Marketing is often a new word to doctors practising in public hospitals as there are always more than enough patients in public service. However, marketing is commonly done in private practice, especially by new doctors.
Over the last ten years in private practice, I have been exposed to different kinds of marketing media and I wish to share them with newcomers. If you are running a busy practice, you can skip my article as you probably won't need marketing. But if you are new (or going to be new) in private practice, you may find what I share useful.
What is marketing?
Marketing refers to communicating with referring doctors, as well as current and future patients, to increase the profile and value of the doctor/service, and to induce behavioural changes in referring doctors and/or future patients.
Legal and ethical issues
Before you start marketing your new clinic, you ought to be aware that we are bound by common laws as well as the Singapore Medical Council (SMC) Ethical Code and Ethical Guidelines (ECEG).
Some pitfalls are listed below:
- "Only the doctor's name, registered field of practice and place of practice may be mentioned in such instances."1
We should not provide too much details of our practice as it may be seen as encouraging potential patients to consult us through public speaking, broadcasting and writing.
- "...information in the public domain must meet the following standards: factual, not sensational, not laudatory, not comparative."1
Hence, you should avoid using comparative words like first, better, best and only in your marketing materials. By saying that you are better, you are implying that your colleagues are not as good. Unless you are absolutely sure, saying that you are the first to perform a certain surgery may be regarded as misleading.
- "...the website may not have on its web pages or provide hyperlinks to, testimonies from satisfied patients or other doctors."
I know colleagues who have received warning letters from the Ministry of Health with regard to patients writing complimentary remarks on their clinics' websites and Facebook pages. Testimonies from patients, even if authentic, are not permitted on the clinic's website.2
- "... photographs or video clips showing results of surgery, consultations taking place or operative procedures being conducted when these are related to identifiable doctors or patients either directly or by inference, are not allowed."2
Many slimming centres use before and after photos of celebrities to entice the public to join their programme. For doctors, this may be deemed as laudatory and we should be careful.
- "...the doctor['s] participation does not occur in such a way as to appear to endorse such products, or to persuade patients or members of the public to use the products."1
Doctors ought to be careful not to promote a particular medical product even if the pharmaceutical or device company sponsors your marketing activities.,
- "Organisations may collect, use, or disclose personal data only with the individual's knowledge and consent."3
It is not a good idea to contact your former public hospital's patients to inform them of your new private practice unless you have their consent.
It will also be embarrassing if you post a letter to the wrong address, or if your patients' family members were not aware of his/her medical conditions. Always seek consent before you send an invitation letter to your patients for a public forum.
Traditional ways of marketing
- Print media including newspapers, general magazines (eg, Her World), or health magazines (eg, SHAPE, Singapore Health).
Some contain invited articles where journalists call and ask the doctor specific questions on a medical topic. Others are paid articles whereby the doctor pays the publisher to get his article published. Charges can be up to S$10,000 for four issues of magazines, in which the paying doctor writes articles on medical conditions that he is familiar with.
- Radio and television interviews including news or health programmes (eg, Body and Soul, Body SOS).
This is usually by invitation only, although I understand one can also pay the producer to make an advertorial programme on the doctor and the medical practice for broadcast on radio or television.
- Public health talks being held at hotel ballrooms or hospital seminar rooms. I know of some specialists who hold talks in their clinics.
Television and radio stations also organise public talks for doctors. They add daily advertisements on the television or radio station in addition to the talk. I am aware of one such seminar, where they included three weeks of daily on-air advertisements, costing close to S$200,000.
- Continuing Medical Education (CME) talks which can be for GPs or other fellow specialists. CME talks can be organised by doctors, clinics, hospitals, societies, or even pharmaceutical companies.
New ways of marketing
With the revolution of the Internet and start of a new economy, many new ways of marketing have emerged.
Google marketing
Doctors can improve their practices' online presence by utilising Google AdWords campaigns. However, it can be costly when many others bid for the same keywords. For example, the phrase "back pain" may be bid on by orthopaedic surgeons, physiotherapists, rheumatologists, chiropractors, spas, mattress retailers and ergonomic chair manufacturers.
Search engine optimisation (SEO)
Google's search engine uses a complex set of algorithms and formulas that produce the best web results for the words or phrases being searched. Ideally, the most relevant and appropriate websites would rank highly and appear on the first page of search results.
There are also Internet marketing companies that claim to know the algorithm to optimise your websites so that they would appear among the top results on Google search.
Facebook
Facebook targets advertisements towards users with specific demographics and preferences. There was once I asked my Facebook friends to recommend a hotel for my holiday in Bintan. After a while, many advertisements featuring hotels in Bintan appeared on my Facebook feed! Facebook knows what I need and provides these opportunities to advertisers.
Credit card promotions and e-commerce platforms
Many service providers, such as hairdressers, spas and art schools, often offer promotional rates in collaboration with credit card companies or e-commerce platforms (eg, Groupon). The idea is to use a promotional entrance fee to attract a patron to try their services, in the hope that the patron will like the service and sign on as a regular customer.
However, doctors ought to be aware that under the Private Hospitals and Medical Clinics (Publicity) Regulations 2004, healthcare institutions are not allowed to give souvenirs, promotional coupons and vouchers.
Internet platform marketing
There are Internet platforms that group many clinics together and advertise/optimise views within one website. They also help patients to book clinic appointments. The cost per clinic is generally lower as it is shared by all participating clinics. However, many of such service providers charge a percentage of the doctor's professional fees in addition to monthly retainer fees, which may be against the SMC ECEG.
Nitty-gritty of medical marketing
Marketing is not cheap
The costs of marketing can go up to more than S$100,000 per year for a clinic. Most of us are not trained in business or marketing; thus we ought to be careful before we spend such big sums of money.
Be clear about your target markets and audience
If you are giving a public seminar on colon cancer at a community centre, your audience would mainly be "heartlanders". If you are giving a talk to a group of private banking clients, you get a different crowd. Choose your target audience carefully.
Your marketing activities are public
Beware that among the audience of your marketing activities, some may be patients of other specialists and some may even be colleagues in the same specialty. If you bear in mind that any audience member could make a complaint to the SMC, you will prepare your activities properly.
Don't try to induce the audience to see you
Remember that we are not supposed to induce or coerce patients to consult us.
Don't tell an audience member that if he has constipation, he may have colon cancer and can die from it, and that he should go to you for a colonoscopy the following morning. Instead, explain the various causes of constipation and encourage the public to consult the appropriate doctors.
Don't transform your marketing activity into a personal consultation
It is common for audience of marketing activities, such as public talks, radio talk shows or live television phone-in shows, to call in and seek medical advice on their personal conditions.
The ECEG clearly states that a doctor is expected to conduct good history-taking and physical examination before forming an opinion. Transforming a question and answer session into a medical consultation would be risky.
It is thus safer to just offer general information to the enquirer, and advise him/her to seek proper medical opinion.
Stay an arm's length from sponsors
The pharmaceutical and device manufacturing industries often spend huge amounts on sponsorships for public and medical education. Under the Singapore Association of Pharmaceutical Industries, sponsored events must give balanced and diverse views on medical knowledge.
While we should show gratitude to the sponsors, we ought to give an independent lecture to the audience.
Set pragmatic expectations
In business, people often talk about key performance indicators and return on investments. But we are doctors and not businessmen. Our aim should be to enhance the knowledge of our patients and the public.
Setting commercial goals may cause your marketing activities to be too commercial, which will eventually change your perspective and attitude towards your audience. Most of us became doctors not to make money, but to do good to mankind.
The wool comes from the sheep
The cost of commercial marketing eventually draws from the revenue of the medical practice, which comes from patients. My anecdotal experience is that clinics that spend a lot on marketing tend to charge more as well.
Final thoughts
Be very good at your work
When I started my private practice ten years ago, a senior specialist told me that he did not believe in marketing and advertising. "If you are good, patients will look for you. You don't have to look for patients," he explained.
I have realised what he said is very true. Marketing can only bring patients to see you once; the rest depends on your level of expertise.
Harness word-of-mouth marketing
When I asked my Facebook friends for recommendations on Bintan hotels, all my friends suggested one particular hotel. Thus, the choice was clear. Word-of-mouth marketing is the most important form of marketing. Patients are more likely to believe their trusted friends than any form of marketing media.
To get good word-of-mouth recommendations from patients, you must be very good at your work, and be very caring and emphatic. You also need to have super passionate patients who are not shy to recommend you to others.
Consider the externalities
Externalities refer to the consequences of an activity which affect other parties.
A year ago, a local newspaper published an article on "flat polyps", which may be more aggressive than the traditional pedunculated polyps in turning into colon cancer. Though the marketing was done by a gastroenterologist at a restructured hospital, other gastroenterologists benefitted as well.
After the news was out, I suddenly saw many new patients consulting me for screening colonoscopies. This should be our mindset: through our marketing, educate the public to take better care of themselves. In doing so, the whole profession can benefit.
Understand that nothing works forever
Ten years ago, the second page of a major local newspaper always featured the same advertisement: "Lasik surgery: S$999 per eye."
I understand from informal sources that it was highly successful at that time but today, you will no longer find that kind of advertisements. Be clear that no single successful marketing strategy works regardless of the times.
Know that nothing works for everyone
Among those who advertise on Google, there are more surgeons and procedurists than physicians. One reason for this is that for each patient who goes for a surgery or a procedure, a large sum, which can help offset the cost of marketing, is charged. However, for physicians, the consultation fees collected may not cover their cost of advertising.
Have the right mindset
I have seen many new specialists being disappointed with their marketing efforts. Despite spending money and personal time on marketing, they don't yield any immediate return.
To me, the aims of marketing to the public are firstly, to educate the public and fellow doctors. Secondly, to allow fellow doctors know what your strengths are, and thirdly, to let them know how to reach you if they require consultation or referrals.
You won't be disappointed if you have the right mindset.
Conclusion
When you enter private practice, many people will offer you various marketing ideas. Beware that many businesses are trying to make money from you. Do read the law and SMC ECEG carefully, and have the right mindset when marketing your practice. If in doubt, ask your friends/colleagues for advice.