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By July 1, 2019September 27th, 2019No Comments

Preservation is wired into our human DNA. We seek to preserve our own lives. In some cultures, we seek to preserve others when they’ve passed away. And since the dawn of time, humanity has devoted much thought into how to better preserve food (as a necessity for survival) and possessions (as a condition of our instinct to hold on to what we’ve accumulated).

Scheduled appointments represent a considerable amount of revenue, and very practice is keenly interested in preserving these appointments. Long before text and email reminders became the norm, healthcare practices knew that sending a postcard or phoning patients to remind them of a coming appointment would preserve scheduled revenue.

Preserving revenue is certainly important, but preserving revenue should never be mistaken as growing revenue. Your appointment reminders will never generate even one penny of new revenue.

Undoubtedly, appointment reminders have a place in the blueprint for building a revenue engine, simply due to their preservation proficiency. But, to view appointment reminder software alone as a solution to growing revenues is folly. Factually, these tools are limited to helping you deliver an electronic reminder—and they do a fine job.

Patient engagement is the key to increasing revenues and growing your practice. And what I mean by ‘patient engagement’ spans far, far beyond a simple reminder.

Patient engagement begins with your database. And here’s why:

With every passing day, most of your patients are waking to one of life’s milestones. Every woman turning 45-years-old today should get a mammogram. Each of your patients who are turning 50 should get a colonoscopy. Your patients diagnosed with a chronic condition, or who are expecting, are waking to additional milestones. And every patient who wakes up without scheduling a much-needed doctor’s appointment is perpetually passing the same milestone over and over again.

Life’s milestones represent potential appointments worth millions of dollars in new appointments. The patients waking to these milestones are buried in your database. So, in essence, your database is a million-dollar money machine.

Life’s milestones represent potential appointments worth millions of dollars in new appointments. The patients waking to these milestones are buried in your database. So, in essence, your database is a million-dollar money machine.

With the objective of scheduling a new appointment, conversing with your patients as they experience these milestones is patient engagement. The objective is to generate an appointment you may not have otherwise scheduled. And that’s how you grow revenue.

Patient Engagement is a Significant Marketing Challenge

Too often, practice executives are led to believe they can address patient engagement tasks using off-the-shelf patient communication software. The error in that thinking becomes crystal clear when the results are less than amazing.

Tools don’t fix problems; skilled craftsmen fix problems using tools. To use an analogy, no matter how many tools you have in your garage, without a working knowledge of how your car operates and why it won’t start, you’ll never be able to repair your car. But, a skilled mechanic knows how to use those tools to fix your car.

Off-the-shelf patient communication software is not a solution: It is a tool. And, I might argue, a poor one at that. Why? Because your run-of-the-mill patient communication tools are developed by software guys, not marketing guys. They may be skilled at developing software, but they are not marketing experts.

An effective patient engagement process, or what I call a revenue engine, requires an expert to design, build, and implement. Once your patient engagement engine is ready to start, patient communication will focus on four fundamental marketing channels.

The Four Fundamental Marketing Channels

The four essential marketing channels you can use to engage with your current patients are texting, email, phone messaging, and direct mail. Keep in mind that patient engagement is not passive communication—it’s active. You know who your patients are and how to contact them, which means you are actively seeking to engage them.

Texting: Quick, Cheap, Effective

Text messaging represents the most effective way to reach most of your patients.


Because it’s the least expensive yet the most effective communication channel. Your patients prefer to communicate via text. For them, texting is fast, more convenient to receive and reply, takes less time, and less confrontational. Text messaging requires less human interaction, which reduces social and emotional anxieties about potential sensitive topics. Texting allows time to think through the response, before sending a response.

Given a choice, most of your patients would choose to communicate with your practice via text message than by email or phone. Texting represents freedom. Let me explain: To your patients, calling your practice is perceived as being an arduous, ineffective, time-consuming task. They expect to navigate a menu of choices and then wait to speak to a live person (all the while listening to sterile music or even more sanitized messages of how to stay healthy). With email, they won’t expect to see a reply, but if they did, it would be tomorrow or the day after. In short, texting puts them in touch with a real person in real time.

Of course, not all of your patients are text enthusiasts. Your more mature patients are either unfamiliar with texting, lack the necessary technology to text, or prefer the human interaction that comes with a telephone call. For these patients, you’ll have to rely on another channel to reach them. Broadly speaking, you’ll have to leverage all four channels to reach most of your patients.

eMail: Quick, Cheap, Not so Effective

Once upon a time, email was the bomb. Now, it’s lost its luster, due in part to its overcommercialization and the rise of other, more convenient and instantaneous communication methods. Still, email remains to be a powerful communications channel. Here’s why:

As far as cost goes, next to texting, email is as close to free as you can get. It’s also a bit more flexible than texting. Within your email you can include links to a patient portal or attach important documents.

If you’re using email as a primary patient engagement vehicle, cadence is critical to preserving the results you’re experiencing, good or bad. With email, your patients are more sensitive to how often they receive messages from your practice. If you send too many, they’ll opt out.

The younger generation prefers text messaging over email. For this group, email is less urgent, reserved for more formal matters, like school or work.

Phone: More Engaging Than Ever

Automated phone messaging can work well, but most often it’s not utilized correctly. Let me give you some examples of worst practices. When your phone rings and you don’t recognize the number, you probably ignore the call. If your phone system isn’t flashing the name of your practice as the caller, your patients ignore it. Who won’t take a call from their primary care provider? Most people will.

Another poor practice with automated phone messaging systems is how stiff and unnatural they can sound. Interesting voices with a natural message are more engaging. Clear advancements have been made in this area with the help of AI. I have been impressed on a number of occasions by systems that sounded and acted like I was speaking with a live person on the other end.

Direct Mail: Junk Mail or a Marketer’s Secret Weapon?

Without question, direct mail will not perform as well as the other channels. Your older patients respond well to direct mail, and you should keep direct mail at the top of your list when working with this demographic. Younger patients may be less inclined to respond to direct mail.

Direct mail gets a bad rap because of how poorly it has been used in the past. While it should be used to surgically reach a specific person, it is not. Too often, practices engage a shotgun approach to direct mail to acquire new patients, and they often tarnish their brand by it.

In this discussion, wherein we talk about engaging your patients, direct mail is really a secret weapon. You know your patient, their address, their medical history, their doctor—there’s little you don’t know about them. Armed with that level of personal information, surely you can create a direct mail campaign that will capture their attention and generate a positive response. Don’t hesitate to engage a direct mail expert to help you as I’m certain most of us do not have those skills.

Like every secret weapon, the downside to direct mail is cost. The Federal Government can spend billions on secret weapon systems, but your practice can not. Postage and printing quickly adds up, which throws a wet towel on ROI. But that’s not the end of the story for direct mail. Read on!

Media Mix Considerations: Why Direct Mail Matters

Your media mix is the list of channels you’re using to engage your patients. In the last five years, I have seen a broader media mix (one that incorporates more than one or two channels) perform better, as a whole. For example, your patient engagement activities may see a better response when you add direct mail to your marketing plan.


Obviously, many variables are at play here that may result in a different experience for you, but here’s the reasoning: Direct mail validates text and email messages. All of us have received messages from Ali, the Nigerian Prince, who is looking for some kind soul to help him move his gold to a Swiss bank account. All of us are a bit leery of what pops into our email inbox. It’s not difficult for any entity or person to create an email account and represent themselves in any manner they wish, whether that’s to be of royal Nigerian blood or something else!

Writing, printing, and mailing a letter is far more time consuming and costly. Therefore, if you send a message to your patients using text or email, and they receive a professional letter in the mail at the same time with the same message, the direct mail is validating the other message. That one-two punch is much more effective than a single, quick punch to the jaw. Bottom line: Your ROI will see an upswing when you incorporate direct mail.

Use Creative that Resonates with Your Patients

Your marketing message must resonate with your target market. That seems obvious, but many times practices get this wrong. Pictures and images play a key role. Your patient must be able to see themselves when they see the creative; it must resonate with them.

For example, if you’re marketing objective is to generate more annual wellness checks, you may use a picture of happy, healthy persons to communicate the desired goal. A picture of an older couple walking on a beach is not the right image for young families in Kansas. You must always keep your target market in mind.

Also consider the season and environment, or incorporate local current events to create a connection with your patients. Use images to match the mood, the temperature, or the season. For example, a western community was socked in by smoke from nearby wildfires. Knowing that many in the community were concerned about the unhealthy air, a local practice used an image of a small child with a runny nose and cough to remind their patients to take advantage of no-cost annual wellness exams. Combined with email and text messaging, the campaign was a success.

Reach Out Often and Consistently

When I was younger, a youth counselor shared with me the 3X Elbow Rule. “If you want to get someone’s attention,” he said, “you need to touch them on the elbow three times.” He wasn’t talking about patient engagement strategies; he was talking about dating. But the 3X Elbow Rule emphasizes my point—though it didn’t really pan out for me on the dating scene.

If you reach out to your patients once, you’ll get some to notice. If you reach out twice, more of your patients are going to take notice, and read your message. On the third touch, your patients will say, “Okay, you have my attention. What do I need to do?” Consistent messaging reinforces your brand, creates expectation, and strengthens the relationship.

Don’t measure ROI on only one touch. If you did everything right, one touch will have a positive ROI. However, to get to the numbers you really want, consistency is paramount. Measured over three months, you should see a strong return on investment numbers.

Movement is Life

In today’s business climate, a hunker-down, stay-in-your-lane mentality is a poor business strategy for your practice. If you’re not engaging your patients, your competition is!

In a popular motion picture, the hero, a former UN war crimes investigator, proves to be successful in battling zombies and finding a cure by moving and staying one step ahead.

“Movement is life,” he explains to another character in the movie. Unfortunately, the other character does not follow our hero’s advice. That character bunkered behind their apartment door and shortly succumbed to the zombie horde.

Patient engagement is the key to increasing revenues and growing your practice. If you don’t have a plan to build a revenue engine for your practice, call your team together today and get started.

Marketing creates energy within your populations, which creates current, no matter how slow. Remember: Movement is life!

Andy Jensen

Andy Jensen is an accomplished columnist, writer, and hands-on marketing soldier with more than 25 years of in-the-trenches marketing experience in healthcare technology. Andy can be reached via email at

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