by TAC Staff D r. Ross Trivas graduated from Palmer College in Davenport, Iowa, in 1989. Immediately after graduation, he founded the National Directory of Chiropractic, an annual printed directory listing all chiropractors in the United States. In 1999. he added Chirodirectory.com to his business portfolio, the online version of the printed Directory; then, in 2004, Chirowebsite. com, which is primarily focused on internet marketing and search engine optimization (SEO) for chiropractic clinics. He is presently on a sabbatical from his private practice on Maui and living in the mountains of Utah, raising his two new babies and running the Directory, which is headquartered in Salt Lake City. Returning to private practice is in the plans for 2012. TAC: Our last interview was in 2008 before the economic recession hit, and much has changed within our economy since that time. The National Directory is in daily contact with chiropractors on a nationwide basis, so you must have a finger on the pulse of our profession. How do you see the present economic climate impacting the chiropractic profession? TRIVAS: My impression is that our profession is weathering the downturn better than most, but also that most chiropractic offices have been affected adversely in one way or another. Some practices have had to close due to the recession but, typically, those clinics were already struggling prior to the recession. Overall, many practices are finding that filling their adjusting rooms takes more effort these days. TAC: How are doctors responding to this change in the economic climate? Your businesses are essentially marketing services. Are chiropractors putting more resources into marketing? TRIVAS: Some doctors are making no changes to their marketing efforts, so some are seeing a decline in their business. Other doctors are adapting and realizing that a more active marketing approach is necessary with this economy. Many of these doctors have actually seen growth and expansion in their practices, even during the recession. TAC: What marketing efforts would you recommend to keep a competitive edge? TRIVAS: Of course, we're in the business of inter- net marketing, so our view is slanted in that direction, but we strongly believe the biggest bang for the buck is in internet marketing. We have seen success story after success story with intelligent internet programs. These days, yellow page ads, mailers, and television ads are hugely expensive, with less and less return on investment. The Internet is where potential clients are searching for chiropractors. My advice is for chiropractors is to restructure their marketing budgets to include internet marketing as a top priority. It's exactly why we got into internet marketing services...we believe in it ourselves. TAC: If the Internet is such a great marketing tool, why aren't all doctors turning to the Internet to market their practice? TRIVAS: Actually, most are turning to the Internet for their marketing. But for those who have been reluctant or slow to get on board, it is usually because there are some obstacles they need to overcome. The biggest hurdle seems to be that most practices have never budgeted marketing dollars toward the Internet, and they are uncertain about the return on their investment. Another common hurdle is that many doctors know they need to put energy into internet marketing, but they are unsure about what direction to take. There are so many different marketing opportunities on the Internet that it can be overwhelming to know where to start. TAC: So where should doctors start once they set aside a budget for internet marketing? TRIVAS: The first thing I suggest is to create a clear message and image. Ask yourself what types of patients you want to attract, and what type of practice you have. Then, using the unlimited space of websites, blogs and social media sites, build that image with your online presence. For instance, if you have great success with sports injury patients, become the expert by writing articles, displaying testimonials and creating dialogue about sports injury on your website and social media outlets. Search engineering relies on valid, on point content. TAC: So once the message is clearly formulated, then what? TRIVAS: Then it is time to focus on getting your message the most exposure possible. No one wants to spend more money than they need to on marketing, so start by doing those things that will cost nothing at all. Creating a business Facebook account is free and so is getting listed on Google Places. If you don't already have these free services, it takes a relatively short time to set them up. If you already have these services in place, then utilize them. Keep discussions and blogs lively and active. The next step is to focus on search engines. The best and most effective way to get your clinic exposed to the world is to get your website on the first page of natural searches on the major search engines, "natural searches" being those search results that float to the top of Google, for example, due to having valid content in relation to the user's search criteria. Roughly 95% of all people use the three main search engines: Google, Yahoo, and Bing. Google claims up to 80% of search traffic. Being on the first page of Google should be the main goal for a successful Internet marketing program. If someone is searching fora chiropractor on the internet, Google is where they will most likely go. TAC: How does one get their website on to the first page of Google? TRIVAS: This is often the job of search engine optimization (SEO) firms, like us. Google and other search engines have algorithms, (computer logic) behind the scenes that constantly, robotically analyze and reanalyze every website in the world, to determine the positioning of any website on their search results pages. Search engineers study the effect that different words, content and positioning have on Google's (for example) algorithms and then implement the actions on your website that are going to bring your website to the top of the list for specific keywords searched. TAC: What are some of the tasks search engineers do? TRIVAS: First, they will perform an interview to help determine which keywords and phrases will bring you the most business. Then they will analyze your website architecture and content, making changes and additions where necessary. Google, and other search engines, use certain standards to analyze how a website is built, and search engineers will make sure your website complies with these standards. The most important, and biggest task of search engineers, is to create back-links to your site. These are clickable links from other websites back to your site. The content of these other websites must be relevant to your content to actually work to your advantage. Back-links are the number one criteria for a Google or a Bing to determine the "natural list" placement of your website in search results. but back-linking is the most labor intensive part of the search engineer's job. Back-linking is an ongoing process. Common sense would tell you that the more back-links the better, but this is not always the case. If a huge site that is very relevant to chiropractic is linked up to your site, this can raise your ranking more than hundreds of irrelevant sites would. Also, spacing the timing of adding back-links is important. Many back-links placed at once, for example, can actually red flag your site and hurt your ranking. There are many of these red-flag traps, and that is why trying to trick the search engines often backfires. Top SEO firms will typically have in-house experimental sites to see how search engines will respond to certain actions before applying these actions to client websites. TAC: Are there other ways to get on the first page of the major search engines? TRIVAS: Yes, Pay-Per-Click(PPC) programs also work to get your site up on the search engine sites. PPC programs act as ads on the web, and are sort of the opposite or counterpoint to "natural list" results. A campaign is set up and these PPC ads are posted to a Google or Yahoo site, and respond to our defined keyword user searches, or appear on other websites that are set up host ads, and have relevant content to your ad. Every time someone clicks your ad, your PPC account gets charged. Typically, PPC programs are best used in addition to your "natural search" program. Another way to get exposure is to subscribe to professional online directories that come up on the first page for local and national searches. Blowing our own horn again, The National Directory of Chiropractic, for instance, gets millions of visitors a year from people looking for a chiropractor. Ours and other professional directories are generally inexpensive to join and the return is usually well worth it. The other main benefit to joining highly relevant directories is they act as excellent back-links. TAC: Can a doctor get online traffic to their own website without hiring an outside firm? TRIVAS: To keep up on all the nuances of search engine algorithms is a job in and of itself and to compete successfully with someone who does SEO as their full time is nearly impossible, unless it's your full time night job. Experienced search engineers have libraries of back-link sites built from years of research. My suggestion is for doctors to spend their time on blogs and social media sites, then let search engineers handle the "natural searches" and PPC programs. TAC: Is it possible for a site to come up on the first page of search results without the help of search engineers? TRIVAS: Some sites will come up without the help of search engineers. If you are not sure where you are coming up, just go to a search engine, like Google, and type in "chiropractor" and the name of your area to see where your site is listed. If you want a higher ranking, you are probably going to want to hire help. If you like your positioning now, it may only be a matter of time before other websites start rising higher than yours, though, and you must constantly monitor positioning. Search Engineering Optimization is currently very hot, so more and more doctors are catching that train by hiring experts to get their websites positioned higher in search results. If your "natural search" position is good, then you already know how important it is, and how important it is to stay on top of the results. TAC: How should one go about choosing a search engineering partner firm? TRIVAS: Look for a company that has a money-back guarantee. This way the company is accountable for their performance. You want to ask about long-term performance guarantees as well. It is one thing getting your site up to the first page of Google, and another having it stay there. Choose an experienced firm that already knows your business. Ask to see success stories. You do not want to be someone's experiment. Your local web designer might be great at making websites, but may have very limited experience in SEO. Be wary of firms that ask for a large startup fee and bind you to a contract. Lastly, you get what you pay for. Remember that SEO is an ongoing job that takes dedication and hard work. If a firm is offering you incredible results for a nominal fee, you can be certain that they will not be putting in the time necessary to perform the task. Of course, we hope that doctors will take a look at our company, but there are more than a few to choose from. However, we believe that being chiropractic-centered would give us an advantage. TAC: How long should it take to see results? TRIVAS: With "Pay Per Click" programs, results are fast. In the time it takes to set up a campaign, you will see your website rise high in search results. With "natural search" SEO programs. you can expect to see results in one to six months, depending on how competitive your geographic area is. It's convenient and easy to check an SEO firm's work and see the results, or lack thereof, for yourself. If you are in Omaha, you'd expect to appear on the first page when a user searches using keywords, "Omaha, Nebraska Chiropractor". Type your own relevant keywords right into Google yourself, to see if your website is, indeed, on the first page or not. TAC: How much should be a chiropractic practice budget for search engineering? TRIVAS: Some are surprised that internet marketing does not have to be expensive. I would say $300/month would cover most internet marketing programs. Very aggressive programs will cost more. The more competitive a geographic area is, the more you can expect to pay. TAC: Is there any other parting advice you can give on Internet marketing? TRIVAS: A positive return on internet marketing requires action and consistency. Devoting a little time once a week to your Facebook page, and a blog will really make a difference. Start right now with an SEO program. Internet marketing is an ongoing marathon, just like all of your marketing programs, and the sooner you get in the SEO race, the further ahead you will be, especially compared to those that are not even out of the starting blocks. With internet marketing, it's the tortoise that comes out on top with the mantra, "slow and steady wins the race." For more tips on internet marketing, including free information on Google Places and Business Facebook Pages, contact The National Directory of Chiropractic at 801-533-4199. Dr. Ross Trivas can also he contacted for SEO advice.
