Originl rtile Orthodonti mrketing through soil medi networks: The ptient nd prtitioner s perspetive Kristin L. Nelson ; Bhvn Shroff ; l M. Best ; Steven J. Linduer d BSTRCT Ojetive: To (1) ssess orthodonti ptient nd prtitioner use of nd preferenes for soil medi nd (2) investigte the potentil enefit of soil medi in mrketing nd ommunition strtegies in orthodonti prties. Mterils nd Methods: survey ws developed nd rndomly distriuted to orthodontists vi the merin ssoition of Orthodontists nd to ptients/prents vi privte prties throughout the United Sttes. Prtiipnts were sked to nswer questions relted to their use of soil medi nd their pereptions of the use of soil medi in the orthodonti prtie. Results: Of the prtiipnts, 76% of orthodontists nd 89% of ptients/prents use soil medi. Furthermore, Feook ws the soil medi pltform tht ws most preferred. Soil medi use ws more ommon in femle nd younger dult prtiipnts. Orthodontists posted informtion more often in the morning (40%) nd fternoon (56%), nd ptients/prents used soil medi minly in the evening (76%). The most ommonly used mrketing strtegies in the orthodonti prties were soil medi (76%) nd prtie wesite (59%). Soil medi nd prtie wesites were positively relted with new ptient strts (P 5.0376, P 5.0035, respetively). Conlusions: Most orthodontists nd ptients/prents used soil medi. Soil medi my e n effetive mrketing nd ommunition tool in n orthodonti prtie. (ngle Orthod. 2015;85:1035 1041.) KEY WORDS: Orthodontis; Soil medi; Mrketing INTRODUCTION The introdution of soil medi hs revolutionized the wy people intert through the soil We. 1 Soil medi is defined s online tehnologies nd prties tht people use to shre opinions, experienes, nd perspetives with eh other. 2 These wesites llow people to hve dilogue with their friends, fmily, nd other people in glol environment. s result, Privte Prtie, shurn, V. Professor nd Grdute Progrm Diretor, Deprtment of Orthodontis, Virgini Commonwelth University, Rihmond, V. Professor, Deprtment of Reserh dministrtion, Shool of Dentistry, Virgini Commonwelth University, Rihmond, V. d Professor nd Chir, Deprtment of Orthodontis, Virgini Commonwelth University, Rihmond, V. Corresponding uthor: Dr Bhvn Shroff, Deprtment of Orthodontis, VCU Shool of Dentistry, 520 North 12th St, Suite 111, Rihmond, V 23298 (e-mil: shroff@vu.edu) epted: Jnury 2015. Sumitted: Novemer 2014. Pulished Online: Mrh 4, 2015 G 2015 y The EH ngle Edution nd Reserh Foundtion, In. millions of people hve strted ommuniting through soil medi wesites. One of the most populr soil medi wesites, Feook, hs grown into worldwide network of more thn 1 illion susriers sine its retion in 2004. 1 lthough soil medi networks were originlly reted for personl use, they re now effetively used y usinesses of ll sizes to dvertise their produts or servies nd to ommunite with urrent nd prospetive onsumers. 3 Compred with trditionl dvertising, soil medi mrketing is n intertive, ost-effetive, nd more effiient solution for promoting servies nd produts, espeilly euse more ustomers re spending time online. 3 ording to reent report, Feook ws the numer one soil mrketing tool used y ompnies with 100+ employees, followed y Twitter. 4 In study on onsumer ehvior, 51% of the onsumers reognized tht they were more likely to uy produt fter eoming fn on Feook. 5 The enefits of soil medi mrketing re urrently seen in the field of helth re, nd soil medi mjor tti in dentl mrketing. Soil medi mrketing is DOI: 10.2319/110714-797.1 1035 ngle Orthodontist, Vol 85, No 6, 2015
1036 NELSON, SHROFF, BEST, LINDUER ost effetive mens to reh hundreds of potentil new ptients who seek prtitioner s expertise nd servies. 6 8 Soil medi is lso emerging s n importnt nd powerful reputtion mngement tool. Edwrds et l. 9 reported tht the top ftor in the seletion of n orthodontist ws his or her good reputtion. 9 Using soil medi, ptients n shre their experienes with roder nd more ttentive udiene through wide vriety of word-of-mouth messging tehniques. 10 Jorgensen 11 emphsizes the importne nd explins the enefits of using soil medi in n orthodonti prtie to ommunite with ptients, estlish reputtion, nd ttrt new ptients. lthough the impt of soil medi in helth re hs een desried, 12 15 the literture on its use in the field of orthodontis is limited. The im of this study ws to ssess how orthodonti ptients nd prtitioners use soil medi, exmine ptient nd prtitioner preferenes regrding soil medi, nd investigte the potentil enefit of soil medi in mrketing nd ommunition strtegies of orthodonti prties. MTERILS ND METHODS survey ws developed to explore the use of soil medi in orthodonti prties nd ws rndomly distriuted to ll prtiipnts fter pprovl from the Virgini Commonwelth University institutionl review ord. The study prtiipnts inluded orthodontists nd ptients/prents. The merin ssoition of Orthodontists Prtnership in Reserh ws ontted, nd n eletroni survey ws distriuted to 500 rndomly seleted orthodontists within the United Sttes. The ptient popultion inluded ptients 18 yers old or older nd prents of ptients who were younger thn 18 yers from privte prties throughout the United Sttes. n e-mil ws sent out to ll orthodontists in the Virgini Orthodonti Reserh nd Edution Foundtion, whih hs memers ntionwide, nd set of pper-sed surveys (30) ws sent to eh offie tht greed to prtiipte. The surveys were distriuted y eh offie to their ptients nd prents of ptients. The prtiipnts ould tke the survey t ny time during tretment. The survey inluded definition of soil medi long with mny exmples of soil medi wesites. Demogrphi informtion ws gthered for ll prtiipnts, nd the survey onsisted of questions relted to the prtiipnt s usge hits nd pereptions of soil medi usge in the orthodonti prtie. For exmple, ptients/prents were sked, Do you use soil medi, nd orthodontists were sked, Do you use soil medi s mrketing tool in your prtie. Tle 1. Demogrphis Orthodontists Ptients/Prents Chrteristis % No. % No. ge (yers) 18 through 24 0 0 10 18 25 through 34 12 22 18 34 35 through 44 32 60 35 65 45 through 54 33 61 28 53 55 through 64 22 41 9 17 65 nd older 2 3 1 1 Sex Femle 29 55 88 165 Mle 71 132 12 22 Re* White 87 165 90 169 Blk or frin merin 3 6 6 12 merin Indin/lsk 1 1 1 2 Ntive sin 6 11 3 6 Pifi Islnder 1 2 1 1 Other 4 8 0 0 Ethniity Hispni or Ltino 2 2 8 32 Not Hispni or Ltino 98 125 92 390 * Perentges re sed on the totl numer of those who responded to eh question. Perentges dd to vlue other thn 100% euse of rounding. Desriptive sttistis were lulted to desrie the two popultions (mens or perentges, s pproprite). The groups were ompred on individul ftors using x 2 tests. When more thn one ftor ws onsidered, logisti regression ws used. Comprisons etween survey items were performed using repeted mesures logisti regression. The impt of mrketing prties on new ptient strts ws nlyzed using multiple regression nlysis. Group differenes were indited using the Tukey honestly signifint differene multiple omprison proedure. ll lultions were done with SS softwre (JMP pro version 10, SS, Cry, NC). RESULTS totl of 189 orthodontists nd 188 ptients/prents from privte prties responded to similr surveys etween July 1, 2013, nd Otoer 1, 2013. Response rtes for the orthodontist nd ptient/prent group were 38% nd 76%, respetively. Demogrphi hrteristis of the prtiipnts re listed in Tle 1. Most of the prtiipnts in the ptient/prent group were prents of ptients (77%). Results showed tht 76% of the orthodontists used soil medi in their prtie nd 89% of the ptients/ prents used soil medi. Soil medi use ws ssoited with ge (P,.0001), nd gender (P 5 ngle Orthodontist, Vol 85, No 6, 2015
ORTHODONTIC MRKETING THROUGH SOCIL MEDI 1037 Figure 1. Soil medi usge in reltion to ge, sex, nd group. In ge groups 25 34 yers nd 35 44 yers, ptients/prents used soil medi more thn orthodontists. In ge groups 45 54 yers nd 55 64 yers, ptients/prents nd orthodontists used soil medi similrly. Femle prtiipnts used soil medi more thn mle prtiipnts..0029), ut not re or ethniity (P..15). To urtely ompre the groups on soil medi use, multiple logisti regression ws used fter djusting for ge nd gender. The results of the multiple regression nlysis re shown in Figure 1 nd Tle 2, where the derese in soil medi use in older dults is evident (P,.0001). In the younger ge groups (25 34 yers nd 35 44 yers), soil medi use ws signifintly higher in ptients/prents thn in orthodontists. However, this pttern hnged fter ge 44. Ptients/prents nd orthodontists used soil medi to similr degree in the ge groups 45 54 yers nd 55 64 yers. Tle 2. Soil Medi Use y ge, Sex, nd Group Groups No. Femle Mle * ge 18 through 24 yers Ptients/prents 18 99.8 99.6 ge 25 through 34 yers Orthodontists 22 93.9 89.2 B Ptients/prents 34 99.3 98.6 ge 35 through 44 yers Orthodontists 60 89.6 82.1 B Ptients/prents 65 96.4 93.5 ge 45 through 54 yers Orthodontists 61 82.6 71.8 Ptients/prents 53 84.3 74.2 ge 55 through 64 yers Orthodontists 41 72.5 58.5 Ptients/prents 17 51.8 36.5 Within eh ge group, groups with different supersript re signifintly different (P,.05). The perentges re sed on those who responded to the questions involved. Prtiipnts were then sked to list whih soil medi wesites they use. Usge vried y medi nd prtiipnts group nd is summrized for eh group nd medi type in Tle 3 nd Figure 2. When ompring the different medi pltforms mong orthodontists, Feook (74.6%) ws the most ommonly used soil medi pltform, followed y YouTue (29.1%). Ptients nd prents lso used Feook (80.3%) more thn ny other site, followed y YouTue (49.5%) nd Pinterest (49.5%). signifintly higher perentge of ptients/prents used YouTue ompred with orthodontists (P 5.0188). Ptients/prents nd orthodontists use oth Feook nd Twitter similrly (P 5.3878 nd P 5.9922, respetively). Tle 3. Perentge Use of Speifi Soil Medi Pltforms y Group Group Medi Pltform Orthodontists Ptients/ Prents Overll P Vlue Feook 74.6 80.3 77.7.3878 Twitter 24.9 BC 23.4 C 21.1 C.9922 Google+ 23.3 BC 29.8 C 26.6 C.8308 YouTue 29.1 B 49.5 B 38.8 B.0188 LinkedIn 18.0 BC 25.5 C 21.4 C.0774 Pinterest 6.9 D 49.5 B 21.2 C,.0001 Instgrm 17.5 C 30.3 C 23.5 C.4379 Blogger 4.2 D 3.2 D 3.7 D.6157 Wiki 0.0 1.6 0.1 Other 1.1 0.5 0.7 Perentge use ws ompred y group nd medi pltform using repeted-mesures logisti regression. Medi pltforms shring the sme supersript were not signifintly different. The tegories of Wiki nd other were not inluded in the nlysis euse of their ner-zero perentges. ngle Orthodontist, Vol 85, No 6, 2015
1038 NELSON, SHROFF, BEST, LINDUER Tle 4. Time of Dy Groups Used Soil Medi Ptients/ Orthodontists Prents Time Used % No. % No. P Vlue Morning (8 M to 12 PM) 40 76 44 83.4389 fternoon (12 PM to 5 PM) 56 71 33 62.3513 Evening (fter 5 PM) 23 29 76 142,.0001 Figure 2. Use of speifi soil medi pltforms y group. Ptients/ prents nd orthodontists used Feook more thn ny other soil medi pltform. Ptients/prents used YouTue nd Pinterest more thn orthodontists. The times of the dy when orthodontists posted informtion nd when ptients/prents used soil medi were signifintly different (P,.0001) (see Tle 4). Orthodontists posted informtion more often in the morning nd fternoon (40% nd 56%, respetively) nd ptients/prents used soil medi minly in the evening (76%). The orthodontists were sked wht ontent they posted on soil medi wesites, nd the ptient/prent group ws sked wht types of ontent they onsidered interesting. The perentge of orthodontists tht posted speifi type of ontent ws ompred with the perentge of ptients/prents tht onsidered tht speifi type of informtion interesting (Figure 3). sttistilly signifint differene nd positive ssoition ws found etween the perentge of orthodontists tht posted pitures of themselves (35.5%) (P 5.0032), informtion explining new produts nd proedures (37.6%) (P,.0001), involvement of the orthodontist in hritle progrms (47.1%) (P 5.0005) nd ommunity servie events (48.2%) (P 5.0045), nd updtes out the offie (51.3%) (P,.0001) nd the perentge of ptients/prents tht onsider these types of ontent to e interesting (50.5%, 73.9%, 64.9%, 62.8%, nd 80.3%, respetively). sttistilly signifint differene nd negtive ssoition ws found etween the perentge of orthodontists tht posted pitures of ptients (57.7%) nd the perentge of ptients/prents tht onsidered pitures of ptients to e interesting (42%) (P 5.0025). The use of different mrketing tools nd their potentil impt on the numer of new ptients per yer ws exmined sed on the informtion provided y the privte prties tht responded to the survey. The results re summrized in Tle 5. Most used usiness rds or rohures (52%), prtie wesite (59%), nd soil medi sites (76%). multiple regression nlysis tested for the ssoition of eh mrketing prtie type nd the numer of new ptient strts per yer. signifint reltionship ws found overll (R 2 5 0.47, P,.0001), nd the following mrketing prties were found to hve signifint orreltion with new ptients: newspper dvertisements, prtie wesites, nd soil medi. In ddition, 40% of the orthodontists pereived tht implementing soil medi hs rought new ptients into their prtie. Newspper dvertisements were negtively orrelted with new ptients (verge of 188 new ptient strts without newspper dvertisements versus 129 with; P 5.0003). The use of prtie wesite ws positively relted to new ptients (186 new ptient strts with prtie wesite versus 131 without; P 5.0035). Orthodontists using soil medi lso reported higher new ptient strts (181 new ptient strts with use of soil medi versus 134 without; P 5.0376). The following strtegies were not found to e signifintly ssoited with new ptients: phone ook dvertisements, TV dvertisements, emil mrketing, usiness rds, or other forms of mrketing. To test for the effet of eh individul soil medi pltform on new ptient strts, ll pltforms were entered into multiple regression model tht lso inluded the two other signifint mrketing ftors (newspper ds nd prtie wesite). The multiple regression inresed in preditive ility of new ptient strts to 28% when ll signifint mrketing ftors were omined. Tle 6 summrizes these findings. Orthodontists who used Feook reported positive ssoition with new ptient strts (179 new ptient strts with Feook use versus 124 without; P 5.0004). Twitter use ws lso positively relted to new ptient strts (171 new ptient strts with Twitter use versus 130 without; P 5.0128). YouTue use ws negtively relted to new ptient strts (128 new ptient strts with YouTue use versus 173 without; P 5.0046). None of the other soil medi pltforms ws signifintly ssoited with new ptient strts. In summry, orthodontists who engged in the mrketing prties negtively ssoited with new ptients were predited to hve ount of 65 new ptients per yer (95% onfidene intervl 5 47 90). Orthodontists who engged in ll the positive mrketing prties were predited to hve 335 new ptients per yer (95% onfidene intervl 5 276 405). ngle Orthodontist, Vol 85, No 6, 2015
ORTHODONTIC MRKETING THROUGH SOCIL MEDI 1039 Figure 3. Type of ontent posted y orthodontists ompred with the type of ontent viewed s interesting y ptients/prents. sttistilly signifint differene ws found for pitures of ptients, pitures of the orthodontist, informtion explining new produts nd proedures, updtes out the offie, nd involvement of the orthodontist in hritle progrms nd ommunity servie events (*P,.05). DISCUSSION Reently, soil medi hs tken signifint role in helth re s reported in numerous studies. 12 15 To our knowledge, this is the first study in the orthodonti literture to report on soil medi usge nd the pereption of soil medi use in the orthodonti prtie mong ptients nd orthodontists. Tle 5. Mrketing Prties Used y Orthodontists nd the Reltionship to Numer of New Ptients per Yer Mrketing Prtie % No. P Vlue Bet Stndrd Phone ook dvertisements 29 54.7740 0.02 TV dvertisements 5 9.8019 0.02 Newspper dvertisements 16 30.0003* 20.27 Emil mrketing 12 22.9040 0.01 Use of usiness rds or rohures 52 99.6576 0.05 Prtie wesite 59 112.0035* 0.23 Soil medi d 76 143.0376* 0.25 Multiple regression on the log ount (R 2 5 22%; P,.0001). The stndrdized et oeffiient n e interpreted like orreltion. Bsed on orthodontists response to the question Do you hve prtie wesite for your orthodonti prtie? d Bsed on orthodontists response to the question Do you use soil medi in your prtie? reent report 16 found tht 73% of online dults use soil networking sites nd tht 79% of femle dults use soil medi ompred with 69% of mle dults. The uthors lso found tht 89% of dults etween 18 nd 29 yers old use soil medi nd tht usge deresed stedily with ge. 16 The results from our Tle 6. Soil Medi Pltforms Relted to New Ptients per Yer Medi Pltform % No. P Vlue Stndrd Bet Feook 74.6 141.0004* 0.31 Twitter 24.9 47.0128* 0.23 Google+ 23.3 44.4288 20.06 YouTue 29.1 55.0046* 20.27 LinkedIn 18.0 34.9376 20.01 Pinterest 6.9 13.2331 0.09 Instgrm 17.5 33.4738 0.06 Blogger 4.2 8.4020 0.06 Wiki 0.0 0 Other 1.1 2.4193 20.05 Multiple regression on the log ount nd inluded the following preditors: newspper dvertisements nd prtie wesite (R 2 5 28%; P,.0001). The stndrdized et oeffiient n e interpreted like orreltion. The tegories of Wiki nd others were not inluded in the nlysis euse of their ner-zero perentges. * P,.05. ngle Orthodontist, Vol 85, No 6, 2015
1040 NELSON, SHROFF, BEST, LINDUER study re onsistent with these findings, s they indited tht most ptients/prents nd orthodontists used soil medi nd tht use ws more ommon in femles nd younger dults. The respondents, however, my hve soil medi wesite without tively viewing posts. Thus, the diffiulty in differentiting etween user nd n tive user my e viewed s limittion to this study. Mrketing reserh hs reveled tht Feook is the most populr site s two-thirds of online dults sy tht they re Feook users. 17 The results from our study support similr trends, s Feook ws the most ommonly used soil medi pltform mong orthodontists nd ptients/prents. The lrgest disrepny found etween soil medi sites used y the ptients/ prents nd orthodontists ws for Pinterest. This is n opportunity eing ignored y most orthodonti prties nd should e onsidered s potentil mrketing tool for urrent nd prospetive ptients. The optiml time for usiness to post on soil medi wesite seems to depend on the vilility of the udiene tht views the informtion. In our study, there ws disrepny etween when orthodontists post informtion nd when ptients nd prents tully used soil medi. reent report y Cormier 18 stted tht Feook post reeives hlf of its reh within 30 minutes nd tht one should try to determine when fns re on Feook nd im to shedule posting of informtion round tht time. Perhps orthodontists should onsider posting informtion on their soil medi sites in the evening rther thn during norml usiness hours for more onvenient ess of the informtion y ptients/ prents. Over the yers, mrketing hs een prtied vi trditionl mens of medi, suh s television, illords, pmphlets, rdio, newspper, nd phone ook ds. Soil medi mrketing hs llowed usinesses to hve n intertive dilogue with onsumers in wy not possile with trditionl dvertising. Previous onsumer reserh hs found tht only 14% of people trust dvertising ompred with 78% who trust reommendtions nd referrls. 19 Engging onsumers on soil medi n uild trusting reltionships nd give prospetive ptients n opportunity to red reviews y their friends, fmily, nd the generl puli. Reserhers in the dentl field suggest tht dentl prties will not survive without strong online presene. 6 8 The results of our study support these suggestions s they showed tht most orthodontists use soil medi sites nd prtie wesite to mrket to their prospetive ptients. Orthodontists who used soil medi nd prtie wesite hd more new ptient strts per yer thn those who did not. previous study found orreltion etween soil medi presene nd new ptient visits in hospitls. 20 Keim et l. 21 found tht soil medi use in n orthodonti prtie ws firly effetive s prtie-uilding method. 21 However, to our knowledge, this study is the first to report orreltion etween soil medi usge nd new ptient strts in n orthodonti prtie. lthough there is orreltion, it is importnt to note tht there is no proven usend-effet reltionship etween new ptient strts nd soil medi usge. The results my lso e interpreted to men tht the more suessful prties re lso more tive on soil medi nd other mrketing tehniques. s doumented in previous studies, the hoie of n orthodontist is lrgely sed on his or her reputtion. 9 Soil medi hs proven to e n importnt reputtion mngement tool. When ptients nd prents were sked if good reputtion on soil medi wesite would influene their deision to go to or ring their hild to tht orthodontist, 63% stted tht it would. This study lso found tht orthodontists who use newspper dvertisements were likely to hve fewer new ptient strts per yer. Prospetive ptients my view newspper dvertisements s inditive tht prtie is less tehnologilly dvned thn other orthodonti offies. In ddition, potentil ptients my not e viewing newspper dvertisements euse newspper redership is deresing nd n extensive mount of informtion n e esily essed online. Our ptient popultion ws le to tke the survey t ny time during tretment. Perhps prospetive pproh ould hve dded to the strength of this study. The results of this study showed tht soil medi ws used y most of ptients/prents nd orthodontists surveyed nd tht soil medi my e n effetive mrketing tool in n orthodonti prtie. CONCLUSIONS N Soil medi use ws more ommon in femles nd younger dults, nd Feook ws the most ommonly used soil medi site mong ptients nd orthodonti prties. N disrepny ws found etween the time orthodontists posted informtion nd the time ptients/ prents essed soil medi, inditing tht orthodontists should post informtion in the evening rther thn during regulr usiness hours. N Ptients/prents were more interested in viewing informtion regrding the prtie nd the ommunity thn informtion out other ptients. N The most ommonly used mrketing strtegies in the orthodonti prtie were soil medi nd prtie ngle Orthodontist, Vol 85, No 6, 2015
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