The Tip of the Spear: Creating a Virtual Presence Inexpensively

From the article initially published in Mobility Management Magazine

By Patrick B. Boardman

The question hasn’t changed in thousands of years. How do I get my goods and services in front of the people who have the ability to buy them? A Chinese General and Strategist named Sun Tzu pointed out that while there are things such as morale, wisdom, intelligence, and tools during a campaign, it is only those who apply them in a flexible fashion that win.

With the internet age well upon us, companies are scrambling to assess how they should position themselves on the web through websites, social networking, blogs, and other web-based mediums.

Our company, based in the Houston Texas market has taken a much closer look at how to create this additional dimension of marketing known as virtual presence.

Starting back in 2007, our first step was to create a website. Our options were many. Do we create a website that serves as a fancy electronic business card? Such a site would be a way that if someone already knew who we are, they can use a web browser to locate by typing our name. A result would then appear and they could click a link and locate our telephone number and address.

The second option that was available to us was creating a site that was more than an electronic business card. We decided to invest in a site that would work much more like the hub of a wagon wheel. In the center of the hub is our electronic business card. The difference was that each spoke of the wheel created a different channel of information.

The spokes are varied but include things like:

• Medical Dictionary

• Links to Other Helpful Agencies

• Online Referral Forms

• Product Catalogs

• Guides to Medicare and Other Insurances

• Blogs

• Information for Patients and Caregivers

Once we elected to go with this format we implemented the site and at first nothing really happened. To combat this we realized we needed to make frequent content changes to the website. This began to increase our relevance and we occasionally would show up on an internet web search

Our company has always had a commitment to education. We frequently do the in-services and “Lunch and Learn” meetings like many other HME/Complex Rehab companies. Our next logical step was to start a blog to expand our educational message. The addition of our blog sky-rocketed our relevance in Google Searches.

We realized very quickly that there are a plethora of benefits to having a blog.
• Educational information shared with consumers, referrals, and competitors

• Requiring our key personnel to write the blogs improves their global understanding of our industry

• Blogs can be linked to our website

• Professional Development for our blogging staff

• Frequent blogging increases relevance in Google searches

• Internal resource for our own employees

• Branding


In our organization all of our ATP’s and sales personnel are required to contribute a monthly blog. We also have a few local healthcare professionals who are working on blogs for us and will soon be featured on Complex Rehab Network (our blog). Keep in mind that you can blog for free on Google just as we do.

Another important piece of virtual presence is email marketing campaigns. Let me be clear. We are not talking about spam here. You will not help yourself if you continually bombard your referrals with “Deals of the Week.” It is critical that you take great care with the type and quantity of the message you send. Remember that email marketing is a double edged sword. If you mail something without thinking it through, you could offend the very people you are trying to build a relationship with.
Email marketing is driven more from a perspective of education and branding, not the immediate sale. Email marketing is vital in getting the word out systematically to the community about your organization. Email marketing for us is truly the “tip of the spear.”

From a branding perspective, email marketing is a way you can hone a message or perception about your company to a very specific audience. In this way if we have relevant information to share such as change to Complex rehab evaluation documentation requirements, we can send an email to just the therapists to alert them to the new change.

Such targeted customization of your corporate message has never been more possible than it is in today’s marketplace. The software we use is called Constant Contact and is absurdly affordable. For less than 100.00 per month you can send newsletters, surveys, and events to your contacts.
Most small businesses would be stunned to realize the quantity of new contacts that slip through their fingers every day.

It was uncomfortable for us to face the fact that our intake staff would receive a referral from a new source and we would not capture them as a new contact. Now, when a new referral calls we capture their information with their permission and add them to our database for future newsletters, events etc.

The initial investment of compiling your database is the hardest part.

The next virtual step for us in 2010 will be using You Tube and other social networking sites. Next year we plan to release many different educational videos on our website that include everything from how to put a power chair in free-wheel, how to clean your concentrator filter etc.

It is important to remember that while websites, blogs, social networking, and email campaigns are great tools, nothing will ever replace good customer service techniques such as courteousness, good communication, and follow-through.
Sun Tzu’s advice still rings true after 2000 years. Be introspective and flexible and you will win the marketing campaign.

Pat Boardman


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The Healthcare Refugee

By Patrick Boardman
J and R Medical

When we hear the word “refugee,” most of us envision a far away, war-torn land. We visualize a city of tents where desperate people have lost everything and have become devoid of hope.

What most people do not realize is that there are refugees in every city and every town in America. These people are "healthcare refugees."

Here in the Houston market, our company has experienced first hand this rising population of people. These are wheelchair users who in good faith purchased a new manual or power wheelchair from a local supplier. That supplier then went out of business and now the patient has nowhere to go for repairs. They lost have their mobility and independence.

Over the last 2 years approximately 20% of the complex rehab providers in Houston have closed their doors. Some got out because their business failed. Others closed because their business model was no longer profitable with complex rehab as one of its divisions.

As a result, thousands of patients suddenly had lost the lifeline of service for their equipment. We were made painfully aware of this situation in late 2007 and early 2008. We noticed a tremendous influx of patients needing service and repairs. The vast majority of the clients had purchased their equipment from a supplier who was no longer in the rehab business. Most of them were distraught and afraid that they would not be able to be independent again.

The Simon Study that came out in 2007 reported that 45% of rehab companies made 5% or less in net profits for the year. It is no wonder that these companies had to draw a line in the sand and say “no.” I do not fault them for making a business decision that kept their doors open.

There are some large national companies in our industry who hope to capitalize on competitive bidding and other continued cuts. They know that their buying power will create an un-level playing field and that their market share could increase. This is classic complex–rehab-out-of-a-box thinking.

Healthcare refugees will only increase under continued cuts and competitive bidding. If someone is lucky enough to win a bid under competitive bidding, they will likely be seeing cuts as deep as 18% or more. If this happens, many companies will simply stop doing Medicare.

This will create an even greater population of health care refugees who will have no one willing to come help them. They will be trapped as prisoners in their beds because their only mobility will be broken with no one to come fix it.

Recently, Texas Medicaid attempted to invoke the same 9.5 % cut that Medicare had done a short time ago. TXRPC, our state complex rehab association, testified at the Medicaid rate hearing to articulate why this was a very bad choice. Such a cut would create a plethora of access-to-care issues for TMHP beneficiaries.

We recently heard from TMHP that the rate cut was not invoked. So for the time being we staved off creating a new population of healthcare refugees. It must be noted that TMHP is one of the few agencies that I have ever encountered that seems to truly take steps to make sincerely good decisions for their beneficiaries. Hats off to Texas Medicaid for listening and doing the right thing for their beneficiaries in Texas.

When the first "Health Care Refugees" started knocking on our door, we made the decision that someone had to help these people. Often we heard the same story: "I have called 4 places, and they all say that if the chair isn't purchased from us then we can't service it."

We decided to do something about the problem. We created a new job within J and R Medical called Service Coordinator. This person schedules technicians and handles all of the paperwork for all clients that have equipment in need of repair. To date we are able to continue to service all clients that have service issues and that are in our geographical service area. It must be noted that we have had to shrink our service area size.

It is imperative that rehab providers, referrals, and patients work together to create a louder voice for our industry. A few days ago President Obama announced that he was going to cut 500 billion from Medicare through eliminating fraud and abuse.

I think everyone will agree that eliminating fraud and abuse is a good thing. The alarming part is that, if this happens, there could be further cuts that create more healthcare refugees.

No one knows what the road ahead holds for these patients and the rehab suppliers. It is imperative that suppliers make an effort to inform their own staff about the challenges we are facing in our industry. Your sales people and ATP’s should be well-versed in the big picture so they can inform patients and referral sources about the challenges we all face. Have your staff hammer your elected officials prior to big votes that affect our industry. Without a coalition and unity, there will be more refugees.

Patrick Boardman

J and R Medical Supply and Rehab
Houston Texas Market