You’ve probably seen the poster of the shiny red apple amongst all the green ones. Well, I’ve always taken pride in being the red apple. My experience has been that “thinking-like-group” rarely leads to new or innovative solutions. Here’s an example of what I believe is chiropractic “group thinking” (the green apples). Most practice management consultants and Doctors of Chiropractic arbitrarily dismiss the use of radio as an effective medium to market chiropractic. Likely their beliefs are due to unsatisfactory past experiences with radio marketing, and they’ll keep on telling each other that it won’t work for chiropractic.
In fact, most of these past radio marketing failures probably could have been avoided if consideration had been given to the following critical marketing concepts:
- Media intrusiveness.
- Scheduling for rigid-regularity.
- Non-event (non-retail) advertising.
- Top-of-mind awareness.
- In-market and out-of-market consumers.
- Long-term commitment.
As an independent-thinking media strategist, I’m confident that when you’ve fully analyzed these six concepts you’ll understand why the medium of radio actually offers some unmatched strategic advantages that can help build your practice, as well as the chiropractic profession. If you’ll read on, keeping your mind open to some red-apple thinking, I’ll explain these concepts. It might also help to remember that there are no “short cuts” in any successful marketing effort.
Media Intrusiveness
During the last two years, I’ve worked with quite a few DC’s by assisting them in airing a public education radio campaign designed to change misconceptions about chiropractic health care. I’ve learned that a major problem relating to the promotion of chiropractic in the media has been a lack of consideration given to media intrusiveness, which is defined as the ability of a chosen advertising medium to get a message into the mind of a consumer even when they’ve not consciously chosen to pay attention to the message. Among local advertising options, radio has excellent intrusiveness and newspaper has practically none at all. Listeners tune-in their local radio station for many reasons (local news or music), not necessarily to hear advertising messages, but while listening it’s nearly impossible to tune-out the highly intrusive spoken-word messages integrated into the programming. For the most part, newspaper ads tend to lack this intrusiveness unless a consumer actually chooses to stop, pay attention to and read a specific ad. A newspaper laying beside an easy-chair communicates with no one.
My point is to get new perception-changing information into the minds of the 80% to 90% of the public who’ve never considered using chiropractic services, it’s of paramount importance to select a medium (radio) that has a tremendous ability to get messages into the consumer’s head even when “uninvited.” It’s just not possible to communicate with a disinterested, non-reader of a newspaper ad, but with continuous, systematic, long term repetition it’s quite possible to get messages (intrusively) into the mind of a radio listenereven the disinterested radio listener!
Rigid Regularity
Another crucial concept to understand is the morning radio listener’s tendency toward nearly rigid-regularity-defined as setting their clock radio alarms to arise at exactly the same minute each morning. Rigid job or school arrival requirements form the basis for this tendency. This means that if you schedule a radio ad at the same exact time each morning, it’s extremely likely that you’ll reach the same exact people arising at that time each day. If you reschedule the ad’s air time to an hour earlier each day, you will begin reaching an entirely different audience segment arising to meet their wake-up requirements.
An important component of a chiropractic public education radio series is a scheduling system that systematically rotates the messages through all the critical morning drive “audience wake-up segments.” This allows a near 100% reach of a station’s huge, total morning audience on an annualized basis. Advertising research has proven that for promotional campaigns to be effective, it’s crucial for the same person to hear the same message a minimum of three times within a relatively short time-frame. (In advertising terminology, this is known as frequency or repetition.)
When you combine the effect of the rigid-regularity tendency with the media intrusiveness concept, the synergy makes it possibleutilizing only one ad per dayto reach the same listeners up to 20 times in a month. That builds sufficient repetition to intrusively embed the message into the listener’s mind, even if it’s an uninvited message. The next month the message is delivered to an entirely new portion of the morning audience. By systematically rotating the ad times 12 months a year, the total morning audience can be cost-effectively reached multiple times by continuously creating an appropriate awareness of chiropractic. Since radio stations don’t automatically operate in the best interest of every advertising client when it comes to ad scheduling, it’s extremely important to have a scheduling system that allows you to capitalize on this rigid-regularity.
Event Versus Non Event Advertising.
It is important to understand that there are only two basic types of advertising campaigns:
- Event advertising (retail).
- Non-event (non-retail) advertising.
Event Advertising
Event-advertising (retail) schedules a large number of ads (30 to 50 ads within 7 days) designed to get immediate response from the current in-market segment. Retailers selling “widgets”(product units) use this type of advertising campaign to promote “an event.” For example, the BIG sale this week only! Retailers who effectively utilize this type of high frequency advertising usually air between 1,200 to 2,000 ad units on each station annually. Only volume retailers who can “draw from this week’s in-market segment” (2% to 5%), and still make a profit can afford this type of ad scheduling approach.
Chiropractors and many smaller non-retail businesses will likely not see the necessary return-on-investment to justify the high frequency approach. Unless you are holding an open house for a new clinic (an event), chiropractic is not an event-based business. Because retailers are the heaviest users of radio advertising, radio advertising sales people tend to make the mistake of attempting to sell all clients an event-based, high frequency schedule of ads, even when it might not be in the client’s best interest.
Non-event advertising (non-retail)
This style of campaign is best suited for non-retail businesses such as insurance agents, roofers, funeral homes and Doctors of Chiropractic. It utilizes a much smaller schedule of ads on a consistent long-range basis (48 to 52 weeks a year) with the objective of continuously maintaining top-of-mind-awareness. This means maintaining a sufficient level of awareness to be either the number one or number two choice when a triggering-event (a back injury or a roof leak) moves the consumer “into market” for services and forces “a consumer choice” about which business (or medical practice) in the consumer’s perception might help them the most.
This consistent approach utilizes only one ad each week day (260 days per year) and allows the advertiser to cost-effectively keep a message in front of consumers once every week day, pacing naturally along with the daily/weekly flow of consumers (patients) from out-of-market status (no back pain) to in-market status (an unexpected back injury to them or a family member). The ad copy for non-event campaigns, called a positioning message, is not time-sensitive. It defines and differentiates your business’ “unique market position” (which rarely changes), and is usually repeated for a year or more.
The AIDA Theory
The AIDA theory of communicating with out-of-market consumers (non-chiropractic patients) is that with longer campaigns, the messages create awareness of chiropractic-deliver information to heighten the interest in chiropractic-slowly building a desire to try it-increasing the likelihood that when the circumstance presents itself (low back pain) they finally take action by making an appointment with a Doctor of Chiropractic.
It should be apparent why the chiropractic profession can derive greater benefits from the non-event (non-retail) approach, rather than the retail-based event approach to advertising. Scheduling high frequency bursts of radio ads (in a week or a month) won’t solve what is a long-term problem. The event approach unnecessarily gobbles-up too many ad dollars in a short period of time and does little to change public perceptions. The chiropractic health care profession needs to communicate with the 80% to 90% of the public who have never scheduled an appointment with a Doctor of Chiropractic due to misconceptions and misunderstandings about the profession. The long-term, systematic approach simply makes better sense for educating the public and changing perceptions.
Long-Term Commitment
Finally, there’s the concept of long-term commitment. Make no mistake, there will be no short cuts in changing the long-held misconceptions about chiropractic health care. Although it shocks many DC’s, for the purposes of this article a short-term public education campaign is defined as 52 weeks. Long-term is three to five years. My experience has been that the real successes for non-event campaigns are in their second, third, and fourth years-yet many clients, in my opinion, give up just before they experience success. Too often it seems the chiropractic profession is ready to move-on to something new rather than commit to a long-term strategy, regardless of what medium is chosen.
Once you’ve analyzed these marketing concepts, it’s a shame not to utilize radio’s unmatched strategic advantages to help build your practice and your profession. I hope it’s apparent that past failures weren’t caused by the radio medium itself, but more likely by a lack of understanding about how to effectively apply these factors in marketing chiropractic via radio.
It’s time for chiropractic to seize the moment! The AHCPR studies, the Manga Report and others, all legitimate research, are piling up findings supportive of chiropractic health care. These facts need to be professionally and effectively communicated to the public. It’s time for Doctors of Chiropractic to rightfully claim and positively position themselves in the minds of non-chiropractic patients, community leaders and other health care professionals. Radio can “intrusively” help lead the way.
George Joachim has been involved with the management and ownership of several small market radio stations in Ohio and operates Media Marketing Strategies, a marketing consulting business with a diverse client base. He currently teaches business, sales, marketing and management courses at Marion Technical College and his son and daughter-in-law are both DC’s. Please contact Mr. Joachim by calling 1-800-463-0700, or via e-mail: georgej@acc-net.com.
What You Don’t Know Will Hurt You
Advantages/Disadvantages of Marketing Mediums
All marketing media options are not created equal! Each medium has it’s own set of strengths and weaknesses. If you’re not considering the advantages and/or disadvantages of each medium in marketing your chiropractic practice, you might not be efficiently spending your marketing budget.
RADIO
Advantages include intrusiveness of the message, ability to get repeat messages to the same persons, targetability of listener lifestyle by radio programming format, ability to deliver a fairly detailed message of up to 60 seconds, natural word-of-mouth communication, reasonable expense factor-especially in delivering repeat frequency of messages, large segment of in-automobile listening, consistent seasonal listenership levels and relative immediacy. On the average, listeners spend over 3.5 hours per day with radio.
Disadvantages include not being visual and individual stations are not considered as true mass-mediums. Intangibility makes it more difficult to measure results (no coupons, etc.).
NEWSPAPER
Advantages include being one of the last remaining “mass mediums” reaching relatively large audiences (up to 50% of the market) in a single exposure. Good for visual appeal through pictures and graphics. Can list long, detailed information, if needed. Can track response through coupons. One of the oldest and most highly regarded mediums. Can place ad in specific sections, if applicable to your marketing plan. Daily editions allow you to select a specific day of the week. Good target for older readers who have a long habit of reading the newspaper.
Disadvantages include distribution primarily in the city zone with much less distribution in the county zone. Passive medium good for listing choices (prices/items) once a consumer’s decision to buy has been made, but not necessarily the best medium for building awareness and getting consumers ready to buy (creating demand). Readers don’t read every ad-according to Strach readership studies only 41% on the average even note a full page ad. Readers tend to skip ads they have no interest in, again making it difficult to put new information into reader’s minds. High expense factor when attempting to deliver repeat frequency messages each day or several times each week.
CABLE TV
Advantages include being perceived as “discount TV,” offering some of the benefits (sight, sound and motion) of broadcast TV at comparatively lower rates. Allows targetability when advertising is placed within specific programs. Intrusive. An average of 54 channels per system now reach nearly 70% of US households.
Disadvantages of cable channel advertising include much smaller audiences than those of broadcast TV channels due to fractionalization of the audience among the 50+ channels. Because only six to eight of the 50+ channels offer the option of airing “local commercials,” the potential audience reach is even further limited. The lowest discount rates prohibit local advertisers from placing their ads inside programs or within more limited time frames that would be more effective for the advertiser. Inferior production quality of locally produced TV commercials can have a negative impact on the advertiser’s image because viewers compare them with the higher quality national/regional commercials.
BROADCAST TV
Advantages include a large, mass-reach audience with a single exposure. Offers sight, sound and motion to grab attention, when needed. Primary audience target is younger (50 and under). Of all media options, viewers spend the most time with television, an average of four hours each day. Intrusive. Offers the ability to deliver somewhat detailed messages of up to 30 seconds.
Disadvantages include relatively high expense factors for both advertising and production costs. Good medium for getting a message to a large audience of different people via different programs, yet the ability to reach the same viewers with the same repeated messages is more difficult and expensive to achieve. Unique to television is “zapping” or “surfing” of channels with the remote or VCR recordingsmeaning that many commercial messages are avoided.
OUTDOOR BILLBOARDS
Advantages include the ability to be placed at high traffic or other strategic locations. Effective for communicating short messages. Often used as a means of giving or pointing directions to a business location. Grabs attention through the use of size, color and illumination. Fairly cost-efficient expense factor. Year round and 24 hour a day usage.
Disadvantages include the extremely short messages, usually of six words or less, making it difficult to communicate more detailed information such as competitive advantages and specific consumer benefits. Unfortunately, prime locations are usually controlled by contracts with large, frequent users, making it difficult for smaller advertisers to access the highest traffic boards.
DIRECT MAIL
Advantages include the ability to target consumers in geographically specific areas/neighborhoods or by product affinity and/or potential interests via database mailing lists. Has the potential to reach every household in the market. Good for reinforcing relationships with current customers. Easy to track response via coupon redemption or return-card/call back options. Good for very detailed messages and delivering product samples.
Disadvantages include a low response rate when direct mail gets thrown away unopened. Studies indicate the direct mail that does get opened tends to be from advertisers with whom the consumer is already familiar, making this medium less effective for attracting new customers. Direct mail has one of the highest cost-per-thousand factors of any media. “Junk mail,” as consumers commonly refer to the advertising that fills their mailboxes each day, is not held in high esteem by consumers.
YELLOW PAGES
Advantages primarily accrue to “crisis” and “emergency-based” businesses such as plumbing, furnace, air conditioning and washer/dryer repair-people. Based on the premise that when vital equipment fails to operate properly, there’s a segment of consumers /businesses who can’t remember the name of someone who helped them the last time it happened, so they turn to a directory for a list of potential service providers.
Disadvantages include large monthly dollar commitments that provide no marketing assistance in developing awareness and interest of new, non-chiropractic consumers. There’s little evidence that consumers who develop musculoskelatal problems immediately look in the Yellow pages to find potential relief. Another disadvantage is over-commitment of dollars that could be re-committed to more pro-active forms of marketing.
INTERNET WEBSITE
Advantages include the ability to conduct business, disperse and receive customer information on a global basisnearly instantly, if needed.
Disadvantages include the costs of establishing a world wide web site that might not be of much help in reaching customers (patients) with whom you can actually do business and live in your neighborhood just a few miles from your practice/business.
How to Choose an Appropriate Radio Station
In most smaller communities (under 100,000 population), the newspaper isn’t published as a morning edition-making the primary source of early morning local news and information a local radio station. A surprising fact to many people under age 40 is that this news radio station may likely be on the AM dial rather than the FM band. Although it may not appear to be as “popular” as stations from a neighboring larger city, this home town station usually attracts a large cross-section of the local listeners who tune-in regularly for their primary source of early morning local news (police-fire-city government news, weather, school information, high school sports scores and important local activities). In reality, many of these early morning listeners might stay tuned for only 10 to 20 minutes before switching to their favorite music/personality station. Yet, during the morning hours of 6:00 to 10:00 am, these local news-source radio stations are like magnets-attracting huge numbers of listeners for a few minutes, on a regular daily basis. This type of station also reaches many opinion leaders and decision-makers in the community who need to be educated about chiropractic.
These local stations present an ideal marketing situation-three to four prime hours each morning, in which to concentrate an ongoing promotional campaign. Since the non-event advertising approach utilizes a minimum of only one ad each week day, it’s vitally important to schedule the ad where it can have great impact and these stations provide that kind of opportunity. Also, it’s important to understand that listeners tune-in to these stations “seeking new information,” so there’s probably no better environment in which to place intrusive, persuasive infomercials designed to change misconceptions about chiropractic health care. I strongly recommend choosing this type of station if it’s an option.
While the above scenario is also applicable to larger cities, the fact remains that it’s more affordable in smaller towns where it’s still within the budget parameters of the individual chiropractic practice. In larger markets, it usually becomes necessary to form groups of DC’s to share the investment. However, the same type of local news station is still strongly recommended.
If a local news station is not a viable alternative, then your analysis of the alternative stations should concentrate on who listens-not how many people listen to these stations. From a marketing perspective, your goal should be to find a station whose listenership base similarly aligns with your practice’s patient base. Radio station formats are very specifically targeted to appeal to certain lifestyle and demographic groups. While the format of a particular radio station may be very appealing to you personally, it may not appeal, for example, to the high percentage of blue collar, heavy-industry workers who heavily populate your practice. So, rather than choosing an upscale targeted soft rock station (the one you like), it might to be more appropriate to choose the contemporary country music station, which is a stronger magnet for production line workers who have a higher likelihood of job-related musculoskelatal problems.
On the surface, it appears that advertising on the number one rated station in a city is the best way to go, yet many advertisers have found that it can be the most expensive if it reaches many inappropriate customers who are too young , too old or lack the ability to pay for your services. It’s usually more cost efficient to utilize a radio station with a smaller, but appropriate segment of listeners (potential patients).
How to Analyze Market Expenditures
“Measure Cost versus Return-On-Investment”
How much should I spend marketing my chiropractic practice? Too often, this discussion begins without setting an objective foundation. In my opinion, it’s best to start by determining the minimum dollar amount needed to do an effective advertising campaign-in one appropriate medium that can accomplish your strategic objectives. The philosophy is that it’s better to do one medium effectively, rather than attempt several mediums at ineffective levels.
Unfortunately, many advertisers and marketing consultants tend to equally divide a marketing budget into what appears to be an appealing multimedia campaign (electronic/ mail/print). Yet, by dividing the budget to include several mediums, the actual dollars allocated to each medium are not enough to ensure that the advertising develops the sufficient frequency and reach levels to make it effective.
You should begin by analyzing the objectives of your campaign. Compare the individual advantages and disadvantages of the available local marketing mediums-billboards, radio, newspaper, cable, direct mail and internet web site-in terms of reaching and most effectively delivering your message to the appropriate target market. Then choose what appears to be the best medium with the greatest likelihood of accomplishing your specific campaign objectives. For example, you might decide that it’s impossible to communicate the message of your campaign in six words or less, so outdoor billboards would probably be eliminated as an option in favor of a medium that allows communication of a more in-depth message. You might determine that cable TV reaches a lot of different people, but because of the manner in which ads are scheduled there is little potential of reaching the same people over and over to give your campaign enough frequency to embed the message in the consumer’s mind. Or, since the newspaper reaches less than 50% of the households in your county, delivers older readers and lacks intrusiveness, it might not help you reach disinterested consumers. Consequently, radio may be chosen due to the factors already discussed.
The next step is determining the cost to use the chosen medium on an annual basis by utilizing appropriate scheduling techniques. Using the non-event (non-retail) scheduling approach described previously (one ad per day/260 days per year), the two examples that follow illustrate the annual investments needed to effectively utilize radio marketing-one in a smaller town, the other in a larger market. In typical Smalltown, Ohio, (pop. 20,000) the cost of a campaign on a radio station is approximately $5,000 annually. In Fort Wayne, Indiana, (pop. 400,000+) the cost of a radio campaign on one station would take an investment of at least $20,000 per year.
With this knowledge, we are now in a better position to decide whether the annual investment can be justified or supported in relationship to the gross revenue of the practice(s) involved. In general, businesses determine their marketing expenditures as a percentage of gross revenue averaging about 5%, with more aggressive marketers investing 8% to 10%. This means a practice generating an annual gross revenue of $150,000 should be able to justify a budget of $7,500 annually at the 5% marketing level.
The final step in analyzing your marketing investment is determining the return on investment (ROI) or break-even point-the point at which you’ve recouped your original promotion investment. It should be determined by the number of new patients required to generate enough new revenue to equal the promotional dollar outlay. According to chiropractors I’ve worked with recently, a new patient probably generates (over 10-12 visits) additional revenue of approximately $1,000. Yet, for calculating the ROI/break-even point, let’s use $750 of new revenue as a more realistic average. On a promotional investment of $5,000, it means the ROI/break-even point would be 6.6 patients. Only seven new patients over an entire 12 months of the campaign generates enough revenue to recoup your investment. Only 27 patients are needed for the $20,000 investment-only three new patients per practice-for a joint-effort involving a minimum of 10 individual practices.
The long-held negative perceptions and misunderstandings about chiropractic will not be erased in just one year. My experience with non-event advertisers is they begin to experience greater results in years two, three and four of their campaigns. So, breaking even in the first 12 to 18 months of a chiropractic public education campaign is a realistic goal. Success will come only to those willing to persevere.
