When Brett Groom joined ATI, the nation’s largest brand physical therapy company, as CMO in 2018, he was faced with a set of challenges unique to the PT industry. Key to all these issues was a general lack of understanding among consumers of just what physical therapy is and what it can do for the patients for whom it is prescribed.

“In any given year,” Groom explains, “about 7% of people get a prescription for PT, but only about 3.5% actually fill it.” Many of those who don’t, he says, either figure they’ll work out their back or joint pain issues themselves or they’ll opt for seeing a chiropractor who, as Groom notes, provides immediate pain relief but doesn’t address the root issues behind the pain—issues that can, PT practitioners stress, only be resolved by exercise involving significant effort by the patient. “Only 8% of people in America who have a back problem think of PT,” Groom says, “and a quarter of those think of chiropractors. Yet 40% of our business is actually back injuries. We’re very good at that, but we don’t get the recognition we need.”

Still, raising patient consciousness is only part of the battle ATI is fighting. Even if a patient is looking for physical therapy, the likelihood that they’ll find and choose ATI varies by market. In Atlanta, for example, ATI has just opened locations, so potential patients are unlikely to find reviews of ATI’s services since the offices are too new to have generated them. Without reviews, Groom says, “you get penalized by Google, you don’t show up as well on the organic search, and it becomes a more expensive proposition.”

Think Local—and Long-Term

Then there’s the fact that PT is a very localized service. “While patients in need of shoulder surgery will travel anywhere in their metropolitan area to find the best surgeon,” Groom explains, “they’re not traveling more than five or 10 minutes to go to PT because it’s just too much of a hassle.” Beyond a three- or four-mile radius, he notes, “we have a significantly reduced chance of getting” that patient.

This lag time can wreak havoc with reporting the success of marketing campaigns to a finance team focused on immediate revenue impact.

And “getting the patient” takes time. Even if the patient is convinced that PT is the answer to their pain and even if, in their searching, they’ve found a local ATI office, it’s a week to 10 days from click to consultation. “When a lead comes in,” Groom says, “I don’t know that they’re a patient until they come in for that initial evaluation. They have to agree with the course of treatment. They have to be comfortable with what they’re going to pay on the insurance side. And then they’ve got to start coming.”  Moreover, he adds, “we don’t generate revenue when they come in for the first appointment, we do so over the course of eight or 10 appointments, which means that from the day a patient clicks and I have to pay Google for said lead, I am probably not collecting the full revenue in the company until about eight weeks later,” longer, he notes, if you factor in payment from the insurance company.

This lag time can wreak havoc with reporting the success of marketing campaigns to a finance team that is focused on an immediate revenue impact—and an industry balancing demand with staffing.

This has required, notes Larry Fisher, CEO of Rise Interactive, a digital marketing agency with a financially based approach to marketing it calls Interactive Investment Management, “thinking more strategically and understanding how to partner with the CFO, how to prove the incremental impact of marketing investments, and how to put together the right data framework to tell the success story to stakeholders.

The strategic plan that Groom and his team developed, working with Rise, addressed the needs of the finance team at the same time that it focused on the needs of the market.

Partnering with Finance

For the former, Groom explains, “we didn’t rely on finance to determine the right approach to measurement.” Instead, the marketing department itself figured out just “how we should be thinking about our return on ads. We asked ourselves, ‘What would be our goal?’ This led us to develop a structure through which we were able to prove the incremental impact of every dollar invested.”

With this strategy defined, Groom’s team worked with finance to refine the methodology of their approach including market share and the right assumptions on incrementality. This meant, for example, looking at different types of keywords and determining what percentage of potential patients choosing ATI in a particular market—depending on such factors as market share, reimbursement rates, and conversion rates—would be incremental. “We actually walked them through all those factors and the numbers and our optimization process as well as our tracking,” he explains. By demonstrating how consumers who started as leads finally evolved into patients, they were able to give finance confidence that “the channel was providing a direct match.”

The result: “When they had clarity that we’re actually reporting on real patients and that we were taking the most conservative approach in terms of incrementality, absorbing all the incremental cost, that allowed us to set a number with which they were ‘very comfortable.’”

Mindset Changes: For Finance, Marketing—and Patients

Across the board, Groom says, this approach has required “a mindset change.” With finance that meant “taking them through the discipline of all the things we were doing to go from cost per lead to this return on ad spend based on market”—including website improvements that would speed up page load and response time.

With this approach, a marketing department needs more data engineers: "people who can connect data sets and automate process."

With marketing this meant shifting the focus from social listening to behavioral listening. “If you start with the data and the search,” Groom says, “what is more powerful that asking people what they do? It’s watching what they actually do and learning and making your optimizations from that. It lets you focus on impact, not activity. And I don’t want activity; I want impact.”  This approach, he adds shifts measurement from marketing KPIs to business KPIs. And that, he says, “is a much more interesting conversation.”

This approach, Rise’s Fisher notes, will also have an impact on the types of people a marketing department like Groom’s hires. “It will need more data engineers,” he says, “people who can connect data sets and automate process.”

And for patients, the goal is to bring about a change in mindset that pushes PT ahead of chiropractors or other less clinically based solutions (including ignoring the issue) for consumers looking for pain relief. To date, Groom says, “what we have seen is that if somebody is searching for chiro, we don’t have a lot of success winning them because they come in with a different mindset.” But the strategy his team has put in place, combined with the company’s direct sales efforts and the tremendous support the strategy has received from finance may well put this company on the road to changing those minds.

Over the course of the past five blog post installments, we’ve looked at a number of ways in which CMOs need to evolve if they’re to stay competitive, from moving along the “digital marketing curve” to fueling brand engines, from future-proofing audience strategies to proving impact. In the next—and last—installment in this series, we’ll bring it all together to paint a picture of tomorrow’s CMO, today.