Q&A on Digital Marketing – Part Two

On Friday, 8 May 2020, ASAPS held Part 2 of the webinar on digital marketing so that members could understand marketing concepts and have the opportunity to ask questions on what businesses will look like post-COVID – what needs to change, what needs to start, what needs to be tweaked.

As in Part 1, the session was chaired by Sean Collins of Incite Partners. Questions were posed to Drew Hankin from The Azuri Groupin the Gold Coast, who is an industry veteran and an expert in this niched area of plastic surgery and marketing and Elzanne Strydomof Connected Culture, a Sydney-based digital marketing agency that helps ASAPS with its digital marketing strategies.

It is important that you get specific professional advice in relation to your circumstances since the situation is fluid and subject to change.


This information shared is accurate as of 08 May 2020. It should not be treated as legal advice.


Q: What have you noticed that successful business owners are doing well during the pandemic and, conversely, what are the unsuccessful ones failing to do?

Elzanne Strydom: Successful business owners take the role and responsibility of marketing very seriously. They are in the trenches with us in terms of strategy; looking after their money and their marketing. Whether they do their marketing in-house or outsource it to agencies like the ones I run, they take the time to plan and strategise.

The unsuccessful ones are the ones who are not willing to go beyond what they do – they stick to being the clinician, the practitioner. They are finding this period extremely hard to get into the thinking or strategy required for the new normal. They do not want to be responsible for thinking about the marketing for their business.

Drew Hankin: Figuring out who’s responsible for marketing initiatives in the clinic- the successful ones are doing this & the unsuccessful are not. Also ascertaining exactly which measures are successful and those who aren’t. It all comes down to measuring the results with the appropriate KPI’s- whether it be SEO, Adwords, social media or a content piece.

Successful clinics have had their finger on the pulse with all active initiatives to know what changes to make through COVID19, whether it be increasing or decreasing spend in various areas.


Q: What would you suggest that people do so that they cannot be caught in that trap? How do identify those objectives and those KPIs effectively?

DH: I’ll explain all the KPIs in a matter of 45 seconds. The three main modalities to be measured are going to be SEO, Adwords and social media ads. The key KPI’s to monitor for an SEO campaign are the rankings gained for targeted keywords, and the impact on your organic traffic that these rankings have had. You might look at that on a month-on-month, and on a year-on-year basis, and ensure there’s always progress being made. If there isn’t, then the job is not being done.

Google AdWords is (most of the time) best measured cost per lead. If you know your cost per lead from an Adwords campaign is $20, you’ll know that for every $1000 you spend that you’ll get 20 leads. The clinic can then produce a list of those inquiries and then cross-reference them and then calculate an exact to the cent yield from that spend, which is the ROAS (Return On Ad Spend). This will calculate yield to the cent.

This is also true for social media ad campaigns – how many leads you’re getting for every $1000 you spend; how many of those turn into procedures. How many people saw the ads doesn’t matter; what ultimately matters is how many of them enquire and actually make a booking. Marketing agencies are there to produce revenue, not fluffy pictures. Your marketing reports are equally as important as your P&L’s in Xero, they’re critical to your business.


Q: How important is marketing content at the top end of the funnel?

ES: I believe that content marketing delivers performance and real results. Firstly, through traffic that is measured in clicks and views. Once you get the customer to your website, your social media pages, or booking page, what does your story look like? Let’s say a potential customer lands on your website, you need to check the following: Is it easy to contact you? Do you have your credentials on there? Who are you? Is there social proof? Is the website easy to navigate? Is it mobile-friendly? Are you talking in video as well as in text? Good content equals great SEO. One more thing: Google My Business is free – use it. Post on it regularly. We get between 26 and 30% bookings through Google My Business.


Q: What does knowing your audience really mean? What are the specific things that people should start to think about knowing their audience?

DH: There are different kinds of traffic via different acquisition sources. Knowing your audience is very important when targeting set demographics through social media campaigns. For example: Being men or women between age brackets X and Y, having kids that go to a particular school, drive this car, do Pilates, etc. You then create personas and work out which audiences and which behaviours, which traits, which affinities to target.

There is a rich field of data available on Facebook and Google that you can leverage. A simple way is to boost a post and choose age, gender, basic things that they like or don’t like. Then there’s creating ads, which is done in business.facebook.com – it’s the Facebook Business managing done via the ads manager. This is where far more detailed campaigns and advertising initiatives are created, which also allow quite detailed re-targeting measures.

That’s a far more detailed platform. There are courses like Facebook Blueprint that you can do that will teach you how to use that.


Q: Let’s say, a smaller practice that has got a practice manager or a nominated individual who’s responsible for the marketing initiatives but perhaps not all the doing. Would you suggest they go and invest in training in those areas?  

DH: Provided the person has got the spare time, I absolutely recommend they give it a crack. Facebook has grown to be the enormous media company that it is because it’s a platform that is relatively simple for a layman to learn and use. And by doing that, people don’t need to rely on agencies. However, when you’re looking at competitive markets that do require a pretty innate knowledge of how to convert traffic into leads, it’s worth getting the training and expertise.

Knowing your audience by using Facebook ads can be done in several ways. You can A: identify the personas of people coming into the clinic and their behaviours. Or B: you can use A/B testing with a variety of ads. Example: someone wants to target breast augmentation in Melbourne. They might have an ad which they’ll test to four different audiences – their age, where they live, the type of car they drive, the private schools their kids go to, the method of exercise they like, the political stance even. By running ads to a spectrum of attributes and gauging response, the data will tell you which ad performed the best and give you insight into relevant user attributes. If you use data to help you make decisions rather than intuition, you’ll do much better than otherwise.

I’m strong believer in always continuing to push boundaries and test new audiences regardless of whatever the success is in a campaign. We always allocate 15% of a clients marketing spend to exploring new audiences for that clinic, to try to find new pockets of efficiency and ultimately to produce great leads.


Q: What would you change in a content perspective if the proper audience or the ideal target audience is not popping up?

ES:We take your database of current patients and put it in the backend of the engine – be it Facebook or Google – and use that as a base to start the testing. Then we’ll build out A/B testing as we try and find your top of funnel. Then, we just go interest-based audiences. At Connected Culture, we split the budgets – 50-60% for finding new audiences (customers that look/behave/have similar interests to your current patients) and 30-40% on warmer audiences.

You have to know who your preferred client is learn what matters to that patient. We make decisions based on emotions, especially the need to have plastic surgery; you have to tap into that and engage potential in order for them to buy.


Q: What signals do consumers look for to distinguish between the fluff and the reality, the fake credentials versus the real ones, the quantity versus quality?

ES:At the moment, research is saying to us that the experience of the surgeon is everything. It is more important than the cost of the surgery. The patient needs to feel a sense of safety, that they’re making a secure investment and discernment in where to spend their dollars.

DH:In consultations surgeons will explain their experience, convey their interest and specific approach to certain procedures, share results using before/afters- and give a considerable amount of tailored information to demonstrate to the patient receiving the consult of the facts why that surgeon is a great choice. Content on your website needs to reflect exactly this. Too many websites simply give a rough overview of a procedure rather than focusing on the surgeon him/herself. A website needs to demonstrate a lot of things for the consumer to distinguish them as the ideal choice.

The largest and most critical part of marketing in the medical industry is education and explaining things to people. If it can be explained in an easy-to-understand, compelling way on a website that shows the clinic’s experience, as well showing the Before/After photos (within the boundaries of AHPRA regulations). You can display your content in a variety of different ways – some people like a block of text, some people like video, some people like pictures. If you can explain those things via visual mediums as well as a textual medium, that will have a greater effect on people. People need to see the surgeon’s expertise about that procedure, reviews on the way that they do it – make it personal.


Q: Is it better to have a lot of information – pages and pages –  on a landing page or have the short and sweet version? Which one is more effective in the current climate?  

ES:It depends if that page is broken down into video as well as text, as well as images. We know people are spending more time online. My job as the digital making agency is to make you feel pretty “warm”. You feel you know my brand as you’ve spent time looking at my ads and now you want more so you’ve come to my landing page. I need to give you more in terms of more videos, information, education –  to teach and convert me. I never stop giving buying signals as people scroll down. People need to get the information they need upfront. Test to see what’s working – it’s in a long blog, is it a nice video, is it a graphic?

DH:Make the decision based on data as it’s different from clinic to clinic. A/B test different pages and quantities of data to find out. What works for one clinic, might not work for another. We will see variations in statistics from a 4% conversion rate to a 20% conversion rate from making basic layout, structure, and content changes to a campaign landing page. Without having that large amount of data and tracking, it gives you limited clusters of data to make your decisions on.

Generally, the less scrolling, the better, but within reason. You want to convey experience but you don’t want it to look like a biography on the surgeon. It’s a balance. Your call to action needs to be compelling. What it comes down to, at the end of the day, is not how many enquiries you get; it’s the yield of those. Also, many make the mistake of having their key call to action as an Ebook download. We’d rather get five inquiries for a client than 50 e-book downloads, because we know from statistically proving internal conversion rates that actual enquiries have a staggeringly higher conversion rate than ebook downloads.

Q: How long should a campaign run without changing it? Is it a week, isit a month? For how long do people need to commit?  

DH:This depends on spend. The more you spend, the more data you get. The more data you get, the quicker you’ll accumulate sufficient data to make informed decisions based on fact. You’ve got macro and micro changes. Macro changes are the large ones that you don’t want to change too much.  Short-term changes are optimising text used, image used, provided you’ve got a large enough cluster of data. The more data you get, the quicker you can make adjustments. It has to be calibrated based on the spend and have a sufficient cluster of data in order to make data-based insight decisions. In both Facebook and Adwords, there is a minimum of 2 weeks required for the machine learning measures within the platforms to properly “learn” your campaign.

ES: We do a rapid-fire test when we set up any new client and we tell them we’re not going to touch it for the first 3-5 days at least to give it time. When it comes to testing audiences, I will not allow you to make changes before our first week, or even two weeks. Monitor it daily but give it time to run.

Q: Is there a privacy issue uploading the patient database, email, mobile etc. to Facebook to try and create that defined target audience? There are concerns the data isn’t stored in Australia. Are there any privacy or border constraints around that?

ES:No. Facebook puts us through a rigorous process – they want to verify that you’ve got this data legitimately. It’s hashed data in the backend, your name will never be revealed.

DH:The customer data an agency uses is a list of email addresses which is imported into Facebook. Just as no two people have the same email address, (it’s almost like fingerprint) it will match them to their corresponding Facebook profiles and set that as an audience. There’s actually no user data that Facebook holds. Well, it does actually hold an obscene amount of data on all of us, that’s got something like 7500 data points on every individual, but the only way that an agency will use information of customers is a list of email addresses and they’ll be correlated with their appropriate profiles on Facebook. No concerns with usage of data by simply importing a list of email addresses.

Q: Which brings us to email marketing…

ES:Practitioners and clinicians have got to create a bit of a content nurture plan in there. Segment your current audience between cold, warm and hot. Most clinics have got poor management of their CRM – customer relationship management.

You need to segment your customers into at least cold, warm and hot audiences and target them appropriately. Make a content plan around this and start communicating the right message at the right time. Use technology and automations to do some of the heavy lifting. Do you have a chat function on your website? Don’t forget your existing customer databases and use email marketing to reach out to them. Don’t assume you have to go and get new customers all the time. Think about your existing patients –  how can you upsell your services?

Q: So, as a good activity is to sit down with your team, maybe the practice manager or the surgeons, and go through your patient list, put some notes against those old contacts?

ES:It would be a worthwhile activity if you invest in a little bit of marketing technology – HubSpot, Salesforce, Marketo, Zoho, Infusionsoft. There’s also cheaper options like ActiveCampaign, Campaign Monitor and Mailchimp. It’s an opportunity to sit down and think about how we leverage and manage our data more efficiently and more effectively and moving towards platforms such as these automation pieces that gives us more leverage and more leverage ability into the future.

DH:I think a generic broad email campaign is pretty useless these days since the open rates of these emails are lower than ever. People get hundreds of them a day. Some businesses get massive success from it, depending on the nature of their leads, but most don’t. How do you choose which CRM is the right one for your business? You’ve got ones like ActiveCampaign and HubSpot, which are complete sales management and automation programs where what I believe is the best practice is to say put in place individual automations on a per procedure basis. You might have a set of five emails for someone that inquires about breast augmentation – Emails 1, 2, 3 in Week 1, emails 4, 5, 6 in Week 2 and so on. It’s there to simulate person to person contact and touching base with them, “How are you going, just checking in.”

Do that on a per procedure basis. Set up email automation based on specific procedures –breast augmentation, reduction, revision, face lift, abdominoplasty, etc.


Q: What’s a good open rate perhaps for e-newsletter from a plastic surgeon?

DH:It is so varied – anything between 1% to 35%. This is one of the few figures that you can look at broad multi-industry benchmarks for open rates. Just jump on Google and find out average open rates for newsletter in your industry and you can work out what a good, bad and ugly open rate is and benchmark yourself. Our general outlook is that there are far smarter ways of email marketing than a newsletter.

ES:I’d say we say about 20%. Check WordStream and look at the open rate for the health sector. As I’ve said before, set up automations to help you do the lifting to drive people to the inquiry so they can talk to you.

Q: What’s the correct legal way to obtain consent from a patient to post Before/ After photographs that you want to use on a social media platform or email marketing campaign?

ES:We have an opt-in form for everything as they are giving us information. They’ve got to opt out from the website. Every form they fill has got to ask the “can we, can’t we” question. Be honest with what you will do with that Before/After photo. If the person is uncomfortable, don’t push it.

Q: How do practitioners mess up their email marketing?

DH: If practitioners send out too many emails to their list and barrage them with EDM’s, the unsubscribe’ rate will go through the roof. We see some clinics sending 1 or 2 emails out to their whole list each week- which is far too frequent. The fundamental reason of sending out email marketing is to convey information to people. A superior way to convey information to an email list is to take your email list, import it as an audience into Facebook, Facebook will then correlate email addresses with their profiles. Then, let’s just say there’s something you want to convey to people e.g. differences between breast implants, rather than send an email with a blog about it, have a post on Facebook and promote that to the users. The difference in the interaction for that user will be they cannot unsubscribe from it, they’re going to see it multiple times rather than once, they’re going to go past, see an image, see a snippet of it. Their likelihood of clicking and exploring and reading that article is unbelievably higher than that of an email.

It is important to see the different between a surgical practice to a non-surgical practice. A surgical practice is going to be fairly transactional – someone’s coming to get a procedure when they’re 25 and 15 years later at 40 years old, they might say, “Hey, Dr John Smith did a great job. I’m going to ask about getting a face lift with him.”

A non-surgical practice is a far more frequently visited business and works very differently in every single way. You’ll have people come back multiple times a year. That’s when a closer eye needs to be cast upon the ongoing marketing, because it’s a very different set of interaction than it is for primary surgical marketing.

Q: If people were starting to build their financial plan over the next six months, what would, either a percentage or a dollar value, be appropriate for them to consider investing in marketing?

ES:People who invest 5-8% in marketing are doing the right thing currently in terms of turnover. When I say marketing, I don’t just mean the ad dollar. I mean the website, I mean the blog, it’s a holistic spend, it’s an investment.

DH:What you spend and budget depends on the modality. AdWords is great for some clinics, it’s hopeless for others. It’s the same with SEO, same with social media. The outlook I take is to start with a small spend based on the ROI. When you’ve got an ROI $ figure and the clinic knows that (for example) for every $1 they spend, they get $7 back, they’ll be willing to spend more. I agree with there are benchmarks with what you should spend in terms of percentage of your revenue, but don’t spend it for the sake of it; it needs to be measured before scaling.

Q: Please share your action plan on what practices should be focusing on in the next two/three weeks or even two/three months.

ES:Set up your virtual consults, use your bios in your Instagram, make sure that you actually answer the phone and do it well. Get your website set up properly. Think about your databases – who sits where, how to segment them. This is your time to shine on social media – have a conversation, create relevant content and put your personality out there. Use hashtags properly. Don’t stop all your marketing efforts due to the downturn! Think about how you will emerge successfully after the COVID pandemic. Examine your own branding and be critical of it. The intent behind this is to improve and grow.

DH:Grow your marketing spend by virtue of measuring and act upon evidence. You practice evidence-based medicine; now practice evidence-based marketing. Don’t use intuition and instinct; use data measuring tools and employ agencies that have access to this information. It will save you money in the long run.