No, not your patients—Stanch the flow of your marketing dollars with internal marketing

When you give a patient a transfusion, your first priority is to replace lost blood. But sooner or later, you must repair the leak. Similarly, after you’ve invested resources to attract patients to your plastic surgery practice, you must find ways to prevent them from “leaking” out.

A “leaky practice” aggressively chases patients through the front door while leaving the rear door unlocked. Thousands upon thousands of dollars are lavished on ads in phone books, newspapers, magazines, business directories, and cable-TV shows; and on Web sites and search-engine services.

But nothing is done to make sure that the people who respond to all this expensive advertising love the service they’re getting, love the follow-up to their surgery, and feel committed to you for their repeat procedures as well as the care of their friends and families.

Consider the following two points.

Point 1: Repeat business doesn’t require advertising. You are lucky to have a large menu of repeat business options.

In the past 10 years, laser skin rejuvenation, injectables, chemical peels, and dermabrasion have become major profit centers for plastic surgeons, as younger Americans opt for anti-aging treatments. Astute businessmen have leaped at the opportunity. What could be better? A continuous stream of income comes in the front door with little effort on your part.

Once you’ve produced beautiful results for your patients with these procedures, all you have to do is nudge them now and again to come back in.

Point 2: Scheduling surgery requires trust. You are in the most trust-sensitive specialty in medicine. Would you let someone alter your looks forever if you didn’t trust him or her?

To overcome their skepticism of plastic surgery (and their fear of disfigurement), people let their friends test the waters for them. Patients overwhelmingly choose plastic surgeons their friends have used. They want to see results in the flesh. Your advertising, your promises, and your portfolio mean nothing to them at the moment of truth—the moment they actually schedule surgery.

Your business stands or falls on the issue of trust. Sensible people shy away from trusting anyone who doesn’t have a track record—especially with their friends.

Stop wasting precious time in your consulting room with marginal prospects who find you through impersonal channels. Get on the referral grapevine. These prospects have already overcome the number-one barrier to scheduling surgery: lack of trust.

Get a Foundation, Then Soar

With a solid foundation of referrals and repeat business, you’ll be wresting full value from all of your expensive advertising. Now, your practice can begin to soar. Try innovative techniques, and look into the products and instruments just coming onto the market.

To get into this comfortable, steady-state condition in which you are constantly building on a strong foundation of trust, all you have to do is shift your marketing budget. Take some of the thousands you’re spending on advertising and move it into a strong internal marketing campaign.

Shift your emphasis from attracting patients to keeping patients, from chasing prospects to receiving referrals, and watch your bottom line grow.

Here are the elements of a strong, proactive internal-marketing campaign:

• a special-member discount campaign;

• training staff to connect with patients and gain their trust;

• follow-up protocols that surround patients with security and warmth; and

• communication tools for personalizing further patient contact.

Staff Training

All over the country, there are workshops dedicated to training office staff in your specialty. A quick Google® search will net you dozens of them. They are valuable for any practice, but they are essential in your specialty.

Patients must be handled with kid gloves. From the second they walk into your office for the first time, they are like land mines waiting to explode. Don’t mistake a quiet demeanor for a contented psyche. They are in crisis—even when they don’t know it. You and your staff need help from professionals to teach you to cope with them successfully.

Nothing Rational About It

Let me give you an example of the kind of hot-button sensitivity you might find in a typical patient who comes in for a facelift. This was told to me by a friend—let’s call her Tonia—who postponed surgery for 2 months over a patient coordinator’s body language.

For more than 1 year, Tonia had researched plastic surgeons. She finally found the one physician with whom she felt comfortable. Even though his office was 3 hours from her home, this was the surgeon she trusted and the one she would allow to operate on her face.

One day, she went to the surgeon’s office to make her down payment and schedule surgery. The patient coordinator was talking pleasantly with her when the operating-room nurse dropped by, just as Tonia was pulling out her ATM card. Tonia got into an animated discussion with the nurse, and momentarily forgot about her wallet and the ATM card.

After a few moments, the patient coordinator started fiddling around at her desk, straightening papers, and trying to make use of her time. This made Tonia furious. “Those people are such phonies!” she told me hotly. “That coordinator was so nice to me, and then when I didn’t give her the money instantly, she lost interest. She had other things to do. I don’t think I can work with people like that. I have to think this over some more.”

At the time, Tonia pretended that nothing was wrong. (It’s rare that you’ll know when you’ve crossed the line with a prospect.) But later that day, she called the patient coordinator and said she wanted to think it over, and would call when she was ready.

Professional staff trainers can sensitize your office staff to the critical moments and issues apt to trigger negative emotions in your prospects. The exchange of money is a classic moment for misunderstanding, and there are protocols designed to deal with it. With the right coaching, your staff will keep your patient in a warm, trusting place throughout your relationship. It’s essential to your success.

Follow-Up Protocols 

The recovery period is when your patients need you the most. Your staff must be well-trained in the timing, art, and practice of reassurance. Nightly check-up phone calls for the first 4 days after surgery are a given. When stitches and staples come out, your nurse should be volunteering a cornucopia of information, advice, and comparisons to keep the patient firmly grounded in the reality of the recovery process. She should not wait for the patient to ask questions.

Tools for Future Contact

If you’ve handled your patient well through surgery and recovery, and delivered excellent results, you have the makings of a lifelong fan. “Plastic surgeons can expect to get 50% or more of their new business from old business,” says Karen Zupko of the Chicago practice-management firm KarenZupko & Associates. Your satisfied patient is the building block of the self-sustaining practice—your goal.

How do you keep her firmly inside your loop? How do you transform her from a satisfied patient to a rabid fan who sends all of her friends and family to you? There are many ways.

Unless your scheduling software is ancient, it contains features that will automatically prompt your staff to contact your patients on important dates, such as when they’re due for repeat botulinum toxin Type A injections or special occasions—birthdays or anniversaries of surgeries.

These are all excellent opportunities for getting back in touch. Sending a special discount offer on a small procedure on someone’s birthday is endearing. Mailing a special skin-care product 1 year after surgery with a little note is thoughtful, too.

Discounts are welcome during holidays, especially on procedures that can boost party-going confidence (such as low-impact laser skin rejuvenation). Every time you touch your patients like this, it cements your relationship with them. Patient loyalty is the key to that steady-state, self-sustaining practice you are seeking.

Many physicians like to publish their special-discount offers in newsletters. They send these out regularly, along with anti-aging information that hasn’t yet been made available to consumers.

Anti-aging information presented without hype is hard to find these days. People appreciate it—they’re weary of all the conflicting claims that make it so hard to be savvy consumers of cosmetic medicine. Done with integrity, newsletters can be powerful communication tools that add to the foundation of trust so important to elective-surgery practices. Even when patients don’t respond to the discount offer in a newsletter, the outreach is not wasted. The information works subliminally to build your reputation—which, after all, is nothing more than a brick-by-brick compilation of positive experiences your patients have with you.

Print newsletters are expensive to send out ($3,500–$6,000 per mailing, depending on the size of your database), so more and more physicians are going to e-newsletters. When done by an advertising agency or marketing company, these will usually cost less than $1,000 per issue. You are required to ask your patients for permission to send the newsletters to their inboxes. Antispam-ming laws prohibit you from using the Internet to send unwanted email.

When you ask patients for their email addresses, emphasize that you will never, ever sell their information or abuse it by sending them third-party promotions. Be clear that you will be impeccable about honoring their information.

In signup offers, patients should be asked politely whether they want to receive late-breaking news and solid medical advice about cosmetic enhancement, along with members-only special offers and discounted services. Reassure patients that you will make it easy for them to opt out if they want to be taken off your list.

You Can’t Go Wrong

However you choose to organize your internal marketing campaign, know that every penny you spend on it is an investment in yourself. Instead of supporting the local media, you’re investing in your life’s work. The people who are helping you fulfill the promise of your talent—your staff and your patients—will love you for it. PSP

Joyce Sunilais the president of Practice Helpers, an e-newsletter marketing service specializing in the aesthetic medical industry. She can be reached at (866) 706-0550 or via her Web site,