Chiropractic Products sits down with four marketing experts to find out how DCs can stay competitive in today’s health care market

In the health care industry, words like public relations, marketing, and advertising were once considered taboo. Quality care and patient satisfaction were expected to speak for themselves—sans the glossy marketing campaigns. But times are changing. The world is saturated with information, advertising, and media glitz, and competition in even the health care industry is fierce. Doctors have been forced to become savvy in marketing and media. These days, hiring specialized firms to tackle this new era of practice promotion is becoming more common.

To address the growing question of “to promote or not to promote,” four professionals in the field join Chiropractic Products for a discussion on the why’s, what’s, and how’s of marketing your practice.

Michael Day, president of TNG Systems, Houston, has worked in marketing, advertising, and public relations for 24 years. Kent S. Greenawalt is president and CEO of Foot Levelers Inc, Roanoke, Va. Foot Levelers Inc has specialized in custom-made orthotics for 50 years. Paul Herreras is a senior marketing director for Practice Builders (a division of Chiropractic Products’ parent company), South Coast Metro, Calif. He has been a marketing consultant to more than 3,700 practitioners with more than 20 years of experience. Katherine M. Rothman is president of her own Manhattan-based public relations firm, KMR Communications Inc. Rothman’s firm was named one of the 50 top health care public relations firms in the United States by PR Week Magazine in its first year of business.

What is the biggest misconception about marketing—advertising and public relations—that you have encountered from DCs?

Day: One misconception is that you do not have to constantly frequent a message or offer. The tendency of DCs is to shoot from the hip when designing a campaign and not use experienced personnel or consultants. Consequently, when the campaign fails, business owners become frustrated with the results and want to cut their marketing or public relations budget. Some business owners think if they do a good job, it will create a large enough referral base so they won’t need to do marketing, advertising, or public relations.

Greenawalt: A big misconception is the strategy of buying a big Yellow Pages ad and giving something away free will be a big marketing success. The best marketing method is to help people and charge them for it. When people get better, they’re willing to pay.

Herreras: The average person does not understand [marketing] lingo, which is one of the reasons why chiropractic, globally, hasn’t significantly increased market share in 15 years. Chiropractors are speaking to the average consumer in “tongues.” The only people who understand most chiropractic ads are existing and competitors’ patients.

Rothman: Chiropractors who think they must be in a big city to take advantage of the benefits of public relations is the biggest misconception. Second, I do not think chiropractors fully understand that national press is beneficial to them no matter where they are located, because it gives them tremendous prestige and credibility. When chiropractors in a suburban area are featured in the media on a consistent basis, it often circumvents the problem of their local patient population seeking care in a city.

What is the difference between chiropractors and other health care professionals in terms of a marketing approach?

Day: Overall, I find chiropractors to be open-minded and receptive to fresh ideas when it comes to expanding their patient base by utilizing creative marketing/advertising approaches. This is not always the norm with other health care professionals.

Greenawalt: Other health care providers have so many resources that do marketing for them. Medical doctors have the luxury of entire public relations teams at hospitals, promoting them along with their facilities. Even drug companies get involved by urging consumers to visit their doctors. According to the National Institute for Health Care Management, drug companies spent more than $2.5 billion on direct-to-consumer advertising—directly referring patients to the medical physicians. Chiropractors tend to be one of the few health care professionals who are competing in a marketplace where they are clearly underfunded and outgunned.

Herreras: DCs, as well as other practitioners, spend hundreds of hours on clinical continuing education, but have no formal training when it comes to health science marketing. They usually put on their “Darren Stevens” [from the television show “Bewitched”] advertising cap and have at it. The outcome, in my 21 years of marketing experience, is predictable—more than 90% of marketing ventures fail. When they do hit pay dirt, they do not know why their project worked. They then are tempted to tinker with the marketing formula, and when they relaunch, they see their one-time profits disappear into thin air.

Rothman: For the purpose of public relations, I think the big difference in representing chiropractors is that the public is not familiar with the scope of what a chiropractor covers. People tend to think of them as simply backcrackers. With public relations, [the goal] is to educate the public on how comprehensive chiropractic can be and the many applications there are for the whole body, not just the back.

Also, chiropractors have been the subject of much negative press in the form of undercover investigative television segments. There have been many exposés on bad treatments or practices, which is something you do not encounter as much with other subspecialties of medicine.

Tell us a success story about one of your DC clients.

Day: One of our clients is a young chiropractor in South Carolina who purchased one of our patient marketing systems, with which he built a practice from a few patients to a very large practice in a just 2 years.

Greenawalt: I was in Chicago talking with a young chiropractor who had just graduated and was starting a solo practice emphasizing sports. I suggested he take some time to find his unique selling points and share these points with the people he wanted to draw to his practice. We decided it would be best if he called the local gyms and fitness facilities to address their members on the importance of proper exercises related to health.

As you can imagine, it was somewhat like drilling for oil. He hit a lot of holes but got gushers too. For example, during his visit to the YMCA, he had 25 new patients at the end of his lecture. Of course, he gave 23 lay lectures with only having four patients before he got his 25. Peristence and determination pay off.

Herreras: One of my clients had a fabulous location for his practice, where hundreds of people walked past his office each day. But the sign in front only read, chiropractor. So we took the sign and added neck and back pain center, headache relief, auto accidents and on-the-job injuries to the window with a phone number and new-patient offer. This brought in three to four new patients a week—people who just happened to be walking by. We also helped him put something in the Yellow Pages—which is the second highest producer of patients for chiropractors. We also created a brochure for patients and referrals. Finally, he hired a solid staff, trained to properly answer patient questions about chiropractic. All of this was a small financial investment that reaped huge benefits for his practice.

Rothman: We represented the Georgia Chiropractic Association, which was comprised of a few hundred members throughout Georgia. We planned a media campaign around the Christmas holiday called “Driving While Drowsy.” The premise was that after September 11, fewer people would be flying home for the holidays and more would be driving. We had doctors talk about how to keep alert on the road and avoid accidents. The story was picked up by wire services throughout the country and major newspapers.

In April, which is National Backpack Safety month, we sent a press release for one of our clients about children and backpacks and what every parent should know. This story appeared in the Wall Street Journal. Again, this was picked up by many papers because it is timely and had a worthwhile consumer angle.

What should chiropractors expect from their advertising/public relations firm?

Day: People, who genuinely have chiropractors’ best interest at heart, can give suggestions on a plan that makes sense, fits the chiropractor’s budget, and will produce results based on realistic solutions—prior to asking for money to implement the campaign.

Greenawalt: A realistic plan, honesty, and a branding image with which you feel comfortable being associated is important. To achieve this, you need a firm that is willing to listen to your desires and goals. Concentrate on results and set goals to measure their progress. Slick brochures are nice to look at, but the key is whether they generate results.

Herreras: Chiropractors should expect their ad agency/PR firm to have a solid understanding of their branch of the health sciences; the needs, wants, and fears of prospective patients (who live in the trading area); and to be able to create campaigns that bring the right patients to their front door.

Rothman: Chiropractors should expect steady media coverage with media placements in their desired target markets. They should expect their firms to come up with innovative ideas for promotion as they pertain to their practice and to provide weekly updates. If desired, they should expect their firm to arrange speaking engagements for them at various events as a means for reaching their target audience.

What are some aspects of firms they should be wary of?

Day: Be wary of companies that seem to be interested only in making a sale rather than having your best interest at heart.

Herreras: Chiropractors should be aware of boutique ad agencies whose main clientele are retailers and commercial businesses. These ad agencies deal in either direct response ads, such as buy one pizza get another free, or name recognition ads, such as when you need a chiropractor, call me, I’m a chiropractor. This latter model is rarely powerful enough to turn a profit.

Rothman: Chiropractors should be wary of engaging a public relations firm that has never represented doctors or does not have a firm niche in medical public relations. They should be wary of firms promising to increase their business. Just as with advertising, a public relations firm cannot and should not make guarantees with respect to returns on investment. Be wary of firms that cannot provide doctor references or examples of media placements. They should be wary of firms with several chiropractors on contract in one small area, such as a firm that represents three chiropractors in Nashville.

Describe the pros and cons of developing a campaign for an established practice vs a new practice.

Greenawalt: The fresh introduction of a practice has the advantage of creating excitement: new techniques, approaches to patient care, equipment, and facilities. The downside is that an identity or branding has not been established. Sometimes there is the new kid on the block syndrome to overcome. But, it can be overcome with a little bit of time and hard work.

Herreras: Most established practices have experience and may have already built a name for themselves. These variables can often empower an ad campaign. Established practices also know they need to keep feeding the machine so they can stay in business. Unfortunately for most new practices, they have spent all their money on buildings, breakouts, equipment, and décor. Whatever funds are left, they spend on marketing. The rationalization at this point is, “If I build it, they will come.” Well, maybe this strategy worked once for Kevin Costner, but it does not work in the real world. Underfunding of marketing campaigns is one of the biggest reasons why most practitioners never really turn a good return on investment.

Rothman: One of the pros of working with an established practice is the office functions like a well-oiled machine because they are typically organized and have key staff members in place to avail themselves of media opportunities. With public relations, doctors need to respond promptly to media leads, so organized or established practices will be able to quickly and appropriately respond. Also, when writing about a specific treatment, the media frequently needs testimonials from patients who have undergone the treatment outlined in a press release. Established practices will have a greater roster of patients to rely on for such circumstances.

The benefit of developing a campaign for a new practice is a public relations firm can guide them at the outset on molding a practice for future public relation endeavors.

When building a brand identity or image, what do you see as the biggest hurdle for chiropractors?

Day: The biggest hurdle is sustaining a budget that allows time for a campaign or concept to be ingrained in the mind of the public. If a marketing/advertising campaign is instantaneously successful, some doctors not will continue advertising, but chiropractors must understand that building brand identity or image takes time.

Greenawalt: Education is a significant part of any branding effort. Once you have identified your unique selling principles, use them to build a message that will be associated with your business. For example, Coca-ColaTM has done an extraordinary job worldwide by making the word Coke synonymous with soft drink. This branding success was achieved over a long period of time with repeated fortification of their message. Chiropractors can do the same by constantly repeating and educating the public on the benefits of their practice. Problem, solution, demonstration, and testimonial are the keys to this education process. The biggest hurdle is having the discipline to continually tell people who you are, what you do, and why it is unique and needed.

Herreras: Chiropractors must forget their needs and focus solely on the emotional needs of their prospective patients or professional referrers.

Rothman: Chiropractors and many of their treatments have faced a great deal of controversy in the past, bringing much skepticism from the media, other doctors, and patients. One of the biggest benefits of public relations, as compared to advertising, is media coverage can give credibility back to chiropractors. The general public places tremendous faith in what the media dictates because it is seen as objective and a third-party endorsement.

Julie Z. Lee is a contributing writer for Chiropractic Products.