Physician marketing: Can direct mail still deliver?

In today's digital world, it would seem hard to imagine that the old-fashioned method of mailing a postcard, letter or pamphlet is more effective than an email in marketing a physician practice and its services to prospective patients.

But health care marketing experts say it can be, when the direct mail effort is part of a strategic, comprehensive marketing plan, something that is becoming more of a necessity for physicians as the Affordable Care Act continues to change the health care landscape.

In general, recent studies on what elicits a better response rate — direct mail or email marketing — favor direct mail marketing. A 2012 study by the Direct Marketing Assn., whose members include direct mail, phone and electronic marketers, found that direct mail has a response rate much greater than that of email: a 4.4% response rate for direct mail compared with 0.12% for email. An August 2012 Harvard Business Review article found the outcomes more comparable, with direct mail eliciting a 24% response rate and email, 23%.

Both studies found that email marketing provides a greater return on investment because it doesn't involve the cost of printing and mailing. But marketing experts said direct mail is regaining ground because, unlike with a lot of electronic solicitation, someone is likely to look at it first before deciding what to do with it.

“Direct mail is still tried and true for certain objectives,” said Nina Grant, vice president, agency managing director/corporate partnerships for Practice Builders, a health care marketing firm in Irvine, Calif., especially as more email inboxes are “inundated” with solicitations.

“Direct mail is excellent for new patient acquisition as well as re-engaging patients who have not been active for some time,” said Greg Fawcett, president of Precision Marketing Partners in Raleigh, N.C.

Formulate a strategy

As with any marketing tool, direct mail needs to be used judiciously and reflect specific business goals. “Whenever we work with a practice or group, we prefer to do a marketing plan,” said Andrew Crème, CEO of MD Practice Consulting in Lake Mary, Fla.

This includes having the practice review market trends within its specialty and community and determine who it is trying to reach, Grant said. Physicians “need to be clear with themselves” about what kind of cases they enjoy, who their typical patient is, where there are untapped opportunities for financial return, and what their unique position is in the market.

Practices should ensure that their internal marketing strategies are honed and implemented and that their basic communication tools — the practice website and phone coverage, for example — are up to date and functioning optimally before the practice embarks on an effort to attract new patients.

The practice “really needs to focus on everything that they are currently doing to ensure excellence in their office space, patient care and patient satisfaction,” Crème said. “That's the first and most important aspect of internal marketing — making sure the ship is tight and there is excellence at every level of care.”

Marketing efforts always should include patients.

“The lowest-hanging fruit always is going to be [a practice's] patient base,” Grant said. Many practices have patients in for a single condition, and yet patients don't realize the full scope of the practice. Ideal internal marketing ensures patient retention, allowing physicians to up-sell to other services and request referrals.

“These efforts are free, but a lot of practices don't even think of them,” Grant said.

Decide when to use direct mail

Many announcements do not warrant the expense or effort of a direct mail campaign, such as a change in office hours or the addition of a new physician to the practice. Although important, this information easily can be shared with existing patients through a flier, poster or email, or by proactive office staff conversations with patients.

Direct mail should be used either as a “branding strategy” — a way to introduce patients to a physician or practice — or as a “call to action” to alert potential patients to a seminar, new service, screening or promotion, Crème said.

For example, a “branding” direct mail postcard or pamphlet could introduce a new practice to a community, or reintroduce a urologist who has worked in the community for 25 years to potential patients.

An invitation, or call to action, should provide a time-sensitive offer or a “value add,” Grant said, such as a healthy eating seminar or a cooperative partnership with a school, community organization or hospital. It could come with a special promotion so physicians get a better sense of who is reacting to the mail solicitation.

Don't forget the graphics

To ensure that your message is read and retained, the art and copy on a postcard or pamphlet must be appropriate and engaging.

“The more professional, the better,” Grant said. The message should be time-sensitive, reflect value in the practice, provide a “high-value offer,” and reflect a clear intent of what the practice wants to achieve. “You want to fight for your image.”

An introduction or invitation should lead potential patients back to a website. “Patients see doctors they know, like or trust,” Crème said. “We need to get them back to the website” where a potential patient can learn more about the practice and physician. “No marketing piece alone is going to make someone know, like and trust you.”

Crème cautioned that medical advertising — especially ads involving promotions for free or discounted services — are regulated by the Federal Trade Commission and local medical board guidelines. For example, cash rebates, payment for patient referrals and discounts for Medicare patients are prohibited, and other promotions may require a disclaimer. Any patient testimonials must meet standards of the Health Insurance Portability and Accountability Act. HIPAA doesn't restrict the use of testimonials, but they should be in the patient's own words and should not share information that may identify any patients with specific treatments.

Make a list, and determine the cost

When choosing the audience for postcards or letters, the practice first needs to do research, Crème said. It can be as simple as looking at the current demographics — male or female, age, ZIP code and health conditions — of the last 50 patients who visited the practice for an appointment. That information will give the practice a clear sense of who its typical patient is and whom to target.

“Another reason for profiling your prime targets is that with modern digital printing, you can personalize and/or change the message and graphics on a particular direct mail campaign targeted toward specific demographics,” Fawcett said. “That is a more expensive option but proves to be very successful because of the personalization factor.”

Once you have determined the parameters of the practice's “perfect mailing list,” you can take the information to a print shop or mail house that will handle the entire project, Crème said. Lists also can be purchased through a list broker or online according to demographics.

“This is important,” Grant said. “If you're a pediatric practice, you don't want to mail to seniors.”

Each demographic category you select will add to the total cost of the list. Grant suggested determining a budget for the project — design, printing and mailing — before purchasing a list. For optimal effectiveness, a mailing may need to be done more than once.

If possible, test the effectiveness of one type of direct mail — a postcard versus a letter, for example — before launching a full campaign, Grant said. “You could do what is called an 'A/B split' where half of your recipients get a letter, and half receive a postcard,” and measure the effectiveness of each.

Total costs for a direct mail campaign can “be as cheap as $600 or $700” or as high as “$10,000 for a large, multicentered group who want to blanket the area reaching everyone over age 18,” Crème said.

In addition to personalizing direct mail pieces, practices sometimes include a promotional item, such as a magnet or key chain with practice information, which can add to direct mail costs. To save money, staff can purchase mailing lists online and then print out and apply labels to postcards or letters to save money.

Measure your effectiveness

A website address, appearing only on the direct mail piece, or a unique phone number can help gauge the success of a campaign. However, both need to be available for a long time, Crème said, because people may not need particular care for six months or more.

There are other, “vaguer” ways to measure success, Crème added. “Are more people searching on Google for your practice? Are you getting more phone calls? Has your average daily patient number grown from 75 to 95? These also will gauge whether or not your campaign is effective.”

The return on investment often is determined over time, Grant said. “Did the phone ring? Was the appointment scheduled? Did the person come to the appointment, and was the person converted to a patient? Only then do you know that you have a definitive return on your investment.”

Grant said it's possible that a less expensive email solicitation could reach more people, but direct mail is more likely to result in a more serious response. “You may say, 'My email campaign was so much more effective,' but effective with what? Maybe direct mail only got three responses, but the responses resulted in three new patients with high case size.”