Across the country, direct-to-consumer marketing gets a boost as practices and imaging centers reach out to the customer—their patients.
By Jenny Lower
Charlotte radiology created an ad campaign around low dose CT screening for lung cancer.
It used to be that imaging followed a predictable pattern: a referring physician prescribed a procedure for a patient, and often told him where to get it done. The patient made an appointment, had the procedure, and called it a day.
The times, how they have changed. Today’s patients are savvier, smarter, and more engaged in their healthcare than ever before. They have the Web at their fingertips. They’re more likely to conduct their own research before ever setting foot in a doctor’s office and to have opinions about the direction of their care once they do. Unlike their parents’ generation, they’re more comfortable questioning a doctor’s orders.
“Physicians have traditionally stayed away from marketing to consumers, but that just doesn’t work anymore,” said Ronald Ruff, MD, a radiologist and vice president of the board of directors of Mountain Medical in Salt Lake City. He also serves as the medical director for the practice’s two freestanding clinics. “Patients are more responsible for their own healthcare than they have ever been. They have to pay for it, they have more choices in where they receive it, and they need to take part in the process.”
Changes to insurance policies have forced employees to shoulder a greater portion of their healthcare costs than ever before, inviting closer scrutiny of costs that were once handled by insurance companies. At the same time, a plethora of tools have sprung up to aid the careful consumer: mobile apps such as Healthcare BlueBook offer regional price comparisons for medical care. Technology is allowing patients to price a CT scan with the same ease and transparency they’ve come to expect when shopping for a pair of hiking boots.
“We are in the middle of the information age,” Ruff said. “If radiologists don’t recognize this, they are going to struggle.”
Get to the Point
But for practices and imaging centers of all sizes, delving into this unfamiliar territory can prove daunting. Marketing avenues range from traditional media like print, radio, and television to newer strategies such as social media, online ads, outdoor billboards, and specialized events. Despite a wide range of potential media, campaigns must remain tightly focused to be successful, said Katie Robbins, marketing director at Charlotte Radiology in North Carolina. People encounter hundreds of advertisements per day in the marketplace. “If you’re not getting specific with your message when it comes to consumers, they’re going to miss it.”
Katie Robbins, Director of Marketing, Charlotte Radiology
That means identifying your practice’s core strength relative to the marketplace, such as lower costs to consumers. And while it’s often challenging to pinpoint a target audience, it’s a good idea to narrow your focus based on the service you want to promote, eg, mammography for women over 40. But when it comes to crafting the actual language and appearance of a campaign, many radiologists forget they’re not talking to other physicians. “People try to make it about themselves instead of about the consumer,” Robbins said. “When you look at Coke and Nike, they make it about the person who’s using that brand. The underlying theme is always there—it’s going to taste great, it’s going to fit great—but what is it going to do for you?”
Mountain Medical is the largest radiology group in Utah, comprising 65 full-time radiologists and serving as the sole imaging provider for 11 local hospitals. The practice also owns and operates two independent facilities in the Salt Lake City metro region. Known for its high-quality healthcare, the area regularly attracts medical tourists from out of state and neighboring towns, but imaging remains hospital-dominated. There are few outpatient imaging centers available, so many patients aren’t aware of alternatives.
During the financial crisis, doctors began complaining that many patients could no longer afford the scans they needed. Mountain Medical knew its centers charged up to 40% less for procedures than many local hospitals. In 2012, following a successful campaign aimed at educating referring physicians, Mountain Medical quintupled its marketing budget and reached out directly to consumers.
With the help of an advertising agency, the practice purchased six billboards in the metro area: one stationed along a busy highway, and another half dozen on electronic rotation. The ads included the center’s rebranded design and a catchy URL: lowerimagingcosts.com. The link took visitors to a microsite that explained how patients could pay less by getting services at a clinic instead of a hospital. Staff built a simple spreadsheet factoring in fee schedules and deductibles so that when customers called, they could quote out-of-pocket costs over the phone. According to Mountain Medical, when those customers tried to price similar imaging services at hospitals, they often received vague information or were told to contact their insurance companies.
“We were reluctant as a company to talk about money and price,” said Mary Christensen, director of marketing. “That’s just not something medical practices have been comfortable with in the past.” But surveys later indicated that 10% of patients in 2012 were driven by the billboard campaign, while three times as many patients that year cited awareness of lower costs as a factor in their decision to seek services.
Mary Christensen, Marketing Director, Mountain Medical
Throughout the campaign, Mountain Medical was strategic about the language they used. “We were very careful that we weren’t cheap,” Christensen said. “It was affordable and accessible. It was still quality. We were just being more open with our pricing.”
As word of mouth grew, the campaign attracted astute consumers, including one man from Alaska who needed an MRI. It was less expensive for him to fly into Salt Lake, visit family, and go skiing, he noted, than to pay for the same procedure at home.
Everyone was a little nervous going into the campaign, said Christensen. It was more money than they had ever spent on any marketing effort in the practice’s history. “But it was something we believed in,” she said. “Overall, imaging utilization in our area has slowed down—but we have increased. We attribute that to more customer awareness.”
Be Creative
But building a successful campaign isn’t just about the content of your message—tone matters too. For that, professional wordsmiths and designers come in handy.
Among the biggest radiology practices in the country, Charlotte Radiology owns and operates 13 breast centers, a pair of vein and vascular centers, and several vascular and interventional clinics, along with Carolinas Imaging Services. Robbins, a former account executive at an advertising agency, oversees a team of six full- and part-time marketing staff there.
The practice has earned a number of Quest awards from the Radiology Business Management Association (RBMA), most recently winning a Gold in advertising at the 2014 ceremony. Building on the recent United States Preventive Services Task Force recommendation for CT lung cancer screening for adults 55 to 80 years old with a 30 pack-year smoking history, the print and online campaign featured a pair of lung-shaped ashtrays with the tagline, “How much damage have you done?”
“You want something that is going to jolt patients, but not scare them to death—or scare them away,” Robbins said. “You also want something eye-catching that’s going to get them to stop and think.”
The marketing team worked closely with radiologists and pulmonologists to develop an appropriate approach. Smaller practices lacking in-house experience may wish to consider working with a full-service advertising agency, or at the very least a professional creative team, Robbins said. Too often small practices promote a go-getter from within to handle their marketing efforts, instead of a strategist who can show radiologists what they need to do to get where they want to go. The former approach might work fine for physician liaisons, but consumer marketing is “a different beast,” she said.
Charlotte Radiology keeps marketing in-house due to their large volume of advertising, but they hire a freelance writer and graphic designer to create their message. For each campaign, Robbins provides a strategy-driven brief outlining the target audience, objectives, budget, and competitive landscape to guide the creative team. But once that vision has been articulated and she is satisfied the creative team understands it, Robbins lets go. “We’ve had to learn to trust. We’ve been told that our stuff is a little edgy, but we had to step out on that ledge with our creative team in order to be successful. They’ve hit the nail on the head for us every time.”
Charlotte Radiology provides breast cancer screenings for more than 80,000 patients per year, and surveys have shown that of those, 8% to 12% are the result of the patient having seen their advertising. Robbins points to their most recent breast screening campaign, first launched in 2008. The tagline read, “1 in 8 women is affected by breast cancer. Win the fight with early detection.” Robbins was reluctant about the accompanying art—eight female figures linked in a circle that looked much like the symbols on the outside of women’s restrooms. But in the end, she opted to back her team and approved the campaign.
The practice saw a 10% jump in screening mammography that year. They have repurposed the ad in various forms since, most recently raising the flat pink figure into a 3D image to promote breast tomosynthesis. According to Robbins, it takes an average of seven viewings for an ad to penetrate a customer’s awareness—so right around the time you’re tired of it, the customer is just getting used to it.
“I could not have been more dead wrong. And did I understand the service line, did I know the clients and the women and the target audience? Absolutely,” Robbins said. “But sometimes you have to trust your creative team.”
The Medium Is the Message
Once a practice has nailed down a campaign’s content and tone, there’s the delivery method to consider. For Outpatient Imaging Affiliates, that meant an unconventional approach its organizers refer to as “guerilla marketing.”
Outpatient Diagnostic Center partnered with local businesses to promote savings through a Random Acts of Value campaign.
Outpatient Imaging Affiliates operates 27 facilities across the country, including two owned centers—Outpatient Diagnostic Centers—in Huntsville and Madison, Ala. Although the company had previously only dabbled in direct-to-consumer marketing, in January 2014 it undertook a novel campaign with its advertising partner, Marketing Works. Outpatient Diagnostic could offer consumers steep savings—up to 33% compared with local hospitals—so it made sense to promote this benefit. The approach to delivering the message was the really unusual part.
Through an ongoing “Random Acts of Value” campaign, the imaging centers target customers in unexpected venues—from movie theaters to a local bread company—offering promotions from local vendors that link radiology with value. At each event, representatives from Outpatient Diagnostic are on hand to educate consumers and discuss the advantages of their services. One Superbowl Sunday promotion offered customers $5 off a large pizza, along with a flyer about the diagnostic center.
“The whole point is to be in some place unexpected, to break through the clutter,” said Dave Dierolf, vice president of performance improvement, Outpatient Imaging Affiliates. “If I can get you talking—‘I saw a healthcare place marketing at a pizza shop’—that’s a win.”
At one event, a woman who needed an MRI approached and discussed options with the center’s staff. That kind of face time is more valuable for the company than attending health fairs, which can turn into “goodie grabs,” according to Gail Schwartz, vice president, healthcare at Marketing Works. “People just want to walk around and get free stuff. You’re not really having a lot of great meaningful conversation. When you take it outside that setting, it’s very different,” she said.
“You can’t create demand for imaging studies,” Schwartz added. “People have to know who you are, what you offer, what makes you different. You’ve got to get on their radar screens so that when they do have a need, you’re on their list of places they might consider going.”
Lessons Learned
When moving forward, it’s important to remember a few key things, say experts. Don’t ignore your referring physician base, especially when introducing new services. Consumer marketing should supplement, not replace, existing efforts.
Saving money on scans is the message in this billboard.
Measuring results, via patient surveys or other methods, is critical. “If you’re not going to put the energy and the money into tracking, it’s probably not a good idea to go too far down a consumer path,” Robbins said. If you don’t bother to gather metrics, you’ll have a tough time evaluating what works, what doesn’t, and whether the payoff justifies an ongoing investment.
Finally, don’t delay. Customers are going to talk, but with the right campaign, you can steer the conversation.
“It’s easy for patients to become informed, even if it’s not all accurate,” Ruff said. “They’re going to ask questions, and you have to be prepared to deal with them. You might as well be talking to them directly.”
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Jenny Lower is the associate editor for Axis Imaging News.
