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How to use today’s marketing tools to enhance your practice and the image of physical therapy.

By Stephanie Stephens

When and where does marketing fit in with physical therapy practices? “Some physical therapists (PTs) still have the old feeling that, somehow, marketing is sales and that it’s not ethical,” says Lynn Steffes, PT, president/consultant of Steffes & Associates Consulting Group of New Berlin, Wisconsin. “This is about reaching people, getting their attention, and educating them about the tremendous service we offer.”

If that’s the challenge, then the next logical question is “How?” PTs went to school to become PTs, not marketing gurus. Addressing the “how,” some PTs take on the marketing burden themselves. Others hire an outside firm. Your choice depends on your level of interest, skills, time commitment, and, of course, your budget. “Ask yourself, ‘What portion of the marketing role can I realistically carry?’” suggests Steffes. ”Know that your everyday interaction with patients, families, referral sources, and payers is the most natural and powerful way to market. However, using additional marketing staff or resources might give your practice the edge it needs. Marketing is as integral to your success as treating your patients.”

Keep it Simple

Many PTs’ initial marketing efforts are confined to delivering flowers, donuts, and the latest printed piece during physician visits armed with hope and a smile. Hang on there, warns Steffes, who confides that some physicians have told her they want to run from PTs “who only talk about themselves and then hand me huge brochures and folders.”

That’s not enough, she says: The most powerful word in the English language is you, so ask questions and be interested in the doctor’s practice. Physicians are busy people too, so PTs should understand the effect and impact of neuromarketing, says Steffes. That’s the study of the brain’s responses to ads, brands, and the rest of the messages littering our cultural landscape.

“Reach them on an emotional level, and remember that, as their minds make decisions, they’re asking themselves ‘Do I like you?’ ‘Do you appeal to me?’” PTs pride themselves on being “people persons.” The advice, then, is “Just be yourself.”

Steffes also suggests that PTs present themselves to physicians as colleagues: “We’ll work together and can benefit from each other,” should be your mantra. Consider “turning the tables” and write referrals to physicians. “‘I send you, you send me’ works great,” says Steffes, who also recommends suggesting screenings, education of nurse practitioners, and a collaborative approach: “I will help you manage your patients.”

Remember that every time a PT connects with a patient/client and treats him or her, that consumer provides a word-of-mouth opportunity. Capitalize on it, Steffes says. “Be really sure the patient feels the care you give is special. Ask, ‘Is there anything else I can do for you?’ Ask the question, ‘Does your family have a physical therapist?’”

Steffes notes that many patients and clients, while motivated to find relief for their pain, would prefer not to have surgery or to rely on medications. That’s significant, she says, so let your potential patients/clients know.

Before diving into major marketing, why not dip your toe into a simple direct-mail postcard campaign or e-newsletter? Your postcard can ask: “Got shoulder pain?” Send a thank-you card post-visit or do a yearly mailing that asks, “Have you had your annual PT check-up?” Begin the relationship and maintain it, she recommends.

If you need help, contact a direct mail or database management firm to build the list of names. Your e-newsletter, preferably with an attractive mix of text, illustrations, and photos, can tie back to your Web page. And yes, Steffes and others insist, PTs really do need Web sites. How do you obtain those names and email addresses? “You ask gently for them when you’ve treated the patient,” she says. PTs, however, must make sure that any such activities fully conform to the provisions of HIPAA.

Another technique to obtain the names and e-mail addresses of prospective patients and clients is to offer a free report or information online. In order for the patient to receive the report, he or she must provide a name and a valid e-mail address to which the free report is sent. APTA has a number of free reports and brochures to help members get started. (See “APTA Resources.”)

Use your list for smart permission marketing. Invite consumers to a course, exercise class, or special event. E-mail a follow-up: “How are you doing after treatment?” Find a reason to be seen and to be called. E-mail consistently, but don’t overdo it. In many cases, once or twice a month is effective.

Must Get the Net

Your “customers” can’t know you if they don’t know you’re there. And there may still be a perception of PTs as ancillary care providers, says David Straight, PT, MPT, OCS, president of E-rehab, LLC, in Carlsbad, California.

Because “we possess the knowledge and the skill set and have proven that we should be the primary caregivers for musculoskeletal dysfunction,” Straight says that PTs have to position themselves as those primary caregivers. And that means embracing the Internet, he advises. “It’s leveled the playing field and allowed us to really communicate what we can do for the public.” The cost may run into the thousands of dollars. However, Straight notes, “A ‘serious’ Web site isn’t a ‘do-it-yourself’ hobby any more. To be truly effective, PTs should outsource Web development to experts. A complete Internet marketing solution is an investment, not an expense.”

The Internet can propel PTs on to effective retention marketing—engaging new customers early to build a long-term relationship—and to general repeat business and word-of-mouth. Like Steffes, Straight champions the e-newsletter for potential and current patients, with its automated distribution and cost effectiveness. He likes the incorporation of cost-effective, leveraged, “rich” media like audio and video on Web sites to deliver a custom experience. Why not illustrate how you would help an individual, or showcase a video case-study, or incorporate FAQs (frequently asked questions) and testimonials?

The Web allows your patients to download and fill out cumbersome pre-consultation paperwork too. Involving the consumer via interactivity will become ever more common—and necessary—in years to come, Straight predicts. In the interim, “PTs needn’t be at the bottom of the marketing food chain when it comes to adopting new trends.”

Peer Pressure

One visible change shows consumers becoming more self-sufficient with their health care, says Daniel J Vreeman, PT, DPT, MSc, assistant research professor of physical therapy, Indiana University, and research scientist at the Regenstrief Institute, Inc, a non-profit medical research organization. Vreeman also is president of APTA’s Technology in Physical Therapy Special Interest Group.

A medical informatics researcher who also handles Web design consulting for rehabilitation-related organizations, Vreeman urges PTs “to consider how we can enable consumers to make informed decisions.” Define for them your specialties, programs, and services. As the expert provider, “distill down information about types of conditions in which you have expertise. They then will trust you as their information source.”

Like Straight, he suggests using your Web site to help consumers make a wise decision—to use physical therapy and the services you offer. “Increasingly, consumers are looking for choice,” says Vreeman. “Bland, static pages won’t differentiate you from the clinic down the road.”

Straight lauds Internet workhorse automation capabilities, including the ability to conduct surveys and to measure outcomes. He urges PTs to become aware of social marketing, calling it the next big thing. In 2006, the global public relations firm, Edelman, found that 68% of Web viewers trust peers when it comes to making decisions. If you’re seeing more “rating systems” on sites, it’s just the beginning.

“A client who’s been to your practice and substantiates it via a rating on the Web means others are more likely to trust you too,” Straight says, citing the fact that 7 out 10 of us trust our peers when we don’t trust CEOs, politicians, or marketers. “Social marketing is indelible and the honest person wins, not necessarily the one who hires the big public relations firm or spends the most money. PTs need to realize they have tremendous potential here. They must leverage their human element.”

Rise Above It All

Straight cites 2006 statistics that show 135 million health searches were done at the computer. That’s a lot of typing, so you’ll want to understand search engine optimization (SEO): the process of improving the volume and quality of traffic to a Web site from search engines.

Straight is pleased that his practice attracts 3 to 4 new patients per month via listings that occur in one of three categories: 1) organic, natural listings in the top, lefthand side of a Web search page, 2) local or geographic searches, and 3) pay per-click listings, such as those offered by Yahoo and Google. Each time someone clicks your ad, they’re “taken” to your site. You pay only if people click on your ads. The cost varies but often is in the range of 50 cents to $2 per click, depending on the key word and how high up you want your ad listed.

Whether you show up in the main search results depends on a variety of factors, says Vreeman, such as how many links point to your site. “Getting other sites to link to you and having many pages in your site linking to each other is very helpful.” A Web site’s content also should be search-engine accessible via key search words in the Web site’s “header” and in the Web page text. Many PTs will choose to farm this out to a pro.

“If you do this yourself or hire a hosting provider to do it, it’s probably helpful to use a program that analyzes the “hits” on your Web page,” Vreeman advises.

He also urges PTs to work with Web professionals to ensure the accessibility of their online content. Can it be used as effectively by people with disabilities as by those without? Including accessibility features such as alt-text—text that will display when the browser is unable to display images—not only creates a positive Web experience for people with disabilities, but also improves your site’s indexing by search engines and performance on smaller devices like cell phones or personal digital assistants (PDAs).

If this all sounds a bit intimidating, you’re not alone. One of Straight’s model self-starting clients is Tim Richardson, PT, of Medical Arts Rehabilitation, Inc, with 2 clinics in Manatee County, Fla. Richardson has owned the 25-year-old practice for 2 years and eagerly embraces electronic marketing as a way “to create a highly loyal, educated group of targeted clients that have my clinic at the top of mind when they need physical therapy services,” he says.

Richardson uses Internet location targeting and pay-per-click with Google’s AdWords for top positioning, and spends significant time devising and tracking how he’s doing with these techniques. “My wife would tell you ‘too much time,’” he chuckles, convinced that it’s really not rocket science. It’s hard to argue with the cost, which he gauges at between $30 and $50 a month.

The avid do-it-yourselfer uses professional services for the “heavy lifting”, like maintaining the Web site and making e-mail-changes. Richardson took a 6-week course at community college to learn about search engine optimization (SEO), Web-page design and construction, and HTML coding. “You used to have to be a ‘geek,’ but now it’s just like driving,” professes Richardson. “Necessity really is the mother of invention.”

Step Up

The list of marketing requirements may be similar for small and large practices, but resources are not. Large practice consortiums may employ a dedicated professional like Scott Wick, director of marketing for Therapeutic Associates, Inc, (TAI) with 55 clinics in Washington, Oregon, and Idaho. Each clinic has its own advertising budget with an individual PT director owner. Wick is the in-house consultant. He suspects what many PTs may be thinking is: “I can’t have a director of marketing unless it’s me, myself, and I.”

Like others cited here, Wick urges PTs not to take a back seat to other health care providers. “Physical therapists are the experts in musculoskeletal issues and need to act like it. Many primary care providers have limited training in musculoskeletal issues and struggle to identify which patients would benefit from physical therapy and when to refer,” he says.

Physical therapists must join forces and commit to educating the masses, says Wick, “if we are to realize Vision 2020. Study the marketing example of chiropractors who’ve taught consumers what they do and when to come see them.”

To follow Wick’s lead, consider an initial focus on training: His internal program includes lecture, role-playing, and on-the-job-training for practice employees. TAI offers practice owners management training modules, five classes of six hours each, “to teach PTs what they need to know to run a business.” To hone relationship marketing skills, they’re encouraged to start niche programs to meet physician market demand in areas such as diabetes and women’s health, and they’re prodded gently to go see doctors regularly each quarter.

External marketing has included a logo consolidation in the late 1990s and steps to increase name recognition through mass media marketing. The latter was costly and afforded him a diminishing return, he says. TAI management ran television ads to celebrate its 50th anniversary in 2002 with an “Ask the Expert” campaign. “It was very difficult to track return on investment,” admits Wick, who does share that he spent 23% of his annual marketing budget on TV that year.

Now his clinics employ, and see results from, relationship marketing to patients, referral groups, and the community. “We ask our patients how they heard about us and have for years. Our findings, consistent over time, are first, recommendation from doctor; second, returning patient; and third, recommendation from friend, relative, or co-worker. One of our marketing strategies is to increase word-of-mouth referrals. Just like every other business, it is less expensive to keep the customers or patients you currently have than to go find new ones.”

One size doesn’t fit all, so be flexible. “We’ve not found a silver bullet, and each market is very different; target marketing is our best success with programs specific to demographic needs.”

Be Penny-wiser

Again, if you don’t have the time or the inclination, consider hiring a public relations firm on an hourly basis to tackle these opportunities for you. “If somebody else says [something good] about you, it’s worth more than if you say it yourself in an ad,” says Wick.

Regarding these ads, E-rehab’s Straight says he believes Internet marketing will replace the Yellow Pages®. Wick provides supporting evidence. “That book used to be a scare tactic: ‘You’ve got to be here or you won’t get patients.’” He’s cut his once-healthy Yellow Book budget 60% and hasn’t seen a decline in business as he’s diverted funding to search engine advertising with prime placement. Tracking shows the number of consumers locking on to his Web site from Google directly has risen from 2% to 30%.

Having done minimal direct mail, Wick was elated with the response of TAI’s first custom publication in 2007, entitled Therapeutic Outlook: 100,000 copies are produced twice-yearly, mailed to past patients and distributed at community events. Editorial content has included articles on the history of physical therapy, direct access, prevention, and general musculoskeletal health. “Our hope is that this vehicle will educate consumers about the benefits of physical therapy so consumers can experience the best physical health life can offer,” Wick says.

Make marketing your new friend, encourages Richardson. “This is not going away. If I intend to stay in small business, I can’t just bury my head in the sand and think someone will do it for me: It’s not going to happen. For better or worse, I’ve got to make it work.”
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Stephanie Stephens is a freelance writer.

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