s say, would be a good one because there’s an increase in diabetes in the neighborhood or in the community.”

Threats may be the number of other podiatrists in your practice’s area, or that insurer reimbursements have dropped. “A threat,” says Anwar, “might also be they’re ill— they have cancer and they’re under treatment and aren’t able to work as much.”

Anwar suggests a competition and geographical analysis as well. “Really find out more information about your competitors. How are they marketing? How long have they been in practice, and where are they located? What I also do is define where my clients are coming from and call that the service area, or the market area, or the trade area. Look at your patients for the last couple of years—their zip code origin; in other words, where they live—and you can run those counts.” By determining where most of your patients are coming from, you can focus your marketing efforts to the areas where the majority of your clients are originating from.

“You have to look at your population,” says Anwar, “and see whether it’s growing or it’s declining or is it transitioning. If it’s an older population, which podiatrists tend to do well in, and suddenly there’s a new housing development and all the people are young, that may be why your patient population is being eaten away, or it’s not doing as well. You’ll also want to look at nursing homes. Those kinds of areas are sources for patients, so once you’ve got all that information, you can really be prepared to target where you want to target your marketing efforts. There’s no point to putting an advertisement in a newspaper if it doesn’t target the population you’re after.”

Set Your Goals/Set Your Budget
“You want to set your goals,” says Anwar, “but you want to see if your goals are attainable, given your practice analysis. You can have the loftiest goals, but goals should be set not only in statements, but should be measurable goals. If you want to increase your patient population, okay, but tell me how much. Do you want 10 percent? Twenty percent? What can you actually accommodate without getting in trouble? They need to have a thorough understanding of their own practice and their own practice environment and community in the practice environment.”

If you have your measurable goals, then you need to create a budget. “I think the best approach for creating a budget,” says Kraus, “is creating a baseline for the practice and then adding to the baseline certain revenue goals for the upcoming year. In other words, let’s say you have a practice and you spend zero dollars on it in marketing, and without that expenditure grew 2 percent just through word-of-mouth or whatever. If you wanted to take that 2 percent in the following year and turn it into 10 percent, you have to create a budget that recognizes, without any investments, you’re going to get 2 percent and you want to work forward to how much you’d have to spend to get the additional 8 percent.”

Kraus notes that it never seems to quite work that way. Say, for instance, that you spend $10,000 on marketing and are getting 5 percent growth. If you want 10 percent growth, you should be able to theoretically double your spending to $20,000 a year on marketing and get 10 percent growth. That’s the theory, anyway.

“You really have to allocate (marketing dollars) based on your return on investment,” says Lombardi. “The problem with that is you have to try some things before you know how well they’re going to work. The thing we hear over and over is the Yellow Pages don’t attract the right type and quantity of patients like it used to. So what we’re telling doctors to do is to reallocate a good portion of their monthly fees. We just recommend you spread it out. Try different things. Make sure you track exactly where each patient comes from, and from there, it becomes very evident where to spend your money.”

“The more you spend on marketing,” says Denning, “the more patients you get, assuming it’s marketing that works. So if you’ve already got lots of patients and are happy, you don’t spend very much. If you’ve got nothing else to do but market and no patients to see, then you spend as much as you can to get the phone to ring.”

Anwar says, “Generally, the rule of thumb among marketers in the medical world is you spend 1% to 3% of your gross revenue on marketing.”

Tracking the Wily Marketing Beast
Every single person interviewed for this article insisted that it was important to track whether your marketing efforts were working. “Whatever effort you make to get your message out to the public,” says Denning, “you need to be monitoring the effectiveness of that effort, especially if it’s expensive.” He suggests if you put an ad in the newspaper, have a phone number that links directly to that ad, even if that requires adding an additional phone line. “It’s easy to track revenue specifically to a marketing effort.”

Kraus agrees. “Probably one of the things that most people don’t do a very good job on is tracking. They spend the money on Yellow Page advertising. They spend the money on radio. They’ll spend the money on direct mail and a whole variety of other tools and yet they’re not very diligent in finding out how well any of those things are working in the practice. Like any marketing program, in order to manage it, you have to measure it.”

Measuring it can be as simple as insisting that your office staff ask questions of people who call about your practice and who follow up and make appointments. It can be as complicated as tracking zip codes and coding information in your print, TV and/or radio ads. “There are things you can do,” says Kraus, “systems certainly that you can set up to try to track a performance so you can know on an ongoing basis to make adjustments to ones that are working and maybe invest more heavily in them. With the ones that seem to be underperforming, either reduce the investment or cancel it altogether.”

What Works?
Everyone agrees, word-of-mouth works. Denning says, “The extraordinary internal marketer gets talked about in an evangelistic way by patients. They don’t wait for somebody to say, ‘Oh, my toe hurts.’ They say, ‘You know, if you ever have a problem with your feet, you should go see my doctor.’”

As mentioned earlier, The Yellow Pages seem to be losing their edge, and the cost of a large ad can be prohibitive. Anwar says you should have a website. “That has become the new Yellow Pages.”

Andersen agrees. “We have a website and I think the website has done more for marketing than anything—people who do a web search might come up with our practice.”

Patient brochures and patient information? Absolutely. Anwar says, “They should also have a practice brochure so when people come, they take that home. They should also have patient education materials. The podiatric societies probably have their own brochures about specific foot problems like hammertoe and fungus and all that kind of stuff. Have that kind of patient information out there, but they should be labeled by the practice’s name, not just out there.”

Or for an even more tailored marketing tool, have a writer produce patient brochures that focus on your practice’s specialties with quotes from you. If you have the time and are comfortable with your own writing and layout skills, write them yourself.

Advertising in newspapers or magazines might work if it’s targeted. Reid says, “We’ve been advertising in Chicago Magazine, a pretty big publication, and it’s kind of on par with the plastic surgeons. More of our market is professionals.”

Radio and TV? “Unless they have a lot of money,” says Anwar, “it’s probably
not economically feasible.”

Denning thinks that would depend on your market. “If the doctor’s in a large media market like L.A. or New York or Chicago, the broadcast media, and even newspaper advertising, can be prohibitive. Basically, because it’s going to reach so many readers, they charge by the reader or by the listener on radio and so forth. With small media markets like Palm Springs or Lubbock, Texas, it may be easier to afford.”

Events? Anwar says, “Seminars are great if they’re on a specific topic, not a general topic. Be sure to formally invite your current patient population or your bigger patient base.”

Who Are You?
One consideration that shouldn’t be lost in the minutiae of marketing and advertising is the image you want to project. You want to be known as competent, caring professionals, presumably. So that’s the image that you should try to give no matter what your marketing strategy, whether it be Yellow Pages ads, websites, brochures, newsletters, TV and radio ads, or anything else. Denning says, “I think (podiatrists) should be proud of their profession and explain to patients how their training and focus differs from how other folks, like orthopedic surgeons, take care of feet. And to me, keeping a dignified marketing sense is all part of that.”

Jane Andersen sums it up very well. “Be really good to your patients and make sure they have a positive experience from the moment they call to the moment they leave the office.”

Mark Terry is a freelance writer, editor and author. He writes mostly about medicine, health and biotechnology. His latest novel, Dirty Deeds, involves identity theft and Internet crime. He lives with his wife and sons in Michigan.