Q&A on Digital Marketing – Part One

This information shared is accurate as of 01 May 2020. It should not be treated as legal advice.

On Friday, 1 May 2020, ASAPS hosted a webinar on digital marketing to provide members with clarity during the present COVID-19 crisis. The focus was on what ASAPS members should be doing now in their practices in relation to email marketing, website updates, increasing conversion rates and funnels to prepare for the future.  

Questions were posed to Elzanne Strydom from Connected Culture, a Sydney-based digital marketing agency that helps ASAPS with its digital marketing strategies and Drew Hankin from The Azuri Group in the Gold Coast, who is an industry veteran and an expert in this niched area of plastic surgery and marketing. Sean Collins from Incite Partners chaired this session. 

Please use this information as a guide but speak to your own agency professionals so that you can decide if and how it applies to your practice. 

 

Q: What changes have you observed in customer sentiment and behaviour in recent weeks since the COVID-19 impact? What impact is this having on marketing strategies that are currently in place? 

Elzanne Strydom: The key thing that has changed is the recognition that we are never going to go back to the normal that we knew. Volumes have dropped in terms of traffic during those first few weeks. There was the panic, there was the stress, in terms of search. Ad spends have dropped, which have also opened up new opportunities. We have helped clients shift online at a rate that you can’t believe. There is a collective consciousness of being proud to be Australian, doing business with Australia, for Australia. I’m talking across the board, from hand creams to furniture. It is about creating a reputable brand online – nothing else is resonating. There are great opportunities out there but be extremely mindful of your tone which needs to be sensitive to our current situation.

Drew Hankin: The question that arose for us at the start of the pandemic, was how people spending more time at home and on screens was going to affect conversion rates and cost per click, and is it going to unbalance that supply/demand ratio for things like Google AdWords and subsequently affect campaign efficiency and cost per acquisition.

We did a study on around 500,000 website visits in the last 11 weeks (the biggest data study that’s been done in the industry for organic website behaviour), so we have statistics on what’s been happening on a week by week basis. This pandemic has changed every modality of online marketing in many different ways. Something to remember is, everyone’s running off the same wind; it’s just how we set our sails – make the most of certain variables and avoid the negative aspects of others. Keep measuring to navigate around the negatives and seize the positives.

Q: What is content marketing and how important is it right now? 

ES: Content marketing takes people on a journey – it’s a process from awareness (of a product or service) through to action (purchase). People will often start Googling something. Content marketing takes them from this initial idea stage, to getting in touch with you. That is, in its essence, what content marketing is all about. It’s the content that supports this journey, from your website to your social media presence, to the AdWords, to the Facebook ad, to the blog you’ve written, to the white papers you are featuring on. It’s everything.

Q: What is the tone/ positioning you should be adopting right now? 

ES: You have to first accept the current situation – be realistic in your expectations of your customer before you invite them on the journey with you. Serve, not sell – you have a much better chance of getting people on your journey this way. Teach and educate your audience.

DH: We’ve initially seen a large decline in searches, but we’ve seen higher time spent on page by visitors. Those who have been searching, have been clicking and exploring more than they usually would. The conversion rate has been higher, but the amount of traffic has been lower, which is interesting. We’re also seeing such different data in different states and areas.

Q: Can you define time on page, and perhaps the characteristics or the attributes that increase that time on page? 

DH: “Time on page” is the amount of time that somebody spends on a website page, or on a website, to which an important contributing factor is the quality of traffic. If you’ve got irrelevant traffic, they’re not going to spend very long there. You’ve also got the nature of the content, and how it’s displayed to the user. There was the assumption that during this time, it’s going to be an amazing time to advertise because there’s going to be so many eyes on screens with people at home. We’ve seen that in some areas, but not in others.

If we look at Sydney and Melbourne clinic data, the most significant decline in traffic was in Weeks 10 and 11 (Week 10 being March 1st to 7th; Week 11 being March 8th to 14th), which was when Scott Morrison made the initial large announcement with the COVID business restrictions- where we measured a 34% drop compared to this time last year in organic search volume. This time of year is always highly volatile, and the data shows that COVID has further exacerbated this seasonal drop. Nobody ever looks forward to the February/March period, but this has all made it much worse.

The positive line though, Week 14 (March 29th to April 4th), is when everything started picking up dramatically with just over a 30% increase across the board in gross organic traffic (bringing traffic close to pre-COVID levels). Note: we’re talking about organic traffic here, because it’s completely isolated from AdWords and social media engagement- which are unique channels in their own ways. With things like Google Trends, you can vaguely see fluctuations over the year of certain searches and how many people are searching them- but nothing quantitative or concrete, which is why we’ve done the study so we can truly quantify all aspects of the fallout.

Q: What are the things that practices and businesses should consider doing now? 

ES: First of all, know your audience. You need to tap straight into the emotional drivers and levers. For many of our patients, the buying decision is based around emotions. It could be a long-held desire to have something fixed or enhanced. So, the content should help you target that preferred patient.

Q: How do you best go about knowing the audience? 

ES: Look at how is your traffic – where is it coming from? Look at the demographic and psychographics and break down in your analytics or get somebody to help you so that you get to know who’s looking, where are they living, what do they look like… Be true to your brand, your positioning and your representation.  You can’t create something you’re not.

Q: It is true that the cost-per-click has dropped? 

ES: We have not seen prices like this since 2014 in lead generation on social media. Now is the golden time to acquire names so you can communicate, educate and nurture them to become part of your brand and your community.

DH: Generally, the largest contributing factor that affects cost per click is a supply and demand ratio. Supply is the amount of people searching for a phrase, and demand would be the number of clinics who are bidding on it.

Our hypothesis was that searches are going to go up dramatically (increasing supply), clinics are going to want to reduce their spends (decreasing demand), and that, in turn, resulting in lower cost per click. We’ve seen that in some areas, with the broader more ubiquitous terms- this has happened exactly, but not in others.

For instance, take “breast augmentation” as a term. If you target that on AdWords, it’s very broad, it’s very well-contested by other clinics (expensive), and it’s very low converting, because you’re attracting people at the beginning of the buying cycle (searching for a vague term) and we’ve seen terms like this have decreased CPC’s. Whereas if you’re looking at terms that have less searches, that are more niche, that are more conducive to people who are the later stages of buying, like ‘breast augmentation cost in Sydney’, or ‘best breast surgeon in Sydney’, we’ve seen those cost per clicks remain the same. The broad/ubiquitous terms have come down in price, though these are seldom terms which yield revenue for clinics.

The question really is of whether or not it’s commercially viable to target them. It just comes down to cost per acquisition (CPA). The content they see on the page will obviously also influence them to make an inquiry or not (their conversion rate), so lead generation doesn’t simply come down to CPC.

Q: Is it true that video is the most important thing that people should be doing right now? 

ES: Yes, it is important, but we need to remember that not everybody is good on video. Generally speaking, the older generation needs guidance when it comes to making videos; for the youngsters, it’s part of their daily lives. Everybody is consuming content and video content – take the rise and rise of TikTok. But you have to find something that you are comfortable with that represents you as a brand. If your consumer finds you inauthentic, your message will not resonate. You can set up a YouTube channel and do a TikTok dance. But is that the real you? How about you produce content that looks at your case studies and shows your results/ How about a video that broadens your patients’ understanding of what you can deliver? If you need help making videos, get it. Don’t just jump on the bandwagon just because your competitors are on TikTok or YouTube.

Q: What channels should people be mindful of investing in? 

DH: Act based on data insights – evidence-based marketing. We’ve had a broad spectrum of clinics responding in different ways. Some clinics had campaigns that bombed straight away; other clients had campaigns that were doing brilliantly.  Like Warren Buffett said, “Be greedy when others are fearful, and fearful when others are greedy.” Let the data tell you the story and keep your finger on the pulse. It’s imperative to re-test and re-check your campaigns and data constantly. Let your data tell you which channels are working and which aren’t, because this is different for every clinic.

Q: What would you suggest that clients shouldn’t do now? What should they stop?

DH: Clinics should be acting on their data more than ever, and not flying blind. Know your marketing figures as well as you know your figures on Xero. Use the time as well to retrospectively look back at your figures, and work out your previous conversion rates, and where your wins were coming from. Plastic surgeons, who are usually so overworked, suddenly have time on their hands. Use it to get hands-on with the figures.

Q: If there were three things that clients should focus on, what would they be? 

DH: It depends on the modality of marketing. If we’re talking about Google AdWords, it comes down to one figure – it is your cost per lead, and a contributing factor to that – your quality of leads. If we’re looking at SEO, that’s a completely different kettle of fish. You’re looking at the rankings gained, the traffic produced by organic means. If you look at social media, there’s the fluffy side of doing pretty posts and stimulating your engagement and your existing followers- That’s one side of it, that’s ancillary to the rest. But true social media marketing with marketing and sales funnels, and that kind of thing, more or less should be measured the same as AdWords, it comes down to cost per lead. And then you look at the viability and the propensity for those leads to convert into actual sales to work out what the true yield is from your ad campaigns. By following this methodology it’s very possible to ascertain what your return is for every $1 you spend- which is more critical now than ever.

ES: I would spend money in marketing virtual consults. I would also consider charging for the consults – not just doing it for free. The price point that we are finding in Sydney and Melbourne is between $100-$200. You can only do that if you have invested in a nurturing email marketing program. I would invest in a funnel in terms of email marketing that gets driven from social media, so we want to get the books, or the waiting lists, or the conversations going. I would shine on social media. Use it to talk in your own authentic voice. I would examine and spend time on SEO and look at my own brand.

Q: How regularly should somebody be posting and connecting with their audience? 

ES: Once you start feeding the beast, the beast just gets hungrier. What do you feel comfortable with? The algorithm requires regular activity and consistency. Post on Facebook once, twice a week, have an Instagram story once or twice a week. make sure you’re on LinkedIn. Set some basic rules for yourself to be there once or twice a week. Here is the key: If somebody comments, make sure you reply with more than a ‘Like’ or a smiley face. The same goes for Google My Business, same thing. You need to engage.

Q: If practices are currently not on platforms like Instagram, Facebook, LinkedIn, etc., should they start or should they invest in their existing infrastructure like their website?

ES: Firstly, clean your home before you attempt to do too much. I would, however, urge you to at least have a Facebook page and a pixel that tracks information so that you can make informed decisions. If you don’t have a pixel tracker, find out how to set it up or get someone to do it for you and help you gather data.

DH: It’s a good time to look at the back-end and clean the house. Plastic surgeons never really get time to do this. Get all your photos done, blogs written, get personalised articles uploaded, reach out to your followers. Take, for example, Davin Lim, a dermatologist in Brisbane who is in my opinion one of the best (if not the best) creators of medical content in the world. His YouTube channel just passed 60 million views purely because the content he’s making is so unique and helpful. He’s not selling his services; he’s demonstrating his knowledge by explaining things in such a simple-to-understand way.

In terms of content on your page, it’s important to analyse who is going to see the content, where to post it, what’s the purpose of it. There’s different content for different places. Think about the purpose of the content you’re creating, and where you’re posting, who’s going to see it, and what the desired outcome is. It’s got to be a thought-out process, rather than just thinking, “We’re going to make the most amazing video that anyone’s ever made”, and then post it on their Facebook. It’s not enough. Do you need an expensive three-minute video made for $8K or could you pick up your own webcam or your phone, and do something yourself? There is an enormous debate in my industry between professionally produced content versus casual content and which is superior.

Those beautiful professional videos you put on your website showcasing your clinic is fantastic for reinforcing the quality of your brand. But don’t use it anywhere and everywhere. There is nothing wrong with the authentic do-it-yourself video.

Q: You talk about the right marketing at the right place, or the right time, and you referred to the funnel. Can you explain what the funnel is and what is ‘top of funnel’, etc.?

DH: To put it in an in-clinic perspective (a sales funnel), the ‘top of funnel’ is inquiries that come in, ‘middle of funnel’ is turning them into consultations, ‘bottom of funnel’ is turning them into procedures. Prior to that (a marketing funnel), you’ve got people who are first seeing an ad (very top), clicking an ad (top-middle), engaging with that ad (middle), getting remarketed to (middle), and then making an inquiry (bottom). And at those varying stages, there is different content required for a term that we call nurturing, and that is to increase what we also refer to as intent. Nurturing to create intent is really the fundamental goal, taking someone from casually seeing an ad to the inquiry. Now if we look at the intent, the inherent intent of, say, AdWords versus Facebook, is both very different.

In AdWords, you’re getting people who are searching for a product or service, and you can narrow the terms and devise terms that are going to be conducive to someone being in the later stages of the buying cycle. These people are going to be very high converting, as they’re already seeking the product/service and have most likely already had a lot of consideration. In a way it’s “reactive” rather than “proactive”, as you’re serving them content which reacts to their searches. This is where you’ll generally attract enquiries who have already done a considerable amount of research.

A platform like Facebook is very different and generally produces lower “intent” enquiries, and are lower converting. With Facebook ads you’re casting a net proactively out to a ton of people, between 20 and 50 bucks for every thousand people that see a post and trying to attract people in there. And then, those people that might not have intent then and there or willingness to convert, are the ones you need to put into a funnel to create intent. Without doing that, you’re going to get a lot of inquiries that aren’t converting and are tyre kickers- or people who are just beginning their process of research.

Q: What about self-promotion of your business and services?

ES: It’s the testimonies and the reviews that make for powerful marketing. Of course, there are AHPRA rules to follow. Ultimately, the best source is your clients who have gone through procedure or had an experience from interacting with you. Getting them to do testimonials, to do recommendations. You have to be very careful, because you are operating as medical professionals and need to adhere to AHPRA rules.

Q: What about influencer marketing? Their cosmetic plastic surgery videos get hundreds, perhaps thousands, of views. Why do they outperform plastic surgeon videos? 

DH: The effectiveness of an influencer has changed at an unbelievable rate, and in short is decreasing.

At one time, businesses would pay the Kardashians a quarter of a million bucks for a post as it’d reach all of her millions of followers, now the posts of any influencer will reach a small fraction of his/her followers. Instagram and Facebook were/are well aware of influencers making money off their platforms and want to cash in by squeezing organic reach and forcing businesses to spend with the platform rather than with the influencer. Nowadays, if these influencers need to reach their followers, they themselves need to pay to reach all of their own followers, which often negates the opportunity itself in having the influencer post. What is progressively occurring  is the squeeze of that influencers organic reach to their following, and the only merit in hiring an influencer, is for their face as a model, not their following- we will see this evolve more and more over time. The tables have now turned – Facebook is a public company and they’re there to make money so they’ve drastically changed the algorithms and platform measures to put the profit in their own pockets rather 20 something year olds with a million followers.

Q: What are the activities that people can invest in right now to leverage when they’re coming out of COVID-19 and, ideally, get the best leverage from an uplift perspective? What does that marketing strategy look like? 

I’m going to come back to email marketing. There are a lot of databases in practices which are under-utilised. I would set up automated email campaigns to educate, engage, and promote the practice. When was the last time that you’ve done this properly or correctly? Invest in getting this set up correctly and create different types of messaging across it. Find out who you can re-engage with, and who you can activate. Don’t forget SEO.

Q: Is having an app, or utilising apps, and not just having your website mobile-friendly something a practice should consider?  

DH: Nine years ago, when I started Azuri just after I left Apple, making apps was the core of my business. It was a gold rush in the time of making apps –  everybody wanted one. Today, the advancement of what you can include in a website in terms of functionality has grown vastly and has negated the requirement for an app in the majority of cases. So, what you used to require to make an app for: online booking functionality, use of the camera on the phone, you can now do it on a website with the help of a good web developer. In most business cases, an app can be replaced by a functional website. Mobile responsiveness is critical, and it isn’t just a matter of whether or not your site is responsive, it’s how responsive it is which matters.

Q: With restrictions lifting, has the traffic for cosmetic cases increased, in either search criteria or search terms? 

DH: Looking at Week 14 of the year, which is March 29th until April 4th, it’s a 30.1% increase on the previous year. That would indicate that things are back to normal in search of volume. What the unknown is, is their propensity to convert from inquiry to consult which we’re yet to measure.

It’s not just about how many leads you can get; it’s how many convert to becoming patients. There has been a resistance for them to book and different views on the virtual consult. Time will tell what the propensity for those virtual consults is to convert into a patient. We’re in uncharted waters.

Q: Has print-based marketing gone away? Is it still valid? 

ES: I was in print-based media for 20 years and, over time, it was decimated. It does not mean though, that a patient or a customer might not appreciate a handwritten note. It does not mean that a poster can’t do a thing or two. It does not mean that for a credibility piece, you might buy Sydney Morning Herald digital traffic or place an ad in the Good Weekend.

DH: You can also look at alternate means of communication like SMS, which has had a resurgence. The highest performing converting clinics are using SMS very efficiently in their sales funnel. Quite often, emails are going unread as people are getting too many of them in their Inbox every day and have become accustomed/seasoned to see marketing emails as an annoyance rather than a conveyance of information

Q: What’s the difference between a patient’s story, a case study, a patient diary and a testimonial? 

ES: It’s for me all the same – it depends on which medium you put it. A story is something that you can record on a video; a case study is you presenting your own findings; a patient diary can be turned into a blog type of post; and a testimonial is me posting a Google review saying, “This was the best doctor I’ve ever seen.” It is how you use it, keeping in mind the legalities.

Q: If there were three things that people did in the next two weeks, what would those three activities be? What would you suggest they invest in?

ES: I suggest looking into email marketing, text messaging, together with your social media activity, and your social media advertising. Think of things like Messenger bots, because you get automated systems to do a little bit of your heavy lifting. Don’t forget SEO.

DH: Know your figures and look where the easiest opportunities for improvement are. Improve the incremental conversion rates at varying points in the business. If the clinic changes their on-site conversion rate from 2% to 2.5%, the result is 25% more enquiries. By putting measures in place and paying attention to your conversion rate from inquiry to consult, taking that from 10% to 15%- is a 50% increase in consultations. Not enough clinics look at or focus on those conversion figures. The most successful clinics that we work with know the exact figures off the top of their head. “What’s your conversion rate?” we ask. “19.5%,” they reply immediately.

Secondly, use the time off to get your website in order – what content is in there and what content you can produce for it.

Lastly, there’s no real Kryptonite or secret sauce for marketing, or to get rich quick, or get successful quickly. It’s an enormous combination of small factors that collectively produce an amazing outcome. Pay attention to each figure and detail because collectively making effort across a spectrum of aspects of your business come together to produce a fantastic result.