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Successful Internet Marketing for Infertility Practices

Cliff Bernstein, Ph.D.
President, Internet Health Resources

Presentation at the
Western Section Post Graduate Meeting of the
American Society of Reproductive Medicine
San Francisco, CA
April 10, 1999

This presentation is geared toward physicians who have had some experience with the Internet, and who:

• have no Web site, but want to build one
• or have a Web site and want to promote it

Internet usage has dramatically increased over the last few years. Although there is much Internet hype, the Internet does offer a very effective means for promoting infertility services.  This presentation offers some help in how to do this.

The Internet is a vast network of computers all connected via common communication protocols. There are many different technologies that make up the Internet (e.g., HTML, Web servers, HTTP, and Java). However, from a user point of view, the Internet is basically a giant ubiquitous communication system.

The Internet contains these major forms of communication, including:

Email:

Millions of Americans now use email to send electronic letters and newsletters to friends, family members, colleagues, or customers. The email arrives within seconds or minutes, rather than days like a postal letter.

World Wide Web (or just "Web"):

The Web is the most written about "place" on the Internet. It is typically the place where users go to get information or make purchases online. The structure of the Web is built around Web pages, which are typically part of a Web site, which is stored on a Web server. The Web is like a giant electronic file cabinet of limitless information that is available 24 hours a day, 7 days a week.

Newsgroups and List Discussions:

Both of these forms of communication are based on affinity groups of people that share a common interest in a particular topic, such as infertility, adoption, or surrogacy. The over 30,000 Newsgroups allow users to interact with each other via online discussions. The Newsgroups require special software which allows users to post to, and follow, the conversation threads. The over 80,000 List Discussions use standard email. Periodic (e.g., daily) emails, filled with discussion comments, are sent to the list of pre-registered participants.

When these three communication forms are understood and properly used, they can be combined into a powerful and successful infertility marketing strategy, which will be discussed later.

The demographics of Internet users are similar to that of infertility patients. This means that your potential target population is using the Internet. The Graphic, Visualization, & Usability Center's (GVU) 8th WWW User Survey found the following characteristics of Internet users:

• 47% of respondents completed a college or advanced degree
• mean average household income is $53K (USD)
• 40% married
• 60% male, 40% female
• 88% Caucasian/White

Infertility physicians might compare these demographics to those of their patients. From my experience, the Internet demographics, except for the male-female ratio, are somewhat similar to those of infertility patients. Females are continuing to get online at a higher rate then males, so it is expected to even out to about 50/50.

• ubiquitous communication - information is available to millions of people around the world
• information available 24 hours a day, 7 days a week
• interactive - allows people to immediately communicate with each other

These features create numerous marketing advantages over traditional marketing:

• Easy to reach the target market
• Low costs to reach the target market anywhere in the world
• Users can access information even when your organization is closed
• After information is added to a Web site, there does not have to be additional ongoing charges for promoting that information
• A Web site can provide extensive amounts of information that are not possible with traditional media
• A user can immediately request further information when they are reviewing your Web site. There is no need for them to lick stamps or call a telephone number.

Clinic can easily reach patients beyond its local area: Considering the high cost of ART treatment and the fact that patients are willing to travel distances for a specialist, an infertility organization can use the Internet to market its services far beyond its local area. For example, one infertility clinic has received patients from Japan, Hong Kong, and the Philippines via the Internet, at no additional cost. Many other clinics are drawing patients from other states or nearby counties. Since the Internet cost is basically the same to market locally versus globally, the Internet offers a significant cost advantage to those clinics that draw from beyond their local area.

Infertility patients are eager for more information: You can post dozens of pages of educational information on your Web site for these information-seeking patients. Although you might pay additional money to add the extra Web pages, after the initial cost, there are no additional ongoing costs. Contrast this with the additional ongoing cost of adding more information to a newspaper, magazine, or radio ad.

Potential infertility patients can obtain information anonymously. Infertility is a private and difficult issue for many individuals. The Web provides an easy vehicle from which to obtain information in the privacy of one's home. Users can anonymously read extensive infertility information, without having to call a clinic and give their name and address to request information by mail.

Before talking about how to conduct Internet infertility marketing it's important to know how Internet users find infertility information on the Internet. Here is a typical scenario:

1. The user either enters an infertility keyword description into an Internet search engine or accesses an infertility Web directory to obtain a list of infertility Web sites.
2. When the list is displayed, the user clicks on a hypertext link and accesses one of the infertility web sites.
3. Once on the web site, the user may email the organization for further information.

The primary method that you can use to promote your infertility services on the Internet is to build and promote a Web site. Web site promotion methods include:

1. Register in search engines
2. Get listed on infertility Web directories
3. Send email newsletters
4. Participate in Newsgroups or List discussions
5. Advertise your Web site in print media
6. Buy banner ads
7. Buy keywords in search engines

Because there is so much information on the Internet, Web-based search engines have been developed to allow users to find specific information of interest. A user can go to a search engine, enter one or more keyword (e.g., "infertility" or "infertility Bay Area"), press a "submit" button, and the search engine then returns thousands of listings that fit their keywords.

You can register your Web site, for free, in Internet search engines. This is the simplest and most basic method to promote your Web site. After registering, the search engine sends out a robot to gather information about that Web site and adds the retrieved information to its existing database of information. Then, when an Internet user enters one or more keywords into the search engine, the search engine reviews its database and returns a list of Web pages that fit the entered keywords. The most popular search engines are:

• Alta Vista
• AOL NetFind
• Excite
• HotBot
• InfoSeek
• Lycos
• Northern Lights
• WebCrawler
• Yahoo

Don't worry too much about registering your Web site with the smaller search engines, because they don't generate much traffic.

Yahoo is the most important search engine. If you don't register your site in any other search engine, make sure that you register it with Yahoo. Although Yahoo does not guarantee they will list your web site, if you carefully follow their online instructions, you will increase your chances of being listed.

You can find additional sources of information about search engines on these Web pages:

• Introduction to Search Engines
• Search Engine Watch

Due to the sheer volume of information, it is very difficult to get listed near the top of Internet search engines, where Internet users can find your Web site. For example, on 11/28/98, a search on "infertility" produced the following number of Web pages in the most popular search engines:

If your Web site listing were the 200^th listing, a typical user would probably not find it. Consequently, to stand out, you might want to consider getting listed on an infertility Web directory.

In addition to search engines, a second major way that information is organized on the Internet is via topical Web directory sites. These Web sites provide dedicated information about a particular topic, such as golf, finance, or infertility.

There are some infertility Web directories that provide links to extensive infertility information, including infertility services. On a Web directory, it's easier for users to find an infertility clinic listing because the information is better organized and more selective than it is on a search engine.

Thus, you might want to consider obtaining a promotional listing on one of these sites to drive additional traffic to your site. Examples of these infertility Web directories include:

• Infertility Resources
• The American Surrogacy Center
• RESOLVE
• InterNational Council on Infertility Information Dissemination (INCIID)

When a user visits an infertility organization's Web site, they can be asked to sign a guest book or in some way leave their email address. The organization can then periodically send email newsletters to these users. Note that this method is only used after the Internet user has found the infertility web site. It can be an excellent method to regularly remind potential patients about your services. However, it takes additional time to gather email names and regularly develop the content

Your staff members can visit online infertility Newsgroups and answer participants' medical questions. This is an excellent way to show potential patients that the clinic wants to help. A disadvantage is that it takes a lot of time to monitor the infertility Newsgroups and when clinic staff post messages, they must be careful to avoid appearing to "sell their services." This Web page has a list of consumer infertility Newsgroups and List Discussions:

http://www.ihr.com/infertility/newsgrp.html

Add your Web address to all print material including:

• Business cards, brochures, and flyers
• Stationery
• Display ads
• Research and educational articles

Many patients now expect to see this.

A banner ad is a graphic advertisement (typically about one-inch by six inches on a computer monitor) that displays on a Web page. When a user clicks on the banner ad they navigate to the advertiser's Web page. Infertility organizations buy banner ads on infertility Web directories or in search engines.

When purchased from search engines, banner ads are typically bought in conjunction with keywords. The process works as follows: an infertility organization buys, for example, the keyword "infertility" and supplies a banner ad to the search engine. Then when an Internet user enters "infertility" into the search engine, the advertiser's banner ad prominently displays at the top of search engine's Web page. As an example (on 11/29/98), the Genetics and IVF Institute (in Fairfax, Virginia and Gaithersburg, Maryland) had purchased the keyword "infertility" on the Alta Vista and Infoseek search engines. This tactic allows for very targeted marketing in search engines.

However, although this method allows the advertiser's message to stand out among the other infertility clinics, the search engines charge for this service, whereas a simple text listing is free. This tactic is only cost-effective for an infertility organization that has numerous clinics in numerous locations; it is not cost-effective for infertility clinics with only one location.

Additional Tips for Marketing Your Web Site

1. Regularly ensure that your Web site is still registered in the major search engines.
   Sometimes Web site listings disappear from search engines. One reason - search engines periodically send out a robot to verify that the links in their database are still active. If your Web site's Web server happened to be temporarily down when this occurred, the search engine might drop your listing from its database.
    
2. Review what people in Internet Newsgroups are saying about your organization or its doctors.
   The Deja News Web site ⁸ is devoted to Internet Newsgroups and contains a powerful search engine allowing users to enter keyword searches in order to search against millions of Newsgroup postings. You might, for example, enter the following keywords:

• "Dr. Henry Jacobson" - to see what Internet users are saying about Dr. Jacobson
• "infertility money-back guarantee" - If you are offering, or are considering offering, a money-back guarantee, you can use this search string to see what Internet users are saying about infertility money-back guarantees. In September 1998, this was a topic of discussion in misc.health.infertility.

3. Use an email "signature" on all of your emails.
   Most email packages allow users to set up a signature file which the email software automatically adds to the end of all of the outgoing emails. You should use a signature file in your emails. At a minimum, your signature file should contain your name, organization, email address, Web address, and perhaps a short promotional statement. If you post information in Newsgroups, a signature file allows participants to review your signature file and possibly contact you.
    
4. Review your "hit reports" to see which Web sites are sending traffic to your Web site. If you don't have access to hit reports discuss this with your Web site developer or the company that hosts your Web site.

If you do not currently have a Web site, and are considering hiring an outside company to build and market your Web site, here are some selection criteria:

1. Hire a company with a track record of completed projects.
2. Review their previous work online.
3. Preferably, hire a company that has done work in healthcare. Healthcare Web sites need to be authoritative, serious, and without flashy graphics, whereas entertainment Web sites can be funny and use flashy graphics.
4. Ask if the Web development company has done Web site promotion and will help you with your Web site promotion. They can build you a beautiful Web site, but you need to drive traffic to your Web site, if it is to be successful.

In addition to building an attractive, easy-to-use Web site, you can add features to your Web site which will increase its marketing success.

1. Update the META tags in your Web pages.
   Some of the following tips require technical knowledge of Web site development, so you may want to discuss them with your Web site developer. Owners of Web pages can place hidden META keywords and META descriptions at the top of their Web pages. Most search engines will use this information in their database. You should ensure that your META keywords and/or description include the organization's city and the doctors' names. Doing this allows Internet users to search by entering keywords such as "infertility Dallas," in order to find infertility organizations in Dallas. Or, if they hear about one of your physicians, they may want to enter the doctor's name in a search engine to find your organization's Web site.
    
2. Design your Web pages so that it's easy for search engines to gather indexing information about those pages.
   Some of the following tips require technical knowledge of Web site development, so you may want to discuss them with your Web site developer. Search Engine Watch ³ provides additional details on these tips.

1. Don't use keyword spam (e.g., adding the keyword "infertility" hundreds of time on a web page) to try to fool search engines into ranking your Web site higher in their listings. Search engines are aware of this tactic and are now penalizing this.
2. Search engines can't read graphics, so make sure your keywords are in your HTML text. If you must use some graphics that contain keywords, then add the keywords into the graphics' ALT tags.
3. Some search engines do not read image maps, so they won't be able to drill down into your other pages unless you use HTML text links. If you must use an image map, you can put text links at the bottom of your web page, or have an HTML site map, or use META tags.
4. Using frames in Web sites is not recommended if you want to promote individual Web pages in addition to your home page. Most search engines have difficulty following frame links. There are some ways to reduce this problem, described on the Search Engine Watch Web site ³.

3. Add lots of educational Web pages to your Web site.
   Adding lots of educational Web pages (e.g., Frequently Asked Questions, explanations of procedures, etc.) facilitates successful marketing for numerous reasons:

• Many search engines index every Web page on a Web site. Thus, the more pages you have on your Web site, the more pages the search engines can index, and the more likely that one of your pages will display as the result of a user's search.
• Users want lots of information. The more helpful information you can provide, the more likely they will think your clinic is helpful.
• If you have useful educational Web pages, then infertility Web directories may link to those pages, thus sending more traffic to your web site.

4. Ensure that your Web site is user-friendly:

• Ensure that pages download fast. Users typically don't want to wait to get information. Large graphics can slow down this process. Try timing your home page. It should totally download within 30 seconds.
• Add pictures of your staff to the Web site to give it a human touch.
• Ensure that your Web site is easy to navigate. A confusing site design can turn off users and keep them from finding important information.

References

1. Graphic, Visualization, & Usability Center's (GVU) 8th WWW User Survey - http://www.gvu.gatech.edu/user_surveys/survey-1997-10/
2. Introduction to Search Engines (a review) - http://www.kcpl.lib.mo.us/search/srchengines.htm
3. Search Engine Watch - http://www.searchenginewatch.com/
4. Infertility Resources - http://www.ihr.com/infertility/
5. The American Surrogacy Center - http://www.surrogacy.com/
6. RESOLVE - http://www.resolve.org/
7. InterNational Council on Infertility Information Dissemination (INCIID) - http://www.inciid.org/
8. The Deja News Web site is located at: http://www.dejanews.com