Refractive surgeons know that certain approaches for selling a procedure work better in some markets than others and may produce variable results for practices in the same market. Often, the only way to decide where to invest the practice's marketing money is by trial and error. No marketing vehicle is perfect; each has its unique upsides and downsides. Here, we share one particular marketing avenue that has been very effective for one of our practices.

TRADITIONAL AVENUES FAILED
Within our high-volume refractive surgery practice in Southern California, we have three laser centers located in three geographically and economically distinct markets. Our flagship practice is in a suburban community north of Los Angeles. Initially at this location, radio, TV, and newspaper advertising did not give us the expected return on investment; we therefore looked to alternative avenues of marketing our practice such as direct mail

DOING RESEARCH
When a refractive surgery practice starts advertising, multiple companies will approach its directors with claims that they will "increase sales by 100" in exchange for a "small investment of capital." We did not have to look far to determine our choices for marketing our practice through direct mail. We evaluated multiple companies that made such claims and explored the option of developing the mailer ourselves.

Initially, we considered an in-house mailing program. We evaluated many factors, including the demographic we were trying to reach as well as the costs of mailing lists, production, and postage. As we explored many (well beyond 50) different ideas and samples of direct-mail pieces, we paid significant attention to the samples from various businesses that came to our own mailboxes. The direct mail piece that impressed us the most was one from a bath and bedding retailer. However, in attempting to adapt this mailer for our purposes, we found that the cost was prohibitive to sufficiently penetrating the market. Therefore, we considered other alternatives.

Next, we contacted a company that produced a high-end bundled mailer piece called RSVP. This direct mail item, which we received in our own mailbox, includes multiple cards featuring various services such as restaurants, pool heating companies, and dentists. We concluded that the products and services this mailer marketed were ones we might use ourselves, and we liked its presentation. Before calling this specific company, we contacted four of the featured businesses to find out how well the cards worked. Uniformly, each business owner told us that he had received a great response from the mailer and a good return on investment. When we contacted the advertising company, the cost of being included in the mailer was reasonable, and the company was willing to give us exclusivity in marketing refractive surgery services.

DESIGNING THE AD
Any advertisement needs a call to action. We decided on a minimal, per-eye discount for refractive surgery that equaled the cost of a tank of gas. We also made sure that the discount expired a few months after the mailing date to give a sense of urgency to the potential patient. In designing the mailer, we focused on maintaining our corporate identity and attempted not to be perceived as the McDonald's of eye surgery, as one competing national corporate laser center has been labeled. We targeted homeowners with an income of more than $80,000 per year.

RESPONSE
After the initial mailing went out, it took a few weeks until we started seeing an increase in call volume. We received calls from all over the very wide geographic area in which we distributed the mailer. The initial response rate from potential patients inquiring by telephone about refractive surgery was an incredible 8. Although this response rate did not continue after the first mailing, we always receive an increased number of calls and book more consultations within 1 week of the RSVP mailer's distribution.

The number of surgeries we booked through this referral source paid for the entire mailer within the first month of its distribution. Due to this high response rate, we have continued to use this particular mailer successfully at our suburban practice location. Unfortunately, we have not had the same success with this marketing vehicle at our other two practices. This difference underscores the fact that marketing tactics need to suit the center/community. There is no single right answer in marketing.

TRACKING REFERRAL SOURCES
Given the amount of marketing capital a refractive surgical practice requires, it is important to track the referral source for each surgical patient. Direct mail makes such tracking easy by requiring the patient to bring in the mailer to get the discount. However, just because the patient has the coupon in hand does not mean that this was his only source of referral. We often find that patients will have three to five informational sources that helped them choose our practice. When training consulting staff, one should keep this fact in mind.

Paul J. Dougherty, MD, is Clinical Instructor of Ophthalmology at the Jules Stein Eye Institute, University of California, Los Angeles, and Medical Director at Dougherty Laser Vision in Camarillo, California. Dr. Dougherty may be reached at (805) 987-5300; info@doughertylaservision.com.
Yvonne Martin, MBA, is Executive Director at Dougherty Laser Vision in Camarillo, California. Ms. Martin may be reached at (805) 987-5300; yvo13@aol.com.