The brilliance and big problem of Google Health

Google Health launched yesterday to give patients a simple way to maintain a personal health record. It will probably fail, despite Google's billions and drugstore partners, because physicians have no market incentive to share information.

To understand the problem, let's first put a human face on it. The photo above is our mom, a cancer patient being admitted to Dartmouth-Hitchcock, one of the best hospitals in the United States. The procedure was about her 25th at this hospital, yet she was asked to fill out a form listing past surgeries and current prescriptions.

Mom is sharp, but she takes about 30 pills a day and her body has more scars than an Iwo Jima vet. If her surgical success depends on her personal memory, well, that's not a great idea.

Now we won't go off on the stupidity of this; Dartmouth is a fine hospital and is simply doing what physician groups do around the United States -- using isolated information systems that don't talk to anyone outside the walls. The problem is physicians have reason not to share.

You see, hospitals are just like the United States Postal Service. USPS makes a lot of money from some customers (businesses who ship packages) and loses a boatload of cash on others (Aunt Ginnie who needs letters delivered in rural Oklahoma). Physician groups have the same customer value issue. They make a huge profit from some patients (knee replacement, bariatrics) and lose money on other patients (inner city emergency care). Hospitals have to provide both levels of service, so it is vital that they attract lots of high-profit patients to offset the losses elsewhere.

Sharing information via a personal health record would disrupt that model. What happens to a surgeon who "owns" your personal records if suddenly those records are easily transported to any other expert in the country? Think how much the competing surgeon groups would love to have a quick, complete history of your health.

And this, dear patient, is why unified health records do not exist in the United States.

There is hope. Other industries, finance in particular, have built unified views of customers because they realize sharing information outweighs the costs. Your credit score is a perfect example of every lender and transaction being recorded instantly and shared, to help banks offset the risk of giving loans to deadbeats. But this system only works because the market benefit -- avoiding risk -- outweighs the market cost -- giving away competitive information.

Pharmacies are the first to start building unified records; MedCo and RxAmerica have partnered with Google, because the unified view of a patient could make ordering pills a lot safer. But hospitals and physician groups still have little incentive to join. The only hope is that some hospital somewhere will realize giving patients control over their information may be a competitive advantage -- a new way to help that sets them apart.

For now, Google Health invites consumers to upload and manage their own information. Good luck remembering that tonsillectomy, and downloading the file to your surgical team next time you're bleeding in the emergency room. We love Google's initiative and hope it succeeds. But the reality is for many years more, your docs will ask you to fill out a form.

Google CEO Eric Schmidt gives a brilliant view of the problem here:

Scrubbing with Verve: How the green movement motivates good design

Spring and green are in the air. Norway just made news by announcing it would be carbon neutral by 2050. The New York Auto Show this week, filled with depressed automakers who realize Americans are not buying high-margin gas-guzzling SUVs and may retrench from buying cars at all in our home equity hangover, had one bright spot -- sexy designs of small, nimble, efficient cars like the Ford Verve. One glance and you think, finally, designers are getting green right.

Our favorite environmental push, though, comes from Deirdre Imus, who founded dienviro.com with Hackensack to educate the public about how to control environmental factors such as mercury, lead and tobacco that may trigger cancer. Imus launched a line of home cleaning products, called Greening the Cleaning, which scrub scum with plant-based enzymes and none of those toxic fumes that require a gas mask.


This is a brilliant move, because the shelf-space for green environmental cleaners is still pretty empty, and Imus could rapidly build momentum even as the big CPGs catch on. Proceeds support a 4,000-acre cattle ranch in New Mexico for kids with cancer.

All of which seems a bit logical. Producing products that are beautiful, efficient, non-toxic, and give something back to the world. Can you hear the marketing opportunity for your own brand?

This just in: Cell phone that runs on blood

OK, this is a bit icky, but you knew machines would eventually meld with people. Engineer Jim Mielke has designed a wireless keyboard display that slides under your skin and is powered by blood (which flows into and out of a coin-sized fuel cell). The display includes an on-off button, a touchscreen interface, and microscopic spheres that change color from clear to black -- your iPhone meets the tattoo. The designer claims the device could actually have medical benefits, such as monitoring blood disorders and warning you of pending health trouble.

Imagine the future.

Hon, hold on one moment. I have another call on my other arm.

Please turn off all cell phones and body parts during the motion picture.

Son, have you been drinking? Let me see your wrist display!

The device was unveiled at the Greener Gadgets Design Competition, where you could also find degradable phones, camping umbrellas that produce solar energy, and, our favorite, the powerstrip with small foot ejector pedals (who wants to bend to get the cord?).

Of bariatric searchers and women's knees

Have you heard of gender-specific knee replacement? It's a marketing push by some in the orthopedics industry, and it provides a fascinating look at how direct-to-consumer marketing in health care is growing stronger every year -- first with pills, then with screenings and treatments, and now implants.

Consumer healthcare communications have been around for more than a century (Coca-Cola started out as a pharma pitch with 5 ounces of coca leaf per gallon of syrup, the same root source of cocaine), but really took off in 1997 when the FDA began allowing pharma firms to broadcast specific drug names to the U.S. public. Pharma had always been aggressive; there are about 100,000 pharmaceutical sales reps in the United States calling on 830,000 healthcare professionals who make prescriptions. But advertising spending skyrocketed after the rule change from $700 million DTC in 1997 to $4.8 billion in 2007.

Some critics don't like this, saying healthcare promotion drives up health costs, stimulates unnecessary demand, and disrupts physicians' practices and expertise as consumers walk in demanding a purple pill. But these critics also miss two parallel trends that cannot be stopped -- the rapid adoption of internet use to find solutions, and the rapidly aging Baby Boomer generation tipping into retirement.

Pew has reported that 80% of U.S. consumers with internet access search for health information online every year. We tested this in one hospital market recently, and ran Google ads for two days for search terms related to bariatrics. Hmm. Consumers searched on these terms 6,706 times within two days -- only within the hospital's catchment area -- and the ads generated 55 visits to the test web site at a cost per click of $1.27.

Let's see. If 8% of the consumers who reached the web site filled out a lead form, that would be $15.87 to identify a potential patient in the market for surgery. We're not sure what the margin is on bariatrics operations, but it's probably higher than $15.87.


Which brings us back to artificial joint replacement. Some ortho groups are promoting gender-specific knees, since men and women typically have different size knees and so the implants need to be tailored to fit exactly. Others might say the reality is knee replacements already come in a wide range of sizes, and it doesn't matter if your leg is male or female -- the orthopedics surgeon will get the exact size parts for your leg anyway.

Does it matter? Consumers with knee problems need help. Surgeons who offer this practice need to market their services. By using media to promote the surgery, and using a sexy offer -- hey, parts that fit my gender! -- surgeons are building patient volume while educating the public that help exists for joint pain.

Like it or not, healthcare marketing to consumers is a genie out of the bottle. The question for health providers is: Are you letting the millions of consumers searching for health solutions find you?

Add 'microsite' to your 2008 to-do list

One of our goals in 2008 is to encourage clients to rethink their web landing pages. As media planners, we focus on the front end of advertising -- reaching specific demographic groups most likely to want your product, for example, men age 35-44 who are weekend warriors likely to blow out a knee and need orthopedics, or the women in their lives who guide the majority of healthcare decisions.

We don't build web pages and so have no vested interest in saying this: But let's face it. Your web site probably needs work.

The challenge with advertising, especially advertising online, is that you can lead a prospective patient or customer to your web site -- but what happens when they get there? Many web sites are ill-structured to convert a visitor to a qualified "lead." And web sites are not always easy to modify. Smaller businesses don't revamp web sites often, and large bureaucracies often find changes mired in Steering Committee or IT meetings.

The quickest solution is to build a microsite, such as the bariatrics site above. This concept is simple -- build a small, nimble subset of your brand, focus it around a specific customer or patient need, and launch quickly. Microsites have several benefits:

+ You can typically complete the entire project within 6-8 weeks
+ You avoid nasty internal debates over how to improve the current vast main site
+ It extends your reach on the internet, creating more "points of entry" for customers
+ You can rapidly add a visible lead form -- to collect the visitor's name, email, phone and ZIP -- to build a prospect database
+ You can show your boss, hey, look, we actually did something this year (Admit it. That would feel good.)

Some marketing executives shy away from this concept, certain that their master web site is enough. This isn't the case. If you pull a report of the first pages visitors hit within your web site, you'll find the majority are landing deep inside -- because most web users start at Google, and Google's search engine throws them past your home page into the innards.

A microsite replicates what people want when using the internet -- finding information rapidly about what they are searching for. Worth considering in 2008. Plus, it makes internet and media planners like us much happier when the leads we deliver to your web site find a simple way to give you information, so you can turn them into customers.

Glenn Beck to melt the brain of hospital CEO

Or something like that. Apparently CNN talk guy Glenn Beck had a botched surgery and posted a video on YouTube lashing out at a hospital in the Connecticut or New York region, dang, while he's still in the bed. Beck says he's debating "naming names" when he returns to the air Monday, and may tell stories that will "melt the brain of the CEO of this hospital."

Thoughts:

1. Beck, we really liked you back when you were just a DJ in Hamden, Conn.
2. Sorry about your back.
3. Geez, we're glad we're not the CEO of the hospital you're gonna name.
4. This whole democratization of video on the internet is getting really scary.
5. Somebody, get PR on the phone FAST.

Danbury Hospital's brilliant, but hidden, heart web site

Speaking of Plaid, they recently helped Danbury Hospital in Connecticut launch a cardiology micro web site with a blood pressure and exercise log that allows potential patients to track their risks, and progress, between doctors' appointments. The site works brilliantly to identify potential patients, differentiate the hospital, build a relationship between visits, and establish switching costs. It's also frankly helpful to give patients a simple way to track their health on a timeline continuum, vs. the point checks physicians typically make months apart.

Too bad no one can find the web site on Google, since the hospital marketing team apparently isn't running pay-per-click Adwords. Search for "heart care Danbury" and you get a series of press releases but no link to the main Danbury Hospital heart sites:


Geez. You also see none of Danbury Hospital's competitors are advertising here, either. NO ONE is managing Google in this space in western Connecticut, and the first cardiology docs who do will rule for pennies a click. Please, please, health marketers, print out the Pew study and take it to your next board meeting -- and explain to them that today, consumers start searching on Google, not on yourhospitalname.org.

Pew reports 113 million (that's right, MILLION) Americans search for health information online each year, and most start on a search engine, not a specific web site. For now, few will find Danbury Hospital.

UPDATE: Danbury Hospital marketing team, if you'd like to fix this problem, get a credit card and sign up directly at Google here. Be sure to select the geo-targeting option, pick 100 words related to cardio, and link to the new site. It will take you about 10 minutes, and for $20 a day, you can put your heart site on the top of Google's rankings 40 miles around Danbury to start getting heart patients. Merry Christmas.

What will Google do with a time machine for world health?

The concept is brilliantly simple: The best way to understand data is to animate it so you can watch trends over time. Go to Gapminder and you can plot variables against each other, and watch bouncing balls shift and wobble as the years roll by.

Gapminder is really Trendalyzer, software developed by Swede Hans Rosling to plot world health trends. Google purchased the software back in March, and we're waiting to hear if Google will do anything with it other than juice its web analytics tools. Rosling was just honored by Discover Magazine as a Notable Scientist of the Year.

The way data jumps off the page is quite startling. The above screen shot, for example, is one part of an animation showing how faster economic growth in China vs. India correlates with increases in carbon emissions. The software also helps assess if there is no connection between two variables; liberals in the United States will be pleased to find that increases in military spending appear to have no impact on U.S. fertility rates.

Until Google releases an update, healthcare policymakers can be tempted with limited data sets here.

Mayo's new web site focuses on search, not docs

We admire the courage it must have taken in board meetings for someone at Mayo Clinic's marketing group to push through a web design that didn't muck up the home page with millions of pieces of arcane jargon from each medical service line. The products are missing from this home page; you don't see the words oncology, bariatrics, radiology, orthopedics, or cardio anywhere. Why? Because in the real world, patients don't talk like that. Patients just want to find a doctor or a cure.


The brilliance of this new site design is that Mayo has streamlined the information down to three points of entry: find a disease, find a location, or request an appointment. Push is gone (newsletter whacked), and pull is in. Someone at Mayo must have read Pew's research pointing out that 113 million Americans search for health-care information online.

Let's look more closely at how Mayo helps users search. Compare the clarity of the alphabetical search menu for disease information, above, with the prior site from back in January 2007:



Mayo removed extraneous elements to make search easier. The newsletter is now gone, and Mayo also removed those crowing, all-about-us PR statements such as Top 100 logos. (Memo to regional hospital execs: Most patients don't know there are more than 100 hospitals in the entire nation.) Mayo still runs two web sites, mayoclinic.com and mayoclinic.org, a curious dual front-page approach given that 66% of internet health searchers begin typing at a search engine and are then thrown deep into the bowels of a web site anyway. Most users of Mayo content will never see either home page.

No matter. We admire Mayo for the courage to remove technical terms and make search simple. It's the equivalent of removing a crowd of shouting physicians from the hospital lobby to help patients get through the front door.

In central Africa, the doctor will not be seeing you soon

Brilliant poster by creative shop EuroRSCG of Amsterdam, Netherlands, showing a world map of patient-to-doctor ratios in each country. The mission was to educate the Dutch people about how fortunate they are in health care, plus raise awareness about the urgent needs elsewhere. Michael Moore would appreciate the top-performing country in terms of doctors per patient population: Cuba.

Paging Dr. Google: Why physicians need search advertising

About twice a month we get a phone call from a doctor wondering how to advertise her practice or hospital in her local area. She usually has a preconception -- radio! cable TV! -- and as our first step, if the medical practice has a small marketing budget, we recommend Google search engine ads. These Adword campaigns can be targeted locally (and agencies such as Mediassociates can run the campaigns using thousands of keyword search terms to drive down costs).

Alas, we usually get a skeptical response: Nope. Listen, I've been a doctor for 30 years, and I don't believe that consumers will find me on the web. Or, Look, I already have a web site. Isn't that enough?

Unfortunately, both answers are wrong. So we're sharing, again, the Pew Internet & American Life Project's study on how U.S. consumers are flocking to search engines for health care information. Last fall Pew found that 8 out of 10 consumers with internet access use the web to research health care information, and of them, 66% of health seekers started at a search engine vs. only 27% at a specific health-related site. On a typical single day, about 8 million Americans are searching for health-care information online.

And then the data got really interesting. The table below shows what these consumers are looking for. Note the top category -- specialty services, which are usually the highest-contribution practices within hospitals.


Some health pros recognized the trend early. Big pharma has gone DTC for years, with ad spending up from $700 million in 1997 to $4 billion in 2004. 2007 estimates are as high as $12 billion. Bariatrics programs in particular are very aggressive on Google. But we know that inside the board rooms of hospitals, skeptics still think physician referrals drive 99% of patient volume.

So we tested it. Back in February of this year, we ran a Google search campaign for terms related to radiology in a 15-mile driving radius of Ridgefield, Conn. Radiology is one of the health-care specialties that has supposed low consumer interest, and many hospital marketing execs will argue vehemently that only physician referrals drive volume. Guess how many times consumers searched for radiology in one month on Google in a 20-minute drive around one radiology facility? 18,000.

We invite physicians and hospitals to think beyond their walls, their web site, and their physician feeder networks. Yes, physicians give specialists referrals. Yes, your hospital probably just spent $200,000 to relaunch a fancy web site.

But many consumers of health care aren't researching your specialty from a doctor's office, and they are not typing in your hospital URL. They are sitting in their bedroom in front of a computer, thinking, Oh my God, I may have cancer, and they are punching obscure medical phrases in to Google to try to find help. It's happening all around you, doc. Please get on Google and let these patients find you.

The madness of crowds, or why doughnuts might be good for you

You know how kids should have their tonsils taken out? NYTimes points out that not all common beliefs are true, even among experts, due to "information cascades." This is a bit like viral marketing, or urban legends, in which people tend to draw conclusions based on believing other influential people around them.

For example, back in 1988 U.S. surgeon general C. Everett Koop declared that fatty food was as horrible for your health as smoking, and that a diet high in fat led to early death. The message was picked up by marketers, who promptly focused in the early 1990s on "no cholesteral" claims. Trouble was, this wasn't true. Researcher after researcher tried to prove this hypothesis to no avail. Americans have always had fatty diets; our first settlers consumed large portions of meat. Dr. Koop had been swayed by a few reports, which in turn created an information cascade.

There are a lot of messages in the market that cascade like this. In the 1970s, most children had tonsillectomies, because physicians cascaded this message to their peers. Medical research later showed that this is often unnecessary. Today, you can see the viral messages spread about global warming, trans fats, tainted meat products, urban gangs flashing headlights at your car, and Hillary Clinton's horrible laugh. Some of the messages are true, and some are not.

Scott Adams, the genius behind Dilbert, posts a further take on the trouble with truth in his blog. It's a great Saturday morning read, with a cup of coffee and a doughnut.

Microsoft HealthVault finally addresses lack of shared data

One of our parents is dying from cancer. Call it what it is. She's a wonderful woman, and on a recent voyage to the hospital we watched her pull out a long list of prescriptions she's been taking for two years. No current doctor seemed to know what all that stuff was. Sure, computers at CVS were checking something, but man -- all those pills?

Microsoft today launches HealthVault, a new portal for finally managing the complex health records for you and your family. We won't get all Michael Moore on you, but we do predict this could be huge. Eighty percent of Americans with computers search for health information online -- about 113 million people each year. There are 8 million searches for health info every day in the U.S. And we ain't getting any younger.

It's brilliant, when you think of it. Microsoft runs 90% of the software on computers across the globe. There is now no single network to control your info (though regional hospitals, Wal-Mart and some insurance cos try). Microsoft will tie this in to a search engine -- the platform where advertisers can bid in -- and new software that can do life-saving things like import data from heart-rate monitors. Word is the American Heart Association, American Lung Association, and Johnson & Johnson are jumping aboard.

Course, we got a ways to go. About 80-85% of physicians in private practices don't keep electronic information. Hospitals fall short. Privacy advocates will howl. It will be many years before you have a single card, or chip, or click with all the data you need to save your life and prevent you from overdosing. Until then, mom carries her notepad.

Big pharma lessons in the media mix

The recent tussle over an FDA bill which could have restricted some direct-to-consumer advertising from pharmaceutical companies has a lesson, buried within, for local hospitals or health awareness campaigns. WSJ reports that of $5.3 billion in pharma ads in 2006, 55% was spent on TV, 36% on magazine, 4% on newspaper, and only 2% on radio and outdoor.

We find this interesting because regional hospitals often spend heavily on TV during branding campaigns, and then go deep into outdoor and local newsprint ... while not touching magazines. Pharma loves glossy print. Local hospitals don't. What gives?

Pharma marketers are smart. They pick TV because older demos "over index" on heavy TV consumption, and diseases are a function of age. They pick magazines because of all media categories, women -- who make the majority of healthcare decisions around the home -- over index on magazines. If you work in health care communications and don't have magazines in your plan, it's worth revisiting -- you could test glossies with unique 800 numbers, zone the buy in tight geographies without going national, and potentially have a new home run in your media plan.

And as for the old, old argument from some hospital execs who say advertising doesn't work in influencing physician referral patterns, we say this: Ask pharma why they spent $5.3 billion last year talking to consumers. And then ask your doctor.

Viral marketing for viral healing

The Centers for Disease Control and U.S. Department of Health and Human Services are rolling out two fall campaigns encouraging consumers to prepare for the flu -- both small-scale winter sniffles and potential for large-scale pandemic.

Mediassociates was honored to participate in the planning, and while we usually don't tout clients at the risk of being self-serving, saving lives is a good cause. It's worth noting the HHS has put up a resource-rich site called pandemicflu.gov which gives away tons of content to health care professionals, policymakers, and the media, hoping that they will cascade the message. It's such a simple idea, and yet powerful -- rather than do all the advertising yourself, what if you use the media and the web to encourage others to share your message? Most businesses have passionate advocates. Give them the tools to tell others.

It's nice work (and no, we can't take credit for the site). Check it out, get a flu shot, and stock up on bottled water. Be safe this winter, friends.

Thanks go to the nonprofit Academy for Educational Development, human and social development marketers, for leading communications on this.

Avoid brand new mistakes

Is your organization rebranding? Make sure you address all those business units under your umbrella carefully. We love this discussion of Google vs. Microsoft brand architecture. The point here is that consumers can only remember a few brands in each product category, so perhaps it's best to keep the brand architecture simple. Sub-brands can work, but they require focus and restraint.

First, consider Microsoft's approach to brand architecture.


We think Microsoft tends to obfuscate their branding, with numerous arcane names-within-names that each compete for customers' finite attention span. On the little brand reception ladder in each of our heads, we only have so much room for names in one product category. Give us too many names, we'll lose interest.

Now, look at Google's branding:

Google uses a major brand name, followed by subsets each with a clear descriptor of the consumer need. If you go to Google and want news, you can find it easily at Google News. No muss, no fuss. Note, however, that Gmail pops out as a separate entity. Google recognizes that email is a huge component of computer users' needs, and so elevated this "brand flag" to its own name.

Brand simplicity isn't always the right solution, but brand balance is. For example, a hospital's orthopedics practice meets a huge subset of specialized needs -- bad backs, sports medicine -- and so might be elevated to a sub-brand under the hospital umbrella. This would make sense, because people seeking specialists for spine or joint problems want to go to a group that focuses only on that, and their needs are very removed from the perception of a general hospital. But if a hospital tries to create a sub-brand name for every service line, consumers are just gonna get confused.

Pick and choose your brand flags carefully, because the media plans that execute against each name will need focus -- and consumers will only see the few brand flags that make sense.

Biomed scientists target themselves

Health care professionals, biomed scientists, grad students and other brainy types have a hard time keeping abreast of the 16,000 new science publications indexed by PubMed every single week. The internet, crowded with commerce and YouTube, makes it hard to sift through the abstracts and papers. How to keep up?

SciVee has launched a brainiac site with the science class version of YouTube: researchers post video introductions with the text of their papers, users easily find digestable content, and the web community (one hopes) makes the most brilliant research float to the top. SciVee was thought up by Philip Bourne, prof at University of California at San Diego, with NSF seed funds and major wattage from the UCSD Supercomputer Center. No word yet on how or if advertisers can crack in to this sweet audience, but we're sure they're trying.

If you want to know how Arabic medical texts addressed pericardial pathology 900 years ago, SciVee is your thing.

If your customers rarely call you, go outdoors

We were on the phone a few years back with the head of marketing for a major washing machine manufacturer. The guy had a problem -- washing machines tend to work very well for more than a decade, but when they break, consumers rush out and buy a new one within 48 hours. His question: How in the world could he market in such a low-interest consumer category when customers never think about his brand, until suddenly and urgently they do?

We describe such customers as having high modality. It doesn't mean your product is bad or that your customers don't like you. It means your product may be so good, or such a simple subscription model, that consumers don't think about it often until some distant switching point in the future.

If you have customers who don't call often, outdoor should be in your media plan. It works.

Billboard gets a bad rap by some marketers who don't understand it, and say things like "outdoor is just for branding." We challenge that opinion with some raw numbers: Billboard is the second-fastest growing medium in terms of total advertising dollars in the U.S., with share of ad spending up exactly 300% from 1996 to 2007. After the internet, no other ad channel is growing so quickly. By comparison, newsprint ad spending is down 25.6% in the same period.

Major advertisers wouldn't triple their spending in a category unless it was working. Look at OAAA's list of top billboard advertisers and you'll find two patterns: companies that try to steer you off the next highway exit (amusement parks, McDonald's), and organizations such as hospitals, cell phone carriers, and insurance companies where consumers need them only very infrequently.

Why? Billboards build cheap buzz. Companies who have consumers with high modality need to intercept them at a low-cost hum level. American consumers are spending more time in cars, and less time with traditional media as the internet captures attention inside the home. Outdoor has gotten its act together with cleaner formats and new digital boards. Outdoor is the cheapest way to provide a low-level hum.

Outdoor does have problems -- it's difficult to measure response, DEC metrics don't exactly match up with the media math in other channels, bad designs or locations can spoil the impact, and billboards work best when integrated with other channels, making results, yes, even harder to measure. But if customers love you only infrequently, try meeting them in the great outdoors.

A product launch we hate to love

HeadOn is still giving us a headache with their on-your-face ad campaign for a topical headache treatment that looks a bit like a glue stick. Seth Stevenson noted a year ago that the thing looks like a viral prank -- 10 or 15 seconds of TV spot with the product name repeated over and over again. A year later, it's still running on cable. Egad.

Yet there is something there. Apparently HeadOn used focus-group tests for numerous formats and found that maximizing repetition blew away any other ad approach in, yes, getting the message to stick. HeadOn has updated the spots with a chorus line of voices in the background, sort of like the reverb echo in my head. Short spots, cheap cable buys, and a staccato pulse have made HeadOn break through. Talk about reaching for frequency.

It's Friday. Pass me the glue stick.

Paging Dr. Who? Dr. Who?

Doctor who? That's the question healthcare consumers will have if they can't find you. We are constantly amazed by the number of healthcare organizations reluctant to use the Internet to help consumers find them.

By internet, we don't mean your web site. Sites are great, and we love them. But web search is what brings home the bacon. Eighty percent of Americans use the internet to search for health information, and of these 66% of consumers begin at a search engine vs. only 27% at a specific web site. Specialists in elective surgery such as bariatrics have been the groundbreakers on the internet, but conventional wisdom inside hospitals has said that physician referrals drive the majority of patient volume, so why bother?

Hmm. We ran a few Google tests for supposed low-interest consumer categories such as radiology, and found 18,000 impressions on a test ad within a 15-mile radius in a single month. Pause. Think. Impressions in pay-per-click mean that the Google text ad was served up on the screen only after the consumer had typed one of several specific radiology phrases -- MRI, radiologist, breast screening -- into the Google search window. 18,000 consumer web searches. In one month. For radiology. Within 15 miles of a small town in Connecticut.

Conclusion: If you think physician referrals drive all healthcare decisions, you are wrong. The pharma marketers have known for decades that consumers make up their own minds (Purple Pill, anyone?), and hospitals and small-town practitioners are just catching on. The cheapest way to advertise to consumers is to catch them on Google, when they are already looking for you. Pay-per-click campaigns can be targeted to tight geographic areas and even single PCPs can test the channel for a few hundred dollars.