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Cover story: Head Off the Competition with Marketing Strategies that Work

Pallarito, Karen

doi: 10.1097/01.HJ.0000416271.13977.8d
Cover Story

When prospective patients decide to do something about their hearing loss, will they think of your business first, or at all? You may be an excellent clinician, but impressive credentials alone are not going to book appointments. Consumers have plenty of options available to them, such as local private practices, clinics, and hospitals, as well as brand-name hearing aid franchises and retail outlets that sell everything from Angus beef and lawn furniture to socks and toilet paper. With all those choices, experts agree you have to promote your business if you want to head off the competition.

Few audiologists and hearing aid dispensers, however, are skilled marketers. Missteps and missed opportunities abound. Phonak commissioned a nationwide survey of hearing healthcare professionals on key industry metrics, and found only a mere 18 percent rated their 2010 marketing program as “very effective.” A total of 386 hearing professionals responded to the web-based survey conducted in July and August 2011, and 51 percent deemed their efforts only “somewhat effective,” down six percent from the prior year. Another 15 percent admitted to having “somewhat” or “very” ineffective marketing, up five percent from the previous year. (See FastLinks.)

The survey also found that relatively few practitioners are heavily invested in marketing. Four of every five practices in 2010 spent 9.4 percent or less of gross revenue on marketing, while the median for all practices was just 4.4 percent. The most aggressive marketers, the top 20 percent of practices in the survey, spent 16.2 percent. Median expenditures ranged from 3.8 percent for a solo practice, 4.3 percent for two or more professionals, and 7.1 percent for practices with multiple locations.

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About 25 percent of gross revenue should be spent on a new practice and anywhere from six to 15 percent for an established practice, according to marketing experts interviewed by The Hearing Journal.

“I would say that there are some people doing a really good job, but the vast majority are not,” said Matt Perry, AuD, the host of the web TV show Audiology Marketing Now and the owner of Harmony Hearing & Audiology in Bel Air, MD. (See FastLinks.) Overall he gives the industry a “C” for its mediocre marketing effort, noting that “there's a lot of room for improvement.”

The competition for new and repeat customers is stiffer than ever with popular retailers like Costco, Sam's Club, and Walmart selling hearing aids. Costco especially has a sizable footprint in the market. A Costco in Issaquah, WA, expanded the number of stores where it sells hearing aids from 237 to 427 between 2007 and 2011, while gross revenues from that line of business more than doubled over that period to $165 million from $80 million, according to Michael Clayman, president of HHC Publishing, Inc., in Foxboro, MA, a publisher of data and information on the warehouse club industry.

Large retailers pose a business threat to smaller players, making marketing all that more important. “I think there are still a lot of people out there that don't realize how many patients some of the chains are actually stealing from them,” said Kevin St. Clergy, the president and CEO of and the author of The Death of Audiology. (See FastLinks.) If the independents would “just learn to do some modern marketing at the local level,” they would “beat these guys at the own game,” he insisted, adding that it is much more difficult for a national outfit with hundreds of locations to compete at the local level.

“Of course, there's some impact,” said Chris McCormick, the vice president of marketing at Starkey Hearing Technologies in Eden Prairie, MN, but he said he views it as a “perceived potential threat” than an actual one. “If you look at markets where there are big box retailers, there are also thriving independent small business ENT and audiology businesses that are still growing year after year,” Mr. McCormick said, noting the industry's “very low” market penetration rates.

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Large chains wield enormous purchasing power and advertising clout so they primarily compete on price, Dr. Perry noted. This is not so true for small private practices. The challenge is to come up with a unique selling proposition, something that sets your practice apart from the crowd. “Give them a reason to go to you instead of somebody else,” he urged. Dr. Perry's practice promotes the use of cutting-edge technology, such as surround sound to simulate real-life listening situations during hearing aid demonstrations. “What we market is that experience,” he said.

Jim W. Wilson, a general partner of the Wilson Group, a Fort Worth, TX, marketing firm whose clients include hearing aid dispensing practices, recommended the same approach. “The audiologist is really leading this patient through a pathway, which is an experience, and this experience had better be good,” he said. “That's the difference between, in my opinion, what you're going to get at Costco, which is a product, and then what you get in an audiology practice, which is a process.”

Once you have identified what sets you apart from the crowd, it is time to strategize. Hearing healthcare practitioners need to develop a comprehensive marketing plan, execute it, track the results, and make decisions based on outcomes, Mr. McCormick said. Starkey employs a team of nearly 30 full-time professionals to assist customers in doing just that. “Those practices that are doing that well I don't think are feeling a huge impact from the big box retailers,” he noted.

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Marketing experts largely agree: the Internet is where hearing healthcare professionals need to be to gain recognition, build credibility, and recruit patients. “There are still some practices out there that say, ‘I have a website; I don't get any patients from it.’ In their minds, they think it's because [their] patients are not on the Internet,” Dr. Perry said. “But I guarantee there's somebody else in your area who is getting those patients because there are people looking online for your services. They're going somewhere.”

Mr. St. Clergy recommended a variety of Internet-based strategies, including blogging, writing articles, sending press releases to local newspapers, video marketing, testimonials, using search engine optimization (SEO), soliciting reviews on Google Places, and getting listed on Yelp and Angie's List.

Using Google Places, a free local business listing, or pay-per-click advertising, such as Google AdWords, can help get your business get noticed in your marketplace, Dr. Perry explained. When someone types “hearing aids” into a Google search, your business is not going to pop up unless you use one of those services, which ferret out local businesses, he said.

Internet marketing services, from web design and SEO to writing articles and social media marketing, can cost anywhere from a couple hundred to a few thousand dollars a month, depending on how much you need to outsource, Mr. St. Clergy explained. The right investment can reduce the cost per call to your practice. “We've been able to make the phone ring from anywhere from $50 to $80 per call, and traditional media is costing anywhere from $250 to $500 per call,” he said.

Amanda N. Mueller, AuD, the sole proprietor of Hear at Home, a hearing evaluation and hearing aid business, is leveraging the power of the Internet on a shoestring budget. She has produced several promotional and educational videos with the help of her filmmaker husband that appear on YouTube and on her two websites. (See FastLinks.) She and her husband do the SEO to boost traffic to the sites, and she also writes a blog on hearing healthcare topics. While potential patients may not be surfing the web, their adult children are, Dr. Mueller observed, and they contact her on their parents’ behalf.

Avada Audiology & Hearing Care Centers, by contrast, spend “millions of dollars annually” on marketing its 280 locations in 20 states, according to CEO Steve Barlow. The company is preparing to launch a completely revamped website, taking advantage of SEO and social media outlets, including Facebook and Twitter. Avada is also taking steps to quantify the company's return on that investment. “We keep very detailed and specific metrics on all of our marketing, so we track virtually every dollar we spend,” he said.

Avada's centers also engage in local marketing using various outlets, such as speaking engagements, lunch-and-learn events, newspaper inserts, and display ads, Mr. Barlow added.

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Newspaper and direct mail remain the most frequently used marketing tactics in the industry. Seventy-two percent of Phonak survey respondents ran newspaper ads in 2010, while 58 percent ran direct mail programs. Practices that used newspaper ads spent an average of 36 percent of their marketing budget; direct mailers, 32 percent.

Are these communication channels still effective in a point-and-click era? Data from the Pew Research Center's Project for Excellence in Journalism show that the percentage nationally who read a daily newspaper has declined steadily since 1999. Readership among adults 65 and older, the most likely newspaper readers, had the smallest decline, dropping 10 percent from 1999 to 2010. (See FastLinks.)

Direct mail still works, but it does not have the pull it once did because of cluttered mailboxes, the Internet's popularity, and other factors. Response rates range from 0.2 percent to a 0.5 percent, on average, according to Alex Hughes, the president of Beeman Marketing, LLC, in Williamston, MI, which provides direct mail and marketing services to the hearing healthcare industry. Hearing healthcare professionals can make the most of the medium, he said, by integrating direct mail with an Internet strategy and using modern analytics to target mailings and track responses to their communications. Physician referral programs ranked third among marketing tactics used in 2010, after newspaper and direct mail, with 39 percent using that technique, according to the Phonak survey.

Granville Brady Jr, AuD, whose eponymous practice operates in Clifton and East Brunswick, NJ, is big on referrals. He employs his son as a field representative to call on physician offices, leave brochures in waiting rooms, and spend time schmoozing the office staff. Dr. Brady also spends roughly $40,000 annually on cable TV ads at a cost ranging from $2 to $6 or $7 per 30-second spot. “So when the person comes in the door, they've seen me on TV, so they feel they know me. I have credibility,” he said.

TV is part of Dr. Brady's marketing continuum, and he is a provider on most HMOs for audiology services. People see him on TV, check with their health insurance, and then visit his website, which receives about 300 hits a month. By the time someone walks in the door with a referral, he hopes that person has decided to receive care and that he should provide it. “I don't want people to just walk in the door because I'm not Costco. It's got to have value.”

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When Evan Bernstein, AuD, launched his Staten Island-based practice Advanced Care Audiology in November 2010, he thought, “Why not? Patients will come.” In reality it took some trial and error before he smoothed out the kinks in his marketing strategy and began booking appointments.

Lacking much of a budget, Dr. Bernstein had a friend develop his website. “It was terrible,” he admitted. He also shelled out $900 a month — more than his office's rent — for SEO. The local newspaper cost him another $1,900 each time he ran an ad, and those ads generated a weak response.

Dr. Bernstein refined his marketing strategy with guidance from Dr. Perry and tips from his website. A professional-looking website cost roughly $500 to develop, and his new SEO vendor charges just $100 a month. He produced a mailer with help from his new hearing aid vendor, NuEar, a unit of Starkey Laboratories, announcing a three-day grand opening event with special pricing. The mailer resulted in nine patient visits and six hearing aid sales, plus revenue for the hearing tests he performed. His latest mailer resulted in 40 patient visits and additional hearing aid sales.

Dr. Bernstein knows he cannot outspend Miracle Ear, the nation's largest hearing aid retailer and his main competition in Staten Island, but he said he is carving out a niche for himself with a careful marketing investment.

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* See Phonak's nationwide survey of hearing healthcare professionals at

* Watch Dr. Perry's web TV show at

* Check out Mr. St Clergy's website at

* Visit Dr. Mueller's websites at and

* Read data from the Pew Research Center's Project for Excellence in Journalism at

* Visit HJ's Student Blog at

* Check out HJ’s R&D Blog at

* Click and Connect! Access the links in The Hearing Journal by reading this issue on our website or in our new iPad app, both available at

* Comments about this article? Write to HJ at

* Follow us on Twitter at and like us on Facebook at

© 2012 Lippincott Williams & Wilkins, Inc.