A plastic surgeon explains how he uses his Web site to grow his practice

And the small shall act big ….”

This principle is repeated again and again in Thomas L. Friedman’s The World Is Flat, the best-selling book about the massive economic changes we’re seeing—and will continue to see—as Internet use spreads to the far corners of American society. It refers to the power shift that’s taking place as the Internet allows small, new businesses to look and behave exactly like big, established businesses.

With Internet marketing, the advantages that used to accrue to dominant forces in the marketplace are rapidly disappearing. Using a sophisticated Web site, a tech-savvy webmaster, and an aggressive, proactive attitude, even small businesses can now get the same results as global powerhouses.

This has momentous implications for aesthetic plastic surgeons. It means that straight-out-of-medical-school physicians can now go head to head with revered surgeons. It no longer matters that a top-ranking surgeon might have carved out a solid reputation over 20 or 30 years, or that he’s managing a $250,000 annual marketing budget. A new physician with a small budget and just a few years of experience can leverage Internet power to achieve parity with him.

Using search-engine optimization, pay-per-click advertising, media promotions, and mass e-mailings, he can draw prospective patients into his orbit and win them over. With 80% of Internet users now researching or finding their medical professionals online, he wields a turbocharged marketing tool unheard of in earlier decades.

So beware all you Goliaths with your well-capitalized practices boasting monster advertising budgets. Here comes tech-savvy David, light on his feet and armed with a measly $50,000. With that pittance, he can accelerate from 0 mph to the speed of sound faster than you could have found 20 patients 20 years ago.

A Well-Oiled Internet Strategy

“I just happened to enjoy the tech stuff and have a lot of time on my hands.”

That’s how Jon E. Mendelsohn, MD, medical director at Advanced Cosmetic Surgery & Laser Center in Cincinnati, sums up the extraordinary growth of his private practice, begun in 2000 and now catering to more than 800 patients per month.

The 18-employee practice includes five dedicated skin-care specialists who see clients every half hour to 45 minutes. Mendelsohn himself does about 20 major surgeries every week, and he’s bringing on a full-time associate to handle body sculpting. The phone rings off the hook all day long, and his database of past and present patients numbers 8,000.

“The growth spurt started as soon as we got our Internet strategy implemented,” he claims. “We quickly saw a spike in business of about 1,200%.”

Today, he estimates that 80% of his new patients have seen his Web site or have been referred by it, and that one out of three or four patients comes directly from the Internet with no intermediary.

Old-Fashioned Advertising

Before that happened, he used old-fashioned marketing tools—radio and print advertising—to drive his business. He also began an ambitious public-relations (PR) campaign, holding seminars in the community and courting the local television stations with stories about low-impact procedures that were gaining popularity everywhere.

Whenever he hosted a seminar, he made sure he collected the e-mail addresses of everyone present and received permission from them to send them a newsletter and announcements. As these stories he pitched about aesthetic plastic surgery began to appear on the news shows, he leapt at the opportunity to maximize his visibility. “The moment the shows aired, we digitized them instantly. We got them up on the Web site the next day,” Mendelsohn explains.

Then came another crucial action: announcing the television appearances through e-mails to everyone in his database. A few patients might have seen them live anyway, but these e-mails made sure every patient who’d ever filled out a sign-up sheet got to see them.

Through these news stories, he leveraged the power of the media to legitimize his practice. Then, through his Web site, he leveraged the Internet to amplify it. This had roughly the same effect 20 years of word-of-mouth recommendations would have had 20 or 30 years ago: It made him a household name in the Cincinnati area.

A Gradual Process

“In the beginning, we didn’t use our Web site to drive new business,” Mendelsohn says. “We had to build a rich Web site before that could happen, and building a rich Web site is a gradual process.”

To do so, Mendelsohn relied on a highly skilled independent webmaster to help him implement his ideas. “We didn’t use any of the established Web-design houses that cater to plastic surgeons and other medical specialties,” he says. “In my opinion, they overcharge and underserve. These are mostly a bunch of geeks who got to the party early. Today they’re taking advantage of doctors who don’t understand the Internet.”

Ryan Miller of Etna Interactive, a Web-design and online marketing firm that takes a boutique approach to serving the aesthetic medicine market, confirms Mendelsohn’s perception. “Doctors mistakenly think they’re ‘going first class’ by using these big, expensive firms. In actual fact, many of them are being shortchanged. These firms do volume business and aren’t really looking out for you. They produce graphically beautiful sites that are often technically deficient.

“There are lots of subtleties to planning, writing, and coding a Web site,” Miller continues. “Nowadays, the right code will attract the search engines and the wrong code will repel them. Many doctors have sites whose code is hurting their search-engine rankings. But a big firm won’t go back and redo the basic design. It costs them money, and they know the doctor is ignorant about software coding.”

Mendelsohn was tech-savvy enough from the get-go to understand coding, so he got it right the first time. He avoided the two extremes: the big firms that don’t care about you, and the local webmasters who lack up-to-date technical knowledge.

Rich Content

While adding the streaming video, collecting e-mail addresses, and giving seminars, Mendelsohn also created extensive text content for his Web site. As a tech-savvy practitioner, he knew that content is king when it comes to search-engine rankings. So, in the beginning, rather than buying pay-per-click advertising, he invested in the text that would create a strong foundation for search-engine primacy.

Describing his procedures at length, adding information about preparation and recovery from surgery, even describing skin care products available through his practice—all of this enriched his Web site with “spider food.” (“Spiders” are the robots search engines send out to evaluate the usefulness of your Web site.)

“The way the search engines work today, you have to keep adding content to your Web site to stay high in the rankings,” Mendelsohn notes. This presents a problem for the surgeons who already have adequate procedure descriptions, videos, and other perks on their Web sites. They don’t want to add so much every month that it makes their Web sites unwieldy.

A solution is to send out and then archive newsletters with a few well-written, 500-word articles every month. This keeps the “spiders” happy while maintaining the integrity of their basic information.

Today, the Web site (www.cosmeticfacedoc.com) describes 22 surgical procedures, has 12 separate pages on low-impact skin-care procedures, carries 18 categories of skin-care products, and boasts an up-to-date events calendar and dozens of other pages of ancillary information. “It’s evolving constantly,” he confirms. “We never stop adding to it.”

Dynamic, rich content makes his Web site internally optimized for a high search-engine ranking. And now that his site is built and he has a larger marketing budget, Mendelsohn invests about $500 per month in pay-per-click advertising.

The Support System: E-mail

Throughout this process, Mendelsohn balanced his spending by using the free services of the Internet—namely, e-mail.

He became an inveterate e-mailer. “We announced everything through e-mail: not just TV appearances but community events, special discounts, extreme make­overs—we kept in touch with patients regularly.” With time to compose the e-mails himself, he had the luxury of sending out not only free announcements, but free newsletters.

Before the advent of e-mail, plastic surgeons spent thousands of dollars every month to design, write, and mail their newsletters. It was a major line item in the marketing budget. Today, getting in touch is free to anyone with a computer. Surgeons who do not have the time to compose e-newsletters can use one of the many inexpensive newsletter services on the market.

Mendelsohn sees e-mail as a cornerstone of his continued success. “We’re planning to increase our newsletter production. We want to have a newsletter for each of our segments—skin care, facial surgery, body surgery, and hair restoration. I personally ask for patients’ e-mail addresses whenever I see them, whether it’s for consultations, follow-up visits, or anything else. I use the Web site to illustrate things, and that’s a good pretext to bring up their availability via e-mail.” A healthy, updated e-mail database is the support matrix for all of his other promotions, which maximizes his exposure.

“It all works in concert,” he says. “Without the public promotions there’d be little to e-mail about, and without the e-mail we’d miss out on high attendance rates. Without the Web site there’d be no way for prospects to check us out and see what a dynamic practice we’ve got going. It’s totally synergistic.”

A Flexible Approach

Contrary to popular wisdom about newsletters, Mendelsohn didn’t stick to a single format once he began using it. Rather, his e-newsletter became a kind of laboratory in which he experimented with different approaches.

“We started out with newsletters that had four or five stories with hyperlinks and a special offer or announcement. Then, we got into more telegraph-style newsletters, with only one- or two-paragraph stories.” These became armatures for discount offers and event announcements. “Some­times I’ll just send out an offer all by itself. It depends on what’s happening in the rest of the practice,” he says.

He never sent out the professional-society newsletters, such as the ones offered by the American Academy of Facial Plastic and Reconstructive Surgery or the American Society for Aesthetic Plastic Surgery, as quarterly e-publications. “Sometimes, we’d subscribe to one of those and just summarize their stories. They’re a good source for content. But I wanted control,” he explains.

For Mendelsohn, personalizing his e-mail and keeping control over the content is all-important. As an evolving, flexible element in his overall marketing mix, his e-newsletters must be nimble and reflect only his practice. Syndicated content would detract from that.

Mendelsohn recommends e-mailing quick bites of information about upcoming events, recent triumphs (befo­re-and-after photos of patients who got impressive results qualifies as news), and high-visibility media events. Anything regarding aesthetic plastic surgery that’s going to be discussed on The Oprah Winfrey Show can be announced, as well as stories currently running in consumer magazines.

Now that his Web site is rich with content, he always links his newsletters back to his Web site.

Not for Everybody

Mendelsohn is the first to admit that his multipronged, proactive approach to marketing isn’t for everybody.

For example, he confirms that established surgeons with extensive word-of-mouth networks don’t need to be as concerned with search-engine position as he does. They’ve already got repeat and referral business flowing in. And their patient network may include an older population that doesn’t rely on e-mail as much as younger patients.

“They can afford printed newsletters, and if it works for them, they should stick with that approach. They only need to check their search-engine positions quarterly,” he recommends.

And physicians who don’t feel comfortable with a breakneck PR schedule and constant promotions won’t be able to implement his strategy at all.

But for those who want to take advantage of technology’s leg up to small businesses, this Cincinnati aesthetic surgeon’s success story is something from which everybody can learn. PSP

Joyce Sunila is the president of Practice Helpers, an e-campaign marketing service for the aesthetic medical industry. She can be reached at (866) 706-0550 or via her Web site, www.practicehelpers.com.