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Mba monograph13 0412_marketinganoptometricpractice


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Mba monograph13 0412_marketinganoptometricpractice

  1. 1. TM Marketing an Optometric Practice ABSTRACT Background: Most optometric practices devote too little attention and resources to marketing the practice to both current and prospective patients. The result can be sub-optimal financial performance. Recommendation: Optometric practices should develop a simple annual marketing plan and budget before the start of each business year with quantitative goals and strategies and programs to achieve goals. Conclusion: Effective marketing planning and execution has potential to increase annual revenue from existing patients and attract new patients to the practice. MONOGRAPH Permission to reprint this article can be obtained by contacting Practice Advancement Associates: 13
  2. 2. Background Along with financial and staff management, directing practice marketing is one of the principal duties of an optometric CEO. Management & Business Academy™ (MBA) surveys among independent ODs consistently reveal that a majority of ODs devote too little time and resources to practice marketing. The median annual marketing expenditure of independent ODs is just 1.2 percent of gross revenue. Less than one- third of practices spend 2 percent or more of revenue for marketing. The median marketing spending per complete exam performed by independent ODs is just $4.11. In 70 percent of OD practices, the majority of marketing funds are spent for internal marketing activities directed toward the existing patient base. One-third of practices spend less than 20 percent of the marketing budget for external marketing programs, including media advertising, websites, exterior signage, direct mail and open houses. Marketing activities are often critical to the financial performance of practices in their formative and early growth stages. The patient base of new practices is often too small to keep a doctor busy full-time, with the unfortunate result that fixed costs consume a high share of practice revenue. Such practices need to attract new patients rapidly. 2 0.1% 0.4% 0.6% 0.9% 1.1% 1.2% 1.3% 1.8% 2.3% 2.7% 4.0% percentile ranking AVERAGE = 1.5% 5th 15th 25th 35th 45th 50th 55th 65th 75th 85th 95th Low Median High Marketing Spending % of Gross Revenue Performance Deciles 0% 6% 15% 22% 34% 40% 45% 58% 65% 80% 95% percentile ranking 5th 15th 25th 35th 45th 50th 55th 65th 75th 85th 95th Low Median High External Marketing % of Total Marketing Spending $0.25 $1.18 $2.05 $2.62 $3.54 $4.11 $4.76 $5.94 $7.82 $10.91 $21.92 percentile ranking AVERAGE = $5.65 5th 15th 25th 35th 45th 50th 55th 65th 75th 85th 95th Low Median High Annual Marketing Spending per Complete Exam Performance Deciles
  3. 3. 3 Practices in their early growth years often need to rapidly increase revenue to enable investment in new instrumentation, to expand facilities or to add staff. They look to both attract new patients and generate more revenue from the existing patient base. When new or early growth stage practices spend less than 2 percent of revenue on marketing, they often short-circuit their growth. Many highly successful, established OD practices spend little on external marketing, relying on patient referrals to attract new patients to offset the inevitable attrition of existing patients. Such practices generate referrals by delivering a consistently high level of patient service, usually the result of carefully planned orchestration of the patient experience. Building patient loyalty and referrals is their chief marketing priority. Such practices are also often effective communicators of the benefits of high-value products and effective merchandisers of products. With these marketing skills, they achieve much higher revenue per patient than other practices. Some ODs equate marketing with advertising. That’s too narrow a definition, because marketing encompasses all forms of patient communication that impact perceptions of the practice and produce a brand identity, including: • Practice positioning, name and logo • The totality of the service process • Product mix presentation and product merchandising • Visual imagery of the facilities, decor, doctor and staff appearance, practice website, marketing communications vehicles • Pricing and fees • Promotional offers • Advertising messages • Social media presence This monograph provides guidelines for developing and delivering marketing messages to attract new patients and to influence the decisions and behavior of existing patients as they visit the practice and between visits. Marketing activities are discussed in four categories: • Marketing during patient visits • Patient recall • Between-visit marketing communications • New patient marketing No space is devoted in the monograph to a discussion of external advertising or to media planning, because it is assumed that few practices will engage in such programs. The monograph concludes with a template for creation of an annual marketing plan. Marketing During Patient Visits A patient visit provides the best opportunity for ODs to create a powerful brand identity and achieve the marketing objectives of a practice. Emails, mailings and the practice web site do much less to influence patient perceptions of a practice than do office visits. Personal interaction at the office creates an indelible, emotional impression of the practice that verbal or visual communications in other media are not likely to alter much. A patient visit experience conveys the essence of an optometric practice brand. Visits should be carefully orchestrated to convey the messages and impressions that will result in achieving marketing objectives and in building loyalty and referrals. Practice owners usually do not think of patient visits as marketing events that create their brand image. But this key insight can be the launching pad for dramatic improvements in patient communications.
  4. 4. 4 The MBA offers many tools to assist practice owners to structure office visits to powerfully communicate the practice value proposition. Two particularly useful tools include the MBA monograph tilted “Patient Experience Engineering” and the MBA Service Excellence Workshop “Service Mapping,” both available on A patient visit is the premier opportunity to showcase what makes a practice unique and special, as well as to educate patients about services offered and patient care goals. It’s important that key messages be explicitly crafted and delivered. The messages can’t be left to chance, or left for patients to decipher from hundreds of spontaneous, non-verbal impressions they gather during a visit. Every practice needs to decide which key messages it wants to convey to each patient. It’s likely that the following key messages should be on every practice’s list. • KEY MESSAGE: “Here’s why you should continue to come here for eyecare.” In most cities, there are plenty of eyecare providers, in both independent practice and commercial settings. Nearly all of them provide competent eye exams and sell eyeglasses and contacts. A powerful brand identity and patient loyalty don’t develop by delivering just the basics that every ECP provides. It occurs only when the service is memorable and exceeds expectations. It’s up to every practice owner to define exactly what will differentiate the practice from others in the community. With input from staff, think of the five to 10 things that can separate you from the pack and keep patients coming back. Write them down. Almost always, these are the things that your raving fans say about you when they refer the practice to their friends and family. The MBA monograph “Mission Statements and Practice Positioning” can help you frame what differentiates your practice. After you decide on the major reasons patients should continue to rely on you for eyecare, with staff input, determine how and when you will communicate these reasons to your patients during their visits. Never assume that patients will intuit the reasons they should return without being told explicitly. A major element of your practice marketing program is the standard patient education script that explains what makes your practice special. • KEY MESSAGE: “We provide therapeutic medical treatment for infections, dry eye, allergy and other ocular conditions.” Many practices assume that patients know the practice offers medical eyecare services. But many patients do not know this and will never relate their symptoms of ocular conditions because they assume the doctor is only interested in eye exams and selling eyeglasses and contacts. Making it highly visible that a practice offers medical eyecare will cause candidates for medical eye care treatment to step forward, and it will enhance perceptions of the OD(s) as medical professionals. • KEY MESSAGE: “A yearly eye exam is an important preventative measure to protect sight.” Dentists have successfully created the expectation that semiannual visits are normal and part of a good oral health prevention plan. Few ODs have been successful at instilling the value of yearly exams, but they can be successful with explicit marketing messaging. From the first words of the receptionist to the closing goodbye, the importance of yearly comprehensive exams should be emphasized to patients.
  5. 5. 5 Each time the word “exam” is used it should be prefixed by the word “yearly.” The appendix contains suggested scripts for doctor and staff to communicate the value of yearly eye exams throughout an office visit. • KEY MESSAGE: “Your insurance allowance covers basics only.” Half of the U.S. vision correction population has vision insurance. Few patients with insurance understand or remember the complexities of their coverage, and many expect that their insurance will cover the total cost of their eye exam and eyewear or contact lenses. But, in fact, many plans cover only a very minimal and basic package. This leads to misunderstanding and disappointment. It should be made clear from the first contact with each patient that his or her allowance should be considered a major discount on products and services, but may not be sufficient to obtain products that offer the performance patients want. The explanation should make clear which fees and charges will be covered by a patient’s plan and which will not, before service begins. Product recommendations should never begin with the words: “Let me show you what your plan covers.” This can inadvertently result in self-imposed constraints on presentation of eyewear or contact lens alternatives to limit or eliminate a patient’s out-of-pocket expense. Insurance coverage should never dictate the sales process. Product Mix Management Every retail store owner knows that the array of products presented to customers-- or product mix--has a huge impact on sales and profits. The product mix a business offers determines the average transaction size. Beyond dollars and cents, the product mix creates an image of a retailer and a stereotype of the customers who are likely to be satisfied by the business. MBA surveys indicate the following benchmarks for median revenue production per patient among independent ODs: • $306 gross revenue per complete eye exam • $227 gross revenue per eyewear Rx dispensed • $150 annual contact lens sales per contact lens exam “Your coverage pays for an exam and a very basic pair of eyeglasses, but can be used to greatly reduce the cost of eyeglasses offering much better performance, that most of our patients prefer to wear.” “Your coverage pays for an exam and a six-month supply of contact lenses. This will greatly reduce the annual cost of your lenses. For extra convenience and savings we recommend an annual supply of lenses, at a modest additional cost.” “Your insurance will greatly reduce the cost of your primary pair of eyeglasses and make it much easier to afford a pair of computer glasses (or polarized sunwear, etc.) that will make your daily work a lot more comfortable.”
  6. 6. 6 The same surveys show that the top performing 20 percent of practices on each metric beat the median productivity benchmark by 50 percent or more. They well exceed industry norms primarily through more effective product presentation, not higher prices and fees. Product dispensing ratios vary widely across OD practices. Disparities in usage of individual product types, such as daily replacement contact lenses or anti-reflective lenses, always trace mainly to ECP preferences and habits and not to patient choice or demographics. Unlike other retail environments, what a doctor chooses to recommend and prescribe creates a sales mix, not what patients request or prefer. Every practice should pay conscious attention to the product mix it routinely presents to patients and to the details of patient education about products and the sales process. Every practice marketing plan should set objectives for revenue per patient and identify the strategies and tactics to improve productivity. The MBA has developed many publications to educate ODs on effective techniques for product mix management, including “Best Practices of Contact Lens Management,” “Best Practices of Spectacle Lens Management” and the MBA monograph “Increasing Gross Revenue per Patient” – all available on Price Promotion Unlike many patients of chain optical retailers, new patients of independent ODs are seldom attracted by price incentives. New patients choose indepenent ODs because they anticipate a higher level of personalized service and expect to pay more for the goods and services they purchase there. As a result, optometric consultants advise independent practice ODs not to market a practice with aggressive promotional campaigns or ongoing discounts on goods and services. To the extent that new patients are attracted by discounts, they tend to be less loyal because they are prone to respond to incentives subsequently offered by competitors. Despite the dictum to avoid price promotion, consultants recommend the following exceptions to build revenue: • Spectacle Lens Bundling An effective technique to increase the average eyewear sale is to bundle lens features into a limited number of packages, and to offer each package at a lower price than if the features were purchased as add-ons. • Multiple Eyewear Purchase Discounts Multiple pair sales can be dramatically increased by offering discounts of up to 50 percent on purchase of second pairs, within a week of an eye exam. • Contact Lens Annual Supply Discounts Sales of annual supplies of soft contact lenses can be increased by offering discounts of about 10 percent on the per box price of soft lens, presented in combination with manufacturer rebates. • Special Event Discounts As a call-to-action to stimulate purchase during special events, event-day discounts are effective.
  7. 7. 7 Practice Brochure A practice brochure is essential to position a practice in the minds of new and existing patients, identifying the service themes and value proposition that define the practice. Keep a stack of brochures in the reception area and include them in information kits. Brochures should be also sent in a welcoming kit to new patients, used in mailings to prospective patients and distributed at any public lectures given by the doctor. Guidelines for effective brochures include the following: • Brochures should be professionally designed. A brochure will make the critical first impression of the practice for many prospective patients, so appearance is important. A well-produced brochure will convey that the practice is a well-run, highly professional business that takes pride in its reputation. • Language and photos should convey that the practice is a caring, friendly place that is medically up-to-date. Pictures of smiling, welcoming doctor(s) and staff are the best devices to convey the human dimension. • Provide a comprehensive listing of services offered. • Provide a brief biography of the doctor and comments on any specialties or patient care philosophy. • If advanced instrumentation is an important asset of the practice, feature it. • Emphasize the ability of the practice to improve the quality of patients’ daily lives through better vision, not merely disease prevention or vision maintenance themes. • A tri-fold 8-1/2” x 11” design is economical to print and sufficient for most practices. Signage and Displays Guidelines for using manufacturer supplied point-of-sale (POS) materials are listed below. • Avoid display clutter. Limit the amount of large signage and displays to a few brands—five or less in a 2,000-square-foot office. Overload may inadvertently create the impression that the practice is primarily interested in selling products over professional care. • Feature products offering high performance and premium profit margins. These are often the products that appeal to segments of the market that may never be discussed unless a patient inquires. • Only use signage that is tasteful, professional and has high production value. Even though you did not produce the signage, tasteless materials creates a negative impression that reflects on your practice. • Regularly refresh displays as new materials become available. Faded or dated posters signal that the store is not being properly minded and that the practice is out-of-date. Patient Recall Among all marketing processes, a practice’s recall system has a larger impact on financial performance than any other and yet many ODs devote little management attention to it. A 2011 MBA survey revealed that the median independent OD practice spends just 3 minutes of staff time on recall activities per exam performed. Assuming an hourly staff salary of $15, just 78¢ is spent on recall per exam in typical practices.
  8. 8. 8 Surveys among independent ODs show that nearly all recommend yearly exams to contact lens patients, 80 percent recommend yearly exams to presbyopes who wear eyeglasses-only and 69 percent recommend yearly exams to non-presbyopic eyeglass-only wearers. Most practices do not track the average interval between patient eye exams and therefore can only guess at the average elapsed time before patients return. ODs recognize that not all patients comply with their recommendations, and they guess that contact lens wearers return for exams every 14 months and eyeglass-only wearers every 18 months. But actual patient compliance with OD recommendations on when to return does not reveal such a rosy picture. Patient surveys reveal that the average interval between exams for contact lens patients is actually about 18 months and is 28 months for eyeglass-only wearers. Confirming these statistics, MBA surveys show that during a year, in typical established independent OD practices, about 40 of every 100 active patients have an eye exam. That’s equivalent to an average interval of two-and-one-half years. Because many ODs have not done a good job conveying the value of annual exams as a preventative measure, patients, left on their own, tend to wait until they notice a vision change or problem, have a mishap with their eyewear or need more contact lenses before they call for an appointment. It’s clear that when ODs take charge of the recall process, proactively setting the date of patients’ next exams and confirming appointments, they reduce the interval between exams. Reducing the interval can have a major positive impact on practice revenue not only by increasing professional fee income but by increasing product sales as well. The table below shows that reducing the average interval between exams from the typical 2.5 years to an optimal two years increases the number of exams and gross revenue by 25 percent. Clearly, effort to improve recall success will be time well spent. Average Interval Between Exams Years Months Median practice Optimal Annual Complete Exams 2,000 2,080 2,175 2,275 2,380 2,500 2.5 2.4 2.3 2.2 2.1 2.0 30.0 28.8 27.6 26.4 25.2 24.0 Annual Gross Revenue $600,000 $624,000 $652,500 $682,500 $714,000 $750,000 Impact of Reducing Interval Between Eye Exams* *Assumes 5,000 active patients, $300 revenue per exam
  9. 9. 9 Every OD practice needs a consistently executed recall system to reduce the interval between patient eye exams. Pre-appointment for the next exam at the conclusion of each eye exam is a best practice used by four-in-10 independent ODs. MBA surveys show that a median 75 percent of pre-appointed patients have an eye exam within three months of their pre-appointment. That compares to a median of just 40 percent who have an exam after receiving a recall mailing. See the MBA “Patient Recall Survey: 2011” report on for a more detailed discussion of effectiveness of recall techniques. An MBA monograph titled “Effective Patient Recall” outlines a detailed marketing process to improve recall success, available on Between-Visit Marketing Communications Just 46 percent of independent ODs say they regularly communicate with patients between office visits. That means in typical situations two or more years pass in silence with no contact with individual patients. That silence opens opportunities for competitors to communicate their value propositions to your patients. Electronic communication is a very cost-effective method of communicating with patients between their office visits. As of 2010, eight of 10 adults used the Internet and nearly half used a social network. Use is nearly universal among people under 65 years of age. For a majority of adults, email has become a daily means of communication with friends, family, businesses and institutions. Electronic communication has rapidly replaced the postal service for much personal communication and is also capturing market share from traditional telephone services. All businesses must adapt to the changed communications environment. Some of the many uses of email to communicate with patients between office visits include: • Birthday greetings • Compliance reminders • Recall notices and eye exam reminders • Opinion surveys • Announcements of new services, significant new products, special events • Staffing change announcements • Articles about eye health topics • Product promotions • Thank-you for referral There has been an upsurge of OD email communications with patients. Currently 63 percent of independent ODs say they use email regularly to communicate with patients, but most still do not maximize their use. Affordable outside services are available to manage email communication. Receptionists should be taught to gather email of address from all patients and ask each patient to confirm their current address. MBA faculty member Dr. Neil Gailmard tells his front desk staff that getting an email address is just as important as getting a patient’s telephone number. When a practice’s email address list is linked to its practice software system, it becomes possible to customize electronic communications to selected individuals or targeted segments within the patient base, increasing the likelihood that emails will be read. As of early 2012, some 68 percent of independent ODs say they host a social media business page. If well managed, these pages can become an effective way to maintain contact with patients between visits as well as to generate new patients. For a discussion of how to get started building a social media presence, see Dr. Gailmard’s Management Tips of the Week numbers 465 and 527 on
  10. 10. 10 Practice Newsletters Just 30 percent of independent OD practices publish a newsletter--despite the fact that Email has made transmission of newsletters virtually cost free. Optometric veteran Dr. Irving Bennett devotes a chapter of his book Optometric Practice Management to newsletters. He views this vehicle as an ideal way to keep in touch with patients during the long interval between office visits which averages more than two years. He prefers a format that gives the appearance of being a personal letter from the optometrist, but professionally formatted newsletters can also be effective. Appropriate content for newsletters includes: • Layman’s explanations of ocular disease, prevention tips, new medical research findings • New staff member profiles • Awards or recognition received by doctor or staff • Doctor publications or speaking engagements • New instrumentation and testing procedures • New services • New product information (While product information is appropriate, the newsletter should not contain a preponderance of product promotions to avoid the appearance of commercialism.) • Special events and promotions • Reinforcement of the practice positioning Other guidelines for newsletter production include: • Hire a freelance writer to develop copy if you are uncomfortable with writing. Discomfort with writing is one of the major reasons ODs do not undertake newsletters. You can easily guide a freelancer to craft your message. • Keep articles brief and conversational, no longer than three to five paragraphs. • Pictures of the staff, instruments, facilities, products and illustrations of ocular conditions add interest. • Publish two to four times annually. Less frequent publication will reduce the newsworthiness of the content. • Request support from key vendors in return for mention of their new products in the newsletter. Special Events Conducting trunk shows and open houses are widely used and highly effective means of gaining a strong short-term revenue boost for a small investment of time and money. They also inject a sense of fun and news into a practice and are a way to maintain contact with patients between routine eye exam visits. Most optometrists partner with frames vendors or contact lens companies to fund the events. Guidelines for planning and executing special events include: • Announce the event two months in advance. Target the specific audience most likely to be interested. If supported by frames vendors, send a mailing to patients who have bought the vendors’ brands in the past or those with high interest in new frames styles. For contact lens events, target patients matching the demographics suggested by the manufacturer sales representative. Post the event details on the practice web site. Send a reminder notice one month before the event. Ask for RSVPs. • Offer catered food and beverages. This makes the event festive, will draw attendance and is a way to thank patients for their past support. • Do not conduct eye exams during the event. Instead, the doctor and staff should mingle with guests. • Put the expertise of frames sales reps to work to present styles to event guests. • Offer discounts to encourage sales during the event.
  11. 11. 11 New Patient Marketing Practice Web Sites Nearly 80 percent of American adults have Internet access. The Internet has become a frequently used source of information about products and services that is gradually replacing traditional vehicles such as the Yellow Pages and service directories. Few retail businesses today can afford not to have an Internet presence. MBA surveys reveal that 80-85 percent of established practices have a web site. But surveys and visits to dozens of optometric sites also reveal that relatively few practices have harnessed the full power of their web site. Just 29 percent of practices update their site monthly or more frequently. A 2011 MBA survey indicated that the median expenditure to host and manage OD practices websites is just $360. Spending on websites accounted for an average of 12 percent of total marketing spending by optometric practices during 2010. The median expenditure to maintain a practice website was $360. Some 17 percent of practices reported spending nothing to maintain their website during the previous year. Another 26% of practices spend more than $1,000 annually to host and maintain their site. The 2011 MBA Web Site Survey showed that ODs estimate that just 4 percent of the new patients they served during the past year were initially attracted by their web site. But some practices attract 20 percent or more of patients with their sites. The survey revealed a positive correlation between the amount of money spent to maintain the site and the number of new patients attracted and between the frequency of site updates and the number of new patients generated. For more details see the “Practice Web Site Management Survey: 2011” on Think of a web site as an unpaid staff member on duty 24 hours a day to answer questions and present the practice in the best possible light. A practice web site has two important functions: • Attract prospective patients and communicate a differentiating practice story that will cause people to make appointments. • Communicateefficientlywithexistingpatientsincludingappointmentscheduling, medical history updates, promotion and product news, contact lens reorders. Visits to more than 100 optometric web sites reveal much opportunity to improve the effectiveness of typical practice web sites. After reading this section, go to your own site and assess what you see against the guidelines provided in this section. The most significant defect found in a majority of optometric sites is that a site fails to tell a memorable story about the practice that differentiates it from every other eye care provider in a community. A typical optometric site conveys about as much human personality and distinctiveness as a typical Yellow Pages display ad. $0 $0 $100 $200 $300 $360 $500 $500 $900 $1,200 $3,400 percentile ranking Source:August 2011 MBA Web Site Survey 5th 15th 25th 35th 45th 50th 55th 65th 75th 85th 95th Low Median High Annual Practice Web Site Spending
  12. 12. 12 If no distinctive words or images are present on the home page, the impression left is that this is a cookie-cutter, plain-vanilla optometric practice, offering about the same services that are available anywhere. Such sites fail to answer the question: “Why should I trust my vision to this practice?” A web site is an excellent vehicle to create a distinctive positioning of a practice, giving prospective patients a compelling reason to make an appointment and a memorable story that current patients can tell others. Some sites make it obvious that the practice devotes little attention to e-communications. Telltale signs of this are news items (new doctors, new staff, special events) on the home page that are outdated. Another indicator is that the most recent practice newsletter is two years old or more. Other sites have expired promotional offers prominently featured. Existing patients will notice if there are photos showing staff who have left the practice. Inattention to the timeliness of the information on the site conveys to both current and prospective patients that the practice is not paying much attention to detail. A few optometric web sites appear more interested in selling products than providing professional care, with home pages dominated by images of new frames styles, new contact lenses or new spectacle lenses. This leaves the impression that professional care is a subordinate element in the service provided., a leading developer of optometric web sites, estimates that optometric sites typically receive about 202 visits each month for every optometrist working in the practice. It’s safe to assume that each visitor is looking for information that would otherwise need to be provided on the telephone which consumes valuable staff time. Using the practice web site to communicate information efficiently can provide important cost savings. An analysis of the traffic at 100 optometric web sites conducted by EyeCarePro. net revealed that 75 percent of site visitors were first time visitors, never having visited before. This does not mean that all new visitors are not current patients, but it suggests that a high proportion of optometric site visitors are not patients of the practice. Prospective patients are looking for someone to entrust with their eyesight, and a practice web site must quickly answer the question: “Why should I trust my vision to this practice?” The answer must be delivered in a flash, because the competition is just one click away. Perhaps surprisingly, relatively few practices attempt to answer this question on their home page, and some do not answer it anywhere on the site. What do patients want from independent practice eye care providers? For most people, it boils down to three things: 1) professional competence; 2) personalized attention and caring; 3) life improvement through better acuity and quality of vision. They choose providers who appear to satisfy these needs. The home page of your site should telegraph how the practice will satisfy the three primary desires of prospective patients. Two other reasons people select eyecare providers are to have a convenient location near their residence or workplace and to have their vision care insurance accepted. Home pages should convey the convenience of a practice’s location and should lead visitors effortlessly to a listing of accepted insurance plans. Contact information and office hours should be found easily on the home page. Here are the other topics most frequently searched for: • Insurance coverage • Questions about ocular conditions • Medical history update • Appointment scheduling • Contact lens reorder
  13. 13. 13 The home page navigation bar should lead patients with a minimum of searching or clicks to this information. Community Outreach Many optometrists believe that active involvement in their local communities is one of the most effective strategies to establish a practice during its formative years. This means being active in church, civic, service and philanthropic organizations. It may also include offering services to local schools, nursing homes, senior centers or manufacturers or conducting seminars at community or club gatherings. Dr. Gailmard’s Management Tip of the Week #464, available on, provides a good discussion of community involvement opportunities. Patient Referrals Many optometric practices do little external marketing and rely on referrals from existing patients to generate new patients. Referrals occur only when patients are extremely satisfied with the care they receive and feel comfortable recommending the practice to others. A good indicator of the quality of patient service of an optometric practice is the percentage of new patients generated by patient referrals. Independent ODs estimate that a median of 30 percent of their new patients come from patient referrals. Consistently delivering exceptional patient experiences is essential to achieving a high number of patient referrals. This aspect of marketing the practice is discussed under “Marketing During Patient Visits” above. In addition, referrals can be encouraged in the following ways: 1. At the conclusion of each eye exam, ask patients for referrals. Tell each patient that the practice welcomes referrals. In busy practices, existing patients may assume that the practice is too busy to accept new patients. Say: “We hope you were pleased with the professional care you received today, which many of our patients tell us is a great value. If you were happy and know people who might benefit from our care, could you give them one of our business cards?” Provide several business cards to receptive patients. 2. Ask each married patient to refer their spouse and each parent to refer their children. As an eye exam concludes, ask married patients if they would like to schedule an exam for their spouse or children. Tell them it’s easy to reschedule if the appointment time does not work. Give the patient a reminder card(s) of the scheduled appointment(s). When entire families are already patients of the practice, before performing an exam for one member of the family, check the records of the other family members to determine if the others are due for an exam. Mention this to the patient having an exam and ask to schedule appointments. Tell them it’s easy to reschedule if the appointment time does not work. Give the patient a reminder card(s) of the scheduled appointment(s). 8% 10% 20% 20% 25% 30% 33% 45% 50% 65% 80% percentile ranking 5th 15th 25th 35th 45th 50th 55th 65th 75th 85th 95th Low Median High % of New Patients from Patient Referrals
  14. 14. 14 3. Ask caregivers to refer aging parents. Add a question to the medical history form asking if the patient is responsible for supervising the medical care of an aging parent. Suggest that the caregiver recommend the practice to the parent. 4. Offer incentives for patient referrals. Send $10 gift cards to patients who refer a friend or relative. Mention this reward to departing patients. Another idea is to conduct an annual referral contest, awarding a weekend at a deluxe hotel to patients who make the most referrals during the year. 5. Send a personal thank-you for each patient referral. Send a personal handwritten note to each patient who makes a referral, thanking them for their trust. This will deepen the relationship and encourage additional referrals. 6. Encourage Facebook fans to write about their experience. Publicity With a minimum of effort, it is possible for practices in smaller communities to obtain free press coverage of practice news. Local newspaper coverage can attract new patients as well as enhance the reputation of the practice among existing patients. As part of the annual marketing planning process, make a short list of the topics that could be developed into press releases. A rule of thumb is that editors will discard material that is promotional or self-serving, but will use information that readers will find of interest or that educates the public. Appropriate topics for news releases include: • New research findings about common ocular conditions such as dry eye, glaucoma or diabetic retinopathy • Significant new product introductions by manufacturers • Special events • Awards and recognition received by the doctor or staff • Support for local charities and civic organizations Developing an Annual Marketing Plan Every practice needs a simple marketing plan, but just 23 percent of established OD practices develop one. Creating a plan does not need to take a lot of time. The purpose is not to create a long document that will sit on a shelf. The chief reason to develop a plan is that it forces you to prioritize your marketing objectives, targets and messages. The focus will create a consistency often lacking when marketing decisions are made in reaction to short-term crises or suggestions from vendors or colleagues. An annual plan will help assure a continuity of effort and that adequate resources are committed. The best time to draft the annual marketing plan is after the annual financial goals for the practice have been set and the principal growth strategies identified. This will assure that the marketing objectives mesh with the overall business plan. The MBA has developed a Management Improvement Implementation Track on Marketing which outlines the analytical steps that should be taken to develop an annual business plan, available on
  15. 15. 15 A practice marketing plan can be summarized on just a few pages: Key elements include the following. • Objectives — A quantitative statement of the results desired. Ideally, select objectives on an analysis of business metrics and a comparison to performance norms found in this manual and other sources. Aim to improve weaknesses in practice performance. Objectives should be limited to five or fewer. They could include the number of new patients to be attracted, revenue forecast from a promotional program, an increase in the average revenue per patient, a reduction in the interval between exams, an increase in recall success rate. • Strategies — The broadly defined approaches that will be used to accomplish the objectives. • Tactical Plan — The specifics of implementation of the plan (communications vehicles, frequency, timing, promotional offer terms, etc.). • Budget — Monthly spending schedule. An example illustrating the relationships between objectives, strategies and tactics appears below. Attract new patients Increase patient referrals -Offer referral incentives -Improve service perception Sponsor media advertising -Run newspaper ads -Conduct mass mailings Acquire a second practice -Purchase ABC Eye Care Increase revenue Upgrade product sales mix -Encourage AR lens purchases per patient visit -Increase daily disposable lens Rxes -Increase penetration of multifocal soft contact lenses by upgrading monovision patients Increase multiple pair sales -Discount second pairs 50 percent Increase retail pricing -Increase photochromic lens mark-up to 2.8 x COG Improve capture rate -Upgrade frames displays -Increase soft contact lens annual supply sales ratio by proactive presentation Expand services -Offer glaucoma treatment -Offer low vision services Increase frequency Improve patient recall -Pre-appoint patients of patient visits methodology Promote new product arrivals -Conduct new product mailings, e-mailings -Conduct trunk show Objectives Strategies Tactics Sample Annual Marketing Plan Item Monthly Expenditure Sample Annual Marketing Budget
  16. 16. 16 Scripts to Reinforce Importance of Yearly Exams • Appointment scheduling: “I want to confirm the date and time of your scheduled yearly eye exam.” • Reception: “Welcome back. It’s great to see you. I see you’re here for your yearly eye exam. That’s a great way to enjoy the peace of mind of always knowing everything is fine with your vision.” • Escort to Testing Room: “Please follow me and we’ll get started with your one-year tests.” • Start of yearly testing: “We’ll be doing a series of tests to be sure that everything is fine with your eyes. It’s important that we do these every 12 months, because problems can begin to develop over those months, and you may not even notice any symptoms.” • During the yearly testing: “This instrument is a retinal camera. By recording a digital image of your retina, we can compare next year’s picture to the one I’ll take right now. That will allow us to detect any subtle changes that are occurring.” • Conclusion of yearly testing: “The doctor will explain what the yearly tests show. We’ll perform these procedures again 12 months from now, to be sure that no problems will go undetected that could threaten your sight.” • Start of eye exam: “Good to see you again. The year went by so fast. I want to compliment you on your good judgment to look after your eye health every year. I recommend that to almost everyone. I have some patients with serious problems like glaucoma or diabetes who come back more often. But so far you’ve been fortunate to only need to come back once a year.” • Handoff to optician: “Thanks for coming in. I look forward to seeing you again one year from now.” • Contact lens fitting: “We encourage our patients to visit us every year to monitor their eye health. While you’re here it’s also an opportunity for you to see some of the new eyewear options that are continuously being introduced.” • Check-out/Departure: “We look forward to seeing you in 12 months for your next comprehensive eye health exam. You will be getting a reminder from us about six weeks before your reserved appointment time. Don’t worry about the exact day or time now. We’ll have plenty of time to change that, if necessary. Thanks for trusting us to look after your vision.” Appendix
  17. 17. 17 Internal and External Marketing “Best Practices” 1. Hire a local advertising agency to create a distinctive graphic identity and logo for the practice. Use those graphics on all marketing materials. 2. Develop a positioning statement encapsulating the key patient benefits of the practice. Communicate the positioning in all marketing materials. 3. Develop relationships with leading product vendors and use the co-op money they make available to invest in marketing communications programs. 4. Measure the performance of all marketing initiatives. When ads are run, include a device on the ad to enable identification of those who respond. Measure incremental revenue from special events. Track success of promotional offers. Ask every new patient how he or she learned about the practice and record responses in a log for later analysis. 5. Continuously inject news into marketing programs—new instrumentation, new technology, new products and new promotions. News attracts, news signals growth, and news conveys your intent to keep current. 6. Except for incentives to buy second pairs of eyeglasses, avoid continuous use of discounts. Cash incentives degrade the perception of value and lower profit margins. 7. At the start of the office visit, ask every patient wearing eyeglasses if he or she intends to purchase a new pair of glasses today. This makes it less likely that people who learn they have no prescription change will avoid purchasing eyewear. 8. Develop a script to answer telephone inquiries from prospective patients who are shopping for a new eye doctor. Include statements about the practice positioning and the doctor’s strengths. Ask to book an appointment and make every attempt to accommodate the new patient’s desires for date and time. 9. Ask female household heads during their office visits if they would like to schedule appointments for other family members. Suggest tentative appointments be made for the spouse and children, even when the schedules of the other family members are not known. Explain that it is easy to reschedule an appointment if there is a conflict. 10. Avoid expensive Yellow Pages display ads. A consensus of optometrists interviewed by Bob Levoy, author of 201 Secrets of a High Performance Optometric Practice, is that Yellow Pages have limited value attracting new patients. They are referenced most by existing patients, so a simple listing is sufficient. 11. Provide departing patients a kit of information including written exam summary, compliance or product usage instruction, warranty, receipt itemizing fees and purchases and practice brochure. Enclose in a branded folder. 12. Build a referral network of other medical professionals in your community including primary care physicians, retinal specialists, cataract and refractive surgeons, pediatricians and school nurses. Offer reciprocal benefits to these professionals. 13. Offer to speak about eyecare to groups of seniors, athletic teams or civic organizations. 14. Use practice management software to create a patient database that categorizes patients by age, sex, ocular condition, product usage and personal interests. This will enable you to target communications effectively and efficiently. 15. Put the practice web site address on business cards, stationery, invoices and other marketing materials as well as on optometry directories and on-line doctor finders. 16. Gather e-mail addresses of patients. Ask them to verify their e-mail address during each visit or when they call to make an appointment. Then use email to communicate practice news to patients.
  18. 18. 18 Marketing Idea File 1. Referral contest. Offer a weekend at a deluxe hotel to the patient who refers the most new patients to the practice during the year. Announce the contest in the practice newsletter, on the practice web site and in a flyer given to patients as they depart the office. 2. Caregiver referrals. Add a question on the patient history form asking if the patient is responsible for supervising the medical care for an aging parent. For patients with caregiver responsibility, offer to provide your services to their parent. Consider offering to have a staff member pick up the parent for his or her first visit. 3. Vision benefit expiration. In October and November, send letters or e-mails to patients with vision benefits, reminding them there is still time to use their benefits before they expire at year-end. 4. Frames aficionados. In every practice there are patients who enjoy having many different frames for different events in their life or to match different outfits. A list should be maintained of these patients. As new frames styles are brought into the practice, send mailings or e-mails to this list. Frames vendors will likely provide funds to defray expenses. 5. Plano sunglass gift certificate. In May, send a $20 gift certificate toward purchase of a pair of plano sunglasses retailing for $60 or more to a targeted list of patients. 6. Local retailer co-promotion. Partner with a local retailer that targets the same demographic as your most loyal and highest spending patients (beauty salons, luxury car dealers, weight control clinics, high-end jewelers, travel agents, high-end clothier, spas). Send a $50 gift certificate toward purchase of a complete pair of eyeglasses to the partner’s customers who are not current patients of the practice. 7. Prize drawing. Place a fishbowl in a favorite local restaurant near the practice. Offer a free weekend getaway at a luxury hotel in a prize drawing to anyone who puts a business card or entry slip into the fishbowl. Gather the names and addresses of the entrants and send a $50 gift certificate to each who is not a current patient. 8. Church donation. Approach the business manager or head of development of your church or synagogue. Offer to mail a $25 gift certificate to congregants who are not current patients and to donate $25 to the place of worship for each certificate redeemed. 9. Partner retailer promotion. Offer a local retailer to mail a gift certificate for its business to your patient base, at the expense of the partner. The certificate should be forwarded with a letter from you thanking your patients for their trust. 10. Advertorials. Place paid monthly articles in your local newspaper discussing eye health topics and featuring you, members of your staff and new instrumentation and products. These articles are paid placements but have the appearance of being written by the newspaper, avoiding a promotional appearance. This is a cost-effective way to attract new patients and to elevate the reputation of a practice among current patients. 11. Anti-reflective (AR) demo glasses. Request a spectacle lens sales representative to provide a pair of glasses in which one lens has AR treatment and the other does not. At the conclusion of each exam, put on this pair of glasses and demonstrate to the patient the difference in the reflections. Also mention that AR lenses allow more light to pass through to improve vision and make it easier to see while driving at night. Close by saying, “I recommend AR lenses for all glasses.” 12. School outreach. Provide “eyecare emergency kits” to local school nurses including contact lens cases, lens disinfectants, artificial tears, saline, eyeglass repair kit, etc. Deliver the kits in person and include referral cards. Offer to be available in emergencies, to renew supplies and to speak. 13. Community lectures. Speak about eyecare to local service clubs, civic groups, senior centers and nursing homes. The AOA provides lecture materials. 14. Pharmacist outreach. Introduce yourself to pharmacists in your community, and offer to treat patients who appear at the pharmacy suffering from red eye or other ocular complaints. Provide referral cards to pharmacists. 15. Safety glasses. Contact the human resources departments of local manufacturers and offer to provide safety glasses to employees.
  19. 19. 19 16. Free vision screenings. Offer to conduct free vision screenings for employees to the human resources department of local manufacturers. Provide contact information to all people screened. Offer to be the no-charge consultant of the company for vision problems. 17. New-resident mailing. People who recently moved into your area may be looking for a new eye doctor and are likely a productive target for external advertising. Companies such as Welcome Wagon provide a vehicle to reach these people. Lists can also be constructed from other sources. Send a personal letter and an office brochure to new residents in a hand-addressed envelope.