Category: SEO

Internet marketing for plastic surgeons presents some interesting challenges. Surgical practices make a lot of money and are attractive targets. Unfortunately, more often than not, the results haven’t matched the promises.

Right when it came out I pointed to a recent article in the NY Times. This post is intended to clarify my thoughts in response.

Table of Contents

• The good news for plastic surgeons’ internet marketing
• The bad news about internet marketing (history)
• Return on Investment (ROI) analysis
• Tracking your results – Important!
• I’m a surgeon (or I work for one) what do I need to know
• A free tip
• What about the Yellow Pages?
• Which portals are worth it?

The good news:

• You can’t ship a procedure, so the customer is most likely local
• There’s a limited number of strong competitors (in most markets)
• Directory and portal sites have to spread their effort
• There are 10 spaces on page 1
• The return on investment is high enough to absorb less than perfect targeting
• Searches with local intent are both easier to compete for and more likely to lead to sales (cases)

The bad news:

• It’s a noisy, channel – given the returns, everybody’s got an angle
• “50% of my marketing budget is wasted, if only I knew which 50%”
• The metrics a sales rep gives don’t mean anything
  • A former partner resold Infospace advertising, they showed 4.5 million unique visitors a month — how many were in Topeka?
  • There’s a lot of searches for non-selling search terms — I’d rather rank for “Portland rhinoplasty specialist” than “Maine plastic surgeon” — see point above
• It’s easy for a portal to be the flavor of the month — get ranked, make sales, fall off
• Every time you pay for advertising in this vertical (maybe all) you increase the incentive for your publisher to outrank you
• As my old partner used to say, “A good salesman can sell anything once” — often that sexy sales pitch is just a pitch — more style than substance

We originally started working in this market around 2 years ago. Our first client was a very niche product peripheral to the mainstream practice. We did well for them and now have a number of cosmetic surgery practices under management and those who’ve been up a while are seeing great results.

So how do we do it? Obviously we can’t give away all the secrets, but surprisingly it’s good old-fashioned SEO, link-building and PPC. What we’ve found is that all the techniques which have historically driven ranking still work.

There is always “the new”, blogging, video optimization, Facebook, social media and the like but the basic unsexy blocking and tackling of traditional online marketing still works like a charm!

We often wonder, given the old – tried and true – methods still work, why is everyone else talking about buzzwords and gadgets. Maybe they’re not willing to put in the effort.

Return on Investment Analysis

One of the great things about modern web site analytics tools is that you can get really granular on the value of a click. What I mean is that we can know where visitors came from, what they wanted and how the contact was made (did they call, did they email).

In some cases, of course, we have less granular data but we can still get within a few percentage points of the value of an ad buy.

I’ve already posted about our use of call-tracking numbers. Honestly, we want to know what’s working. Since we don’t have a directory and we’re not a one-trick pony PPC aggregator we have some latitude. We don’t have a property in which we need to outrank you.

Since our relationship is with our client we get to be agnostic to the medium. We get to focus instead on the massage.

For example, every one of our clients knows to forward us contacts from directory sites whether new or renewing. In each instance, particularly on renewal we will check referrer traffic and see what we’ve gotten.

No traffic, no renewal!

Tracking, tracking, tracking

By tracking where users end up within our site analytics we can get a pretty good view of what actions are being taken by site visitors.

I agree with Jennifer Laycock when she says that it’s more important to focus on incremental improvement rather than out of the box domination. We tend to be more focused on growth in ranking, growth in contacts and of course growth in revenue.

As mentioned above, given you can’t ship a procedure, much of our focus needs to be on the offline conversion which we track by way of call-tracking numbers. Tim of Convert Offline is evaluating a new system which he reports integrates nicely with Google Analytics, but for now we’re doing it the old fashioned way with numbers from VoiceStar

(recently acquired by Marchex) and manual association of the data at the end of each month.

Again, it’s about growth in traffic, not a straight out of the gates flood.

What’s a hard-working plastic surgeon to do?

First and foremost, check references. Good ranking doesn’t necessarily mean results and if you can’t follow the trail from eyeballs on a site to procedures in your office run away.

Know that you are the authority! You don’t have to sell your soul to portals and lead generation sites just to fill your office. And the great news is when you consider the return, the investment is minimal.

Own the content, own the links coming in at YOUR site and you’ll never need to worry about the price going up. It takes work month after month, but at least it’s building your online reputation.

I’m not trying to blow our own horn here, but we verifiably drive leads at a cost of $20 – $50 per contact. The crazy thing is that Google Pay-Per-Click in major markets can cost as much as $15.00 / click for competitive phrases. In case you haven’t already figured it out there’s a big difference between a click and a contact. In fact, you’re doing great if you get above 5% conversion (contact) rate on a click.

The most important thing to remember is you can and should be hyper critical and insist on metrics. There’s no reason you can’t measure this stuff. There’s a margin for error but at a minimum you can see what your team is doing and look for those incremental improvements. As the bankers say “the trend is your friend”.

And… if you don’t know what the money you’re spending buys you, question it and insist on metrics to back up the answers.

Free tip:

If you’re a member of ASPS or ASAPS, sign up for their practice profile. They’re cheap as heck and you can’t get a more higher quality industry reference. And, if you’re a Mentor implant customer sign up for LoveYourLook.com – it’s coming up fast and I think there’s a deal for Mentor surgeons.

Yellow Pages Advertising for Plastic Surgeons

I know it’s scary, but it’s really OK to shut down that Yellow Pages ad. You’re not missing anything with just a bold listing. And, you can get way more bang for that buck online.

One last thing:

For our own information we keep a list of which directory / portal sites are ranking where.

If you want to know who’s ranking well in your town give us a call (504) 208-3900.

Here’s a quick sample (as of March 29th):

Feel free to call with any questions — we love this stuff! (504) 208-3900

In this morning’s session at Small Business Marketing Unleashed Jennifer Laycock was talking about the value of ratings and reviews as a component of social media.

For those of you who don’t know, Search Engine Guide is putting on a show this week focused on small businesses: Small Business Marketing Unleashed .

I have been a huge fan of Search Engine Guide for a long time. I also plan to be a huge promoter of the next show.

For a first show this seems to be a pretty good turnout and even for someone like me who does this for a living there’s always something worth seeing.

What’s really interesting is that even thought these concepts are out of the mainstream, perhaps a little advanced, it’s presented in a way that I think is very accessible to the target market. Small businesses need a way to access this information and they’re not going to get that from the self-referential SEO conferences.

I love it.

Oh, so to the point, Jennifer was talking about ways that small businesses can engage social media. So often I say internet marketing is just like real life. Jennifer points to a number of ways in which this is true and mentioned the difficulty of small businesses incentivizing ratings and reviews.

I got a chance to bring up leavefeedback.org. I advise anyone who has a locally focused business sign up. It’s a great way to help your customers know where to go to leave you reviews.

And, keep an eye on Search Engine Guide and try to get out next time for Small Business Marketing Unleashed. If you have a business online they’ll become critical tools in your kit.

Return on Investment Through Call Tracking

Since I’m clearly not going to get to the proposals I had on tap for tonight I thought I’d go ahead and document a recent client experience I’ve been talking to a few folks about.

I’ve told this story a few times recently in support of our use of call tracking numbers.

There’s an old joke “Half of my marketing budget is wasted, if only I knew which half”.

For anybody who doesn’t know, call tracking is not a new idea. Yellow Pages have used them forever they called them RCF (remote call forwarding) numbers. Essentially a call tracking number is a number which routes calls to the main business number for the purpose of tracking incoming calls. Typically, these are assigned to an ad or campaign to gauge their effectiveness.

I believe in Return on Investment! If what we do doesn’t make money for our clients they should stop paying us. The good news is we make them money and they continue to pay 🙂

But, part of what we do includes helping them understand which of their marketing (ours or otherwise) is worth the money.

We have been blessed to attract a significant number of clients within a high value vertical market. As you might imagine, we’re not the first and so many of our clients are already spending in directories and portals.

Some of these are expensive.

One of our clients was paying $20,000 / year for placement in one of these directories.

And they questioned the value.

So, we recommended the installation of call tracking numbers on their web site both for general web traffic and for referrals coming from this one directory site. After a few months we had the data we needed.

We developed a simple system that would automatically switch the phone numbers displayed on the site depending on the referral source. So, if a visitor arrived from this one site they saw a different number, calls from which were tracked.

To be clear, we did this on their site. Using simple PHP and Javascript we avoided mirroring their site and the only change was the phone number.
After 2 months we made a decision…

They had gotten 4-6 calls a month from referrals from that one site…

They shut it down and now have 20 K a year to put into more effective marketing.

We use call tracking numbers on a number of sites, both for general information and for comparative analysis. This however was a special case, and it was great to be able to help our customer stop wasting money.

Call tracking numbers are inexpensive and easy to set up. If we’d paid 10X as much for the numbers it would have still been worth it when we saved our client 20K.

My friends at Solas Web Design are doing a great interview series on “Local SEO”.

These interviews are a little technical in some cases but still make a great read regardless of your level of knowledge. How do I know so much? One of them is with me 🙂

Among the other usual suspects so far are:

• David Mihm – a small business website designer and SEO consultant off to find fame and fortune as a Portland SEO
• Mike Blumenthal – who devotes way to much time to Understanding Google Maps
• Andrew Shotland – The Local SEO Guide
• Tim – A fellow YP refugee who tells us how to Convert Offline (a pet concept)
• Me

So, the most telling thing I’ve learned thus far is that 3 of 5 interviewees are Yellow Pages refugees.

Miriam is doing a great service blogging, writing over at Search Engine Guide and keeping up with the goings on in local SEO.

It’s a good thing too — It’s easier to live vicariously than try to add all that to my plate.

Following any links in this post will take you to some great reading.

Cheers,

Will

Update:

If you’ve been contacted by SEO Matrix please give us a call. We’ve learned that the way they prospect is by calling people who are spending money on online advertising.

Most of our clients come by referral. We can help you too (and in most cases for much less than SEO Matrix).

We have spoken to a few SEO Matrix cold-call recipients and would love to speak with you too.

Call (504) 208-3900 today.

Original post follows:

Just a quick post to talk about a call I just got from SEO Matrix. Al, from SEOMatrix was kind enough to call and begin to educate me about their services.

Normally I would just sit tight and listen for the competitive value (in the interest of full disclosure, we have used telemarketers and will continue to do so). But, I started poking around their site, got a little more educated and asked a few questions.

My first question for SEO Matrix was “what kind of guarantees do you offer”? And I got a good answer, that they don’t like to over-promise, which let Al into a discussion of the fact that SEOMatrix’s employs only “white hat” techniques. So, for whatever reason that’s where I lost my cool.

Again, I was trying to maintain so I could get a sense for what they were saying to see if it had value when we go back into cold-calling (w/in 30-60 days).

I just couldn’t do it. Why? It offended my sensibilities and I said so. I told Al, that the average consumer of his product doesn’t know what “white hat” is, and that it’s irrelevant to their needs. I then expressed my frustration that he hadn’t even looked at our site — this in itself was funny because he responded that he thought we might do PPC (Note: the title tag includes “Economical SEO“).

In any case, I don’t think they’re Traffic Power, but it would seem they’re not making a great name for themselves in the market since this is the #4 Google result for SEOMatrix.

I’m still trying to pinpoint what set me off. It was one of several things:

• The pricing was silly high
• The caller didn’t even realize he was calling an SEO (even though he knew the company name and was looking at the site)
• The language used was a combination of buzz words and gross oversimplification (my favorite pseudo buzzword: Hard Hat SEO)
• They call themselves an “Ethical Search Engine Optimization Company” — like they’re the only ones

I don’t know, if we have one goal, it’s to de-mystify this stuff. If nothing else the presence of competition, good or bad, validates the business.

I’ll come back and fill in some of the blanks. I just wanted to get this down while fresh in my mind.

—

Due to the inflammatory nature of some of the earlier comments I’ve decided to turn off all comments on this post.

If anyone has issues or questions (especially those of you who gave of your time to post a response) please feel free to contact us directly [email protected] / (504) 208-3900.

I would also like to draw your attention to my post on Swine Insemination.

Andrew Shotland at Local SEO Guide has kicked off a great concept: Giving A Little SEO for Christmas.

To that end, I’m going to work a theme close to home:

• Rebuilding New Orleans
• Support Green Building
• Rebuild The 9th Ward
• New Orleans Business Directory

Nice idea Andrew.

I live in New Orleans where people do occasionally rent a television for the big game.

It’s an event. No need to call consumer credit counseling.

If I’m renting my 17″ Sylvania that may be a problem.

Website promotion is the same. Rent or Own.

Ultimately you want to own.

How do you own your web site ranking? Simple, when someone searches for what you do, it should be YOUR WEBSITE they find.

You may ask “what about paying a top ranked directory or portal? That’s almost the same right?”

If you could rent a car, drive it every day and it was cheaper than owning you’d do it right?

What if I add some conditions?

• I can come take your car any time
• You rented a Cadillac and I replace it with a Yugo
• You’re paying $50 and I raise the rent to $5000

I’m sure you get the point.

This is what it’s like to limit your internet marketing to industry directories.

Stop paying and see what happens.

This is also what it’s like if you advertise with a third-party company where they control all of your listings.

Let me explain…

If you know what my return is on your lead acquisition technology you can raise your prices up to my acceptable profitability and I’ll still pay.

The worst case is that I’ve put all my eggs in your basket — it happens, especially among small and medium sized businesses.

My favorite example from Yellow Pages is the transition from black and white to color, then to multi-page ads.

The Yellow Pages ranking is ad size and seniority. The biggest ad which has been in the book the longest comes first.

Soon enough black & white was no longer good enough and the publishers added color. If you didn’t upgrade you lost your spot.

Then came the “Double-Truck” — an ad spanning 2 pages or more (in Las Vegas some Entertainers cover 4 pages or more).

Upgrade or lose your spot. You don’t own the ranking — it owns you.

I’m not saying directories have no value. There are paid directories which deliver customers. These should be part of any program and they’re not proprietary closed systems. They’re part of an holistic marketing package.

When developing your plan to build online sales (or leads) you must ask “what happens when I stop paying for this?” With little knowledge of online advertising, limited budgets and thin margins, small businesses can be hobbled when the one bet they could afford doesn’t work.

If you rent your store, an increase in rent can be tragic. Ask my friend Nancy Murphy who makes New Orleans Gift Baskets (the irony is that Nancy’s old landlord is still without a new tenant).

In the long term, owning it is usually less expensive than renting. And, if you own it, you don’t have to lose sleep over your provider not performing, or worse yet performing well enough to hold you hostage.

It does makes sense, If you have the budget, to test multiple marketing channels. Just make sure you’re tracking which leads come from where.

If you have a limited budget you must be sure that at the end of the day you can at least drive away free and clear in your Yugo.

Resources:

• Greg Sterling of Screenwerk on aggregated online ad companies for small business
• Andrew Shotland of Local Search Optimization on updating your internet yellow pages listing
• SEOMoz – Directory Link building
• SEOMoz – Beginner’s Guide to SEO
• Search Engine Journal – Local Search Blogs (Best of 2006)
• Content Development Ideas from David Mihm
• Todd Malicoat on The Magic Formula for Retail Website Success
• Matt McGee – How to SEO Your Site in Less Than 60 Minutes
• I would read anything from Jennifer Laycock of Search Engine Guide. Search Engine Guide is the most generally approachable of these.

All of the above offer a wealth of resources for small business owners looking to better understand online marketing.

Photo Credits:

Many thanks to Andrew Shotland of Local SEO Guide for his editorial comments.

Pay No Attention to That Man Behind The Curtain: M-LAT, Medical Lead Acquisition Technology

I’ve mentioned before our current vertical focus on Cosmetic / Plastic Surgery.

I got a call from one of our clients who had attended a dinner in Los Angeles with 40+ of his colleauges in the LA area – “Doc-Hollywoods” he called them. As part of the dinner there’s a chance for vendors to present. At this one, the vendor was a company calling themselves M-LAT (Medical Lead Acquisition Technology).

To hear my client tell it, M-LAT told a story of their new, revolutionary $3 Million dollar product which enabled them to magically capture personal information the moment someone landed on one of the surgeons’ web sites. And then, the surgeon would be able to use data, mystically acquired by the magicians at M-LAT to market to those prospects who’d visited the site.

It was an exciting story. At least in the retelling. Now… to be clear, I wasn’t there. I did not hear them say that they could get the contact information just from a web site visit.

This is what my client asserts they said unequivocally.

So I decided to check it out. I visited the site of one of their clients (something of a poster-boy, in fact) David Hopp a Beverly Hills Cosmetic Surgeon.

And when I got there, after being redirected past a mandatory flash page I saw a pretty average web site with a video intro from the doctor himself. I was looking, searching, and not finding the magic which was going to mystically suck my contact information through the browser. How did these other-worldly medical lead acquisition technologies work and how were they going to acquire me as a lead.

And then, all at once, I saw it! It was an 800 # at the tail end of the video which stayed on screen. It was an 800 # with a list of extensions for different typs of information. What? An 800 #, a 24 hour hotline?

I know there’s no one in the doctor’s office at this time of day.

And then it dawned on me. We occasionally get call-forwarding numbers on behalf of our clients for call tracking. And one of the features is that the system tells you what number is calling, just like caller ID in your home. Ah ha!

Well, that’s a little boring. So, using my Skype out line I called the number – no need for the wife to wonder about some 800 # in LA. It was an information line, closing with “press X to speak to a representative”.

Then, my client faxes me the collateral material from the presentation. I now have a tri-fold slick which talks about what the system that I can study. I have to give these guys credit. They’re good salesmen.

From that tri-fold:

Three million dollar M-LAT Technology, Embedded on Your Talking Web Site

The Medical Lead Acquisition Technology System automatically turns your website’s visitors into live customer leads. This technology extracts key information that includes the potential patient’s phone number, as well as name and address. It instantly turns website browsers and surfers into valuable customer leads [unwritten magic: as soon as they pick up the phone] that your staff can contact and quickly book as consultations.