pyramid resell

What do we mean by the word “Resell”? In the context of an ophthalmology practice, it is to sell elective services to patients who are already established with the practice. These are typically cash-pay services, and what we refer to as premium services.

pyramid resell

Reselling means that while you’re not expanding your market share by attracting new patients, but you are expanding your share of the wallet of every established patient (yes, you guessed it: wallet share). You’re selling additional elective procedures, not annual exams or office visits for medical issues they may have.

Most ophthalmology practices sell one or more of the following kinds of premium services (and if you don’t offer any of these, perhaps you should consider doing so):

  1. Optical – eyewear, contact lenses, and supplies and accessories
  2. Laser vision correction – LASIK, PRK, SMILE, etc.
  3. Refractive lens surgery/premium cataract surgery
  4. Aesthetics – oculoplastics cosmetic surgery, Botox and dermal fillers, skin peels and rejuvenation, and skincare products
  5. Dry eye – testing and treatment, supplies
  6. Hearing – testing and hearing aids, supplies

Chairside Marketing Funnel

The first type of funnel we’ll discuss for resell is using gift cards and postcards for what we call premium services "chairside marketing".

Just as we did for retention, we do premium services chairside marketing at the time of the encounter. The physician has an envelope or a gift of some kind that is a marketing piece. Maybe it’s a printed book. Maybe it’s a video book. Maybe it’s a box of chocolates and a magazine showcasing your premium services suite of offers.

At the end of the encounter, the patient is given this small gift as well as a gift for a friend. It educates both of them about the premium services that you want to promote.

Case Study: Resell Using Chairside Marketing

At the end of their encounter with the doctor, the patient is given an envelope. This has two gift cards in it. One is aimed specifically at the established patient. It comes with a note that is addressed to the patient, thanking them for being a patient and for trusting us with their care. The gift card has an offer for a discount on services or eye care supplies.

The second card is for them to give to a family member or friend. This card offers a gift if the friend schedules a consultation for a premium service. In this case study it’s for a laser vision correction screening appointment – an evaluation. The gift could be a pair of sunglasses, for example. Note that there might be restrictions regarding what sort of offers can be made to new patients, particularly if they are on Medicare, and these may vary from state to state (see the Appendix on Legal & Compliance Considerations in our Ultimate Ophthalmic Marketing Guide).

chairside marketing

Chairside marketing funnel: Established patients are given a gift card that can be activated/redeemed for a premium service (resell) and a second card to give to a friend or family member (referral). Be sure to check state laws regarding the value of free gifts.

The cards are designed in such a way that they need to be activated in order to be redeemed. This is another way to collect information and allows us to perform permission-based marketing so that patients can be educated through additional marketing campaigns.

Another aspect to the chairside marketing piece is that a call-tracking number is assigned to the gift cards so that the number of calls that come into the call center and the cards that are activated can be tracked in the marketing database. This way, we can determine the return on investment in the sales pipeline by marking the call that came in as “appointment booked,” “appointment scheduled and showed up,” or “appointment scheduled and no-show.”

We have phone and email follow-up based on outcomes. Sending an email sequence could get a patient to come in again. If a no-show was just a conflict in scheduling and they do want to come in, then a phone call is made within 24 hours of them booking but not showing up (or registering but never coming in).

Keep in mind that marketing makes the phone ring, but to get the ROI, you must do the follow-up and keep up the patient’s commitment to come in for the evaluation.

The same process can be used for postcard marketing. A call-tracking number is printed on the postcard pieces. The cards urge the prospect to call and schedule an evaluation appointment.

Shock-and-Awe Funnel

A shock-and-awe package is used with prospective patients to amplify the start of a long-term relationship. It is sent in response to inquiries from prospects to establish ACE – authority, credibility, and expertise. We’re assuming that even though you know everything you have to offer to your patients, they need to feel comfortable coming in before you bombard them with information on services or advanced technology (bragging on your femtolasers). The package must first and foremost include pieces about your bedside manner, as well as case studies that tell compelling patient stories. Over half the materials should focus on making people feel safe if they come to you, telegraphing what their patient experience will be like plus any other assurances you feel comfortable including, such as a “Personal Satisfaction Guarantee” or “10 Promises We Make to Every Patient.”

So what else is in it?

If you thought “a services showcase,” you’re right! A smorgasbord of the premium services your practice offers. In addition to establishing trust and authority with content such as “Meet Our Doctors,” where prospects can read about your professional preeminence, we suggest including vision treatment booklets and decision-support checklists, such as “7 Questions to Ask Your Surgeon Before You Get LASIK” or “Things to Ask Your Doctor about Glaucoma on Your Next Visit” (or whatever topics you want to include).

A shock-and-awe box is really meant to instill shock and awe, as in

  • “Wow, that outcome sounds just like what I want.”
  • “These guys really know their stuff.”
  • “I think I’d rather go here. $250 LASIK sounds fishy.”
  • “I didn’t know you did all these things!”
  • “I didn’t know you had all the latest technology in your practice.”
  • “I didn’t know you had a special preparation process for people coming into surgery.”
  • “I had no idea you took such care in your post-op follow-up that you would not only call me after my surgery but would be willing to get me in after hours or on weekends if I have an issue and I need to be seen right away. Wow!”

Each of you has probably heard a patient describe how they had a procedure done elsewhere that they didn’t know could have been performed by you (usually because your practice doesn’t inform patients about all the things you do – you probably expect them to go to your website and read …).

shock and awe package

Sample shock-and-awe package

A shock-and-awe package is best produced as a box. Patients open it up and inside it has a book, it has a pamphlet, it has business cards, it has a DVD or a thumb drive with articles and videos that introduce the practice, that tell a story explaining various conditions and the treatment plans that you have in your suite of premium services. Think of it as a showcase of what you can do for them and why they should pick your practice.

At bare minimum, the shock-and-awe box should be a shock-and-awe packet. You should have some sort of brochure with a page or two dedicated to describing the patient experience. Perhaps go into detail about each premium service delivered by your practice. If you really want to make an impression, include a video book so that people who prefer watching to reading will want to engage.

Don’t just include content about the medical condition and what correcting it can do. Tell a story about a patient whose life was made better because they got a dry eye treatment or because they got RLE (refractive lens exchange) – something more emotional and more narrative than just a clinical description of the condition and the list of services that you perform.

Be sure to cover different modes of communication in the box contents. Some people are auditory and learn things by listening. Some people learn things by seeing them. They’re visual people; they like diagrams. Kinesthetic people, of course, like tactile things. They want to pop open the box; they want to hold the book; they roll up the brochure as they hold it. It doesn’t have to be too extensive, but it has to hit on all the various ways your patient audience might want to consume their information.

Secondly, not all of the pieces in this shock-and-awe box should be informational; you must include offers, perhaps a promise and guarantee to drive the recipient to take an action, a call to action as simple as “Call Us Today” or “This Offer Is Good for One Year after Your First Appointment.”

In addition, the concept of scarcity – as in a limited-time offer – creates urgency to not let this opportunity slip away.

This shock-and-awe box creates a lasting impression of what being treated by you feels like and how their patient experience could be. And this is likely to occur even before they meet you face to face. For this reason, it is imperative you use the highest-quality print and design services possible. Have a graphic artist create a style sheet for your practice that has standardized logos, typography, and colors so that your materials have a consistent and professional look. Cheap paper and subpar graphics create a bad first impression that is impossible to overcome.

Premium Services Education Events Funnel

A great way to promote your premium services is through an educational event such as a lecture or seminar/webinar. These are live events, either in person or online. Since most medical practices don’t have a lot of confidence or capability (yet) in conducting engaging, relevant, and meaningful online events, let’s leave those aside for now.

Instead, let’s look at a hosted event where you’re inviting a specially selected group of established patients. You don’t need to establish credibility or trust – they’re already with you. You’ve identified them either by age or demographic as a potential candidate for one of your premium procedures. Staff members can be instructed to identify and invite established patients for particular events based on specific selection criteria.

Many of you will be familiar with this kind of event marketing. The important thing that changes when you use scientific marketing is that you have a process for how you’re going to track and convert the people who attend. Only 5% of the people who show up might be ready to commit right away. So, before you host an event, you need to think through how you will stay on their radar, and as their willingness to commit ripens, how you will be the one who is in their inbox and mailbox. You need to be there because they expressed enough interest to show up. 

Maybe your event is a 45-minute LASIK seminar and you hit some high spots about the procedure and address the biggest objections and fears. Afterwards, you’ll want to have a four-week or eight-week email/physical mail follow-up campaign (see below) that says, “Now that you’ve learned a little bit about LASIK, let me answer some of the most frequently asked questions that we get.” Automatically and on a preset schedule, you email an answer to one question or maybe some patient testimonials. Surveys have shown that, apart from cost, patients are next most worried about the risks of LASIK, so this continual communication can help to directly address their concerns.

Look at your event as merely the starting point. Don’t think of it as the place where all your money is made (the front end). Sure, if you’re lucky, you’ll get a few conversions for higher-end premium services that will actually pay for the event. But the real value comes from building a relationship with the majority of the patients who need more time to make their decision (the back end).

Let’s also consider what you will say and how you will say it during this event. Many of the events that we see are much like professional meetings for doctors. They are mainly medical education and that’s it.

There’s no real conversion; the people who come to these events are not motivated and incentivized to take any kind of action or make any kind of decision to move the sale forward in any way. No offer and no call to action.

Only the data is presented, and it’s left to the patients to decide whether they’re ready. Then they have to motivate themselves to take the next step – to complete the transaction, in other words. The step from “I’m interested” to “I’m ready” is not facilitated very well by the practice. Patients simply don’t understand what’s required.

Your follow-up process is what gets them from 198 degrees to 212 degrees. This is an important point: it must build up a head of steam until they’re ready to go. This requires a strategy for how you structure the follow-up content you present.

There’s a concept borrowed from platform selling (sales made from a lecture podium or the stage) called the “Perfect Seminar.” The Perfect Seminar isn’t just educational; it motivates the prospect to want to commit, it motivates them to want to pay attention to the presentation until the end, and it motivates them to take action at the end because you’ve addressed their fears and concerns upfront and so, now, their perceived risk is lower. It is a tightly structured, highly scripted presentation that converts audiences into highly interested prospects and, finally, purchasers.

For example, with LASIK seminars, the sale isn’t scheduling a procedure; it’s scheduling a screening or evaluation. You’ve incentivized them to do it with whatever is legal, and you have successfully converted them if they agree to come in. (In the appendix, we go into the legal aspects of medical practice marketing, offers, gifts, and such.)

Bottom line? Don’t just “show up and throw up,” to borrow from sales vernacular. Yes, a thorough discussion of the subject matter is required – make no mistake – but it must be more than just that.

You also need to convey, through a storyline, in a scripted presentation, how their experience at your practice is great and differs from what they will experience at the hands of your competitors with whom they may have already shopped or that friends and family members have recommended. Then you explain how they can decide whether your practice is the one for them when they finally decide to do this procedure and what to do next. Make it as easy as possible for a “Yes” decision to happen.

Email Drip Campaign Funnel

email drip sequence

Email drip campaign sequence

The final funnel in our resell chapter is a good old-fashioned email drip campaign. But the reality is that very few practices have email drip campaigns or even know what they are. So first let’s define the concept.

An email drip campaign is a planned sequence of messages with a single trackable behavior or activity you want the recipient of the email to take. It must be trackable. The emails are sent automatically in sequence over days, weeks, or months.

We have developed a LASIK email drip campaign, a 13-touch sequence, each email a different, graphically pleasing message about LASIK. The first in the series are ACE emails (remember: authority, credibility, and expertise). The rest are educational, each one dedicated to a single question, such as “How much does it cost?” “Does it hurt?” “What happens during the procedure?” “What can I expect after the procedure?” “Is it for me?”

In some emails, we link to a video that talks about the patient experience – in this case, the LASIK experience. It is not a sales pitch; it is just “If this is making sense to you, if you have questions, call. Don’t forget: your evaluation is always free.” Very simple. Very professional. Not cheesy. Then the next three emails fall right back to education, another question answered each time.

And here is the great thing about these email drip campaigns: If you sent one drip email a week and had eight in a sequence, then that would be two months’ worth of marketing just on LASIK. If you have six premium services that you want to showcase, you would have a whole year’s worth of emails already defined. Your marketing calendar is prepared for the entire year. The other great thing about emails is how quickly and easily one can be forwarded to others whom the recipient knows are interested in getting LASIK too.

To compound the impact of this messaging, consider stacking a few other funnels in between the drip emails, such as adding a postcard or two into the mix. Let’s say you send out three emails and then, in the fourth week, you send a giant 9 x 12, can’t-miss-it postcard about LASIK, with more questions and answers or doctor profiles and patient stories.

Key Takeaways:

  • A patient who declines a service or procedure may be a good candidate for another one
  • Don’t assume that your patients are aware of all of the services your practice offers

BONUS Case Study: Resell Using Internal Display Advertising

Patients will frequently come in for their annual exam having had some premium service (such as cosmetic surgery) elsewhere because they were not aware that your practice also performed this procedure or service. The doctors often assume that patients “just know” or that the staff always remembers to mention the services available.

A cost-effective way to resell more cash-pay services is to put display advertisements where patients can readily see them. One example we used in our practice was framed posters showing animals that were being yelled at by their partners because they had a hearing problem.

Although one of the doctors thought these posters were cheesy (actually, what he said is NSFW), patients themselves found them cute and funny. Often the spouse that had to do the yelling used the posters to convince the stubborn spouse to get his or her hearing tested.

A one-time investment of about $600 to put these display ads in every lane yielded an ROI of many hundreds to one, as a hearing aid fitting for a single patient can net a couple of thousand dollars. A similar approach can be employed for other services provided by the practice.

Peter J Polack MD FACS

Founder of Emedikon Marketing Systems and a practicing cornea specialist in a large multispecialty practice. Peter specializes in refractive laser and cataract surgery, cornea, and external diseases.

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