Dental Email Marketing and the Pitfalls of Assuming

The old joke about dentists having bad teeth applies to marketing agencies, too.

The thing we can’t see about ourselves is why a business may not choose to use a particular marketing tactic.

A company doesn’t use social media? They don’t know how!
A company doesn’t blog? They don’t have time!
A business doesn’t use email marketing to gain and keep new clients? They must not know about the fantastic ROI!

We assume a lot about businesses and marketing.

Most of the time our assumptions are correct.

However, when they’re not, we look like fools.

The classic 70s movie Bad News Bears contains a scene that impacted me hard when I first saw it.

The Bears coach (later replaced by Walter Matthau) is lecturing his players on his coaching philosophy. He writes the word ASSUME on a chalk board.

Never ASSUME he said. Whenever you ASSUME, you make an ASS out of YOU and ME.”

Sometimes I lose sight of this advice.

Does a marketing agency perform due diligence?

I recently paid a nice young man from Vietnam to prepare a set of SEO keywords and content map for terms like email marketing.

He knew about my strong interest in marketing to dentists, and so found out that dental email marketing was an excellent keyword for me to pursue.

In a content map he linked to several articles published by competitors that focused on dental email marketing. Each one addressed the hows and whys of email marketing for dental practices.

I dug into each article with gusto, looking to find our unique spin, our special perspective on email marketing for dental practices.

After all, email marketing seemed like a no brainer for dental practices.

Reasons why our competitors believe dentists should use email marketing

  1. Cost effective
    1. ROI of 4300%
    2. For every dollar you spend on email marketing, you can estimate a $32 return.
    3. McKinsey & Co says emails are 40 times better than social media for acquiring new customers.
  2. Excellent opportunity to cultivate new patients.
  3. Increases website traffic.
  4. Maintains ongoing relationships with current patients.
  5. Positions you as an expert.
  6. Good opportunity to encourage referrals.
  7. Keeps patients up to date on new services and promotions
  8. Ripe opportunities: only 20% of North American dental practices engage in email marketing.
  9. Email helps you stay top of mind.

Look at the percentage of dentists who use email marketing in North America: 20%.

That’s low. Absurdly so when you consider that dentists face high-stakes dental practices as they try to gain a new customer.

But I, like other marketing agencies, assumed the low number grew out of a lack of understanding. Dentists, or so we marketing agencies believed, don’t know about the wonders of email marketing.

I pushed ahead with my original article. I sketched out more subheadings for an expert guide, subject headings like “how create a target audience” and “types of dental email marketing.”

Surely I’d be able to pitch our services to many of the dental practices in the Ann Arbor area. Surely some of them, I reasoned, might want to do business with us.

How hard could it be? If none of a dentist’s competitors in my chosen zip codes use email marketing, wouldn’t that offer a competitive edge for a client?

So I kept digging and finally discovered why the email marketing usage rate nationally is so low.

As it turns out, email marketing by dentists is governed by HIPAA rules in the United States.

If a dental practice followed the advice I’d planned on publishing they would probably violate HIPAA rules.

How HIPAA impacts email marketing for dentists

HIPAA governs what types of patient information may be transmitted by telecommunications.

Violating HIPAA costs dentists (and other healthcare providers) money. Every violation may result in a fine.

HIPAA (Health Insurance Portability and Accountability Act), also known as Public Law 104-191, is a law passed in the United States that protects and safeguards the privacy of medical information.

HIPAA has two main purposes: to provide continuous health insurance coverage to workers who switch jobs or lose their jobs; and to standardize the electronic transmission and transactions of patient information for security and protection of patient information.

This law was primarily passed due to a number of data breaches concerning health information in the late 1990s and early 2000s.

Only secure, protected portions of the internet may be used

Patient history information (PHI) and patient identifying information (PII) may be sent from protected portions of the internet only.

PHI consists of chart and ledger notes, x-rays, periocharting, disclosure records (when something was released to a specialist or insurance company), lab test results, billing and planned treatment.

It makes sense that this type of information must be sent in a protected manner.

PII gets a little trickier. PII is anything that can be used to identify an individual. In most states, this is first and last name, date of birth, social security number, a photograph of the patient (face photo) and email or any combination thereof.

Email is on the list because it’s pretty easy to find a first and last name when you put an email address into a search engine.

A possible future diagnosis is protected by HIPAA

HIPAA states that any possible future diagnosis or identifying characteristic can only be sent from the protected internet.

So any SEO or organic marketing for veneers or teeth whitening that offers a lead magnet in exchange for a prospect’s email address probably violates HIPAA.

If the email address is stored with a mainstream email service company like Mailchimp, which explicitly states that it can’t and won’t protect data transmission according to HIPAA requirements, the minute a prospect goes to the dentist for veneers, the practice has probably violated HIPAA.

For our interests, general email is considered insecure, mostly because email service providers can’t guarantee encryption through both sending and receiving email.

Gmail is considered non-HIPAA compliant. So is Applemail.

In addition to Mailchimp, Constant Contact and Send Mail are considered noncompliant.

For an email service to be considered compliant they must guarantee that they will take responsibility for any security breaches.

They don’t want that hassle and the added cost of two-way encryption.

So they choose to remain HIPPA noncompliant.

In fact, Mailchimp says don’t send anything information that might remotely be construed as patient related through their service.

The only email marketing option for dental practices when they use a service like Constant Contact is to send very general marketing emails.

Types of general marketing emails allowed using traditional email marketing software

  1. A mass email to all practice clients explaining a particular type of procedure or service.
  2. A mass email offer for a discounted service.
  3. A mass email introducing a new hygienist.
  4. A mass email stating the dental practice is now accepting x or y insurance.

Each of these emails targets all clients in the practice.

No specific information regarding past, current or future treatment or diagnosis is tied to a particular patient or group of patients.

It is within HIPAA guidelines to send an email to all practice members describing a root canal.

It is a HIPAA violation to send a targeted email to a smaller segment of clients who have crowns and are thus more likely to require a root canal at some point in the future.

HIPAA protects patient information for ALL future diagnoses.

Marketing agencies, don’t ASSUME!

When positioning marketing services to a particular field, especially within the healthcare field, it pays to do your research.

My competitors hadn’t, and it showed. Offering advice without understanding the broader context just makes those of us in marketing look like fools.

I suspect dental practices don’t get much ROI using traditional email marketing providers. Why would they?

If a customer has a problem with their teeth or jaw, their dentist will explain it to them at the time it’s happening.

A mass email explaining a procedure I may never have isn’t helpful. If I’m not interested in the particular procedure, I’ll hit delete, as will dozens of other patients.

Unopen and spam rates may go up as a result. Why pay a monthly fee for what will turn out to be low return on time and money?

One possible option for dental email marketing

Jotforms offers HIPPA-compliant forms, which provides a possible avenue for dental practices to capture prospect data, download the form data as a CSV file or MySQL file and import it into their dental management software, if their software has an email marketing feature add-on, like Dentrix.

If their software does have an email marketing feature, then a dental practice might consider organic and free marketing for a particular area of practice interest or expertise, like veneers.

SEO terms might bring a prospect to a landing page with a lead magnet with an easy win, maybe something along the lines of “a quick home remedy to temporarily reduce caffeine stains.”

Language above the form discusses HIPAA and states Jotforms is HIPAA compliant and — this is very important — the magnet will arrive within one business day because the practice uses a different system to protect the prospects medical information.

I’d encourage a dental practice to turn HIPAA requirements into wins for the prospect. Slow = good. We’re looking out for you, and so on.

Finally, the prospect enters information on the jot form. A thank you message appears, again reminding them that the practice takes their confidentiality very seriously, and so.

Collaborating on the patient journey

Paubox Marketing offers the only HIPAA-compliant email marketing service. (We’re not affiliated with Paubox in any way).

They make a strong and important case for HIPAA-compliant email marketing before, during and after a particular patient journey.

Journey-based email marketing allows a dental practice to begin cultivating new patients before they need treatment.

Before a patient needs treatment a dental practice might leverage SEO, a landing page or two and jot forms, to attract a new customer in a legally correct manner. The protected information then gets uploaded to a service like Paubox, initiating a more targeted, legally compliant customer experience.

Again, don’t assume

Marketing agencies need to adopt a more skeptically attitude as they attempt to attract customers.

If a marketing use rate is low, why is low? Assume the client doesn’t know at your own risk.

Isn’t always better to assume we’re needing ongoing education about our client’s businesses?

Lead from a position of curiosity and humility.


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