In 2008, we thought our national economy had hit rock bottom—only to be surprised in the first quarter of 2009 with an even bleaker forecast. By now, we all have heard the reasons behind the current economic mess: Record high unemployment rates, an uncertain global market, and the downward spiral of the housing market.

But, for those who have weathered the economic storm in the past, all does not have to be gloom and doom. Since World War II, the U.S. has endured 11 recessions, and savvy businesses know how to survive despite the periodic economic downturns.

And, even if your patient load is down, effective marketing can bring your office back to pre-economic downturn status. Just take a cue from researchers at Penn State University and the University of Texas at Austin, who report that businesses that continue aggressive marketing efforts often come out ahead when the recession is finally over.

Even with a smaller budget, intelligent marketing can reach and influence current and new patients. But, knowing how and where to spend your marketing dollars is the key to maximizing your return.  

Change Your Message
Your patients will change their spending habits in a down economy, so you need to adjust your advertising to appeal to their current needs. “Business as usual” will not prove effective in the long run. Instead, tailor your message to what your patients want to hear now. For example, they will tend to spend less on discretionary items, but will spend the same or more on items they trust and value. Your job is to build that trust and reinforce the value of your practice materials and services. Most importantly: Listen to your patients to find out what they need, want and are willing to spend. Then, find the right way to deliver your message on how your practice offers exactly that.

Co-op Marketing
The term “cross marketing” refers to sharing marketing costs with similar businesses. This is an opportunity to collaborate with local O.D.s to share the high costs of mass marketing. Strategic placement of generalized ads with other offices will keep your costs down and still get your messages out to the people. Also, consider co-marketing with other health-related practices, such as pediatricians or internists. Some O.D.s are already sharing high-priced instruments, so why not advertising costs? Placing ads as a group not only saves money, but also shows the cooperation among group practices that some patients look for. 
How Much Does It Cost?

The first thing you should do is assess is your marketing budget and what you can afford to spend. A rule of thumb touted by most practice management experts is somewhere between 1% and 2% of your gross income. So, a practice that grosses $250K should spend about $3,500 annually on marketing. The next factor to consider: What makes your practice unique in your area? Whether it is services, instruments or technology, you’ll want to make the most of your individual strengths to set your office apart from the competition. Then, evaluate your current marketing efforts. Determine which marketing strategies have garnered you the biggest return, and make sure these stay at the top of your list. Any other efforts that don’t produce a good return or can’t be measured should be put on the “if there’s extra marketing dollars” list. Eliminate any marketing that is not working. Be aggressive with value-added offers that differentiate your practice from the competition, such as better service, treating patients like family (“red carpet treatment”), and including small gifts with purchases. These efforts will capture the patients who are looking for a practitioner now and will likely stay with you in the future when the market improves. Remember that both your office image and community awareness of your services are important. If your budget is tight, don’t try to market to the masses. Instead, keep your marketing tactics focused on groups or strategies that will get you the best return on your investment. And, in this type of economy, look for marketing strategies that produce short-term rather than long-term results. There will be time for long-term marketing when the economy turns around. Every marketing effort should have a compelling offer and a call to action. And make sure you continue to advertise continuously to patients even before they walk through your practice’s front door for the very first time. Communicate offers via direct mail and e-mail to patients before their visit, and then reengage them with a thank you postcard or e-mail after their visit. Let them know that you appreciate them, and make it easy for patients to recommend your office to their family and friends.

There are always events going on in your community that need volunteers. Whether it be as a fry cook for a summer festival or answering phones for a charity telethon, volunteering for these will increase your exposure and solidify your place in the community. Check with the service clubs and churches in your area to see what events they have planned and how you can get involved. Most, if not all, will require no money—only a commitment in your time. Consider getting your entire staff involved and volunteering as a practice. Getting staff members involved only multiplies your exposure and gets your staff more committed to your cause—not to mention, it can be a great team-building exercise.

Go Postal

Mass media is more expensive and less effective than a direct, targeted approach. So, rather than marketing to the masses, such as newspaper ads, consider sending repeated direct mailings to your current patients. Your patient database is one of the most valuable possessions you have. A list with such specificity would cost thousands if you were to purchase it outright. But you already own it, so why not take advantage of this rich resource? Use your office management software to customize marketing materials to your current patients. A mailer about new products, current promotions and new services or instruments can quickly add a few appointments to your book. But, send such mailers only to those patients who will be interested in the particular message. Remember, it takes a message more than once to be acted upon, so one mailer may not do the trick. Follow-up mailers will keep your name in front of them and keep them thinking about your office. Generally, a monthly mailer is just fine, unless you have a specific event that merits a more frequent reminder. The only downside to this type of marketing is, of course, the postage. But, by reaching out to focused, targeted groups, you can keep the number of mailers to a reasonable amount and save yourself some mailing costs. Or, you can purchase a mailing list—if you can target the list to people who will help you see the most return on your efforts. By effectively targeting your list, not only will you see more return, but your list will be smaller and less expensive to purchase.

Advertising to the Masses
Mass advertising in the local newspaper can be costly and yield low return. Again, you’re sending a message to thousands, but many will simply have no interest in what you have to say. Some publications, however, reach a specific audience, and that audience may be just the folks you want to reach. Seek out magazines or newspapers in your area whose target demographic is young mothers, older patients or the affluent; place your ads there. Young mothers tend to be the decision-makers in most families; older folks generally need more medical eye care. By advertising in this fashion, you are reaching the people you want to reach in a more targeted approach. You can do the same with radio and possibly TV advertising.  

In the Yellow Pages
It is difficult to judge your return on investment when doing phone book advertising. No doubt, it is a very costly method of marketing. Phone book ads can run into the thousands even with a small ad. Average cost for such an ad would be about $4,000 per year. Some say it is a necessary evil, while others have eschewed it altogether, citing other methods as more cost effective with measurable returns. Adding insult to injury, they say, is the propensity for multiple books to be used in a single area. Now, however, with the availability of the Internet, most Americans are doing their research online. Soon, the phone book may simply become something that kids use to get onto eye level with the rest of us, or that we use to prop up wobbly tables.  

 Would You Sponsor…
With the school year beginning again, there are plenty of opportunities to sponsor something. Whether it be a Little League team, a hot dog eating contest or music in the park, sponsorships are a great way to show that you care about your community and to get your name in front of people. Sponsoring an event is a one-time shot to a non-specific audience, but it’s generally an inexpensive way to get your name out there and show good will—and in a small community, such involvement may build your reputation for you. Get in touch with your local committees to see what opportunities are available.
Instantaneous E-Mail

If you collect your patients’ e-mail addresses, you have another valuable list at your disposal. To send e-mail to your patients is free, and results can be seen in hours rather than days or weeks. On your patient intake form, request patients’ e-mail addresses. Almost all of your patients have one. Also, include a box to be checked that gives you permission to contact them via this medium. You can create and send thousands of e-mails for practically no charge, keeping your marketing costs low while still reaching your audience. Assign a staff member to be in charge of creating and sending a monthly e-mail to keep your patients informed about the happenings in your office. Or, if you don’t want to create these mailings in-house, hire an online service to do it for you. These companies charge a monthly fee (e.g., WebSystems2 charges $49 per month for this service), but they will send out any number of e-mails to your patients, including a monthly e-mail newsletter. Compared to other types of advertising, this can be extremely effective, and you can save big money in your advertising budget.  

Wow Them on the Web
Another very cost-effective way to get your message out: via your office website. You already have a website, so why not include it in your marketing efforts? First, make a few, low-cost changes to get your patients’ attention. Focus on engaging your site’s visitors. For example, include coupons that they can print out and redeem at your practice, or offer an e-newsletter. Then, seek out other local, related businesses and exchange links with them (post links to their sites on your page if they’ll post a link to yours). Visitors to their sites will now see your link on their home page and vice versa. Optimize your home page with carefully selected keywords so that visitors can find your site more easily through a search engine. Tack your advertising on the home page and include a call-to-action from your visitors. A call-to-action is when you ask the person to do something like come in to redeem a coupon or purchase glasses before a certain date to get a discount, etc. You are asking the person to do something. This way, you can tell if this type of marketing is working. If you can’t do this yourself, contact an Internet marketing firm for help. For a reasonable fee, they can provide you with specific Internet marketing advice and the know-how to make it happen.  
Of course, there are hundreds of ways to get free advertising. Here are just a few:
• Go out and speak. There are several clubs and organizations that would love to hear you talk. Contact any one of them and go out and give a talk on anything “eye care.” Every community has their service clubs and organizations. Lions, Rotary, Eagles, Elks, Agencies on Aging, church groups, etc. For example, contact your community Agency on Aging and give a talk on cataracts or glaucoma. Or, contact a “new mothers” group and talk about InfantSee and other infant and toddler issues.
• Send a press release to the newspaper. Every month has some cause associated with it—diabetes, blindness and glaucoma all have a month. So, send a press release with a few paragraphs about the current cause and be sure to quote yourself. Many of these are already pre-written and available to American Optometric Association (AOA) members at no charge on their website.
• Blog. People love blogs. Put one on your Web site and start blogging! All you have to do is say what’s on your mind (it doesn’t need to be eye-care related), and allow visitors to chime in with comments or responses.
• Join clubs/organizations. There is no better advertising than word of mouth. Get out there and join the clubs and organizations that interest you. Meet people, shake hands (kiss babies?), etc. Just get to know people. In turn, they will get to know you, and the rest is up to you to make them your patients.
• Talk to your local schools. Get in touch with the nursing department at the schools in your area. In many communities, there are more and more students, but not enough nurses. Anything you can do to help them will be greatly appreciated and may result in referrals to your office. Offer to help with vision screenings or provide a short class that they can use as credit. And, meet with the coaches of the schools’ teams. Many high schools and most colleges have trainers available to the coaches and players. Eye injuries can occur in many sports, and it would be beneficial to both you and the athletes to forge a relationship with the trainers, athletic directors and coaches. In my office, we are currently setting up vision screenings for the students at the athletic physicals because we found out that they are not doing it currently. Or, give a short presentation in the beginning of the season about how to avoid injuries/what symptoms to look for, hold a meeting with the trainers, or volunteer to be “on-call” for the athletes on certain weekends.   

It is tempting to cut your marketing expenses during a down economy, but successful businesses can instead refine their marketing efforts to gain more exposure and increase business. Take advantage of such strategies while keeping your marketing dollars reasonable, and engage patients in your practices.
Dr. Diecidue is in private practice in Stroudsburg, Pa. He is president of Mountain Computer Systems, a producer of optometric management and EMR software. He can be reached at