The goal of this discussion is to explore the field of Internet marketing, specifically as it relates to audiology. The best place to get started is to break everything down into basics. Let's start with two definitions. According to the Chartered Institute of Marketing (2011), marketing is the management process responsible for identifying, anticipating, educating, and satisfying customers profitably. According to the American Academy of Audiology (2011), "the audiologist is the professional who specializes in evaluating, diagnosing and treating people with hearing loss and balance disorders."
When combining these two definitions, we see a distinct realization of what marketing audiology probably should be. It should be the management process that identifies people requiring audiological care, anticipates the needs of these people, distributes information to them about the solutions that would be most effective and then satisfies the needs of the people who require audiology services. This seems like a fairly simplistic and straightforward approach, but the devil is always in the details. From our perspective as Audiologists, people who require audiology also need some very obvious and fundamental things.
If we believe that hearing loss is a health condition, then we also believe that that this condition will impact a person's health as well as the person's quality of life. The best way to manage any health-related issue is through professional help. Obviously, professional hearing healthcare from a specialist in this field will be of utmost importance to the patient. A proper and accurate diagnosis that leads to specific intervention and treatment is critical in the process. If this is done correctly, the prescribed treatment will yield an outcome that best address the symptoms associated with the patient's condition.
While on paper, this is a clear view of the patient's audiological needs, in reality most people do not recognize or take action on this. For a moment, I would like to change your perspective of thinking. When you are thinking about marketing audiology, does your mind immediately go to what services are in your local community or perhaps what immediate competition you have? Likely so. Instead of this perspective, think about marketing your practice or services from a national perspective.
The average adult with hearing loss who recognizes the deficit says, "I have a hearing loss. I probably need hearing aids." What most adults should be thinking is, "I have a hearing loss. I need to see an audiologist." We estimate that approximately $400 million is spent nationwide each year on marketing hearing healthcare products, hearing aids, and the services related to testing and fitting hearing aids on adults. iData Research, a research firm that publishes data regarding various industries and professions and health services, estimates in 2009 the U.S. market for hearing aids and audiology devices was valued at over 5.2 billion (iData Research, 2010) with more than 90% of these dollars comprised by hearing aids alone.
If you made a modest assumption that for every $10.00 someone earns providing a hearing instrument to a patient, one of those dollars is reinvested into marketing hearing loss services and products back to the community, then a $4.6 billion industry should generate $460 million in marketing. If 2.6 million hearing aids were sold in the United States in 2009 at an average sale price of $1,500, then $400 million was spent on marketing. Whether this number is accurate or a close approximation, the bottom line is that there is a great deal of monetary value invested into the message that results in a patient saying, "I have a hearing loss, I guess I need hearing aids." Shifting the mindset from needing hearing aids to needing an audiologist is no small task.
The audiology solution, as mentioned previously, needs to be delivered to a national market. This means having strategies in place that educate people about the value and expertise of audiological care. We need to deliver our message in a way that reaches the most people who likely could or would require audiology services. It comes as no surprise that this involves having the financial resources to make the message as visible as possible. Promoting audiology today has to be as effective as the promotion of a hearing aid in the past. We need to push the professionals rather than the product.
Promoting Our Practice
If you take into account how often you read and gather major day-today information from the print media, you might guess that newspaper readership is on the decline. People are more readily searching the Internet for information than looking in newspapers. Consequently, print advertising is becoming less of a sure-fire way to distribute information and advertising. Even with that said, however, if you look historically at how newspaper advertising has been utilized by the hearing healthcare industry, regional advertising is probably at the top of the list. Most of regional advertising has a product focus where a practice markets an ad provided to them by a manufacturer, or the practice markets a product and services to compete with the other advertising that is in that particular region. These types of ads that magnify the product and do not focus on the credentials of the provider tend to be the rule rather than the exception.
But one thing we can say for certain is that there are no existing ads in the national print media defining or promoting audiology care. We know that television is a far-reaching media to broadcast a message, but is it realistic for audiology? According to Kantar Media, a national television and media analyst firm, NBC, ABC, CBS and Fox together generated about $23.7 billion in ad revenue in 2008 and $21.9 billion in ad revenue in 2009. The revenue is generated by selling time spots for advertising, particularly during prime-time where the audiences are largest. The cost of prime-time advertising is not cheap, either. A 30-second spot on the program Survivor will cost approximately $1 million; $1.5 million on The Biggest Loser. There are opportunities to advertise during prime-time for less, but even at the low end costs can still be approximately $100,000 for 30 seconds during a lesser-watched program. Even that kind of figure is out of reach for most of us in this industry. While TV advertising is utilized by the industry, it is typically done at the regional level and is dominated by hearing aid service or product ads that, again, either do not focus on the credentials of the provider or blur important distinctions between professionals. Just as with print media, there is no national television message defining and promoting audiological care, either. So how do we get our message mass-produced in a way that is timely, feasible, and affordable?
The Internet
According to Pew Research, 74 percent of American adults access the Internet, and 80 percent of these adults look online for health information (Pew Research Center, 2011). In fact, Pew has coined the term e-patients to describe the people of this group. Fifty-two percent of all online health inquiries are on behalf of someone other than the person actually doing the research on the Internet. This could be parents looking for information for children, or young adults looking for information for their parents.
Most adults who find health information on the Internet indicate that it influenced the decisions they made about how to address an illness or a condition that they were researching. In addition, more than half of e-patients say that the information that they found on the Internet influenced their decisions and that it had a positive effect on how they were making their decisions and what steps to pursue next.
The Internet provides nearly unlimited space for advertising, and in all kinds of different ways. There are opportunities for local practices to have a Web site and build in components that make the site visible on search engines. But if you have ever typed in a search, no matter the product, you get pages of results based off of one keyword entry. One of the challenges with Internet marketing, as with print or television, is still being visible. You have to be at the top of the results list when someone types in "hearing aids" or "audiologist in Texas."
You will also probably notice that many of the manufacturers' brands are quite visible on the Internet when certain keywords are typed in. One of the things that can be a real thorn in the side to audiologists is these companies that now exist on the Internet and are selling products directly to consumers through some form of pre-negotiated distribution channel, advertising in many cases the same brands that are available through actual licensed audiology providers within that same community.
Our professional associations have built some credibility and presence on the Internet over the last several years by providing accurate and hearing-health-related information. The only question is how consumer friendly is the information contained on those professional sites? Most people looking for information on the Internet start by using a search engine, such as Google, Yahoo!, or Bing, and type in key words that define what they are looking for. It has recently also become more apparent to many businesses that another way to distribute information on the Internet is to have postings on various social network sites like Facebook, Twitter, and LinkedIn. Many businesses are putting just as much effort into having their advertising visible on these Internet locations as they are in making sure that they have a good location on search engine browsers.
There are two primary ways to maximize your position on the Internet. First is a Search Engine Optimization, or SEO, which are tactics and strategies that are used in the production and positioning of your Web site to make it as interesting and compelling to search engine crawlers as possible. The second approach is pay-per-click where you sponsor your Web site's location on a search engine results page.
Search Engine Optimization
To get good search engine appeal, several things should probably be in place as far as your Web site is concerned. Highly ranked Web sites have hundreds, if not thousands, of pages of information embedded. This does not necessarily mean that these hundreds or thousands of pages are visible to a person who has landed on that Web site, but it does mean that there are hundreds, if not thousands, of pages worth of information that are associated with that Web site's URL, and are thus visible to search engine crawlers and help to indicate to those search engines that this Web site is rich in content relating to the words that the particular searcher may have typed in.
Highly-ranked Web sites have hundreds to thousands of inbound links, which are links from other Web sites that have found the information on your Web site useful and interesting. Highly-ranked Web sites have regular content updates, so that new information related to the same search words trigger search engine crawlers on a more frequent basis with the latest and greatest information. Highly-ranked Web sites have information people are searching for.
In our industry, for example, people do not type in just one or two keywords to find information about hearing loss or amplification; they type in hundreds of different sorts of words to yield the best possible information outcome. One of the more recent applications that helps in SEO building is having video content on your site. More and more Internet experts are telling us that people are moving further and further away from looking for information by reading it and are more interested in looking for information by watching a video.
One of the other tactics that can be very helpful in garnering better visibility on the Internet for individual practice Web sites is the concept of the "tower" Web site. A tower Web site is one where the substantial investment is made in the SEO to secure optimal and high-level search engine placement. Related businesses would then link their individual practice or business Web site to the tower, with the tower linked back to them, so that a higher visibility is created for the related businesses. Once people find information that they were originally looking for, then they can easily link to other information that can be strategically placed, such as providers in their area, that they may not have found in a general search. For example, a person types in their zip code and it brings up a list of all of the different practice Web sites in that area that are connected to the tower, and it creates links to those Web sites or phone numbers.
AuDNet, as a company, has built a tower Web site for consumer information about audiological care, and that tower Web site is called NowiHear.com. It has been established for over five years, so now it is starting to command quite a presence on the Internet. It has many individual practice Web sites linked to the tower, so now all of a sudden, the tower's search engine appeal increases even further. If a patient gets to NowiHear.com, reads about audiology care and gets to the point where they decide, "Yeah, I'm going to need to see an audiologist," they can go to the locator, find audiologists in their area and, link right back to that member's Web site or practice. This is a seamless connection between that searching consumer and the audiologists in their area.
There are a couple of good prognosticators for determining whether or not the effort you have put into search engine optimization is bearing fruit. First is the number of pages that your Web site has, and the second is the number of inbound links that your Web site has. An easy way to check if those two things are indeed paying off for you is to see where you are listed in a search, particularly in the white section of the first page of the results. Some search engines highlight sponsored links at the top of the results page, with non-sponsored links falling in the white section of the page. Note where you fall on the results page, as well as other consumer sites.
The other option you have to create that search engine presence is pay-per-click. With this approach, you basically sponsor your Web site as an ad, and your site would then be listed at the very top of the first page, usually in a column on the side or in a highlighted box as a result of certain key words in a search. This is also valuable in making sure that on those days or moments when your SEO is not pulling it off, you are still visible.
Sometimes we get lucky and both pay-per-click or sponsored efforts and our SEO efforts get us up at the top of the first page in both the white section and the sponsored links section. Another thing AuDNet has done with our tower Web site is leveraging the content in the social media networks as well. One of the features of NowiHear.com is a blog page where we add new consumer-friendly, consumer-oriented content several times a week, which then e-mails fans on Facebook, LinkedIn, or Twitter, alerting them of a new blog post.
What Does AuDNet Have to Offer?
Now that you have a background on Internet marketing and the opportunities and goals associated with marketing audiological care, it might be helpful to see how to put those practice to best use. This concept of marketing audiology care in the advancing Internet era is something that is going to empower our profession to bring a message forward in a sea of marketing that we simply were not able to achieve previously. The Internet has made it possible to build a nation-wide brand and branch out from local marketing. We have experienced success on NowiHear.com and wanted to share our successes with you.
Figure 1 is a screen shot of the landing page of NowiHear.com. This is where the consumer arrives through all the SEO effort, through linking through local Web sites, and through our public relations activities. There are a lot of components to this site.
Figure 1. Home page of www.NowiHear.com.
The immediate eye-catching visual from the home page is the audiologist locator. If you enter a zip code in the field, it will show the individual listings within a specified mile radius. The listings will come up as links, where more information such as the address and phone number may be displayed. This listing site, called the whiteboard, would also display any additional media the practice may provide such as videos or e-mail links.
AuDNet allows an audiologist to post any information regarding their practice. It may be training and orientation, explaining your practice, promoting your practice, the services you provide, the times you are open, your location, or how to find you. The reader may find out about how to locate you on your local Web site or how to get more information on a national level from NowiHear.com. This is definitely an interactive arrangement. There are many ways to exploit online user activity and to make you as visible as possible in one stop.
As you can see in Figure 1, the landing page has several categories: What Is an Audiologist, Hearing Loss, Hearing Tests and Evaluation, AuDNet Advantages, Hearing Aid Services and Technology, Why See an Audiologist, Testimonials and a little information about who we are, Audiology Students, and of course, Locate an Audiologist. There is also a blog which is maintained on a regular basis, as well as active videos where we have taken every area of the profession and tried to give the consumer a chance to get to know what audiologists do.
AuDNet includes a category for Hearing Solutions which discusses hearing aids and rehabilitative services and the testing process. We also have a category on Hearing and Balance that talks about fall prevention, assessment including ENGs and VNGs, and treatment in the form of canalith repositioning. There is another section on pediatric testing. These kinds of sections allow the consumer to understand about the broad training required to be a licensed audiologist.
The average time on NowiHear.com is 2 minutes and 13 seconds. That may not seem like a long time, but it actually is. Most sites do not have that kind of staying power. Over a period of one month, 88 percent of visitors are new to the site, with 78.9 percent of those directed from search engines. This is direct evidence for us to know that our SEO and sponsored advertising campaign is very important.
The Most Costly Word
The mostly costly word to our profession in terms of Internet keyword would have to be hearing aid. If you were to perform a search on Google for "hearing aid" you would quickly notice that audiology rarely appears on the first results page. In fact, it is less than one in ten searches. Because hearing aid is a household vocabulary term, and audiology is not, what would happen if audiology and audiological services were top on the results search? With increased participation on a Web site such as NowiHear.com, providers could begin to see more Web-based referrals when people search for what they believe they need: hearing aids.
Because you have to "rent" keywords for searches find you specifically, it can be very costly, especially with such a common term. But think of what we could do if 2,000 audiologists paid only $349 a year to be part of a national audiological care Web site? This kind of participation would allow us to have to dominant ad presence on the front page of major search engines. We would allow the consumer to have a representation of choosing and learn about the audiology story. If the hearing aid market is 4 billion dollars and audiologists sell about half of the products out there, it is about a 2 billion dollar sales effort on our part.
AuDNet is the only private enterprise set up to direct a portion of these funds towards promoting audiology care on a nationwide level, and participation directly dictates how much can be spent. AuDNet charges a small annual fee to be listed and sponsored in our directory, but there are no stipulations or requirements as to what hearing aids you sell or promote. The only requirement is that you are a licensed audiologist in the state in which you practice and in good standing.
Take Home Message
The Internet is a global, current marketplace for any business. Hearing care in the past has not explored these avenues, and it certainly has not created any mechanism for the audiology community to promote audiology, even though we generate billions of dollars worth of activity for the industry. We have the ability to promote audiology care nationally and shift the consumer mindset from "I need a hearing aid" to "I need an audiologist." But this kind of mindset also needs to be one of promoting our profession and business rather than as some measure of philanthropy. Up to this point audiology as a profession has chosen to do things on a voluntary basis to try to underwrite efforts like this. While this is still certainly admirable, there is ample room for audiology to take its place as a leading lucrative healthcare business.
AuDNet was established to provide an economic vehicle by which participating audiologists can redirect a portion of the money that is already passing through their hands as they transact business on a daily basis. They can redirect a portion of that towards funding a national campaign to promote and instill in everybody's mind the value and purpose of audiology. Audiology can be a household word if we treat making it that as a business. I am inviting all audiologists who participate in our program to help us build the content in NowiHear.com to represent everything that we do. Let us not limit ourselves to just the hearing aid.
References
American Academy of Audiology. (2011). What's an audiologist? Retrieved March 7, 2011, from www.howsyourhearing.org/whatisanaudiologist.html
Chartered Institute of Marketing (2011). Definition of marketing. Retrieved March 7, 2011, from www.cim.co.uk/resources/understandingmarket/definitionmkting.aspx
iData Research. (2010). U.S. market for hearing aids and audiology devices 2010 - report synopsis. Retrieved May 26, 2010, from www.idataresearch.net/idata/reports_view.php?SubCategoryID=112&Catorgyld=54
Pew Research Center (2011, May 12). The social life of health information, 2011. Retrieved June 3, 2011 from pewinternet.org/
