Mr. Malley: As some of the industry's leading eyecare consultants, we're constantly on the “front lines of marketing,” hearing, seeing, and helping surgeons and administrators throughout the country market their refractive surgery practices. Where do you see the current state of the refractive market, and where do you think it will be in the near future?
Ms. Dunn: I see a stricter focus on improving conversion rates. I think practices are ensuring that the staff follows up with prospective patients and does everything possible to convert them from candidates to patients, so they can maximize the original advertising dollars they spend. They're really paying attention to making sure their dollars are working for them and eliminating some of the tactics that are not working as well as others.
Although the last half of 2001 caused a lot of worry, practices are reporting good numbers this year, and we've seen a very positive response from our advertising. For example, I was just talking to a client who did an analysis of his financial situation over the last 4 months, from January through April of this year, as compared to last year, and his bottom line is up 36%. That's a pleasant surprise.
Ms. Greer: Unquestionably, there was a decline in volume overall. However, a handful of practices did squeeze out small amounts of growth, because they took a proactive approach with their marketing strategy. Last year's decline cannot be completely blamed on 9/11 and the sluggish economy. We also have to factor into the equation consumer skepticism from negative PR stories and the tremendous amount of copycat marketing and advertising. Getting back on track will not only require an improvement in the economy, but a strong commitment to venture outside the traditional marketing box and differentiate your practice from the one down the street.
Mr. Malley: In terms of surgical volume for the first quarter through April of this year—and proposed surgical volume for the next 12 months—are you seeing a tapering effect, an increase or a substantial decrease? Also, what kind of projections are you setting for clients for the next 12 months?
Mr. Rabourn: In the first quarter, as far as number of procedures, for the most part, we have seen a very positive trend, and, overall, our clients have seen an increase in their volume. It's interesting, because, if you look around the country, some markets have been impacted more than others. I think some of it has to do with how aggressive the marketplace has been, market by market.
I was just reading a report from one of the corporate players, and I think they had seen a significant volume increase from at least the fourth quarter of 2001 to the first quarter of this year, so, for the most part, we've seen a little bit of an increase. The economy has had an impact, and, if it continues to do well, we'll probably see an even better increase, maybe in the latter half of the year. A lot of it is going to have to do with the economic setting that we get ourselves into, and then there are going to be some interesting technology issues. If the technology continues to evolve and upgrade lasers and the response to them is positive, it may help increase surgical volume.Mr. Malley: What do you feel or see in terms of increases or decreases in the number of surgeons and/or refractive practices?
Mr. Rabourn: I think growth in the number of refractive surgeons is going to be moderate to low at best. If you look at some of the numbers, we've trained approximately 8,000 people, at least in refractive surgery, and roughly half of those people are actively doing cases. I don't see a huge increase in the number of people saying, ?Now's the time for me to jump into this business.?
Mr. Malley: In my opinion, the future of refractive surgery has never looked brighter. There are always going to be people who weren't ready for refractive surgery 10 years ago, but, with breakthroughs in new technology and surgical techniques, we can now effectively treat a much broader range of patients. What do you think about the future of refractive surgery from a surgical volume standpoint?Ms. Greer: There's huge opportunity. I think the numbers will go up; I don't think it's going to die or go away.
Mr. Rabourn: I totally agree. I think we're going to continue to see more refractive procedures performed. The question is: Will it always be done as LASIK, or will surgeons turn to another means of refractive correction like CK? I don't know. In the future, I think we're going to see a lot more incisional types of procedures, with presbyopic lens correction, or accommodating IOLs. It will all help grow this refractive surgery marketplace.
Mr. Malley: We're seeing fees for refractive lensectomy, PRELEX, and other lens implant procedures up in the $5,000 range. This appears to be a huge market for all the hyperopes aged 55 years and above and high myopes out there who may not be ideal candidates for laser vision correction. Are any of your clients involved in this business, and what do you think of those procedures?
Mr. Rabourn: For some of the refractive lens procedures, the price is substantially higher, and, for the most part, we're looking at $2,500 per eye. Once a better hyperopic procedure with more stable results is available, we could have a nice little turn in our business. New implantable or accommodating IOLs, likewise, could be beneficial.Ms. Greer: I agree. That has, to me, unlimited potential, because it's a whole new target market, and you're also targeting people with more disposable income than the twenty-somethings.
Mr. Malley: Do you think we'll be able to charge more for custom cornea procedures when and if they receive approval?
Ms. Greer: I think the price will start out much higher than the current cost of LASIK. Hopefully, we will be much slower to discount this product line.
Mr. Rabourn: I agree. There's a proven method for that in Canada right now. Many practices there are charging a premium of $200 to $400 per eye for customized LASIK.
KEYS TO INCREASING SURGICAL VOLUME
Mr. Malley: What do you think are the three pillars for growth in the next 12 months?
Ms. Greer: One virtually untapped pillar that I see out there is emotion marketing. Approaching candidates from the consumer's perspective and presenting LASIK benefits that are important to the consumer not only sells the emotional sizzle of your practice, but differentiates your practice in such a way that it will be difficult for the competition to copy. Think of it this way: We love our technology, but consumers don't always understand it. Consumers do understand and want to know “what are the benefits for me?” and “why should I pick your practice over the next one down the street?” Consumer-focused marketing is important, as well as new technology and financing programs. We've already seen the 0% financing programs get the first quarter of 2002 off to a nice start.
Ms. Dunn: The first pillar is direct-response-oriented marketing—promotions designed to generate an immediate and direct response—as opposed to using more image-oriented promotions, which require frequency to generate a response. The second pillar is follow-up and visible payment options for patients. Over the last year, we've included payment options in our advertising, and we've made sure that practice coordinators are mentioning financing to every prospective patient who walks in the door. That has worked very well. The third pillar is database marketing. A lot of practices have not yet tapped into their databases, and, unfortunately, many of them still don't have databases. It's a very low-cost way to market, and it's a pillar of growth that's just waiting to happen. For example, when we mail one of our letters to a practice's database, the average response rate is 5%.
Mr. Rabourn: A key is figuring out ways to raise the educational levels, the competency levels, of some of the refractive coordinators, the people who are dealing with patients inside of the practices. I think there are a number of patients whom our practices lose, because we don't take the time or the energy to really try to help solve their problems and educate them to help them make the right decisions. I think, if we can figure out ways to raise the competency levels of the people inside the organizations with internal work, it will help us be more successful.Mr. Malley: I want to get into specifics about which marketing strategies are working and which ones are not. What are the absolute best marketing tactics practices can take during this economic downturn?
Ms. Dunn: Seminars are No. 1. Just to give you a feel for what kind of response can be obtained, across the country this year alone, the average response is 40 to 60 seminar reservations from just two ad placements, and response can be much higher. In April, a client in Minnesota had 125 people respond to two ad placements. In Pennsylvania, we had 103 responses. In Oklahoma, we promoted a “live” LASIK seminar (another way to reduce fear in prospective patients), and the result was 138 seminar reservations, with 57 appointments made immediately afterward.Mr. Malley: Wow! Are you giving away anything there? Is there an offer of a savings? Are you performing a live surgery or giving away a free procedure?
Ms. Dunn: No, we're not giving anything away; we steer away from that. Our ads simply promote a free seminar. The key to our success is the wording of our ads. That's where my background comes in. I have a degree in advertising and a master's degree in human communication; since we advertise to humans, that's a powerful combination.Scientific research has identified different decision-making processes that every human goes through, no matter how unique the individual market. When we advertise, we advertise to prospective patients in a manner that moves them toward a decision to contact the practice.
We know what helps people move through decision-making, and our advertising copy compels people to pick up the phone and make appointments. If a practice has not had success with seminars, I recommend trying our approach. We offer a guaranteed period in available markets. There are many marketing approaches that work to generate leads, but our experience is that seminars are by far No. 1.
Ms. Greer: What I'm seeing that doesn't work is anything that at all resembles the efforts of the competition. The practices that shine typically have a comprehensive marketing strategy, a realistic budget, measurable goals, and a commitment to execute these plans. The foundation is always research. Before investing in any mass media, the practice should do the homework. This includes evaluating the competitive market: What media are being used; what's the message; what's the call of action; etc. Armed with this information, you can develop a unique marketing program that's going to stand out. It may be seminars. It may be TV, radio, or the Internet. It may be a combination.
Mr. Malley: We have clients that are committing anywhere from $5,000 to $20,000 per year in Internet marketing, and it's difficult to really pin down the direct effect on surgical volume from the hits and e-mails we're receiving. What are your comments and feelings on switching from traditional advertising means (TV, radio, print, billboards) to Internet marketing?
Ms. Greer: Internet marketing is an untapped medium loaded with opportunities. This is especially true for surgeons in very large markets, such as Chicago, New York, and Los Angeles, where media costs are outrageously expensive. The key to Internet marketing is, first, you need a site that sells your practice. It's got to do more than just give information; it's got to sell the sizzle. And, you've got to have a follow-up strategy if you plan to convert leads into patients.Mr. Malley: How are you marketing the site? Are you using billboards? Are you registering with various search engines?
Ms. Greer: You've got to cast as wide a net as possible. This includes driving consumers to your Web site through a number of channels, including your Yellow Pages' advertisement, business cards, brochures, print ads, mass media campaign, and banner advertising. We have found the most effective tool, however, to be search-engine positioning, which means securing first-page listing on the major search engines like Yahoo!, AOL, Google, etc.
Mr. Rabourn: I think you can't have just one strategy; you have to use a combination of media, like radio, TV, print, or whatever works in your practice. Your other advertising can drive people to your Internet site so they can become a little more educated. I think one of the mistakes that ophthalmology has made is to try to put too much information into advertising. Our mission with our ads is to get the patient to move forward, make a decision, make the call. Then we can get them to go to the Web site, as well, to become even further educated. It's a combination of those two things that, at least in our practice, has been successful.
BUDGETING YOUR ADVERTISING DOLLARS
Mr. Malley: If you've got a campaign that's working, and it's generating a 10:1 return on your investment, why limit yourself to some meaningless number just because someone agreed you should only be spending, say, $10,000 per month? Would you discuss the budgeting process, state whether or not your clients ever amend their budgets, and explain what percentage of gross revenue is dedicated to the marketing budget?
Ms. Greer: Budget is, first of all, based on goals and the market that the surgeon is in. Certainly, it's more expensive to advertise in larger metropolitan markets than smaller, midsized markets. I've seen as low as 3%, which is basically a referral-based practice, all the way up to 15% or as high as 20% of gross revenue.
Ms. Dunn: Most smaller practices don't have a set budget; they spend what they need to spend. For practices that do, we recommend budgeting 5 to 8% of revenue for advertising to maintain volume and 10 to 20% to expand aggressively. To give you an idea of what it costs to promote a public seminar, the average cost nationwide to run two newspaper ads is $4,000. From that expenditure, the average response is 50 seminar reservations for a cost per lead of $80.Mr. Malley: In general, do you think practices are cutting costs in marketing or increasing their dollars toward marketing at this particular time, and what has been the trend for the past 6 months?
Ms. Greer: During the fourth quarter of 2001, I saw a definite decrease, but not for everyone. The practices with the lion's share of the market maintained their advertising budgets for the most part. The jury is still out for 2002. I'm seeing a mix in spending. With new technology and a stronger economy, I predict advertising will increase.
Ms. Dunn: Our clients have held their marketing expenditures stable, which has worked; most have been able to maintain their volume. If volume has dropped, it's been slightly. Some of our clients are reporting increased volumes and are now increasing their advertising dollars. In addition, I haven't heard anyone else mention it during this conversation, but a lot of our refractive practices are getting ready to market BOTOX (Allergan Inc., Irvine, CA), so we're getting those campaigns ready to go.
Mr. Rabourn: I've actually seen a pretty fair increase in our practices. I think, for the most part, we try to do an annual budget (so we were looking at budgets in November and December of last year) and then try to project for it. I think the events of September 11 did have their impact, but I think, for the most part, people held true to their budget and went into 2002 saying, “I'm going to spend as much, if not more, in 2002, because I still think there's going to be an opportunity,” so budgets went up with that.Mr. Malley: Let's say this is your practice and your money at stake. Pretend it's June/July 2002. What would you be doing right now with your advertising? Would you be increasing it, decreasing it, or waiting for the economy to turn?
Ms. Dunn: I would keep spending money on marketing and, depending on response, increase it—especially during May and June, which is a critical time to generate leads before the fall season when a lot of business happens.
Ms. Greer: There's never been a better time to advertise than when the economy is slow, because so many surgeons will stop or reduce their advertising budgets. History has shown that industries that increase their advertising during an economic downturn increase their market share over the long term. Those who scale back run the risk of losing market share. I would definitely spend more money.Mr. Rabourn: I agree. While we traditionally think May and June may slow down, it actually appears that those may be really good months. I think you should continue on your course and spend at the level you budget for the year. Don't back off.
Mr. Malley: There's this marketing myth about certain times of year being better to advertise during than others. Is the summer a great time to market refractive surgery, or is it a time when you let your clients go on vacation and come back and hit it in the fall again?
Ms. Dunn: We recommend that a practice go through a summer period with normal advertising, especially if they have not tracked results before. In most markets, the summer season does as well as the rest of the year. There are some markets in which response diminishes slightly, but it's still worth marketing. If the trend is lower advertising response, we recommend supplementing with internal direct mail or other promotions so cash flow remains steady.Mr. Malley: Isn't summer more affordable media-wise? Is it a good time to crank it up, or should you go on vacation?
Ms. Greer: No, I don't believe in folding up the tent and going away, simply because advertising is not a water faucet and what happens is, if you turn the water off and want to turn it on again in the fall, it may not be there. I think what's critical is that you track the seasonality within your practice, but understand you may be creating that seasonality. I believe that you should maintain your marketing presence throughout the year.Mr. Rabourn: I agree with everything that's been said. I think the problem sometimes is self-inflicted, by the physicians and their time off. That affects the number of procedures done during the summer.
CONVERTING CANDIDATES TO PATIENTS
Mr. Malley: In terms of motivating patients to have surgery, how important are refractive surgery results? Should surgeons keep an active database of their results, publish these results, and make them available to patients? Should this information be used as the “sizzle” portion of a marketing campaign?
Mr. Rabourn: I think it's not necessarily one single factor, but rather the entire process that the patient goes through. People undergo refractive surgery for different reasons, but, no matter what the reason is, they're actually buying a comprehensive process from you. Everything you do along the way matters in helping the patient to make the right decision. I'm not sure I can pin it down to just outcomes, or just offering a better price, or a more convenient hour for candidates to come to the center. I think it's a combination of many different things that makes a practice successful.
Ms. Dunn: The sizzle that motivates people to call is the offer in an advertisement. The offer that works best, as far as generating a response, is a free seminar. Seminars are attractive, because they give people an opportunity to learn, in a nonobligatory way, more about LASIK and other procedures. Seminars also give people a chance to meet the surgeon and staff. Once people attend a well-produced seminar, they feel more comfortable taking the next step, which is to schedule an appointment.
Mr. Malley: With most practices, we're trying either to maintain or to raise our prices, and have relied heavily on financing to make LASIK appear to be more affordable. Whether it's low monthly payments, zero down, 12 months no interest, or 6 months no payments, what role do you see patient financing playing in this market when the economy is so down and everybody is concerned, not just about having LASIK, but about their jobs, 401(k), and so on? Finances have to be a huge obstacle right now. What are your thoughts about making the procedure more affordable through financing options?
Ms. Greer: It's critical. Offering financing has been one vehicle to get people moving who really wanted the procedure but just felt like they couldn't afford it. We need to do a better job at selling the financing program. When I secret-shop practices, nine times out of 10, they never mention financing. With financing, you can overcome the price barrier.
Mr. Rabourn: I think patient financing is growing. We've looked back at our practices, and the number of people who are financing the procedure is not getting smaller; it's growing at a pretty good clip. One thing that we try to do is to be sure that, in all of our advertising, we mention that financing is available, and really make sure the patients understand that there are opportunities and ways to have this procedure without having to come up with the cash.
Ms. Dunn: I think financing has played an extremely important role at both the lead-generation and lead-conversion stages of marketing. It's important to let each prospect know that financing is available. For practices with low-price competitors, we advertise that financing is available and what the low monthly payments can be. It's also important to get prospects approved right away, so they can feel comfortable knowing they can afford LASIK and they can have that part of their fear removed. ReferralsMr. Malley: How important is a good referral program to you and your clients?
Ms. Greer: I think it's critical to have that as one component of your total marketing program, because it has a proven track record of stretching your advertising dollars. If you're just out there throwing money at advertising without really getting your internal house in order and really effectively communicating with patients on an ongoing basis, you will become advertising-dependent. That is a very expensive place to be. You need to find a balance, where your advertising is supporting your referral program and your referral program is supporting your advertising program.
Mr. Malley: You mentioned communicating with patients after their procedure. We now introduce our patient referral program in writing to patients at the most opportune times (either at 1 day or 1 week postop) to increase our patient referrals. We put that in writing to let them know that the practice does have a referral program and that we would cherish their referrals and working with their friends and family members. What do you use in terms of a patient referral program, or do you look at it as a whole internal process?
Ms. Dunn: I think one of the key elements of an effective referral program is to provide patients with “tools” that make it easy for them to refer others to the practice. An example of a tool is a gift certificate for a free LASIK evaluation. When you give a certificate to patients at the postoperative exam, for example, it gives them something they can give to one of their friends or family members who may be interested in LASIK. The tool makes it easy for them to refer. If you just ask for referrals, it won't happen in the volume; it will happen with the right tools.
Mr. Malley: We say that, if you don't have something in writing, you don't really have a referral tool; you're just begging for a referral. I agree you need something physical, such as a brochure, paper, or certificate. What are some of the best referral processes you've seen?
Mr. Rabourn: I agree you've got to have a tool to give to patients. But, I think one of the single best things you can do is to make sure that, within your practice, you're providing a real service from the moment they call to the end result, and I don't think you can ever get away from the physician's saying, “If you're happy with this, we've built our business on referrals. If there's anyone that I can take care of for you, I'd be happy to do that.” I think the self-expression from the physician is very powerful.
Mr. Malley: The person I've seen secure patient referrals the best is a young surgeon from Charlotte, NC. When patients thanked him, he would say, “No, thank you, and the way you can thank me is to tell your friends about us. We loved having you as a patient and look forward to helping your family and your friends.” He could say that with sincerity, with meaning, and do it all in about 90 seconds. It continues to work very well for him.
Ms. Greer: I agree. What we really need to do is ask for the referral. If you are using a tool, like a certificate or CD-ROM, be careful not to hide behind the tool. Asking for the referral face-to-face has more impact than any ?tool? you can think of. Of course, not every surgeon feels comfortable with asking for referrals. That's when you have your patient coordinator in the room with the doctor 1 day postop to write down the patient's warm fuzzy comments and then conduct an exit interview. During the interview, it becomes quite natural to ask for the business. Other businesses ask for referrals. Ophthalmologists can, too. Your success in large part depends on whether or not you have built a relationship with the patient prior to asking for referrals. If you've just been running them in like cows, it's going to flop.
Ms. Dunn: I think that what is not working is relying solely on patient referrals and referrals from other professionals. If you just rely on referrals, I don't think the practice will grow very quickly. When I talk to doctors, one of the questions I ask them is, “How are you marketing right now?” The most common answer is, “We have a lot of patient referrals, word-of-mouth.” But then when I ask, “How many referrals do you get on a monthly basis?” the most common answer is about a dozen, and that's just not enough unless you're doing other, more proactive marketing. Relying on referrals is not a proactive way of growing a practice. Proactive marketing would be actually spending money on advertising, conducting some seminars, doing some consultation ads, spending marketing dollars so you're in the media where the public can see you. Mr. Malley: Everyone wants to have a practice built around patient referrals, but we've seen very few, if any, that are strictly patient referrals. Some are optometric-referred or medically referred, but you've got to have an enormous patient base to have a patient referral-only practice. Everybody wants that, but it's very difficult and requires a lot of work.
THE PERSONAL TOUCH
Mr. Malley: Some of our surgeon clients call their patients the night before surgery to tell them that everything is okay, don't worry, we're all set and we'll see you in the morning. With other practices, the doctor or technician calls the day of surgery, in the evening, after the patient has gone home, just to check in. Some of that is unexpected and nontraditional. Are your clients doing that, and has it been a nice little bonus for them?
Ms. Greer: This is an interesting point. It's the easiest thing in the world to do, and it means so much to the patient, and it's something they will tell their friends about. Having the surgeon call always has a higher impact, but that's not always possible. As long as someone is making that contact, it's a way to really separate yourself and create positive word of mouth.Ms. Dunn: It would be nice if the surgeon could make both calls; however, if the surgeon can only make one call, I recommend the one after surgery. Even when the staff has to call, they can say, “The doctor wanted me to call to make sure you're doing well.”
Mr. Malley: We haven't talked a lot about internal marketing and how important the staff is. To me, the technicians spend more time with patients than anybody else in the practice. We hardly talk about the techs, and not very many of them that I've seen are exceptional in terms of an outgoing, wonderful personality. They're more medical and technical. What tips can you share on internal marketing and helping the staff be part of the process?
Ms. Dunn: Internal marketing is extremely important and gets overlooked. The staff needs to be trained in sales and patient contact. For example, when someone calls and asks about price, trained staff must handle those calls. The staff needs to know what consumers may not know to ask; patients ask about price to get a dialog started. Unless the staff is trained how to answer the price question and what's behind the question, they may come to believe that price is the biggest barrier and the service is cost-prohibitive. This may cause them not to be fully committed to selling the service, as they would if they more fully understood what was occurring. Staff meetings are needed for support, as well as further training. I recommend staff meetings at least monthly, but preferably weekly when a practice is trying to make specific improvements.
Mr. Malley: You're right. Everyone wonders why all the patients always ask about the pricing, but, if you look in the paper, a lot of the ads from our competitors are all about price. The industry and some of the doctors have created a pricing monster. If the staff doesn't know how to respond to those, then it doesn't matter how good the surgeon is or how good the practice looks. The patient will never get that far.
Ms. Greer: We need to develop a sales mentality, because we are in the business of selling, whether we like to admit it or not. You are selling your services, and I think there's a way we can do that very professionally and with a great deal of integrity. Whoever is answering the phone and interacting with LASIK prospects needs sales training. You've spent good money to get your phone to ring with an opportunity. You can't afford to take a let's-see-what-happens attitude. As far as the technical staff, I think every member of the team has to be behind the overall marketing plan of the practice, and it all starts at the top. If you don't have leaders in the practice who are really behind building the volume, developing sales programs, developing a first-class internal/external marketing program, the practice isn't going anywhere.We are not tapping into what our technicians are seeing and hearing. Technicians are spending more one-on-one time with the patient than any other staffer. They are hearing information that could help improve our communication with patients and prospects.
Mr. Malley: Everyone's always searching for the ideal LASIK coordinator. I am known for saying that the ideal people are not ones you steal from a competitor or ones who worked for someone else in a different department. We interview former LASIK patients. We look for personality traits. We try to train these people to become the kind of coordinator we would like. Where do you find your ideal LASIK coordinators, and does it work well for your practices?
Ms. Greer: If you can afford the luxury of training, it works to get someone from another industry with a retail sales background. Such a person understands sales and the language, is motivated to perform at a very high level, doesn't have preconceptions specific to this industry, and, therefore, comes at the job with a fresh outlook. If you want to stay within the industry, opticians have proven to be very good LASIK coordinators. They understand sales, and they understand the business. It's just a really nice fit.
Ms. Dunn: We recommend looking for people without industry experience, so a practice can start with a clean slate and train the staff in their own methods. We also recommend someone with a background in sales or customer service, who is outgoing and likes to talk to people. In addition, the candidate must be able to handle the more detailed aspects of the position, such as maintaining the computer database and diligently making follow-up calls. nMichael W. Malley is President and Founder of the Centre for Refractive Marketing (CRM Group), an ophthalmic consulting/advertising agency established in 1988. Mr. Malley may be reached at 1 (888) 880-3466; email@example.com.
Kathryn Dunn is co-founder of the marketing firm K Dunn & Associates, which opened in 1990. She began her career in Los Angeles at Grey Advertising and was later a direct response copywriter for marketing consultant Jay Abraham. Ms. Dunn may be reached at (800) 553-0135; firstname.lastname@example.org.
Wellentina Greer is the Director of Sales and Marketing for Network Affiliates, Inc., a LASIK and cataract marketing and advertising agency. She began her ophthalmic career eight years ago as the marketing director for a large multi-physician practice, and has served as the regional marketing director for a national practice management company. Ms. Greer may be reached at (800) 525-3332, ext. 287; WellentinaG@netaff.com.
William B. Rabourn, Jr., is the founder of Medical Consulting Group and Managing Principal of Consulting Services. He was the co-founder of Vein and Laser Centers Incorporated (cosmetic laser specialty centers) and Chief Marketing Officer and Vice President of a major financial institution. Mr. Rabourn may be reached at (417) 889-2040; email@example.com.