People have studied marketing full time for years on end (among them yours truly). The reality is that one cannot learn to be a dental marketer from a single article. Furthermore, the dynamic nature of marketing requires one to keep current on new strategies and research. My modest intention with this article, therefore, is to lay some groundwork that I believe to be essential to an understanding of, and appreciation for, the power marketing for dentists has for the growth and success of your practice.

Recognizing that readers will be at various stages along the “marketing learning curve,” we begin by providing necessary background, concepts and definitions. Once we’re all on the proverbial same page, we can advance to the key steps to implementing a successful marketing strategy, using direct mail as our example. We continue with Internet marketing strategies, and close with a strategy that is dear to me, namely, cause-related event marketing.

Setting The Stage
To be successful at the marketing game, it is essential that you and your staff are committed to the marketing process, and the promise this vital part of running a successful practice offers to share your message about relieving pain, improving appearance, and over all health for as many patients as your practice wishes to enroll.

To achieve this level of success, a bit of “attitude adjustment” is sometimes required on the part of practitioner and staff. To share the optimism and enthusiasm, and devote the energy and resources necessary for success, you and your staff must believe in, and be happy about, the fact that you have chosen to take command of your practice growth rate.

Just as one of your most important tasks is improving the “Dental I.Q.” of your patients, you may find it useful to enhance your own “Dentistry Marketing I.Q.”

So let’s begin by placing marketing’s role in the dental profession in historical perspective.

A common mistake many practitioners make can be summed up by the old adage of ‘putting the cart before the horse.’ Often, a dentist will amass a staggering debt by purchasing such technological wonders as video imaging, digitized radiography, laser packages, Cerec, needle-less anesthesia, whiz-bang practice management programs, and more. Of course, it’s great to have a state of the art practice. The point is that high tech equipment, by itself, can do little to increase new patient flow.

The only way to assure consistent practice growth is by implementing an effective marketing plan.

Marketing, Advertising, and Selling
The term marketing is often used interchangeably with selling and advertising. In the context of dentistry, ‘selling’ is the act or process of receiving treatment acceptance. Advertising is the process of attracting public attention to your practice, as by paid announcements in the print, broadcast, or electronic media.

Philip Kotler, Ph.D., author of some of the most popular college texts on the subject, defines marketing as “human activity directed at satisfying needs and wants through exchange processes.” To be sure, selling and advertising are essential components of the marketing process, but they are not the whole picture. Success at marketing for dentists depends upon an integrated system of numerous activities (selling and advertising among them) requiring proper timing, planning, execution, and evaluation.

Historical “Parallels”
Dentistry and Marketing, with the exception of internal marketing (more on this later) have, until the latter part of the last century, had little to do with each other. Dentistry historically considered itself “above” marketing. Also, in many cases, there was no perceived need to market. My father and uncle were the first dentists in Glenview, a suburb north of Chicago. They followed the Civilian Conservation Corps (CCC) which was building the Forest Preserve system. Their “marketing plan” consisted of opening their practice near the worksite. Talk about a “captive audience.”

Another reason many practices did (and do) not market is because of the inherent difficulty in measuring “opportunity cost,” that is, the cost of not doing something. The money saved by e.g. not performing a direct mail campaign is easier to measure than the money one would have earned by investing in a given strategy. Even a successful practice could be more successful. In this regard, many practices remain “blissfully unaware.”

Prior to the advent in this country of fluoridated water, managed care, and a decrease in the ratio of population to dentists, most practices had to rely on “word of mouth” to ensure a full appointment schedule. The thought of actively promoting the practice led the dentist to feelings of inadequacy, desperation, or failure as a clinician. “If I deliver high quality dentistry, should that not be sufficient?” went the conventional wisdom.

But perhaps the factor most responsible for the lack of marketing in dentistry and other health professions was the widely held view that it was unethical. In fact, prior to the Federal Trade Commission’s 1979 Ruling (FTC vs. American Medical Association), marketing of professional services was prohibited.

There continue to be regulations maintained by the various state dental societies concerning what constitutes acceptable marketing practice, so one of your first tasks is to continually monitor, and measure your marketing plan against, these regulations.

The Patient/Provider Relationship
There are three paradigms used to describe the dentist-patient relationship: The Guild, Commercial and Interactive Models.

The Guild Model views the patient as incapable of making judgments, not only about kinds of treatment, but the need for therapy in the first place. Since there is no justification offered for decision making by the patient, there is no justification for a dentist to market.

The Commercial Model holds that the relationship between dentist and patient is simply that of producer and consumer. The watch phrase here is caveat emptor, buyer beware.

Dentist and patient are viewed as equal bargainers who have no obligation to one another, except a prohibition of coercion, an obligation to truth (not necessarily the whole truth), and a duty to keep contracts once made.

The goal of the dentist, under The Interactive Model, is to enhance patient autonomy. This assumes both that the patient is capable of understanding, and the dentist owes a duty to assist the patient in making decisions about, dental care.

What distinguishes the Interactive from the Commercial Model is its belief in the moral, not merely the economic, equality of the doctor and patient, and it is the model we believe ought to characterize the patient provider relationship.

Awareness and Persuasion
Most marketing programs consist of two components: an awareness creation component, and a persuasion component. There are those who maintain that persuasion has no legitimate role to play in marketing for dentists. In our view, persuasion has a valuable role to play, provided it has as its primary objective providing necessary and high quality services to the un-served and under-served public.

It may well be that very little persuasion is necessary to achieve your practice growth objectives. We work with a number of practices where, for example, owing to the shortage of providers, rapid population growth in the area, or other factors, all the practice need do is create awareness of it’s existence. An excellent example of this is a doctor in (pre-Katrina) downtown New Orleans, who merely needed to inform businesses and residents of his location to realize a substantial influx of new patients.

Another example of the awareness-creation component of marketing is related by a Client, practicing just north of Chicago. She invested a lot of money to make her office wheel chair accessible. “I just assumed people knew about it. Apparently, they didn’t, and I no doubt missed a lot of opportunities to treat these people.” By simply mentioning this benefit in the copy of her mailings, the response among senior citizens increased markedly.

Internal and External Marketing
Internal marketing concerns itself primarily with communication among your patients of record. In a general sense, anything, which has an impact on your patient’s perception of your practice, is a form of internal marketing.

External marketing is intended to create awareness and induce a response among people with whom you’ve not yet established a relationship.

As mentioned above, some practices need only create awareness of their existence and location to induce a response. Marketing, where the element of persuasion is absent (or subtle) is sometimes called Institutional Marketing. Its sole objective is to convey to, and establish among, the target audience, a certain image about the practice. This is also a component of the Branding Process.

Examples of internal marketing include: treatment presentation, patient recall and reactivation, on-hold messages, and referral programs, a great example of which is Cause-Related Event Marketing (more on this later).

The distinction between internal and external marketing can sometimes blur as when, for example, one considers referral programs. This is because, while directed at patients of record (internal marketing), their intent is to attract prospective patients (external marketing).

Examples of external marketing include: community outreach, as in making presentations on dental hygiene to school children, speaking and networking at chambers of commerce, Internet-based marketing, direct mail, Yellow Page advertising, television, radio, and professional call handling (also called telemarketing). Owing to the fact that convenience is such a strong motivator in an individual’s decision to join a practice, most dentists should consider themselves to be local area marketers. The so-called broadcast marketing channels (advertising on radio, television, newspapers, etc.), therefore, are seldom cost-effective since they are attempting (and you are paying for the attempt) to contact people beyond your Service Area. This has become somewhat less true as television stations have become more numerous, and begun to offer “regional coverage.” It is important you clearly understand the extent to which the particular medium’s ‘reach’ is consistent with your target audience.

Telephone call handling is another area where internal and external marketing can overlap. This is because current, as well as prospective, patients call your office. Proper etiquette in handling these calls is absolutely crucial to the positive perception of your practice among current and prospective patients.

Recent years have seen the proliferation of the use of the Internet for everything from academic research to grocery shopping. Its use in the dental profession has increased significantly as well, both as an internal and external marketing tool. Used as part of an integrated marketing plan, the Internet can serve an internal marketing function by, for example, facilitating cost-effective communications with your patients of record (periodic emailed newsletters, appointment reminders, etc.). External marketing is facilitated both by including your website address prominently on more convention communications, such as direct mail (so called ‘bricks to clicks marketing’), and via direct Internet promotion using such strategies as search engine optimization, paid placement (also called pay-per-click) and link building (both reciprocal and non-reciprocal). In addition, your website can help increase practice efficiency by serving as an administrative tool to e.g. streamline the new patient enrollment process. We will expand on Internet marketing later in the chapter.

Bring It All Together
It is vital to realize that the marketing strategies, which comprise your marketing plan, must form an integrated system and, as such, cannot be viewed as working independently.

An illustration of this interdependency is how success with external marketing requires sound internal marketing systems (and vice versa). As you know, external marketing strategies generate inquiries. Internal marketing is primarily concerned with what you do with the inquiries.

Remember too that, only with a truly integrated system can you realize that illusive phenomenon called synergy, where the whole is greater than the sum of its parts.

by Danny Bobrow



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