Primary care is the front line of the health care industry

It’s not just where conditions are diagnosed and treated; it’s where a doctor’s business policies and practices have to adapt to changes in the industry. And, much to the pain of doctors who can’t stand the word “marketing,” this includes communications.


Primary care is a volume business

Years ago, 50% of med students said they wanted to become a primary care physician. Today, the number is 20%.

Since the advent of HMOs in the 1980s, when insurers implemented cost-control and patient-management practices in exchange for contractually defined monetary benefits, primary care docs have become like public school teachers: too much work, too little time, no room for error, and no end in sight. Obamacare has only intensified the situation.

No question, primary care practitioners have taken it in the teeth.


The communications opportunity

But in business terms, the volume of consumers that primary care providers must serve also means that the field is a dynamic business area where many people can be influenced and informed through all different forms of marketing communications.

If primary care physicians can be a bit more marketing conscious, they can do more than create a coherent identity around their practice and a strong base of patients. They can redefine and reshape what primary care medical practice means.


The new message for primary care marketing: We’re in this thing together.

Primary care physicians (which includes physicians, PAs, nurses, and front and back-office staff) need to send the same message that health care insurers keep trying to send: Healthcare is like home improvement. It’s a DIY world where you learn about it, invest in it smartly, and it feels good and pays you back over time.

By this model of thinking, primary care professionals are like good contractors. They’re incredibly valuable, trusted, experienced, high-quality professionals who are there to educate, diagnose, point things in the right direction, and help make things better. It’s not their house. It’s yours. But they know how it works better than you do.

The old model of patient communication in America was paternalistic: Follow the doctor’s orders. End of discussion.

The new model is participatory: Get the right doctor, get smart, and stay healthy.


4 Tips for Primary Care communications development

So let’s express in real terms the idea of self-reliance and the spirit of savvy consumerism that primary care doctors should be developing though their communications.

Use DIY content marketing. In-office and out-of-office communications should focus on consumer-oriented conditions and problems, boiled down to a handful of actionable items. 5 Things to Cut Out of Your Diet. 7 Things That Keep Kids Under 7 Healthy. And so forth. It’s basic, but content like this – in the form of brochures, email, and waiting room videos – establish a drumbeat of self-empowerment through knowledge.

Make the doctors and staff human. When patients need care, they want to know who’s doing the caring. Personalized bios for staff is a good first step.

Leverage doctor-rating sites. The migration to Healthgrades and other doctor-rating sites has been slow, but more than 250 million consumers use Healthgrades each year. It’s time to start uploading information and encouraging patients to rate their experience – even before they leave the office.

Make patient communication a priority. Patients are powerful consumers, and the goal is to make them smarter and more involved.

So the use of email and text messaging to confirm appointments, notify patients of changes, and remind them how to prepare for office visits is important. Post-visit, asking for feedback through surveys enables participation and gives the practice data to use as proof of performance.

If you’re feeling the sting of not knowing where to turn for health care marketing counsel, contact us. We’ll be happy to buy you a beverage.

Our Top 5 reasons why timesheets suck harder than an airplane toilet


Anyone in professional services knows the issue.

Timesheets, to put it as delicately as possible, suck. Show us someone who likes timesheets and we’ll show you an anal-retentive, neo-maxi zoom dweebie.

The many sucky aspects of timesheets

1. They suck creativity out of the brain. Timesheets are the ultimate buzzkill. They are to creativity what kryptonite is to Superman: a life-denying, soul-shattering, anti-matter experience that leaves a trail of scorched cerebral earth in its path.

2. They suck away time that could be spent on YouTube. One of our employees claims that he can’t work past 3:30 without going on YouTube to watch a baseball manager get thrown out of a game. Timesheets seriously cut into his Watch-a-Grown-Man-Have-A-Hissyfit time. Argue with that.

3. They suck the life out of my Kwan.

As Rod Tidwell said in Jerry McGuire, you gotta have the Kwan. Timesheets are a total Kwan-killer.

4. They suck because all forms suck. Misery comes in many forms. Most are either IRS forms or timesheets.

5. They suck because they make people go shoplifting in convenience stores. Unproven fact: Timesheets are known to cause people to shoplift at their local Gas n Sip, resulting in excess consumption of turkey jerky.

AND why we do them anyhow

  1. They help us understand process. If we’re way over budget or behind schedule, we can look at how we got there.
  2. They help manage workflow. Some tasks take longer than others. Some people work faster than others. Timesheets tell us about ourselves and how we can organize our efforts better.
  3. It’s just good business. We talk about metrics and how they can tell whether something is worth the investment. Timesheets are a metric for telling us if we’re performing at a strong level, fro clients and for ourselves.

Chime in. Let us know your true feelings about timesheets.

SEO for CMOs: What you need to know


Is your brand getting buried alive on search?

When was the last time you clicked through to the second or (gasp) third page of Google in search of a listing for your company’s content? It’s a terrible feeling, as if your content is getting buried alive. It’s important for companies to keep an eye on their rankings for branded, non-branded, and industry terms – and understand how SEO is changing.

Keeping pace with search sophistication.

When search engines were first being used, there was less content Out There. The internet was simpler. A website would only use page titles, meta-descriptions and alt attributes to describe the content that was on a given page.

But search got smarter, and algorithms started discerning which sources of information were better than others. For example, Googlebot – the web crawler that looks for new and updated pages – started assigning more importance to content based on the credibility of the source.

SEO Evolution Timeline

Algorithms: Taking a deeper dive

As search engines got better at patrolling the web, they started looking at factors like inbound/outbound linking, anchor text, domain names and registration information. Then algorithms focused on domain authority (which relies heavily on other sites linking back to yours) and diversity of the external link sources. Linking between two or three sites wasn’t enough anymore.

The most recent and advanced algorithm turn the internet into a popularity contest. Social mentions are important, especially those from (wait for it) Google+. And there is a strong focus on user behavior: Once a visitor hits your site, are they easily finding what they are looking for?

Google wants to ensure content legitimacy, which is all good. Having a physical business location, contact page, and better user interaction are good criteria for search hierarchy. But to win at the game you have to know the rules of the road.

Content is still king.

Content has withstood the test of time admirably. There’s no substitute for having good, useful, usable content.

Keyword stuffing, duplicated content, invisible text, and other black hat tricks have been used to elevate search visibility, but unethical or illegal measures to rank your site higher on Google will most likely result in penalties such as lower rankings or being banned from the index. Our advice: make really good content experiences the centerpiece of your SEO strategy – and stay alert for new SEO advancements.

If you’d like an SEO update, feel free to contact us.

With trending topics, tread carefully


The need to show relevance – and restraint

Social marketing strategy is about staying relevant. We advise clients to add their voice and content to hot topics – when it’s appropriate. Sounds obvious, yes?

But look around and you can see big brands that comment on every trending topic out there. Sure, it’s nice to make it to the top of Twitter timelines and be seen by more potential followers, but it requires diligence and discretion – attributes that easily get lost in the chase to keep up with real time trends.

How DiGiorno pizza got burned

DiGiorno Pizza is one of the biggest players in the twittersphere, with a witty, responsive, and relevant presence (as a rule). They have a smart-alecky, wise-guy voice and they tweet non-stop and comment on trending topics. In addition to sports games and awards show commentary, they even live-tweeted the Sound of Music.

But the practice of diving into as many trending topics as possible recently backfired on the DiGiorno’s social team. They accidentally made a humorous tweet about pizza and attached the #WhyIStayed hashtag – which was referring to domestic violence in response to the Ray Rice scandal.


After a huge corporate social fail, there are different ways of handling the situation. Some companies choose to simply go dark. Others will delete a tweet/post and pretend it never happened. After they joked about the social upheaval in Egypt, Kenneth Cole made an apology and then waited for the next news cycle. DiGiorno also made a couple major apologies and tried to respond to each person who was offended by the post. They have not tweeted again since apologizing for the incident, which took place in early September.

While DiGiorno’s response was the most appropriate for them, most companies don’t have the manpower to devote to individual responses – especially if they have 82k followers.

How to sidestep disaster

Strategize on voice. While developing your social strategy, discuss what the voice of your company should be. Make sure it is in line with your corporate values and brand reputation. Are you going to be witty and funny about anything in pop culture or will you focus only on industry-specific topics?

Research the context. Even if it means your tweet will take 15 minutes longer to be sent, make sure that you research a topic before posting about it – especially trending topics on twitter.

Test it on teammates. A tweet that seems innocuous to you could be offensive to someone else. Take a few minutes to ask your co-workers what they think. Asking 3-5 different people should let you know if there are any potential landmines.

As always, we are here to help with your social strategy… contact us if you have any questions.

Facebook does an about face


Closing the Like-Gate

In a very quiet announcement last week, Facebook announced that the commonly used practice of “like-gating” a page for contests & promotions will be against policy, effective November 5, 2014.

Like–gating refers to the requirement that a visitor must like your Facebook page in order to enter a contest or take part in a promotion. The value of a like is questionable, but like-gating has been widely used as a successful fan-acquisition method. So let’s look at the issue.

The new policy

The updated policy, mixed in with other content on a Facebook Developers blog, says “You must not incentivize people to use social plugins or to like a Page. This includes offering rewards, or gating apps or app content based on whether or not a person has liked a Page. It remains acceptable to incentivize people to login to your app, checkin at a place or enter a promotion on your app’s Page. To ensure quality connections and help businesses reach the people who matter to them, we want people to like Pages because they want to connect and hear from the business, not because of artificial incentives. We believe this update will benefit people and advertisers alike.”

What it means & what you should do

With this new policy in place, contests, rewards, and promotions will be open to everyone on Facebook who encounters the content, no liking required. So you may get a bazillion entries, but not a single new like. For marketers who are still building communities and believe that Facebook likes may actually have some value, here are some ideas.

Use the wall

An on-wall promotion is when a brand makes a post and asks users to comment to enter. On-wall promotions have many benefits. For one, they cost less. They’re also easier to deploy & manage, with fewer barriers to entry for participants. Of course, these posts won’t get you more fans either, but if you run a weekly or monthly promotion, at least people have a reason to return.

Collect additional information

OK, so Facebook won’t let you make becoming a fan a condition for someone entering a promotion – but that doesn’t mean you can’t ask for information prior to entry. Have email as a required field. Maybe try for a phone number. Just remember that your contest has to have enough value to justify asking for the information.

Don’t abandon Facebook

Facebook is concerned about its own usability, which is a good thing for everyone who uses it. And we think Facebook recognizes that the overall quality of brand communities will increase if those communities are not inflated with hit-and-run contestants. So don’t eliminate Facebook outreach. Just make sure it’s not the sole focus of a campaign. Customers have multiple networks to choose from and brands should be available across most of them.

Encourage UGC

And remember that a single piece of UGC makes more impact than a Facebook like. That’s why we sometimes suggest “action-gating,” requiring a customer to submit some form of UGC (on any social media network they like) to be entered in a contest or promotion.

If you have any questions or need a beverage, we’re here.

Listen up: Time for website audio to make a comeback


The argument against websites that autoplay sound is well-known.

It’s annoying.

It’s invasive.

It’s a dead giveaway at work that you’re not really working. And those cheesy speakers with no midrange aren’t helping matters any.

But when we turn off the sound, we’re saying goodbye to a sensory experience that can do a lot for the site experience. We think it’s time clients listen to the case for how sound can support the target experience.

5 reasons why audio should be reconsidered.

1. People work with headphones on. Thanks to tablets and smart phones, more and more people work with in-your-ear audio as a way of getting through the day.

2. YouTube changed everything. The ascendancy of YouTube as a research and learning platform has meant that it’s acceptable to include audio + video content as a core part of everyday life, even in the workplace.

3. Stories are told with sound. Branded content often has an agenda of cultivating a narrative around the product – anecdotes, stories from everyday consumers, and other forms of allegory. Categorically eliminating sound ties one hand behind the back of the website as it seeks engagement. See how this funky Berlin hotel uses audio to create an other-worldly experience

4. It can be subtle. Audio can be atmospheric and textural. It can be simple sound effects that set a tone or mood. Check out how audio works within this scrolling site for a story the Guardian built about a wild fire in Tasmania.

5. It can be elective. Website visitors can be empowered to decide if they want to listen to the audio – just make it clear to them that they’re going to a sound file with a “Hear the full experience” activation button for listeners who want to go deeper.

Sound off – or on? Let us know what you think.

There’s no definitive, yes-or-no answer regarding audio usage on websites. It’s all a question of whether it works for what you’re trying to accomplish. So let us hear your opinion, online or in person.

Finding a home for the Home button


There’s no place like Home. Or is there?

Part of serving a wide range of clients means studying their websites all the time, and looking at usage patterns. It allows us to determine who is currently using our clients’ sites and – how their habits and preferences are shifting. Which brings us to the Home button.

The logo as a Home button.

The practice in recent years has been to eliminate the traditional Home button. By using the logo instead, sites have had a convenient (and content-efficient) way of letting users get back to comfortable, navigable ground. Furthermore, using the logo frees up room in the navigation bar for other navigation elements. The chart below illustrates the percentage of websites using a Home button versus their logo. It proves what we already suspect: the Home button may be on its way out.


Not so fast.

Many of our clients’ websites are trafficked by users who are web savvy – but not all of them. Sites that serve users who are elderly, mentally ill, visually impaired, socioeconomically troubled, or not conversant with traditional site functionality may struggle with the shifting variables in web design.

Giving these people a traditional path back to their starting point can be comforting and can keep them on the site. In Steve Krug’s excellent book Don’t Make Me Think: A Common Sense Approach to Web Usability he writes: “Having a home button in sight at all times offers reassurance that no matter how lost I may get, I can always start over, like pressing a reset button or using a ‘Get out of jail free’ card.”

The breadcrumb alternative

To keep users oriented within a site, breadcrumbs can be helpful. When a user lands on an internal page of your website from another source, breadcrumbs will allow the person to see exactly where they stand within the site’s structure – without taking up much space. Breadcrumbs are also easy to implement into the visual design of a site, and the links contained in a breadcrumb trail give the user additional information.

Home, reconsidered.

For some sites, such as social networks, the homepage is a key feature, with a personalized news feed or a central hub for user activity with key functions. In these cases, clear pathways to get Home are valuable. Look at Facebook. It has made changes to the tool tip when you hover over the logo, reflecting a change in user understanding of how to get back home.

But on sites where the homepage is not the central hub of user interest and activity (such as eBay), the standard practice is to make the route home less prominent. One notable exception to this rule is Pinterest, where the homepage is hugely important to the user but has no dedicated home button – only a clickable logo in the top center, and search in the top left.

3 things to remember

1. Look at the audiences. Are the primary users likely to need directions Home?

2. Evaluate the site’s complexity. Are there complex subpages that might make navigating difficult, and a Home button appealing?

3. Don’t go with the crowd. Trends can be interesting and useful. But they shouldn’t be a substitute for independent thought. Yes, there is movement away from having a Home button, but your site should respond to its users, not what the herd does.

As always, we’re ready to continue the conversation over a beverage.


The Facebook Conspiracy Theory


A few weeks ago, articles and videos were making their way around the web claiming that Facebook ad-buys were completely bogus.

Facebook claimed that if you purchased an ad focused on gaining likes to a page, you would set a budget, create the ad and, over a couple weeks, watch your fan-base grow. The real question is about quality: Who’s doing the “liking?”

We decided to do our own testing.

We created a new page with no likes, posts or engagement whatsoever. We even gave it a title that no one would have interest in liking… “Virtual Apple Tree”. It’s an image of an apple tree doing what apple trees do: Growing apples. We put a $25 spend behind it and waited for the magic to happen.

Sure enough, magic happened. We received 141 likes at around $0.17 cents per like. Amazing, right? But that’s when the concern set in. How could we possibly get 140+ people to like a Facebook page with no content or interaction, simply from paying $25? We dove into the pages of our new friends.

They all seemed to be legitimate people. They had profile pictures, standard US names, some activities on their walls from playing games, sharing content, etc. But then we noticed a startling trend.

Click-farming: Worthless growth

The new fans of the Virtual Apple Tree all seemed to have liked 5,000+, 20,000+ and even 40,000+ pages. The research had brought us face to face with the reality of click-farms – companies that give people small sums of money for every thousand pages they like.

The real cost of empty likes

For unsuspecting Facebook page managers who are just trying to use the advertising tool, these fake likes are much more detrimental to a page than the waste of money. Pages built on click farming are now going to start taking your organic reach away from potential real fans, causing you to want to pay even more money to “promote” posts. And the only way to get rid of these likes? You have to manually delete them one by one.

3 Actions

If you are focused on buying likes, you should:

1. Reevaluate your Facebook strategy. Depending on your target, Facebook may be the wrong venue for your audience or you may simply just be too late to the game to start a new page.

2. Try to increase engagement organically. Although Facebook continuously makes this harder to do, stay focused on reaching the quality fans and worry less about quantity.

3. Consider hosting an on-wall promotion with your advertising budget instead of purchasing ads. This is a way to reward your current fans for their patronage and also gain new fans virally from others posting and sharing the content.

As always, we are here to discuss social media strategy with you. Give us a shout. Let’s talk. Beverages are on us.

Timing Is Everything

Knowing when to promote your Facebook Post

It’s easy for your eye to catch the “boost post” icon when you launch one on your brand’s Facebook page.

We’re here to tell you to wait and really determine if it is worthy of your dollars.

“How are we supposed to know?” You may ask. For that, we’ve put together an acronym for you- RIPE.  RIPE stands for “Relevant, Impact, Patience, Engagement.”

The idea here is that if you can answer “yes” to four-or even three- of the following questions, then your post is RIPE and ready to promote!


Relevant. The best way to gain traction on a promoted post is by letting it run for a few days (ideally 3-5). That being said, you have to make sure that the post will not appear outdated after multiple days on a viewer’s news feed.

Impact.  Without it the viewer is left with no direction or reason to go further down the path to becoming a converted customer (or fan). So ask yourself “Does my post have an enticing call to action?” We talk about how smaller firms need to be disruptive and impactful and a promoted post is a great place to start. So write a short line of copy that will catch the viewer’s eye, and then tell them what to do!

Patience. Let a few hours pass before you promote the post. This helps you to get a feel for how the post may perform once it gets in front of the masses.  Wait time can vary depending on the size of your fan count.

Which brings us to the final determining factor…

Engagement. Your fans will serve as a nice test pool for how your post will reach once promoted. So determine an engagement metric that you want to reach before your promote the post. It can be a percentage (people who like, comment share and/or click, divided by total fan reach) or it can be something simple like a certain number of likes.

Hint: For starters, dig through the engagement on your previous posts and look for similarities on some of your best performing posts.

Any other questions? We’re here when you need us.

5 healthy marketing practices



Healthcare: It’s the largest single business sector in the US – and the world

Yet most of the players in the field have never really had to communicate with consumers through traditional marketing channels (except for Big Pharma). Hospitals and insurers are leading the charge but we can expect many more players on the field soon. Here are a handful of what we think are key guidelines for entering the space of healthcare marketing.

1. Health care is about being local
National brands like Humana, Aetna, and United Healthcare may have girth, but they still need to forge trust and build loyalty with customers. Any healthcare entity entering the marketplace should know that healthcare consumers need the reassurance of feeling that the brand they engage with has a steady, local presence. That means site content that’s sensitive to geography and demographics. It means advertising through geo-targeted networks. Hey, it could even mean sponsoring a Little League team.

2. Playing the numbers game
As the consumer marketplace for healthcare evolves, insurers, hospitals, and group practices will be marketing their performance with statistics. It’s not clear what federal agency (if any) will regulate this area, so marketers should stay strictly open and transparent about what they claim and how they substantiate it. Truth and transparency – especially in medical marketing – is a value consumers can build trust upon. It’s also the easiest thing to remember.

3. Build on your core
One thing we believe strongly is this: The NPS – or Net Promoter Score, which is based on the question “Would you recommend (X) to a freind?”- will be critical. Many resort and service clients use this as the gold standard of consumer loyalty, and it will likely be relevant in healthcare. The endorsement of a friend regarding a doctor, a hospital, a pharmaceutical, or a surgical procedure will carry significant weight. This is why marketers should not lose focus on their existing base of consumers.

4. Social Healthcare Marketing: 5 must-haves
We are all bracing for how healthcare marketing, fully unleashed, will operate in social media. Clients who believe the space is a viable platform for 2-way consumer communications need 5 things:

1. A policy in place that clearly defines rules of engagement – so everyone is on the same page.
2. An internal team structure for managing workload – allocate hours/week and designate decision makers.
3. A content strategy – rooted in reality (things of interest, news, advice, and what you can realistically source or author).
4. A content calendar – forecasting 12 months of enagement.
5. Pepto Bismol – for those difficult days.

Be prepared for low engagement at first, and cling to this cliché: What’s worthwhile is often difficult.

5. Sometimes it hurts
Before the Surpreme Court ruled on Obamacare, Aetna, Humana and United Healthcare committed to adhere to key provisions of the law, regardless of how the ruling turned out. It’s a good example of 2 things: Strong loyalty-building among consumers, and creating a powerful differentiator in the marketplace. We recognize those policies are business decisions. But they appear to be good marketing decisions too. Transparency and sacrifice come with a cost.

As always, we’re ready to discuss it over a healthy beverage!