Darrick Antell, MD, a prominent, board-certified Park Avenue plastic surgeon, knows that you "have to be in it—or them, as the case may be—in order to win it." He isn’t talking about the lottery, though. Antell is referring instead to plastic surgeon directories.

Many directories are available, and Antell now appears in several, such as yourplasticsurgeryguide.com, breastimplants411.com, and implantinfo.com. He is also listed in some of the plastic surgery association member directories, including those by the American Society for Aesthetic Plastic Surgery (ASAPS) and the International Society of Aesthetic Plastic Surgery (ISAPS).

Not listing is, well, not an option for Antell. "It would be like not being listed in the phone book," he says. "People see your name more, and just getting one new case basically pays for the cost of the listing."

It used to be that word of mouth, some well-placed ads in targeted magazines, and some media hits were enough. Not anymore. Today, plastic surgeons and other specialists have many more virtual avenues and angles to consider—and navigate—to remain competitive, especially in the current economic climate.

At the bare minimum, "You have to have a Web presence and a well-listed Web site," Antell says. A directory listing then provides the turnkey. "Directories direct people to your Web site," he adds.

Doctor directories—at least the good ones—are all about exposure, visibility, and owning your market share. With so many available, how can you choose what is best for your practice?


Some directories are really merely glorified Yellow Pages, whereas others offer information portals. These portals are the consumer’s first foray into your practice.

"When consumers find surgeons listed in Web sites that have highly credible and informative content, the consumer lends this credibility to the surgeon," says David Evans, CEO of Ceatus Media Group in San Diego. "Potential patients are looking for the most comprehensive, reliable, and up-to-date information about the plastic surgery procedure(s) that interests them." Ceatus is the parent company of several such directories, including your plasticsurgeryguide.com, yourbariatricsurgeryguide.com, and breastimplants4you.com.

Consequently, directories that are just lists have little credibility with consumers and provide limited value for the practice. On the other hand, directories that use comprehensive plastic surgery information as the foundation for the Web site can become a credible referral point.

Mark L. Jewell, MD, a plastic surgeon in Eugene, Ore, and past president of ASAPS, agrees. "The quality of the educational material counts," he says. "Does it tell you what the risks are? Not everybody is a suitable candidate for breast augmentation, and a Web site shouldn’t suggest or imply that just for a referral."

Jewell suggests reading the articles with a critical eye. "Determine who writes the content, and how relevant and accurate the articles are to your practice," he add


If you list in a directory, consumers should not need a GPS to find your practice. The directory should easily link to your Web site and/or provide a simple way for patients to contact your practice, Antell says.

Jewell agrees. "Make sure patients communicate with you directly," he says. "You need to be able to see your directory listing but then link out to your site."

"In order to more exactly track directory performance, some directories make consumers jump through a few hoops before they can contact your practice," Evans says. "For example, some require the prospective patient to fill out a form or click on a separate page just to visit your Web site or obtain the practice phone number. The goal of the directory should be connecting potential patients with your practice, not establishing a foolproof tracking mechanism."

Some directories offer tracking systems to help you determine the origin of your leads. "The easier it is for the patients to connect with the practice, the more difficult it is to track exactly how many surgery consultations come from the directory," Evans says. Still, the tracking of phone calls has some clear advantages in terms of assessing the value of listing in a particular directory.


At the end of the day, all the directories and Web search engine optimization, blog posts, Facebook fans, and tweets in the world will not do a thing if you are not a good surgeon who has a good rapport with prospective patients.

"A directory may get people to your practice, but you need good office staff that is friendly and accommodating to get potential clients in for consultations or surgeries," Antell says. "If you have a beautiful Web site and a great listing in a top directory, but your office is not clean, patients will be turned off."

This matters more for plastic surgeons than other specialists. "Many plastic surgeons practice in their own private surgical facilities, so your office better be a reflection of how clean your operating rooms are," Antell says. In addition, patients are often coming in seeking beauty; so seeing anything less in terms of your office decor may be off-putting to them.

It is essential to have great external marketing and internal marketing, Antell says. "One without the other is not going to cut it."


Most directories require clients to renew after a period of time or give up their oft-coveted spot on the directory list. So, how do you know if your directory is working for you? That’s a tricky question. Internet marketing is notoriously difficult to track.

"A consumer may research a procedure and a surgeon for 6 months before booking a consultation," Evans says. "It is virtually impossible to track what information the consumer reviewed during the previous 6-month time period before the appointment, or what the major driving force was behind scheduling the consultation."

A tracker is not fail-safe, he says. Phone tracking only determines the last place on the Internet the patient visited before calling your office. It does not provide any information about what information sources the consumer used to make the decision prior to the phone call.

If you lead them, they will come. "Directories allow patients to see your name more often," Antell says. Search engine optimization—an industry buzzword—is an important part of this equation. Consistently getting high rankings on Google as well as other search engines for core terms will entice consumers to click on the portals and, ultimately, your directory listing.

"Like it or not, ranking and being easy to find on Google is associated with a perception of quality, while not being easily found creates a question of doubt," Evans says. "Not being found on Google has a negative impact."

A study by marketing research firm Jupiter Research found that six of seven Internet users click on organic search results. By contrast, one out of seven people click on pay-per-click (PPC) ads. PPC listings are labeled as paid ads and often pop up in a special area on the top of the results page. For instance, type the word "liposuction" in any search engine and you will see the difference between PPC and organic listings.

"Some practices choose to advertise their Web sites using PPC ads versus listing in a directory, and if there is sufficient budget then by all means the practice should do both," Evans says. "Consumers place more credibility on information found through the organic rankings."

Shawn Miele, CEO of Advice Media, a Web site development firm in Little Silver, NJ, agrees. "The organic listings get higher-value traffic. There is still distrust in pay-per-click, and we push for organic listing," he says. Advice Media is the parent company for several directory sites, including implantinfo.com and liposite.com.

PSP Practice Pearls

Review the editorial content on a Web-based directory and check out the site’s editorial advisory board. Don’t focus on the latest and greatest procedures, such as lunchtime lifts. Instead, make sure the three R’s of plastic surgery—risk, results, and recovery—are covered responsibly.

  • Directories should make it easy for consumers to contact you—not throw up roadblocks.
  • It is essential to have excellent external marketing and internal marketing.
  • Don’t hang your hat on the directory site’s tracker, and don’t forget to "Google yourself on Google."
  • Opt for a directory that values organic rankings first versus pay-per-click.
  • Choose directories that list only those professionals with whom you want to rub shoulders.
  • Look for prominent rankings of core search terms, such as facelift, liposuction, or breast augmentation, and observe how the directories you are considering stack up.
  • Ask about the Web traffic related to your specialty.
  • Look for directories with highly monitored discussion boards.

Like everything else in life, you get what you pay for with directories. Do your homework to find and work with reputable directories.


It’s basic psychology 101: You are whom you associate with. As dentists, gynecologists, and other unqualified specialists vie for your market share, it is more important than ever for core-trained physicians to travel together. "You don’t want to be on a site that will list a board-certified plastic surgeon who does liposuction next to a general practitioner who does liposuction," Miele says.

It is important to be listed alongside comparably trained and certified core practitioners versus the gynecologist down the street, Jewell concurs. For Jewell, such practitioners can include dermatologists and facial plastic surgeons depending on the directory’s scope.

Engaging your core is true in the directory business as well as in a Pilates class. Most consumers look for core search terms, such as "breast augmentation" or "tummy tuck" when researching the procedures, and not local terms such as "breast augmentation Newport Beach" or "San Diego tummy tuck."

Traffic volume can be a huge selling point, but make sure you know what the directory sales force is selling. "A directory that is multispecialty with many different types of doctors, in addition to plastic surgeons, will surely have more traffic than a plastic surgery-specific directory, but that might not be good for you or your practice," Evans explains.

Directories that promise placement in multiple Web sites can be problematic—you may not receive increased visibility. "Get a list of the Web sites where you will be listed and do some quick organic searches on Google to see if you can easily find the Web sites," Evans says. "If you can’t find the Web sites, then neither can the consumers. What would you rather have, 10 horse-drawn carriages or one Mercedes sedan?"

Miele agrees. "You can spend $25,000 and set up 10 Web sites with a top SEO firm, or you can have a strong practice site and strategic directory listings. And that should get you on top of Google for your name," he says. "It’s important for surgeons to have grassroots word-of-mouth, so anything [a directory] site does to promote word-of-mouth can be helpful," Miele says.

On The Web!

See also "Educational Tools as Marketing Strategies" by Catherine Maley, MBA, in the January 2008 issue of PSP.


Price points vary. Some sites offer featured listings, which cost more than standard directory listings. "Some directories are inexpensive but have little educational value," Miele says. "The reputable companies that provide a lot of value tend to be higher priced."

A key question to ask a prospective directory firm is how many surgeons are listed in your geographical area, Miele explains. "If it is a directory that charges little money but lists 50 surgeon in small area like Tampa, you will get very little traffic, but of you choose a higher-priced directory that lists four surgeons in Tampa, you will get more traffic," he says.

This may not be true in terms of how many surgeons are listed in your market, but it can be true about how many directories in which you can get listed.

"Before she meets you to discuss breast augmentation, the average woman has done 8 hours of research. If you are on all the sites she looks at, you have been in front of her. So, you are not just getting leads by listing, you are also branding and doing reputation protection," Miele says.

Denise Mann is a freelance health writer in New York. Her articles regularly appear in WebMD, health.com, cnn.com, Arthritis Today magazine, American Profile magazine, and special sections of The Wall Street Journal. She is also the editorial director for several plastic surgery portals, including The Consumer Guide to Plastic Surgery.