What's on first: internal or external marketing?

June 1, 2008
Here's a terrific marketing question that popped up again recently: “What's on first? Which is more important, internal marketing or external marketing — and which comes first?”

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Here's a terrific marketing question that popped up again recently: “What's on first? Which is more important, internal marketing or external marketing — and which comes first?”

It's a great question that we hear from time to time, especially as dentists become more comfortable about marketing and want to take things up a notch to grow the practice. It's also a challenging question to answer, but here goes.

Internal: comfortable, slow, but sometimes inconsistent → It turns out that most dentists are much more familiar with internal marketing. Your current patients are the primary audience for your marketing message. There are many ways to do this type of marketing, such as telling patients about your services, for example, and simply asking for patient referrals. With internal marketing, you're talking to people who already know you, so it feels more comfortable.

Most dentists have heard that they should be doing internal marketing. On the upside, there's little or no cost, so the return on investment is great. On the other hand, a lot of dentists confess that they are inconsistent about internal marketing; it takes time and often requires an active effort from the doctor and staff. Results are seen as a “slow burn” — it builds (with consistency), but slowly.

External: explosive ROI when done right → In comparison, external marketing is a totally different sort of animal where your message is directed to prospective new patients who do not know you. And yes, external marketing — such as Yellow Pages advertising, direct mail, or broadcast — has a higher cost attached to reaching a much larger audience. But the results can be explosive and far more fun. And when you find the right combination of variables that works for you, many external strategies are passive and don't require much of your time to continue to produce great results.

Many dentists shy away from external marketing and never move beyond the cost. It looks too much like a big risk (fear), and an expense. True, there's a bit of a risk factor, especially if you do it wrong. But the marketing-smart (and highly successful) dentists understand that the budget is an investment in the practice … and the ROI is the big upside when you've done it right in the first place.

But what about professional referral marketing? → But wait … there's yet another front for specialized practices — endodontics, perio — where referrals from other practices are a major revenue stream. Marketing to the audience of referring practitioners and practices is a part of the overall marketing plan for some. Like external and internal marketing, taking your message to referring practices requires an organized program with ongoing nurturing. If it's appropriate to your specialty and practice, it will likely be in addition to — and not instead of — external and internal marketing.

And the answer is … → So, exactly what's on first? Do you go with internal, external, or professional referral marketing? The REAL answer is:

1) Begin with the end in mind. First, set a realistic goal for your practice before you select the strategies that will take you where you want to go. If you have “a-little-ahead-of-last-year” goal, then internal marketing alone may get you there over time.

2) Consider the competitive climate. Interestingly, increasing competition nearly everywhere (and rising costs of business anywhere) is pushing hard on the bottom line. Many dentists recognize that standing still leaves them behind, and they can't let the other guys build recognition, experience, and deeply established market share. So if you're serious …

3) Establish a marketing budget. Don't go crazy here, but if you realize it's tougher all the time to win at marketing, then define the resources you'll need to achieve your goal. Then …

4) Create a well-considered plan. Utilize the tools that will bring the best return on investment. It will likely be a reasonable mix of internal, external, and perhaps professional referral marketing.

5) Work the plan. Marketing is an ongoing process of test, track results, adjust to push what's working, and revise what needs fixing.

The “What's on first?” marketing question is tough to answer without doing your homework and defining a clear objective for the year. At the end of the day, if you don't know where you're going, any path will take you there.

Stewart Gandolf, MBA, and Lonnie Hirsch are cofounders of Healthcare Success Strategies, and two of America's most experienced practice marketers. They have worked with dentists for a combined 30 years, have written numerous articles on practice marketing, and have consulted with more than 3,000 private health care practices. You may reach them by calling (888) 679-0050, through their Web site at www.healthcaresuccess.com, or via e-mail at [email protected].

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