It used to be relatively easy to set up a doctor’s practice, particularly when the doctor was returning from training to his/her home town. Hang out a shingle, it was said, and send announcements to family and friends.
But those easy days are gone. Competition in health care is fierce, advertising is increasingly sophisticated and managed care dictates much of the playing field. That’s because patients want their health care costs covered by their insurance policies. Those plans, including HMOs, often make chiropractic coverage contingent upon a medical doctor’s referral. That limits the public’s access to chiropractors because many doctors decline to refer, or refer only to a particular friend in the profession.
Even states such as Kentucky, which have eliminated the need for referrals, require “pre-certification” to secure coverage… And that means managed care still is “putting the squeeze on reimbursement,” says Clay Elswick, DC, of Lexington. Furthermore, that squeeze has the effect of “making it tougher to advertise because dollars are scarcer.”
So establishing a practice and increasing market share require new, more cost-efficient advertising approaches. Direct mail is providing one.
In the past, chiropractors have used direct mail to raise awareness, establish geographic presence and motivate prospective patients. Today, direct mail is most effectively used as a ‘pull’ for the practitioner who must fight for market share in the managed care environment.
“We’ve seen the enormous impact of the changes in the environment in the last four years,” says John Addison, director of sales support and research at Val-Pak Direct Marketing Systems, Inc. “They’ve forced us to ‘re-think’ how our chiropractic clients can do an effective mail campaign.” The result?
Addison counsels salespersons to help chiropractors fashion programs that build awareness from start to finish. He advocates:
- A consistent mailing schedule of the promotions.
- A bold, category-defining headline and chiropractic-related artwork on the coupon. The headline might target specific areas such as pain relief, chronic vs. acute illness, non-invasive care, preventive care, accident-related care, or sports injury treatment.
- A personal identity, established through a quality photo of the doctor or interior shot of the office and staff.
- A prominently displayed practice name and phone number.
- An offer which would form the primary focus of the piece. The strength of the offer should be governed by the level of competition in the doctor’s market: for example, a free exam offer, including any necessary X-rays. A low price point offer that includes an exam, consultation and even a first treatment might pre-qualify prospective patients and have greater potential for retention.
- Supporting offers (dollars off or low price point offers) on ancillary services such as massage therapy or even free services.
- General information about the practice and its areas of specialization.
- Information about the insurance plans accepted and payment plans or information for those without insurance.
Let’s look at what’s working in specific markets for chiropractors who advertise with Val-Pak. Dr. Alex Plum of Bremerton, Washington, left a clinic a year ago to establish a solo practice. Aware of Val-Pak as a consumer, and impressed with its effectiveness for a classmate, he signed on to mail coupons approximately every two months throughout 1997. Dr. Plum offered a free initial exam and consultation, followed by x-rays, if needed, for $19.95. The result?
“I gained four or five patients with each mailing,” he says. His advertising mix included grocery shopping cart signs, ads in small community publications and public health screenings. Direct mail, he says, was the most “cost-effective” mode. While free health screenings pulled in more prospective patients, they were “time-consuming.”
Plum mailed to two zip codes surrounding his office, which is on a main thoroughfare in Bremerton. A devotee of consistency in his discount coupons, he stayed with his initial choice of green ink on a gray background (“not expensive”) and always used his photo with the tag line, “He’s gentle and he cares.” Across the country, in Lexington, Kentucky, Dr. Clay Elswick also finds a free first exam to be an effective offer. He’s been advertising with Val-Pak for seven years and calls it a “vital link” in his advertising program. Dr. Elswick likes the fact that couponing affords easy tracking of results; he estimates he gets one response for every $3 spent on Val-Pak ads compared to one for every $4 spent advertising in the Yellow Pages. “I like radio advertising, too, but couponing gives me hard data,” says this practitioner. “It’s much more difficult to know how many patients radio ads bring in.”
Like his colleague in Bremerton, Dr. Elswick credits consistency of design with achievement of name recognition. He always uses his logo, a locator map and stays with a simple two-color approach. He mails four to six times per year.
In Logan, Utah, Dr. Drew Tribett DC, a native son returning home to practice, used direct mail to bring prospective patients to his grand opening in early 1997. The results were “pretty exciting,” he reports. The majority of those who came through the door had their coupons in hand, entitling them to a free exam, consultation, and (if needed) treatment. Dr. Tribett used “a basic two-color, one-sided” coupon, “the cheapest option,” he says, and found it more effective than the four-color, two-sided coupon he mailed two months later.
Tribett is convinced that the word “free” is the key to his success. While his practice is not yet where he wants it to be in terms of numbers, he says direct mail “got my name out there initially.” He advertises in the Yellow Pages and also offers free screenings. But, he says, with the exception of the latter, which is time-intensive, “direct mail has been the most effective ad form for me.”
According to the American Chiropractic Association, direct mail is the third most popular form of advertising among chiropractors. Used by 20% of chiropractors, it follows newspaper advertising (28%) and the leader, yellow pages advertising (85%).
What does a direct mail campaign cost? Because there are so many variables in a campaign, it’s impossible to assign a “one-price-fits-all” figure. Prices vary, depending upon:
- The coupon format : Color usage, Number of photos, Printed one side or two, Choice of paper stock
- Size of mailing : From as few as 5000 homes to as many as 55-million.
- Frequency of mailings.
At the core of Val-Pak’s business is the customer who mails to a range of 10,000-30,000 homes. This so-called “average customer” pays approximately 3.5 cents per home for the graphics, printing and mailing service. However, this same customer, along with those whose coverage needs are in the millions of homes, can achieve rates substantially lower through increased mailing frequency and/or economies of scale in sizes of print runs. Regardless of your market, your practice status or your pocketbook, there’s a cooperative direct mail program that can bring patients in your door.
