Inside Orthopedics: How can Orthopedic Device Companies Leverage Digital Marketing (Podcast 27)

Brought to you by Tiger Buford.

Hello, orthopedic friends. Welcome to Inside Orthopedics. This is Tiger, an orthopedic industry insider and retained recruiter for early-stage orthopedic companies. This is episode number 27. Titled How Orthopedic Device Companies Can Use Digital Marketing Today. If you're trying to figure out how to leverage digital marketing inside your company today, you're going to love this, this discussion with Lisa Dennison. This is a real treat. Lisa is a seasoned marketing and medical education consultant in the medical device and digital health space. I actually worked with Lisa at Sulzer Orthopedics back in the '90s. Lisa is the rare combination of being a digital marketing expert plus having deep orthopedics experience. Just in the last 5 years, she has been the driver for new digital, social, and direct-to-patient strategies and campaigns for 2 exclusive spine technology companies. Enjoy the discussion.

Okay, we are live with Lisa Dennison. Thanks for joining, Lisa. Are you in Austin?

Yes, I'm here in Austin, Texas.

Oh, perfect. So this is a— I'm really excited about this topic because I'm an engineer. I know enough about marketing to be dangerous, but I know that digital marketing is just not being executed in orthopedic device companies today. And so You're one of the few experts in the field that can basically tell our audience what's working and what's not working today. So—

Right.

Yeah, thanks for your time.

Yeah, you're welcome. This is a really good topic, Tom. I'm glad we're talking about it.

Yeah, yeah. Yeah, so first of all, let's just lay the baseline. How are orthopedic companies using digital marketing?

Today? Yeah, this is a good question. I did, you know, my own little research just to see kind of what I'm seeing currently today. I mean, I think orthopedic companies are generally using, you know, digital marketing, but digital marketing is a very broad category, so we'll dig into that a little bit with more questions that we come to. What I'm seeing though is they're using it broadly, primarily through Google to get patients to their website. We'll talk through kind of what that's called and how that looks, but it— but, I did a quick Google search myself, and I'm seeing, you know, if you were to search on something like hip replacement, the number 1 spot did go to one of the major manufacturers. I won't give a lot of names here. We're not trying to do ads for different companies here, but some of the major manufacturers, one in particular was showing up at the top, mostly through their patient-focused education sites that they've created. And it was way down to like the number 7 spot before I saw something like WebMD, a more not related just to a manufacturer. So to get in the top 3 spots in doing that, you're paying a lot of money. We'll talk more about kind of the budgets and how these things work. But I think it is being used by the large companies because they have the dollars to do it. They're clearly putting some amount, maybe a really good amount, towards something like a Google campaign that is in the realm of digital marketing. It's hard to say how much diversity though that they're using in the digital world. There's many other things we can do which we'll talk about in this call that we're having today. Like banner ads and social media and things like that, may be questionable there. I'm not really aware that a whole lot is being done there, but there could certainly be some. But what we're going to talk more about as we go on is the different ways that we can do this. An important note at this point is that the strategy really here we're talking about with the big companies, the more dollars you spend, the more you throw at something, the more hits you'll just drive, which is kind of— clearly we know is going on. It's what we're talking about here with large companies. Indeed, it's true, the more you spend, the more you drive, but it doesn't directly correlate to the quality of leads, patient and/or surgeon/doctor and customer engagement, and in the end, you know, an actual sale, which we can talk more about, which is really what this should all be about, is ending in that something is actually done that benefits both the patient and/or the doctor by also then benefiting the manufacturers, the companies. So we're seeing it used at the top level is what I'm talking about. But digging a little bit deeper, it's questionable. So that would be my overall kind of assessment.

Right, right. So it's the top of the funnel. And most of it is Google AdWords spends, it sounds like.

Absolutely. And we'll talk more about that and how that works. But yes, that is happening. So you ask, are they using it?

Yeah, they're using it in that way. So, and what happens when a patient, when 1,000 patients, you know, look up hip replacement and they end up at, I don't know if this is a company or not, but I'm just going to say Zimmer, if they end up at Zimmer's website, what happens? Where, you know, what percentage of them go anywhere useful?

I mean, it's a good question. I can tell you what can happen. What actually is happening, I wouldn't be privy to that. I'd have to be on the backend within those companies looking at their analytics. What you hope happens is that you very specifically drive them to the right place where they can get exactly what it is that by the search they have done puts them in exactly the right place, and that they can actually do something about it, that they stay for a little while, that they check into a couple things, that you're— wherever it is you've driven them to, that you're set up to do the right thing with them. "Is that happening?" And is that then, even if it is happening, is that leading to the patient actually getting the procedure with your company, which is why you're putting ad dollars towards it. There's a big "I don't know" because just because you get them to do one thing doesn't mean they might do 2, 3, 4 other things that possibly are needed. We're talking about in some cases big decisions, big procedures, big things. Patients don't make those decisions in one ad, one click. So it is a process. That process is complicated, but you absolutely can play in this process and do it well, but it takes real intention and knowing what you are doing. So yeah, I think they are driving patients to do things. I wouldn't doubt it at all. A lot of money I am sure is being spent there. But how good is what the patient is doing? And is it really leading to what the company wants? That is really what we are kind of trying to talk about. That is what real good digital campaigns can do very well.

Yeah, when I talk to surgeons, they say that patients come in with a printout of a certain procedure or device, and the surgeon says it only takes them 15 seconds to flip them over and say, hey, yeah, thanks for that information, but I'm having great results with this device.

Yeah.

And it's, it's the white lab coat effect, the white surgeon coat effect, where, you know, they, uh, they quickly fall in line once what the surgeon's using.

Well, yeah, I'm glad you brought that up, because that brings up an interesting couple things. One is our process is difficult in the world of, you know, we're talking specifically here orthopedics. We're not just influencing, you know, a patient to do something. You know, we've got the doctor, the surgeon on the other end who's got to be bought in too, and it's both. And so there's some work we have to do on the clinician side as well. We can't just drive patients. We've got to think a little bit about— there are two ways this can go. We either have a technology that a lot of different companies have. We might have a special way we do a couple things, but if they can get it in a number of places, it's not going to work to just, with your company, drive a patient to a doctor because the doctor may not be aligned with your company. So then that strategy just fell flat. I will say, it's kind of an interesting point to take in early in this conversation we are having. If you have something very, very differentiated, exclusive, nobody else had it, obviously that is a dream world. We all want to be in that world. We don't all have that. But where you have something truly exclusive, it is going to be the thing that is better to be using on the patient side. If you are driving patients because of something very specific, then there's only one place that the surgeon provider could get it. Then the process we're talking about works very well if you do it well. If they can get it in a lot of places and you're the one who's driving them to the surgeon, there's no guarantee that you're going to end up with the one that gets the sale in the end. So we need to think about that, and that would be a lot about the strategy we'd put in the front end of where are we engaging the patient, how far down are we qualifying them before we do something with them, and what are we doing over on the clinician side to match this and make sure we've got the right information going to them so that they're not blindsided, 'cause no doctor's gonna like that, so.

Yeah, yeah. So let's go deeper, Lisa, with kind of what can and should device companies be doing today in orthopedics? Let's say you have a specific device, let's say it's differentiated, or a new procedure.

Then we are definitely in the world that we can be working in here. So I'm going to talk generally. We will keep digging deeper as we go into a couple more of the questions I know you've got coming. But I think any digital marketing campaign should be, I'm going to call it multi-pronged, meaning more than one thing we are doing. So we will get into a couple things. It should be highly analyzed and refreshed. Frequently. We'll talk more about that too. And it's got to be with the company's budget in mind. So we really have to figure out what the most effective thing it is we can do for what the budget is that we can spend. We'll talk a little more about all of those things. So first, a targeted PCP, we're going to call that the pay-per-click campaigns. These are really the number one thing to plan, so we need to talk about that. They're very highly effective. They can be amazingly specific and we can know in real time what they are doing to judge what we keep or change or how we keep them going. So we will talk more in detail specifically about PCP marketing in just a bit. I will save some comments on that. But I said multi-pronged a minute ago. So we've got some PCP, but we need to layer in some other things. So an optimal digital campaign would look like this, some PCP, some support. What is PCP? That's the pay-per-click. That I just referred to kind of broadly, but in a minute we have another question I know we are going to talk about. We will go kind of deeper into PCP. But that is that pay-per-click. That is the Google AdWords searching. This is going to be kind of like the anchoring base to your digital campaign. But you do need to layer in some other things to support that in the sense of maybe some banner ads which I'll talk a little bit about that. These are— typically on either patient and/or doctor sites that have large viewership, such as like society websites that are the supporting societies for the therapeutic areas that you're in, that the doctors are that you're targeting. Things like medical information sites like WebMD, and the spine world, it's maybe like a Spine Universe, a Becker's. Large patient chat areas, places where doctors and patients go frequently. You also want to layer in some banner ads on those sites. That are in line with whatever the PCP campaign is that you are also running, and that they funnel the patients to some of the same places. So this is a layering strategy here. And then a nice touch, and especially when you've got something exclusive, which means now I can drive some things directly to patients, is going to be social media, which we need to talk about that in itself. We can talk about which ones in detail, good strategy there, but what's really smart to do and when it makes sense is definitely reaching patients directly. Now, this is rarely done in the big orthopedic world, and I think partly that's because it's hard to be differentiated. And we can spend a whole lot of money and we can very effectively get to patients, but if I can't really specifically drive the patient to do the right thing that I'm wanting, or if by me driving them to really just get somebody else's product, or if I'm not driving them effectively with the right information and if I don't have a good campaign, we can— We can do it right and we can do it wrong. If we do it wrong, we can still spend a whole lot of money and it just isn't effective. So figuring out the right way to be effective is the key with all of this. So I just talked about kind of that layering effect. And then the last thing I'm going to say, you're talking about how companies should do this. Number one is the layering I just talked about. And then the money that you spend needs to be thought about. It can— some of the layerings, the different layers aren't as effective with commoditized products as we actually have just talked about. Without a clear patient distinctive that can really drive them to ask for things by name. So exclusivity is pretty key. And know that the budget for this can be sizable. There are thresholds that if you just don't spend up to a certain threshold or beyond, you are going to spend money and just get nothing back for it. So we definitely have to understand how we spend. On this. I know I talked very generally about some things, but that's how these campaigns should be thought of and done.

Got it, got it. Now, let's talk about budget. Do you actually take marketing budget away from other areas to support this? Is it a substitute for other marketing, or is it layering on top?

You know, it can be either, and obviously, if we're going to add a lot of money with digital, we'd like to be able to take at least some of it from somewhere else and be able to not do some of these other things because we have this going on. I think that is the case for a lot of companies, especially with these exclusive technologies. A whole lot of what can be done better is on the digital side. It doesn't mean that we necessarily erase some traditional things. I don't think really any company would erase all of the traditional things. There'd be some that we would keep, but I think you can reduce some of the traditional things with effective digital. And there are some companies, I don't know if they are going to be any of the companies that you and I are talking about today, but I do consult and work for companies where 100% of what we do is digital. It makes sense because of the nature of the product in the therapeutic area or the service that we are talking about. So it can be done 100% over here in the digital side. But that may not be very realistic for a lot of the orthopedic companies where just the channels that we're going into, the multi-processes that we have to get to the patient actually getting the product. It's not just one customer group, it's multiple. So we may have to keep some traditional things going, absolutely.

Okay. So let's— walk us through kind of an ideal digital campaign and with like some examples of Like, let's just pick a product, a fictitious product, and what would the call to action look like in the banner, and what would the— which social media would you use? Yeah, let's walk through an ideal campaign.

Okay. Well, and as we walk through this, I'll be able to pull in some specific things, like you just said, on PCP as well as social. We'll get into— some of the platforms and things. So this will be a lot of details, I know. So we'll just kind of go through it in order here. So starting with PCP, which again, that means pay-per-click. This is going to be a thing that you're doing primarily on Google, but obviously also Yahoo being the other search engines can be a part of that. Google is so dominant though that you're going to be really focusing a lot there. Well, what you're doing first is you're— You're going to really set up and plan your funnels. I'm going to call them funnels. It's a great way to— and it's what the term that we're really using when we're talking about this. So we're going to think first at the highest level, how do I attract the patient, the surgeon? We'll talk a little bit about the surgeon side in a minute, but let's just say the customer. What's the top-level thing that gets their attention to interact with me? I'm going to use a couple examples as we kind of walk through these. Think very top funnel. So this is something like hip pain, back pain, whatever the big large condition is. You are going to ask questions in your ads the way you lay them out. Are you experiencing— you are going to do this with pictures and graphics and words. And it's got to be something that catches the attention at the top of the funnel. And remember, we are going to have to do multiple rounds of funnels. So if you're doing banner ads, you're doing it that way. If you're doing keywords, you're going to place your money towards the words that patients would be searching on at that level. You're going to put dollars towards back pain, hip pain, trouble with this. You know, you pick the condition, the symptoms, and there's hundreds of them. There's just hundreds of them. So you're going to figure out a keywords list We'll talk a little bit in a minute about partners that you need to do this with that you personally may not have the expertise. So we'll talk about that later. But you're going to lay out these keyword lists. You're going to start figuring out a budget. What does it cost? And by the way, words that are searched on more, and there's analytics about this, very deep analytics about all this. So whatever words it is that you want, there's a cost for those words. The more they're searched, generally the more they cost. Do you got to spend money here? So you are going to kind of pick your list. You are going to start putting ads, dollars behind these words, and you are going to start putting ads behind these words as well. So that is kind of the banner world and the social world. You are going to work these words into everything. So pay-per-click is words. You start putting dollars towards the words you want. When you start getting into more specific words that are very medical and very indications, indication-specific, less patients are searching there to start with. But if they click on the general word that you start with, you may start putting money on that patient. If they were to come back again, you want to place money on what you got them to click on, and now you're going to start putting ads to the more specific words. So this is a process. It's a funnel. This is a numbers game and a words game. You need good partners to help you with that, and there's a lot of analytics that you got to keep looking at.

Right. Explain to the listeners how you can set up one of these campaigns. It's not— I mean, you control the cost. It doesn't get out of control.

You can even set a budget. This is the amount of money I have, and we're going to place it on these words. And you come back and you look at it, and you'll start refining your economies of scale. The ads will stop when your money runs out, and sometimes the clicks can take you further into the— timeframe and sometimes less. And maybe you just don't have money until the next month to put the next bit of money in. So you have budgets and you see how fast the words use up your budget. If you've got more money, the clicks are doing well, the words you are picking are great, you may make decisions month to month to put more money because it was that effective. So there are a lot of marketing people, we love reports. We love analytics and metrics. This is that. This is definitely something where you can see the numbers, see exactly what's working, change it in real time, and adjust. So you're putting a budget towards it, and you're seeing how long it takes for that budget to run out, and do I want to increase my budget next month, or was that not a good use of money? Maybe I decrease it and I refine my words. So you're constantly adjusting up, down, the word list and the budget that matches it. So that's how PCP works. So we are definitely doing that. On the side where we are actually running ads, so this would be banner, this would be social, we are planning those out much more detailed on the layout, the design, the graphics that we use. We absolutely need to work in interaction and engagement, getting people to interact with us, click and go somewhere else. And we can now, walk that patient more down to the next funnel. So if I get them to click on this ad in a banner or on my Facebook ad, I'm then going to deliver because they clicked on this, that tells me I've already got planned 2, 3, 4, 5, 6 more steps down. If they click on this, I know what the next step is, what I'm going to deliver. And you plan that out. You lay it out. And you work interaction into it. So engagement and interaction is the biggest thing you can do. You get them interested. They click on something. What you deliver when they click is going to vary. Based on how many funnels down the way you are. So it gets more specific. It gets more directed at the actual condition. It starts using more medically oriented words. You deliver more clinical information further down the road. So you kind of think about your funnel's top to going down narrow, and narrow, and more focused. So the planning of the funnels, the planning of the words, there is so much planning that has to happen up front. And the planning goes hand-in-hand with budgeting. What is realistic for the budget you can afford? What do you need to cut and shave for the money that you have to still get a good bang for your buck? You don't want to just spend money, dilute it like crazy, and get nothing effective. So a lot of planning. Then what I haven't even layered in here is geography. Google, Facebook, all of these places we are talking about, you can be amazingly specific, literally down to zip codes and street addresses. What's nice about that is, is we get to not so big companies. We get to smaller companies. We may have a geo strategy that's partly because of the size of our company and our budget. And I work with a lot of small companies and I really like being able to give them very powerful ways of doing things with less money, but just because we can focus. So geo is a way to do that. You can do things nationally and just blast it all over, but you need to be a pretty big company to be able to do that. It's expensive. But you can still be really effective in smaller areas geographically to think about that as just another way to go about it.

Right, right. So like what you're saying is a lot of small companies have a regional presence, maybe in 5 states or something. Absolutely. You can target your ads to people who are physically, I guess by their IP address, in one of those 5 states.

You know, it's— It's not exactly a secret, but I mean this is something in the marketing world. I think consumers have caught on to this too, but it is amazing the amount of detail that is known about you whether you know it or not as a consumer. You have a very distinct digital footprint out there. So what you are doing and interacting with and saying and posting and whatever tells a lot about you. And this then is used usually to the benefit of marketeers who want to get to you. I mean I hate to say it because it kind of feels a little bit, you know, stalkish. I know Facebook is getting in a lot of trouble for some of the violations of privacy. I think this all will get worked out. It is fair to say though that we are all out there in the digital world and companies can know a whole lot about us. So that's really of benefit to all of us when things that we want can be delivered directly to us. If the people who are putting money behind it are really looking for us, they are going to find us. So it's very specific, and that's a real benefit for the marketing staff to use as the most powerful tool we probably have today in marketing is on the digital side. It's amazingly specific.

It is, and I think my philosophy is we've already given up our privacy and we don't really care.

Yeah, I mean it's a digital world. It's an online world. We're all out there as consumers doing all kinds of things. So yeah, we're just out there. Now companies on the end where you're a marketing person by profession, we can use that as a powerful tool. We should be. If we're not, we're kind of missing the most current contemporary way to do marketing in a smarter way. I'm a big, big fan of this stuff.

Talking about the Big Brother aspect, I just recently discovered that if you have an Android phone, Google knows where you are in the world at all times. and they share that. And then if you use Gmail, not only do they read all of your emails, the bots do, but they read all the incoming emails too. And they add context to that. And then I heard the other day that Uber sells all of— if you use Uber, it sells that data to Google. So Google knows every time you hire a car. Where you are.

I think more is known about us than we probably can imagine, probably more than we want to think about. But we are interacting so much online, there's so much to know about everybody. It's just the world we live in. So yeah, that information is there. It's powerful. And if leveraged in the right way, it can really help companies absolutely sell their products and services to very specifically the right people. So—

Right, exactly.

That's what this is about.

Yeah, I've written a couple articles about marketing and orthopedics, and I'm just surprised companies don't use it. But I mean, there's like, you know, Betty Jones is sitting at home in Kansas City, you know, talking to her friends about, "Boy, my hip's killing me. I may need a total hip replacement." And, you know, Google and Facebook know that. Absolutely. And the companies can leverage that to reach that patient. So let's talk more about how you get the patient directly to a specific surgeon. Okay. And maybe even in a specific city. Sure. So how does that— that's another step that's really difficult for a lot of companies to understand.

Yeah. Well, I'm going to focus a little bit here on social media, though we could talk about this with the PCP ads on Google. We could talk about it with banner ads on various sites. But let's focus for a minute on social media because this really is the most effective key way you are going to reach patients is through social media and Facebook in particular. I am not sitting here by any means giving, trying to give away, talk anybody into using Facebook. I have no interest in that. But I am just saying they have the most sophisticated platform by far. There's others too, so we'll sprinkle some others in.

Largest reach too, 2 billion people. They're just huge.

They're just a giant. They reach just everybody. So primarily this is where you're going to go. And you can add in creative things like Instagram, Twitter, YouTube, even channel ads on platforms like Pandora, Hulu. It's very interesting to look at those. And when we have the right partners working with us, which you and I will talk about, I know, in a couple questions down the road, You really need some help and guidance in how to do this with all these platforms. But Facebook, we'll focus on them. You can reach the right patient in the right geographical area. You just described that with the patient example you gave. You can follow them to the desired goal completion to a tremendous level. So the way that works is, again, we are going to think about the condition that our technology lives in, and what's the most— this is the funnels— what's the most broadest sense that I can attract patients to start thinking about it. It's not going to be your product to start with. It's going to be the top level. So what is the pain? What is the big thing that affects their life every day that they're— what is it? You kind of got to think about that. And you're going to design words and pictures and ads and links and things they can click on and information, very educational-oriented at the top funnel, and pictures that really look like something they would relate to. So you've got to kind of keep this specific. So if it's an elderly condition, you want your graphics to be of elderly people. You get the idea. Whatever the condition is, if it's pain, you want to kind of have pictures of patients that look like they're in pain. I can't tell you how many times I'll see ads of various companies because I'm always just kind of stalking them online. That the picture doesn't go with what it is they are asking the patient to kind of do. So it is kind of, you have to think about that. So you are going to deliver these ads. If they click, you are thinking about what the next level is you are going to take them to. It is a multiple-step process that gets more specific each time. And what you want them to do at the very end, kind of, you know, we are going in for the sale here, is we very specifically want to get them to the right place that can help them get to, and in our case, doctors are delivering these things. So we got to get them to the doctors. What that looks like, a lot of companies now have doctor finder features. You want to find somebody in your area who is doing this. And so the ads eventually should drive patients to do something like that or the equivalent, whatever it would be to actually get the patient to get where they can get it. That is the end of the funnel. If we can get patients to get to where they can get it, you know, we have done— and if we have done that with multiple steps, that is a lot of delivery. You don't get every patient. You're going to lose some of them along the way, so you have completion rates and goal completions. You're looking at all these things on your analytics. Some of them are going to drop out, absolutely. But you can do your return analysis on how many patients do I have to get for this campaign to just pay for itself? And after that, it's all above board, right? You can do those calculations pretty easily. So you can always be judging for the budget I'm spending, How many am I getting for that? And am I at least breaking even, if not of course much better? That's what you want. You can see that in real time. You can see that weekly, daily, monthly. You should be analyzing this like crazy. And you should be changing what you're doing to get to that. And if you're not watching it, it can get away from you, but that's kind of shame on you, right? Because you should be watching this. This is not the park it and leave it strategy. It's not like a couple months in advance I planned this ad for whatever journal. These are the traditional ways days, and it's going to get delivered. And I may not ever really know how effective that was. This is not that at all. It's about as counter-opposite as it gets. You can know daily, weekly, exactly what's going on, and you can adjust it real-time and make sure you're driving those analytics to exactly where you need them to go.

And so how do you— you're exactly right. The metrics are mind-blowing with digital. It's just the best time in the world to be in marketing, I think. So how do you know, how do you connect the dots with the patient like Betty Smith in Kansas City and she found a hip surgeon in her zip code or near her zip code and all of a sudden she shows up in, you know, Dr. Jones' office. How do you connect those dots in the digital world?

It's a little hard, this specificity you're asking for. It's a little hard. We can get smart though and kind of use some deductive methods here, but, you know, we don't have exact insight at the company level to always know exactly the patient's names that are coming across. We will know the types of interactions we're getting in a given zip code. We know what hospitals are in those zip codes. If we see activity changing within given accounts. We can go back and look at our campaigns to see where, what's happening in our campaigns and what's happening in the accounts. We can connect them that way deductively, right? I mean, it's not specific.

It's a manual exercise.

It's a little bit, but you can kind of automate this with some of the reporting. You can set these up with your reporting within your company of matching up sales reporting through accounts, and you can sort them by different cities, zip codes, all that. You can sort it. Then you can take that and look at your digital report that's lined up the same way, and you can connect the dots pretty well. You also— a lot of these companies are selling through their sales reps, whether that's direct or indirect through distributors. So you really need to be close to your sales team. I'm always a fan of sales and marketing working so close together. They're, no pun intended, they're attached at the hip. They should be. But this is one place where that really pays off is your weekly call, the leads of marketing and the leads of the sales team are talking and you're comparing notes. You're conference calling. These people work out in the field and they're often remote and not in the corporate headquarters where marketing is. But when we were doing this a lot in the last couple companies that I worked at where we really had some some dollars and good intent going this way. We weekly had the right people on the call. We would have different calls for different geo areas. They were telling us what they were seeing on the street that only they could see. We were seeing the reporting, and we were able to put the information together that way. It's worth doing that effort because with the real-time nature of this and your ability to really change it and craft it and make decisions differently each week, and weed out the things that are not working is tremendous. So it should motivate you to really be marketing and sales, just talking frequently about it and connecting those dots, because then when it's effective, you know, those reps are then in the offices of the doctors. They're talking to them, so they're kind of closing the gap, closing the loop, and filling in the details for us. We need that. So we really have to work together.

Got it, got it. So we talked about leading a patient to a Find a Surgeon site and where the patient has to put in their own zip code, but you can also send a patient, you already know where they live, so you can send them to, hey, you need to see this guy at St. Joseph's East. And so you can send them directly to a hospital or an ASC So let's talk about—

I know—

let's talk about what are the laws regarding promoting patients to a specific practice.

Okay, yeah. I'm glad you brought this up. I'm going to tell you, you know, what I've learned and what I've been taught, and I think there's some real, you know, warnings that just do need to be out there. This is just the world we live in, and we want to be sure we're keeping everybody safe, compliant, legal. It's very important. You know, we live in a regulated industry, regulated by the FDA. We have different classifications, of course, of devices. So the higher the class is— and I've lived in both Class II a lot, but I've also lived quite a bit in the Class III world, which is the highest, highest regulated. And this is going to be, you know, even more watched and regulated the higher the classification is. So no, if you're in that Class III world, really heed this. I'm not saying that Class II doesn't also need to, it's regulated. So just, it's a given that we're regulated by the FDA, so we have to be legally compliant. So there's pretty strict laws about this, actually. And when it's coming from the manufacturer, when the money is being put behind it by the manufacturer, the manufacturer is who is regulated by the FDA. Surgeons, you know, are in clinical practice, the FDA regulates the manufacturers. So, it's the manufacturers that have to think about this. Companies drive patients all the time to finder lists, surgeons lists, absolutely. But in general, and I'm going to talk in general here, if the company gives a hint of a very specific surgeon, just one, they single out a surgeon versus giving you a list of everyone that's in that zip code, in no particular rank order, you know, generally you're not going to want to give a sense of just one doctor. You're going to be able to tell them, you know, there's, you know, there's 10 in your zip code, or, you know, search on a bigger radius. There's some in the city right next to you. A list is certainly fine, but when you start giving out very specific doctors, this can be a red flag because that is considered that the company is promoting that doctor specifically, and that is definitely got regulations against it. So, it's a red flag. You can be reprimanded for that pretty harshly.

But you can lead a patient to 5 or 10 surgeons that use your products.

Absolutely. In fact, all the surgeons that use your product, it's a great sales strategy for them to want to use your product because they're going to be able to be on your finder list because that is good advertising, you know, for the surgeon, not specifically just their name, but it's marketing that they get. Honestly for free if you think about it. And a lot of doctors understand that and they're good business-minded people. So companies with conservative legal counsel are going to stay away from anything that gets too specific with just one name. But companies absolutely can send patients to a doctor list, absolutely. And companies are doing it all day long. It's very beneficial to both the patient and the doctor and the company. It's great. I've lived inside companies that have done that very well. And you're able to do that, absolutely. You just got to be careful with it getting too specific.

Got it, got it. But have you ever heard of a company getting slapped for getting too specific, or is it just a threat out there?

No, no, it has happened. In fact, the reason companies are getting more conservative and careful and making sure they're staying compliant with this is they don't want to get wrapped into that, and it has happened absolutely to companies. And again, the higher regulated the device is, the more the— the FDA absolutely has its representatives are on these companies' websites. They're doing the same things the patients are doing and they're watching and they're seeing and they're looking at how it works and they're seeing if it passes their sniff test and if not, they can absolutely issue warning letters and do things and it can get companies in trouble. So it absolutely has happened.

Got it.

Got it.

So you've got experience with Class III devices and those companies typically run large clinical trials. So can you use, can you send patients to your, does it change when you're doing a trial? Can you send patients to the handful of clinicians that are actually doing that procedure?

Absolutely. Once the trial is finished and the product's approved, the answer is absolutely, and they should be, because why do that 8-year study that cost XYZ amount of millions of dollars if it's not going to sell the product? It needs to sell the product, and it's the most powerful marketing tool you have is that clinical evidence. So, yeah, last couple companies I was at, we heavily leveraged the clinical outcomes through the IDE study to sell directly to patients. And patients, as you know, today are very smart consumers, and they're able to really dig in and read. We need to kind of distill it down and help them see key points. And not the multi, multi, multi-pages. But we can give them access absolutely to the clinical information and through the websites and through the ads and through driving them into— I think that's further down the funnel. We talked about funnels, so kind of getting back to that. That wouldn't be necessarily top of the funnel. We get them interested first, but at some point we need to be showing them the clinical evidence for sure.

Makes sense. Makes a lot of sense. So when should a company outsource their digital marketing campaigns, effort, planning, and when should they insource it?

Yeah, you asked me this. You told me you were going to ask me this question, and I think it's a really good point. So I want to impress a couple points here. There are actual— it's mind-blowing today, and it's been years now, it's not just today. There's actual full bachelor's Bachelor degrees just in this specific area of marketing. Social media marketing is an entire degree. It blows my mind, right, to see how far our profession has come. It's a beautiful thing. But it didn't even exist years ago, right? So if you don't have an absolute dedicated expert, either in-house or through outsourcing, and we can talk about the different ways of doing that. If you don't have an absolute dedicated expert though, for this component of your marketing, digital, you have to. You have to have an absolute expert. That's either somebody that's sitting in-house, or you could— there are great third-party resources that do this. And in fact, I'd say more companies do that, especially the smaller they are. They're going to vend this out and have a third party that just does this. It's what they do all day long. They know it backwards, forwards. You know, you need that. So they either need to be sourced out, or you've got to have them sitting right there, which means now it's a headcount. And that person, if they are sitting in-house, needs to be really well-versed and really have done this, or you are going to be missing out on some of the key advice. Because this is such a nuanced specific thing, it requires real specific knowledge to not only check that the strategy is going to work, but to analyze it on the back end. Let me tell you, there are mounds of analytics. And the decisions that you need to make from those analytics are really important, and you need an expert to guide you. It's not a matter of just looking at a report. These reports are coming out daily, weekly. And when you've got a marketing manager who's managing not just this, but possibly also 2, 3, 4 other things about the product or service, they're not going to have the time that will need to be dedicated to this digital campaign for it to really flourish. And make sense, and possibly not even waste your money. So I really can't impress this enough upon companies that either outsource it to a really good expert, or have that person sitting in your company so your budget dollars aren't wasted, and so it can really be analyzed and utilized the right way. So I think that's very important.

Yeah, that's a big— that's a really important thing. Digital marketing is a fluid exercise versus traditional marketing. Once you go to print, or the trade show. That's what it is. Right.

It's fluid. It changes every day. The methods that work also are changing. Our tools are getting better. Like every year, you can't stay on top of it if you're not an expert in it. If you're not a specialist in this, you will not stay up with everything that's changing, and you will not be able to analyze it on the back end. And you would not be able to mix this in with 2, 3, 4 other major things in your marketing group. This, as we've discussed already, is really important. I've absolutely worked with some great firms that do this. I've seen the power of firm— I've worked with firms that are good, and I've worked with firms that aren't as good, or maybe they didn't really specialize in digital, so that's where I learned the lesson. They did a lot of other things, and oh, by the way, we can throw in a digital campaign for you. I got burned by that one time, and I'll never do it again. I then found a very specific, just digital firm, and they did amazing work. And I learned, this is real specific, so you've got to be a specialist in it.

Yeah, yeah. You said a keyword, nuanced. I mean, marketing is always a fuzzy thing. People can't get their arms around it. But everybody agrees, when they see great marketing, they recognize it. But they just don't know how to do great marketing.

It's a real profession. It's got a lot of art and science to it. To it. And it takes just experience to hone that skill just like any other skill. If you take a sales rep that's been at it for 15 years versus a rep that's first year in, you see the difference. You can see the smoothness and the intuition, the delivery, the knowledge. It's the same thing in every profession, and so marketing is the same way. Marketing has so drastically changed just in the last 5 years, but especially the last 10 plus, that if we are not doing the things today that are available to us that are powerful, we are really missing out. Marketing as a profession needs to be using the latest tools. And they are continuing to get better and change. So I think it's a great thing. We embrace it.

So we didn't talk about specifically which Which social media platforms probably are the best for device companies? Or we also didn't talk about text versus images versus video. Okay. Let's touch it. Tell us about that.

Okay, so as far as like which social platforms to use for what, is that what you're asking? Like for patients versus docs? Yeah.

Like Instagram, is it even worth messing with Instagram?

Well, so okay, let's talk about patients first. Facebook primarily, we kind of talked about that. Interestingly, with Instagram being owned by the same platform, it's easy enough to often couple that in sometimes for a volume discount. So it's okay. It's worthy of considering to kind of keep that in. And it functions largely like Facebook. Facebook has definitely a lot more sophistication and capabilities of what it can do. It's just a more intricate platform. So yeah, I think Instagram is fine to throw in there. I think it depends on what economies of scale you can negotiate through your budget.

But the content looks different even though Facebook and Instagram are the same company.

It will look different because of the platform, absolutely. But you've had Instagram ads delivered to you just as a consumer. I certainly have. They find me even though I don't even know what this company is, but they know the stuff I've done on Instagram, so now I start getting ads delivered by other companies because again, they are paying and they figured out I'm a consumer in that area. It's very interesting. So Instagram functions the same way that way as far as they are seeing what you are doing, so they are now going to— a company is going to decide to pay money and drive an ad to you because you did the other thing you did. You are probably going to be good at doing what I want you to do. And it's still pictures and videos that can be delivered. So in that way it's the same. With Facebook though, you can just really add in more layered ads. You can make them look with more dimension, more words. You've got bigger space to work with. And you can place it in different places within Facebook. So Facebook has different pricing depending on if it's on the side versus it's big in the middle versus you can kind of play around with more realms on Facebook, and that it reaches more people. You've got just more intricacy there. So patients dominantly, I would say, are going to be kind of Facebook. And then counter that with— now let's talk about the healthcare providers themselves, especially doctors, especially specialists that are doctors. These are harder people to reach, I think, through social media, LinkedIn is what you are going to think of more with those people. They do definitely network on LinkedIn. Doctors do all the time. That can be a place where you can't— you don't have the sophistication on LinkedIn with ads like you do on Facebook. So it is more postings and boosting of posts that can reach more people. You can put some dollars to reaching groups and things on LinkedIn. So that is a strategy to try and get to clinicians. But I'd say with doctors, social media is going to be a part of what you do, but it isn't going to be the bulk of what you do, unlike patients, I think it would be the bulk of what you do. So with doctors, it's a part. You do it, you try to connect, you try to deliver some things, you do it the best you can. Again, more on LinkedIn, Twitter maybe. But with doctors, I think you're going to be going— banner ads can be a good way. To get to specific specialties by finding the sites where they live. They all are a part of societies. They generally subscribe to the leading couple journals in their area. You can drive ads through those sites, banner ads. Then we are going to get a little more into some of the traditional things where we have talked a little bit about how that will stay a part of our strategy, and that is going to be a bigger part on the clinician side. So you still need to be at the shows, at the society meetings, on the podium. You still need to sponsor things in their areas, get in on things that are going on in their hospital, in the hospital's newsletters. I mean, we could go on, right? All the things.

Yes.

We do specifically need to reach doctors those ways. And then our sales force is why we have them. We've got people right in front of the doctor every day. The things that we're giving the sales reps to do, the tools that we're giving the sales reps what's to use to effectively support the doctor and educate and get him to do the procedure or the product. Those things all have to still happen on the doctor's side. So I think digital is a part and possibly could— with different specialties, we can maybe be more effective on the digital side. Also, age of doctor, we should talk about that a little bit because the younger, let's just be honest, the generations coming straight out of their trainings and their fellowships and their residencies, They are more social. They are more into digital everything.

Interconnected.

They are the— They network. I'm not saying all doctors don't. I'm just saying if we are just stereotyping here, which is going to drive a lot about our global strategies and analytics, in general, by generation you can kind of gauge a little bit about their behavior. The younger generation is going to be definitely more in the digital ways. So where your procedure is something that you need to drive more to different tiers of doctors by their age, you can think about that too.

Right, and LinkedIn knows how old the doctor is, right?

Yeah, I mean, you know, Facebook does too. I mean, we all somewhere put in our birthdate, right? So, yeah, you can get demographics on that, on age, and specialty and different things, as long as it's been recorded, you know, where it is you're going. So, yeah, I know that within the spine community, we knew the exact sites doctors were living on, and we would do some component, and we would get some success there. It's a part, for sure, of the strategy. It's harder, no doubt, on the clinician side. Patient side, man, we can get right to them. The trick now becomes, what do I need to drive directly to the patient, and is it going to be effective? It's only going to be that way really with the more exclusive technologies. So it's again thinking of all of that, right?

Right. Wow, good stuff. So what else— what haven't we covered, Lisa?

Well, let's see here. Um, I'm looking kind of over some of my notes. I would say just to If I'm summarizing kind of maybe the 3 most key things, it's that digital ads, PCP, social media, these are super strategic. They can be complicated. So that's kind of the first thing to impress when we talk about it. So just in summary, don't waste your budget dollars by just ending up with glorified announcements. Make sure by doing something digital that you are actually leading patients down the line and you are having them interact and giving them engagement and not just announcements that go away. So that's kind of the first thing. And then the second thing is to think about realistic amounts of budget dollars. The larger you spend to some extent, the more you reach, but at the same time it still needs to be strategic. So make sure you think about that, and you can get smart with the geo strategy that we talked about. And then third is the analytics side, and that's real-time, and you've got to move quickly. The beauty of this digital world is you can know within days and weeks. But then it's incumbent upon you to act on it, not just park it and leave it. It's real-time. So have that dedicated person or the third-party source. So those are kind of the key things. I guess the last thing I'd say, Tiger, after that summary is we've not even talked about SEO, which is super important, search engine optimization. A lot of the things you do in this digital world, if done well, is going to take your SEO up. I mean, you know, in the PCP world, but also in the side of this advertising world, things that you do can be organic. Patients just find you because they think of a word and they put it in. But if you are boosting things to get to patients, it boosts your SEO. The more people are doing things with your stuff, the higher up you go in SEO. The higher up you go in SEO, the higher up your stuff shows when people search. That's what we're putting dollars behind partly to attain, is to get it higher up there so they see it. And so I think we need to be sure that— and digital firms, by the way, they know SEO backwards and forwards, and they know the things that they can do behind the scenes to be boosting that SEO with everything you do. So we haven't talked about that a lot, but I'd say that a big goal in mind with all of this is that we're also increasing SEO. And that's a part of our strategy behind the scenes as well. Good digital firms know how to do that.

Makes sense. There's some real trickery behind the scenes to do that. And for the listeners, a boost is when you have content you can basically pay extra to have it show up at the top of the page.

Absolutely, both with dollars and placement and all kinds of things there are tricks. But SEO is such an important thing and we are all living in the online world, so that's big. I'm glad I thought to mention that. I didn't want to go without saying that.

No, that's great. Good way to end. Well, wow, thanks for your time. This has been terrific. A lot of people are going to really enjoy this analysis. So where can the listeners find you if they want to talk to you further?

Yeah, yeah, so I'd say probably my, my email address is great. It'd be totally fine. My consulting practice is called Medical Device Training Resources, so that's MDTR, and that is also my, my email address is mdtr. Denison, so my last name, D-E-N-I-S-O-N, one N, @gmail.com. So that's my email. That's the best way for people to get in touch with me. And yeah, I really enjoy any messages that come my way and any tips that are helpful.

Absolutely. Yeah, yeah, you're going to get some contact. This has been— this has shed some light on digital marketing and how to do it correctly.

Excellent. Well, I'm glad. I'm glad I could share, and I wish everyone great success with this very powerful tool. And hey, have some fun with it. It's a ton of fun. So go out there and really get some good marketing done out there with this. So thanks for asking, Tom. I've really enjoyed this. Yeah.

Thank you. Thanks for your time, Lisa. This is good stuff, and we'll talk again soon.

Alrighty, take care.

Okay, bye-bye. Bye-bye.

And that's a wrap. Hope you enjoyed the overview of digital marketing with Lisa. As always, don't forget to subscribe to the podcast and think TigerBuford.com for your next key hire. Keep innovating, my orthopedic friends.