Increasing Your Online Presence to Grow Your Practice

With the proliferation of Internet and web technology over the past five years, there are now many cost-effective ways for mental health professionals to market themselves online. However, each has different benefits, features, and pricing structures. The first step is to identify your goals for getting online. Are you interested in creating a website but don't know where to start? Do you already have a website but want to increase your visibility in the search engines? Are you looking to promote your new book or training video online?

Whether you view it as a marketing tool or educational outlet, creating a professional online presence requires research and smart decision making, similar to any other practice-building investment. However, unlike print advertisements or giving presentations, none has the potential for reaching as many prospective clients and referral sources as the Internet. The following is an overview of web design, Internet marketing, and other tools for mental health professionals who are interested in increasing their exposure online.

Creating a website
The best way to think about building a website is as a long-term real-estate and marketing investment. Buying a domain name (e.g., www.your-name-goes-here.com ) is exactly the same, though much simpler and less expensive, as buying a plot of land. It is yours to own and resell. Likewise, building a website is the same as building a house. You have many different options for choosing the materials and people to help you with the construction and maintenance.

According to the Medical Broadcasting Company (2005), 65 percent of healthcare consumers reported that they use the Internet to research important health topics before and after they visit a doctor. In today's healthcare market, clients not only expect you to have a website, but that it will look professional and provide a comprehensive overview of your practice.

If done right, websites can be dynamic, digital brochures that tell the world every minute of every day that you exist and are open for business. Some other benefits of having a website include: 1) providing prospective patients and referral sources with 24/7 access to learn about your expertise in a particular type of treatment, modality, condition or specialty in mental health; 2) creating a professional online presence that will help build trust, reliability and a well-rounded practice profile; 3) attracting web-oriented clients who are searching for mental and physical health information online; 4) providing visitors with links and education about conditions, treatment options and relevant research; 5) posting forms, job opportunities, directions & maps, answers to frequently asked questions, online polls, your CV and contact information online.

Getting started
The first step is to talk with someone who has website expertise and to start doing online research. Find websites that you like and start deciding on colors, layout, navigation, features, and copy. Next, determine your goals and budget to keep you on track. Otherwise, like buying a car, you might set out for a Honda and end up driving away in a Mercedes. Remember, your practice needs and financial resources may be different than your colleagues, so know your priorities and choose what is best for you.

The essential elements of developing and maintaining a website are the domain, hosting and designer. Purchasing a domain (known as “domain registration”) and domain renewal (either each year or every several years) should not cost more than $10/year per domain. The public still thinks “.com” first so always try to get a “.com” when possible. However, “.com's” are fleeting fast so you may have to be creative in thinking up your domain name. Yahoo.com is the cheapest at $2.99/yr.

Hosting refers to the space, housing materials and technology that will sustain your website. Hosting plans offer tons of different features, but you only really need to pay attention to the disk space and tech support. If the disk space is a good size (e.g., 500-1000 mb), then everything else (e.g., POP email accounts, bandwidth, etc.) is usually fine. Features, such as pictures and video will require extra space. In terms of technical support, make sure it doesn't cost extra and that you will have access to a live person. Many companies save money by forcing customers to submit online trouble tickets when they need assistance, but these can be frustrating if you can't explain the problem. You may also want to ask about website statistics so you can track the number of hits, page views, and unique visitors. And if you plan to build your own site, make sure your hosting platform (Windows or Linux) is compatible with the software you plan to use (e.g., Windows/FrontPage extensions and MS FrontPage). Godaddy.com and ICDsoft.com offer cheap hosting plans, but 1and1.com is the cheapest, starting at $2.99/month.

Overall, the best practitioner websites accomplish three things. First, they are aesthetically pleasing and well designed. There is a sense of balance between the amount of text and placement of relevant pictures and images. Color selection is key; nothing too dark or too light. Second, their navigation system is simple and information is easily accessible. Clients don't want to have to search to learn about you (save all the searching for Google). The most important decision-making information they need should be clearly stated and easy to find. Even sophisticated group practices should strive for a simple navigation system. Here are some commonly used pages: Home, About Me/Us, Services, Therapy Investment, Resources, Getting Started, FAQ's, and Contact. Third, great websites educate the reader. Nothing increases credibility and repeat visitors like education. For example, if you specialize in children, provide parents with helpful information about warning signals, suggested reading material, and how they should proceed if they think their child is developing a behavioral disorder. The more clear and relevant education you provide, the more likely you will earn their trust as an expert. Taken together, if you follow these three guidelines, visitors will be more likely to experience your website as welcoming and professional, which will facilitate them making contact.

Designer options
Now that you have a domain and hosting, who is actually going to build your website? There are basically three options for choosing a designer: doing it yourself with a computer program; doing it yourself with a web-based program; or hiring a professional designer. Recently, there has been a boom in the do-it-yourself online web creation business. Companies (e.g., Yahoo, Godaddy.com, 1and1.com) provide cheap hosting space and online or downloadable software to create and update your website manually. Pricing ranges from $2.99/month to $11.95/month and sometimes includes set-up or activation fees. This is great for clinicians who want an inexpensive and autonomous solution and who have the time, aptitude and patience to learn and navigate new programs. A similar design option, that may or may not include hosting, is to purchase a template-based website (e.g., APA.org, designgalaxy.net, printmania.com), whereby you choose from a template gallery and simply upload your text/images into the pre-formatted areas. Sometimes you can also change color schemes and add/delete viewable sections. If you do it yourself or purchase a template, make sure you have an external domain (e.g., www.your-name-goes-here.com ) and that you submit your website to all the major search directories (e.g., Google and Yahoo). Also, check about access to an image gallery or stock photography because these features are not always included in inexpensive hosting plans. Another inexpensive option is to join an online referral directory such as PsychologyToday.com, which charges members $30/month for one-page of space where you can advertise your practice.

Your last and typically most expensive designer option is to hire a professional to create a customized website from scratch. In the past, this might have cost several thousand dollars, but today you can get a customized website for under $1000 if you shop around. The biggest advantage of hiring a professional is that, besides actually writing your copy, they do all the work so you can focus your efforts on what you do best – treating clients. Customized sites are also great because, if done well, they can accurately represent your personality and practice, and even inspire visitors to call you instead of another practitioner. Your best bet is to find a small design firm or independent contractor who offers hosting space as part of their design packages. Most importantly, however, make sure your designer shares your vision and that you work well together because creating and launching a customized website requires constant communication.

Depending on the package you choose, your designer can handle your domain registration, hosting, design, site maintenance and search engine submission. The best designers incorporate professional business and marketing experience into their design strategies so your website looks good and produces results. Make sure to evaluate work samples to get a sense of their capabilities in design, navigation and creativity. Red flags to be aware of are blocks of shaded text, horizontal scrolling, blurry images, overuse of highlighting, and repetitive formatting styles. As with hosting companies, know about their customer/tech support policy. If you frequently feel rushed off the phone or that your emails are not being answered, you may need to keep looking. In terms of making edits to your site once it's launched, most designers won't charge you if your edit requests are minor and infrequent. However, if you need constant updates, they might ask that you pay a monthly maintenance fee ($25-$75). Another option for $100-$200 per month is a content management system (CMS), whereby you can log into certain sections of your website and make edits on your own. Regardless of which option you choose, make sure to get feedback about your website from both colleagues and non-professionals. The more feedback you get early on, the less time and money you'll spend making fixes later. Finally, make sure the project contract includes a clear outline of development time, features, and pricing. And never pay for the entire website upfront; 50 percent at the start to initiate work and 50 percent upon completion works best.

Some other bells and whistles for your website might include: flash to add movement or animation, such as a rotating logo or fading in/out tagline; e-commerce to sell products and collect credit card payment online; customized contact and treatment forms that clients can complete online, print, and bring to your office; and an e-newsletter subscription box if you plan to develop a mailing list or e-zine and send out regular group emails. And for those interested in conducting online therapy or allowing new patients to submit protected healthcare information over the Internet (e.g., new patient forms), check out Hushmail.com and Cryptoheaven.com which offer secure, encrypted email and instant messaging services. Though their pricing starts at only $2/month, you'll still have to hire a professional if you want their services integrated into your website.

Internet marketing
Similar to any off-line marketing that you may use to generate new referrals, there are several different ways that you can market your website and practice online. Again, it's important to select the right option for your needs based on your budget, technological aptitude, and time availability. Nevertheless, the overarching goal in Internet marketing is to redirect your target audience to your website, where they can learn more and contact you.

Search engine optimization (SEO)
According to a recent online report from Danny Sullivan (2006) of SearchEngineWatch.com, about 70 percent of Internet users at home and work prefer Google and Yahoo, followed by MSN (11 percent) & AOL (7 percent). This means that if you want to be noticed, you must be in Google and Yahoo search. To get your website in their (left column or natural listings) search results, you can either wait for their search robot to find your website, or you can submit it manually for free by using their “Submit/Suggest a site” link. It's also a good idea to apply for a listing in their directories, since their directories feed their search results. Yahoo charges $299 to be listed in their directory, but Google's directory (dmoz.org) is free to join. For a small fee ($25-$75), most designers will submit your website for you using special software which tends to speed up your listing approval time and get your website into many more directories.

However, even if you hire a professional to submit your website to be listed in Google & Yahoo, you still have to get high enough in the rankings to be noticed. The easiest and most direct way to get your website on the first page (very top and right column) of Yahoo and Google is to use Pay-Per-Click (PPC) advertising; Google's program is called “Google Adwords” and Yahoo's version is called “Local/Sponsored Search.” Both PPC optimization programs allow you to bid on particular keywords depending on demand and price. Each time a visitor searches with your keyword and clicks-thru to your website, you pay for the click. The best part about PPC is that you have complete control of your advertising budget and can easily track your return on investment (ROI), not to mention select keywords only for your particular location (e.g., child therapist New York ). However, there is always the risk that you will pay for clicks that do not result in new patients or sales. And, if you don't want to spend the time doing keyword research or monitoring your account, consider hiring a professional.

While PPC helps with the very top and right column search results, securing a top ranking in the left column or natural listings in Google and Yahoo is much more difficult. Google and Yahoo pride themselves on having complex search algorithms that produce keyword and content-relevant search results from the entire worldwide web (i.e., www.). While there is an entire SEO industry devoted to raising websites' ranking in the natural listings, the majority of practitioners cannot afford such services. However, there are things you can do to increase your natural listing rankings and general exposure online. Since Google and Yahoo search prefer websites with lots of outside links, you should offer to exchange links with colleagues and associations. However, this could lead prospective patients astray, so focus on other SEO techniques if possible. Second, write your website copy with lots of keyword and content-rich copy. If you specialize with traumatic brain injury (TBI) patients, make sure to have “TBI” and “traumatic brain injury” as text, not images, throughout your website. Adding relevant articles to your website is also helpful. For those with web design skills, Google Help provides tips to make your website more search robot friendly which can boost your ranking. Another way to boost your rankings and online exposure is to submit online articles, start your own blog, and add RSS feeds to your website.

Submitting articles online
Due to the high volume and rate at which information is shared among search engines, directories, and online news sources, one of the best ways to increase website traffic is to submit online articles. If your target is other mental health professionals, try submitting articles to mental health trade publications with online counterparts, such as Counselor Magazine , Psychotherapy Networker, and National Psychologist . Sometimes, if they won't run your article in their print or online magazine, they will offer you a spot in their e-newsletter or ezine. If you want to market to the general public, try online health portals such as WebMD.com, PsychologyToday.com, Prevention.com, MedicalNewsToday.com, and NYTimes.com. Another way to submit your articles is to use an online PR service, such as Prweb.com, Ezinearticles.com, or Webwire.com. These services range in cost from $10-$619 per submission, but another PR service, Goarticles.com, is free. Knowing how to write the right article for the right news source at the right time is only half the battle; you also need to be persistent and skillful at building relationships with editors and journalists.

Other Internet marketing tactics
In addition to website development, search engine optimization, and article submissions, there are several other ways that you can increase your website traffic and online exposure. First, try to use your hosted email account (e.g., JRosenthal@TherapyMatch.com ) as much as possible, especially when responding to website inquiries or posting to listserves or online groups. Not only does it appear more professional and help with branding, it's a mini advertisement for your website. Second, add your website to your email signature so that every email you send has your contact info and website at the bottom. Third, for newer practitioners, try sending out an email announcement to friends, family, and colleagues. You'd be surprised how often a friend of a friend will eventually find their way to your website and initiate contact. Fourth, if you have the time and material, start your own blog via Blogger.com. Not only is it free, but it's today's fastest growing way to build credibility and expert status in virtually any industry. Plus, blogs are heavily responsible for feeding search engines and great for redirecting visitors to your website. Another easy way to publish online is to develop an e-zine or online newsletter. This can be done for free via your hosting plan by adding a subscription box to your website and using their group email program. Sixth, add real simple syndication (RSS) feeds to your website as a way of attracting visitors and boosting search engine rankings. RSS allows you to display information from other websites in real-time, such as the latest mental health news and research. However, as previously mentioned, adding outside links can work against your intended course of contact and inhibit visitors from calling. Finally, join online groups, message boards, and list-serves via state associations and local community groups. You can find them by searching in Yahoo and Google “Groups.”

As with any solid marketing plan, diversification offers the best opportunity to increase your exposure and reach new clientele. The fact that you are interested in websites and Internet marketing means that you are headed in the right direction. In the past, clinicians believed they could launch and grow their practice without marketing. However, due to increasing competition among disciplines and decreasing reimbursement rates from insurance companies, the Internet is becoming increasingly popular among mental health professionals as a viable and cost-effective practice-building resource. So if technology is not your bag, find someone you trust and get started because new patients are just a click away.

Joshua Rosenthal, MS is the president of TherapyMatch, LLC, a practice-building company that provides custom web and print design, merchant accounts, and online networking solutions for mental health professionals. He can be contacted with questions at jrosenthal@therapymatch.com .

Sections of this article were reprinted with permission from the Independent Practitioner division of APA.org.

References
Medical Broadcasting Company (2005). Internet overwhelmingly viewed as most trustworthy medium for health information according to new consumer survey. Retrieved on June 28, 2005 from http://www.mbcnet.com/news/2005/trustworthy.html

Sullivan, D. (2006, January 24). Nielsen NetRatings search engine ratings. SearchEngineWatch.com . Retrieved on August 5, 2005 from http://searchenginewatch.com/reports/article.php/2156451