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Facebook marketing in contemporary orthodontic practice: A consumer report
Journal of the World Federation of Orthodontists xxx (2014) e1ee5
Contents lists available at ScienceDirect
Journal of the World Federation of Orthodontists journal homepage: www.jwfo.org
Research
Facebook marketing in contemporary orthodontic practice: A consumer report Trent Cox a, Jae Hyun Park b, * a
Formerly, Postgraduate Orthodontic Resident, Postgraduate Orthodontic Program, Arizona School of Dentistry & Oral Health, A.T. Still University, Mesa, Arizona Associate Professor and Chair, Postgraduate Orthodontic Program, Arizona School of Dentistry & Oral Health, A.T. Still University, Mesa, Arizona; and Adjunct Professor, Graduate School of Dentistry, Kyung Hee University, Seoul, Republic of Korea b
a r t i c l e i n f o
a b s t r a c t
Article history: Received 13 March 2013 Received in revised form 11 December 2013 Accepted 18 February 2014 Available online xxx
Background: The introduction of Facebook has brought additional marketing opportunities to orthodontic practice. Social mediaebased marketing is different from traditional marketing strategies due to its interactive nature. The aims of this study were to determine consumers’ perceptions of Facebook marketing and to determine which features of orthodontists’ Facebook pages are the most effective in attracting patients. Methods: This survey-based study contained 35 questions and was administered to 140 individuals. The respondents were aged 18 years or older and represented various ethnicities. This study determined which types of marketing activity are most effective in attracting patients through the social media venue Facebook. The majority of the survey items were formatted based on a 5-point Likert-type scale. Results: Eighty-two percent of the respondents considered themselves to be active Facebook users. Forty percent indicated a likelihood of visiting an orthodontist’s Facebook page before receiving treatment at his or her practice, with approximately 35% indicating that the Facebook page would be an important factor in their decision. The respondents indicated that there were key elements of Facebook that would attract their attention and help them to make their decision about where to receive treatment. Consumers indicated that the most important Facebook marketing components (in order of importance) are: 1) an orthodontist’s credentials; 2) before-and-after photographs; 3) consumer-focused content; and 4) the orthodontist’s photograph. Additional components that are effective include a link to the practice’s Web site, links to oral healtherelated educational articles, and the presence of Facebook “likes” and “recommendations.” Conclusion: A Facebook page may be a useful marketing tool and a valuable addition to other marketing approaches. Ó 2014 World Federation of Orthodontists.
Keywords: Facebook Marketing Orthodontics Social media
1. Introduction Social networking Web sites like Facebook, Myspace, Twitter, YouTube, and LinkedIn have revolutionized the way we communicate. Since its inception in February 2004, Facebook has become the largest and most used social media site [1]. As of July 2012, Facebook comprised 955 million active members, more than half of whom logged on to the Web site each day [1]. In addition, Facebook memberships have increased by an average of 29% in each year of the organization’s existence [1e3], which is a testament to the widespread popularity of the site. Even though Facebook popularity * Corresponding author: Postgraduate Orthodontic Program, Arizona School of Dentistry & Oral Health, A.T. Still University, 5835 East Still Circle, Mesa, AZ 85206. E-mail address: [email protected] (J.H. Park).
has steadily increased, there is volatility associated with this and all other social media venues. Although Facebook began as a social utility to allow friends and family to communicate with one another via “wall” posts, photographs, personal messages, live chats, “pokes,” and status updates, it has evolved into a major platform for social media marketing [4,5]. Businesses can create a Facebook pagedwhich is similar to a personal profiledto market their product, company, or services and gain Facebook “fans” or “likes” via engaging advertisements and quality content. A major goal of Facebook marketing is to influence the “friends” of those who are already “fans” of the organization’s Facebook page, thereby reaching more potential consumers [5]. It is important to note that advertising through a Facebook page is different from using a Web site because it allows for increased interactions and communication among a diverse population [6].
2212-4438/$ e see front matter Ó 2014 World Federation of Orthodontists. http://dx.doi.org/10.1016/j.ejwf.2014.02.003
Please cite this article in press as: Cox T, Park JH, Facebook marketing in contemporary orthodontic practice: A consumer report, Journal of the World Federation of Orthodontists (2014), http://dx.doi.org/10.1016/j.ejwf.2014.02.003
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T. Cox, J.H. Park / Journal of the World Federation of Orthodontists xxx (2014) e1ee5
Several authors have researched factors that play a role in the process in which patients engage when selecting an orthodontist. Walley et al. [7] concluded that the mother is the most significant decision maker in the family when choosing an orthodontic practice. It was also indicated that payment plan options were more influential in the decision compared with the cost of treatment [7]. Those coming from families with higher incomes chose the orthodontic practice based on the skill and excellence of the orthodontist, attention to detail, and convenience [7]. Furthermore, Elgin [8] elucidated the factors affecting patient selection of an orthodontic practice by surveying 210 individuals. Elgin found that the most important factors influencing the decision are being made to feel comfortable, a caring attitude of the practitioner/staff, clear communication from the practitioner/staff, and a clean office. The least important factors were reported to be “office amenities,” which may include refreshments, video games, and Wi-Fi. Respondents also indicated that “doctor demographics,” such as age, sex, religion, and ethnicity, were deemed as unimportant [8]. Bedair et al. [9] performed a noneconsumer-based study to determine orthodontists’ opinions of the factors that influence a patient’s choice of practitioner. The study concluded that orthodontists believe that the factors affecting the choice made by adult patients are “a doctor who makes you feel comfortable,” a doctor with a “caring attitude,” and “the doctor’s overall reputation.” Similarly, orthodontists felt that the factors affecting the decision of the parents of adolescents are “a doctor with a caring attitude,” a doctor “who makes you feel comfortable,” and “a staff with a caring attitude.” A recent article by Jorgensen [10] provides recommendations for orthodontists interested in using social media to promote their practices. However, this work was based on the author’s opinion and experience rather than on data. He states that: the purpose of social media marketing is to bring new patients into the practice; families often realize the need for orthodontic treatment and, whether or not they are given a referral, they begin a search for any recommendations or complaints from former patients; a Facebook page can be useful in allowing the prospective patient to witness the interactions happening on the Facebook page including Facebook “likes” and “recommendations”; and it is important to make a link to the practice’s Web site clear and present so that the potential patient can reference this component of the online presence as well. No study has sought to determine which aspects of social media marketing through Facebook are most valuable as determined by the consumer. The present study sought to meet this need by exploring aspects of a Facebook page. The purpose of this study was to determine which aspects of a Facebook page are most important to the consumer and are most effective from a marketing standpoint.
residency patient pool, parent/guardians of patients, and students and faculty in nonedental-related programs at A.T. Still University, although the majority were approached and invited to participate outside the university campus. Minors were excluded due to their inability to independently make health-care decisions [12]. Approval for the study was received from the institutional review board at A.T. Still University. Of the 140 respondents, 65 were male and 75 were female; there was a fairly broad distribution of age, ranging from 18 to 76 years, with the largest proportion of respondents in the 26-to-34-year age group. About two-thirds of respondents were Caucasian, with the remainder identifying as Hispanic, African American, Asian, or American Indian (Table 1). 3. Results and discussion 3.1. Social media usage Eighty-two percent of respondents were active members of Facebook, and more than two-thirds of the Facebook users reported spending between 1 and 5 hours per week on the site. About 18% of respondents reported that they did not use Facebook (Table 2). All respondents who used social media were on Facebook. 3.2. Influence and advantages of Facebook marketing Seventy-six percent of the respondents indicated that it was likely or very likely that they would visit an orthodontist’s Web site before seeking treatment with that orthodontist, whereas 39% of the respondents reported that it was likely or very likely that they would visit an orthodontist’s Facebook page before considering treatment. Thirty-five percent of respondents indicated that the Facebook page would be an important factor in their final decision (Fig. 1). Nearly 70% of respondents perceived the Facebook page as a valuable addition to an orthodontist’s online presence; however, more people ranked a Web site as being more impactful than a Facebook page. Even though this is the case, the Facebook page has its place among the marketing efforts of the modern orthodontic practice [13]. 3.3. Important Facebook page components The components of a Facebook page that were rated as most important by the respondents included the mentioning of the orthodontist’s credentials, before-and-after photographs, consumerfocused content, and the orthodontist’s photograph (Fig. 2). The components included in Figure 2 were derived from a study
2. Methods and materials A survey containing 35 items regarding respondents’ demographics, Facebook usage, Facebook page content, and objective ratings of orthodontic practices’ Facebook page components was developed. These items were chosen with the goal of determining which aspects of a Facebook page would best attract new patients to an orthodontic practice. The majority of the items were formatted as a 5-point Likert-type scale (1 ¼ very unlikely; 2 ¼ somewhat unlikely; 3 ¼ undecided; 4 ¼ somewhat likely; and 5 ¼ very likely) [11]. The survey was administered to 140 individuals, all of whom were at least 18 years of age. This was a convenience sample; respondents were approached in public locations such as public libraries and youth sporting events throughout Mesa, Arizona, and were asked to participate in the survey. Some respondents included members of the A.T. Still University postgraduate orthodontic
Table 1 Demographic characteristics of the survey respondents Characteristic Sex Female Male Age group 18e<26 y 26e<35 y 35e<45 y 45 y Ethnicity Caucasian Hispanic African American American Indian Asian
% of Respondents 53.6 46.4 17.1 41.4 24.3 17.1 67.1 22.1 5.0 2.9 2.9
Please cite this article in press as: Cox T, Park JH, Facebook marketing in contemporary orthodontic practice: A consumer report, Journal of the World Federation of Orthodontists (2014), http://dx.doi.org/10.1016/j.ejwf.2014.02.003
T. Cox, J.H. Park / Journal of the World Federation of Orthodontists xxx (2014) e1ee5 Table 2 Facebook usage by the survey respondents Parameter Facebook log-ins per week 0 1e5 6e10 11 Hours spent on Facebook per week 0 1e5 6e10 11
% of Respondents 17.9 23.6 38.6 20.0 17.9 69.3 7.9 5.0
published by Wallin [14]. These components were used in surveying the consumer on effective Web site marketing components. Responses to the survey also indicated that there is value in including a link to the practice’s Web site. Similarly, there was a positive perception to the addition of oral health/hygiene links and educational articles (Fig. 3). Nearly 57% of survey respondents indicated that the addition of oral healtheand hygiene-related articles reflect a higher quality of care offered within the orthodontic practice. Over 71% of respondents felt that this type of educational article reflects an orthodontist with more concern for the patient, and 61% reported that the posting of this type information increases the likelihood that they would seek treatment at that practice (Fig. 3). Approximately one-third of respondents felt that the presence of Facebook “likes” and “recommendations” would be influential in deciding which practice to select for treatment (Fig. 4).
3.4. Unimportant components Components that were ranked as least important by respondents included photographs that feature happy and/or smiling individuals, staff biographies, and “warm” or comforting practitioner’s statements. Design and theme were not as important to the consumer; nor were links to a blog. The promotion and/or advertising of contests and patient-appreciation events were not important to the respondents. Based on this research, the “ideal” Facebook page for an orthodontic practice would include the orthodontist’s photograph and credentials. According to the consumer, there is also value in
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including a link to the practice’s Web site, as well as a link from the Web site to the Facebook page. The results of the study show that consumers believe that pictures of an orthodontist with his or her patients would be influential in attracting them to seek treatment in his or her practice. Patient-appreciation events advertised through Facebook were not rated as important to the majority of consumers, whereas Facebook “recommendations” and “likes” would be influential in attracting more patients. The posting of dental education/hygiene-related articles are thought to reflect better care and more concern for patients’ well-being and would increase the likelihood that a patient would seek treatment from a particular orthodontist. The addition of before-and-after photographs were also found to be influential. Although all of these factors have been shown to likely affect the selection of an orthodontic practice, Greco [15] reminds all involved in the marketing efforts to uphold the American Association of Orthodontists’ Principles of Ethics and Code of Conduct, which states that members shall ensure that their public statements, announcements of services, and promotional activities for providing information to aid the public, patients, and/or other health-care providers in making informed decisions are not false, deceptive, or misleading in any material respect. Furthermore, the American Board of Orthodontics forbids a board-certified orthodontists from claiming that their status renders them as more skilled than nonboarded orthodontists [16]. From the previous publications [7e10,13,14], it can be concluded that patients and parents of patients are seeking treatment from practitioners who offer flexible payment plan options, convenience, attention to detail, good communications skills, a caring attitude, and a feeling of comfort while maintaining professionalism as per the American Association of Orthodontists’ code of conduct. These characteristics of a practice and practitioner can be portrayed through a creative marketing campaign that involves the benefits of social media. The findings of this research agree with those from other similar projects, notwithstanding the few that truly share similarities allowing for direct comparison. Consumers have indicated that they value the addition of a Facebook page and have clearly indicated the elements that they look for while accessing this component of the online presence. Social media marketing is less about marketing and more about interaction. The practice can not only communicate with patients but
Fig. 1. Comparison of the influence of online presence components.
Please cite this article in press as: Cox T, Park JH, Facebook marketing in contemporary orthodontic practice: A consumer report, Journal of the World Federation of Orthodontists (2014), http://dx.doi.org/10.1016/j.ejwf.2014.02.003
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Fig. 2. Most influential aspect of a Facebook page (percentage of total respondents).
also engage them in, and harness the power of, social media interactions [17e20]. A purpose of this study was to determine which aspects of a Facebook page are most important to consumers and, therefore, most effective from the perspective of the orthodontic practice. A consumer survey was designed to determine whether Facebook marketing can benefit an orthodontic practice. It can be concluded that the respondent consumers believe that there is value in Facebook marketing above and beyond the benefits derived from other sources of marketing, namely, the traditional Web site. The limitations of the study lie in the fact that there is limited research in the body of literature as it pertains to how consumers perceive social media marketing to build upon. This is a preliminary study that attempts to give an orthodontist a better idea of how to more fully build his or her online presence through the feedback of the consumer. Responses from an increased number of subjects representing a larger and broader demographic would be an
Fig. 3. Respondent opinions on educational material. The degrees to which respondents: 1) feel that links to oral healtherelated educational articles reflect better care at the practice; 2) feel that links to oral healtherelated educational articles indicate that the orthodontist is more concerned for the well-being of the patient; and 3) are more apt to seek treatment from an orthodontist who posts links to this type of article.
improvement on the study at hand. Areas in which future research would be helpful for the orthodontic practitioner could include a consumer survey that investigates how a consumer would rank different marketing interventions comparatively. A larger and broader scope of consumers’ opinions relating to marketing would better direct the efforts of the contemporary orthodontic practice. Despite the marketing potential of Facebook, the hub of a practice’s online presence will still remain the practice’s Web site, at least for the time being [21,22]. Additionally, the consumer cited orthodontists’ credentials and before-and-after photographs as the two most important additions to the Facebook page [22]. This surveybased research successfully determined the aspects of a Facebook page that can be used to maximize marketing potential and attract patients to the orthodontic practice. Although the extent to which Facebook advertising can be deemed advantageous is still debatable, it is clear that currently, it can make a difference. A balanced approach using various marketing modalities should be tested and validated by practitioners in their respective markets. Although this study shows that social mediaebased marketing through Facebook is beneficial in today’s market, this does not indicate that Facebook will always serve as a valid or beneficial tool. Social media is a volatile and ever-changing world as new forms are created and increase in
Fig. 4. The degree to which respondents were willing to seek treatment from an orthodontist if the orthodontist has more Facebook “likes” compared with other practitioners.
Please cite this article in press as: Cox T, Park JH, Facebook marketing in contemporary orthodontic practice: A consumer report, Journal of the World Federation of Orthodontists (2014), http://dx.doi.org/10.1016/j.ejwf.2014.02.003
T. Cox, J.H. Park / Journal of the World Federation of Orthodontists xxx (2014) e1ee5
popularity. This will undoubtedly reflect the amount of time that each practice devotes to social mediaemarketing efforts. 4. Conclusions A Facebook page can be a useful marketing tool and a valuable addition to other marketing approaches. The major difference between Facebook social mediaebased marketing and a practice’s traditional Web site, and the reason why social media marketing is such a useful tool, is its high level of interaction and ability to engage consumers. The majority of consumers (76%) report the likelihood of visiting a practice’s Web site before receiving treatment from an orthodontist, with a significant portion (39%) also indicating that they would visit a Facebook page. Approximately one-third (35%) of individuals indicated that they would use a Facebook page when making a decision about which practice to use for treatment. The consumer has indicated that the following components of a Facebook page attract their attention: a link to the practice’s Web site, the orthodontist’s credentials, a photograph of the orthodontist, before-and-after treatment photographs, and consumer content such as oral healtheand education-related articles. Although Facebook may serve as an effective marketing tool in today’s market, this may change if or when Facebook popularity declines and is replaced by more relevant venues. Acknowledgment The authors thank Dr. James D. Seward for assistance with the statistical analysis. References [1] Facebook: trends and statistics. Available from: https://www.facebook.com/ press/info.php?statistics. Last accessed: October 14, 2012. [2] Clark LA, Roberts SJ. Employer’s use of social networking sites. J Bus Ethics 2010;95:507e25.
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[3] Dunay P, Krueger R. Facebook: marketing for dummies. Indianapolis, IN: Wiley Publishing; 2010. pp. 10e1. [4] Holzner S. Facebook marketing: leverage social media to grow your business. Indianapolis, IN: Que Publishing; 2009. pp. 5e17. [5] Paquette DE. Use of technology in the orthodontic practice: a day in the life. Am J Orthod 2009;136:607e10. [6] Burbary K. Dispelling the youth myth: five useful Facebook demographic statistics. Web Business by Ken Burbary. Available from: https://www. kenburbary.com. Last accessed: October 16, 2012. [7] Walley EK, Silberman SL, Tuncay OC. Patient and parent preferences for orthodontic practices. Clin Orthod Res 1999;2:110e23. [8] Elgin CR. Factors affecting patient selection of an orthodontic practice. Available from: http://etd.ohiolink.edu/send-pdf.cgi/Elgin%20Craig%20Ross.pdf? osu1330704747. Last accessed: October 16, 2012. [9] Bedair TM, Thompson S, Gupta C, Beck FM, Firestone AR. Orthodontists’ opinions of factors affecting patients’ choice of orthodontic practices. Am J Orthod 2010;138:1e7. [10] Jorgensen G. Social media basics for orthodontists. Am J Orthod 2012;141:510e5. [11] Research Methods Knowledge Base. Likert scaling. Available from: http://www. socialresearchmethods.net/kb/scallik.php. Last accessed: November 20, 2012. [12] The Merck Manual: capacity to make health care decisions. Available from: http://www.merckmanuals.com/home/fundamentals/legal_and_ethical_issues/ capacity_to_make_health_care_decisions.html. Last accessed: October 16, 2012. [13] Hillstead MB, Park JH. Marketing in orthodontics through social networking (Facebook). J Clin Orthod 2013;47:321e5. [14] Wallin W. Does your web site draw new patients? Am J Orthod 2009;136:746e52. [15] Greco PM. Truth in advertising. Am J Orthod 2011;139:429e30. [16] American Board of Orthodontics. Guidelines for the diplomat. Available from: http://www.americanboardortho.com/about/policy/guidelines.aspx. Last accessed: November 28, 2012. [17] Haas J, Park JH. Orthodontic marketing through online social networks. J Clin Orthod 2012;46:159e64. [18] Televox.com. Survey uncovers Facebook trends in practices. Available from: https://www.televox.com. Last accessed: October 19, 2012. [19] Pattinson K. How to market your business with Facebook. NY Times, Nov. 11, 2009. [20] Revankar AV, Gandedkar NH. Effective communication in the cyberage. Am J Orthod 2010;137:712e4. [21] Thompson LA, Black E, Duff WP. Protected health information on social networking sites: ethical and legal considerations. J Med Internet Res 2011;13:e8. [22] Anderson C, Wolff M. The Web is dead. Long live the Internet. Available from: http://www.wired.com/magazine/2010/08/ff_webrip/all/1. Last accessed: October 16, 2012.
Please cite this article in press as: Cox T, Park JH, Facebook marketing in contemporary orthodontic practice: A consumer report, Journal of the World Federation of Orthodontists (2014), http://dx.doi.org/10.1016/j.ejwf.2014.02.003
Contents lists available at ScienceDirect
Journal of the World Federation of Orthodontists journal homepage: www.jwfo.org
Research
Facebook marketing in contemporary orthodontic practice: A consumer report Trent Cox a, Jae Hyun Park b, * a
Formerly, Postgraduate Orthodontic Resident, Postgraduate Orthodontic Program, Arizona School of Dentistry & Oral Health, A.T. Still University, Mesa, Arizona Associate Professor and Chair, Postgraduate Orthodontic Program, Arizona School of Dentistry & Oral Health, A.T. Still University, Mesa, Arizona; and Adjunct Professor, Graduate School of Dentistry, Kyung Hee University, Seoul, Republic of Korea b
a r t i c l e i n f o
a b s t r a c t
Article history: Received 13 March 2013 Received in revised form 11 December 2013 Accepted 18 February 2014 Available online xxx
Background: The introduction of Facebook has brought additional marketing opportunities to orthodontic practice. Social mediaebased marketing is different from traditional marketing strategies due to its interactive nature. The aims of this study were to determine consumers’ perceptions of Facebook marketing and to determine which features of orthodontists’ Facebook pages are the most effective in attracting patients. Methods: This survey-based study contained 35 questions and was administered to 140 individuals. The respondents were aged 18 years or older and represented various ethnicities. This study determined which types of marketing activity are most effective in attracting patients through the social media venue Facebook. The majority of the survey items were formatted based on a 5-point Likert-type scale. Results: Eighty-two percent of the respondents considered themselves to be active Facebook users. Forty percent indicated a likelihood of visiting an orthodontist’s Facebook page before receiving treatment at his or her practice, with approximately 35% indicating that the Facebook page would be an important factor in their decision. The respondents indicated that there were key elements of Facebook that would attract their attention and help them to make their decision about where to receive treatment. Consumers indicated that the most important Facebook marketing components (in order of importance) are: 1) an orthodontist’s credentials; 2) before-and-after photographs; 3) consumer-focused content; and 4) the orthodontist’s photograph. Additional components that are effective include a link to the practice’s Web site, links to oral healtherelated educational articles, and the presence of Facebook “likes” and “recommendations.” Conclusion: A Facebook page may be a useful marketing tool and a valuable addition to other marketing approaches. Ó 2014 World Federation of Orthodontists.
Keywords: Facebook Marketing Orthodontics Social media
1. Introduction Social networking Web sites like Facebook, Myspace, Twitter, YouTube, and LinkedIn have revolutionized the way we communicate. Since its inception in February 2004, Facebook has become the largest and most used social media site [1]. As of July 2012, Facebook comprised 955 million active members, more than half of whom logged on to the Web site each day [1]. In addition, Facebook memberships have increased by an average of 29% in each year of the organization’s existence [1e3], which is a testament to the widespread popularity of the site. Even though Facebook popularity * Corresponding author: Postgraduate Orthodontic Program, Arizona School of Dentistry & Oral Health, A.T. Still University, 5835 East Still Circle, Mesa, AZ 85206. E-mail address: [email protected] (J.H. Park).
has steadily increased, there is volatility associated with this and all other social media venues. Although Facebook began as a social utility to allow friends and family to communicate with one another via “wall” posts, photographs, personal messages, live chats, “pokes,” and status updates, it has evolved into a major platform for social media marketing [4,5]. Businesses can create a Facebook pagedwhich is similar to a personal profiledto market their product, company, or services and gain Facebook “fans” or “likes” via engaging advertisements and quality content. A major goal of Facebook marketing is to influence the “friends” of those who are already “fans” of the organization’s Facebook page, thereby reaching more potential consumers [5]. It is important to note that advertising through a Facebook page is different from using a Web site because it allows for increased interactions and communication among a diverse population [6].
2212-4438/$ e see front matter Ó 2014 World Federation of Orthodontists. http://dx.doi.org/10.1016/j.ejwf.2014.02.003
Please cite this article in press as: Cox T, Park JH, Facebook marketing in contemporary orthodontic practice: A consumer report, Journal of the World Federation of Orthodontists (2014), http://dx.doi.org/10.1016/j.ejwf.2014.02.003
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T. Cox, J.H. Park / Journal of the World Federation of Orthodontists xxx (2014) e1ee5
Several authors have researched factors that play a role in the process in which patients engage when selecting an orthodontist. Walley et al. [7] concluded that the mother is the most significant decision maker in the family when choosing an orthodontic practice. It was also indicated that payment plan options were more influential in the decision compared with the cost of treatment [7]. Those coming from families with higher incomes chose the orthodontic practice based on the skill and excellence of the orthodontist, attention to detail, and convenience [7]. Furthermore, Elgin [8] elucidated the factors affecting patient selection of an orthodontic practice by surveying 210 individuals. Elgin found that the most important factors influencing the decision are being made to feel comfortable, a caring attitude of the practitioner/staff, clear communication from the practitioner/staff, and a clean office. The least important factors were reported to be “office amenities,” which may include refreshments, video games, and Wi-Fi. Respondents also indicated that “doctor demographics,” such as age, sex, religion, and ethnicity, were deemed as unimportant [8]. Bedair et al. [9] performed a noneconsumer-based study to determine orthodontists’ opinions of the factors that influence a patient’s choice of practitioner. The study concluded that orthodontists believe that the factors affecting the choice made by adult patients are “a doctor who makes you feel comfortable,” a doctor with a “caring attitude,” and “the doctor’s overall reputation.” Similarly, orthodontists felt that the factors affecting the decision of the parents of adolescents are “a doctor with a caring attitude,” a doctor “who makes you feel comfortable,” and “a staff with a caring attitude.” A recent article by Jorgensen [10] provides recommendations for orthodontists interested in using social media to promote their practices. However, this work was based on the author’s opinion and experience rather than on data. He states that: the purpose of social media marketing is to bring new patients into the practice; families often realize the need for orthodontic treatment and, whether or not they are given a referral, they begin a search for any recommendations or complaints from former patients; a Facebook page can be useful in allowing the prospective patient to witness the interactions happening on the Facebook page including Facebook “likes” and “recommendations”; and it is important to make a link to the practice’s Web site clear and present so that the potential patient can reference this component of the online presence as well. No study has sought to determine which aspects of social media marketing through Facebook are most valuable as determined by the consumer. The present study sought to meet this need by exploring aspects of a Facebook page. The purpose of this study was to determine which aspects of a Facebook page are most important to the consumer and are most effective from a marketing standpoint.
residency patient pool, parent/guardians of patients, and students and faculty in nonedental-related programs at A.T. Still University, although the majority were approached and invited to participate outside the university campus. Minors were excluded due to their inability to independently make health-care decisions [12]. Approval for the study was received from the institutional review board at A.T. Still University. Of the 140 respondents, 65 were male and 75 were female; there was a fairly broad distribution of age, ranging from 18 to 76 years, with the largest proportion of respondents in the 26-to-34-year age group. About two-thirds of respondents were Caucasian, with the remainder identifying as Hispanic, African American, Asian, or American Indian (Table 1). 3. Results and discussion 3.1. Social media usage Eighty-two percent of respondents were active members of Facebook, and more than two-thirds of the Facebook users reported spending between 1 and 5 hours per week on the site. About 18% of respondents reported that they did not use Facebook (Table 2). All respondents who used social media were on Facebook. 3.2. Influence and advantages of Facebook marketing Seventy-six percent of the respondents indicated that it was likely or very likely that they would visit an orthodontist’s Web site before seeking treatment with that orthodontist, whereas 39% of the respondents reported that it was likely or very likely that they would visit an orthodontist’s Facebook page before considering treatment. Thirty-five percent of respondents indicated that the Facebook page would be an important factor in their final decision (Fig. 1). Nearly 70% of respondents perceived the Facebook page as a valuable addition to an orthodontist’s online presence; however, more people ranked a Web site as being more impactful than a Facebook page. Even though this is the case, the Facebook page has its place among the marketing efforts of the modern orthodontic practice [13]. 3.3. Important Facebook page components The components of a Facebook page that were rated as most important by the respondents included the mentioning of the orthodontist’s credentials, before-and-after photographs, consumerfocused content, and the orthodontist’s photograph (Fig. 2). The components included in Figure 2 were derived from a study
2. Methods and materials A survey containing 35 items regarding respondents’ demographics, Facebook usage, Facebook page content, and objective ratings of orthodontic practices’ Facebook page components was developed. These items were chosen with the goal of determining which aspects of a Facebook page would best attract new patients to an orthodontic practice. The majority of the items were formatted as a 5-point Likert-type scale (1 ¼ very unlikely; 2 ¼ somewhat unlikely; 3 ¼ undecided; 4 ¼ somewhat likely; and 5 ¼ very likely) [11]. The survey was administered to 140 individuals, all of whom were at least 18 years of age. This was a convenience sample; respondents were approached in public locations such as public libraries and youth sporting events throughout Mesa, Arizona, and were asked to participate in the survey. Some respondents included members of the A.T. Still University postgraduate orthodontic
Table 1 Demographic characteristics of the survey respondents Characteristic Sex Female Male Age group 18e<26 y 26e<35 y 35e<45 y 45 y Ethnicity Caucasian Hispanic African American American Indian Asian
% of Respondents 53.6 46.4 17.1 41.4 24.3 17.1 67.1 22.1 5.0 2.9 2.9
Please cite this article in press as: Cox T, Park JH, Facebook marketing in contemporary orthodontic practice: A consumer report, Journal of the World Federation of Orthodontists (2014), http://dx.doi.org/10.1016/j.ejwf.2014.02.003
T. Cox, J.H. Park / Journal of the World Federation of Orthodontists xxx (2014) e1ee5 Table 2 Facebook usage by the survey respondents Parameter Facebook log-ins per week 0 1e5 6e10 11 Hours spent on Facebook per week 0 1e5 6e10 11
% of Respondents 17.9 23.6 38.6 20.0 17.9 69.3 7.9 5.0
published by Wallin [14]. These components were used in surveying the consumer on effective Web site marketing components. Responses to the survey also indicated that there is value in including a link to the practice’s Web site. Similarly, there was a positive perception to the addition of oral health/hygiene links and educational articles (Fig. 3). Nearly 57% of survey respondents indicated that the addition of oral healtheand hygiene-related articles reflect a higher quality of care offered within the orthodontic practice. Over 71% of respondents felt that this type of educational article reflects an orthodontist with more concern for the patient, and 61% reported that the posting of this type information increases the likelihood that they would seek treatment at that practice (Fig. 3). Approximately one-third of respondents felt that the presence of Facebook “likes” and “recommendations” would be influential in deciding which practice to select for treatment (Fig. 4).
3.4. Unimportant components Components that were ranked as least important by respondents included photographs that feature happy and/or smiling individuals, staff biographies, and “warm” or comforting practitioner’s statements. Design and theme were not as important to the consumer; nor were links to a blog. The promotion and/or advertising of contests and patient-appreciation events were not important to the respondents. Based on this research, the “ideal” Facebook page for an orthodontic practice would include the orthodontist’s photograph and credentials. According to the consumer, there is also value in
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including a link to the practice’s Web site, as well as a link from the Web site to the Facebook page. The results of the study show that consumers believe that pictures of an orthodontist with his or her patients would be influential in attracting them to seek treatment in his or her practice. Patient-appreciation events advertised through Facebook were not rated as important to the majority of consumers, whereas Facebook “recommendations” and “likes” would be influential in attracting more patients. The posting of dental education/hygiene-related articles are thought to reflect better care and more concern for patients’ well-being and would increase the likelihood that a patient would seek treatment from a particular orthodontist. The addition of before-and-after photographs were also found to be influential. Although all of these factors have been shown to likely affect the selection of an orthodontic practice, Greco [15] reminds all involved in the marketing efforts to uphold the American Association of Orthodontists’ Principles of Ethics and Code of Conduct, which states that members shall ensure that their public statements, announcements of services, and promotional activities for providing information to aid the public, patients, and/or other health-care providers in making informed decisions are not false, deceptive, or misleading in any material respect. Furthermore, the American Board of Orthodontics forbids a board-certified orthodontists from claiming that their status renders them as more skilled than nonboarded orthodontists [16]. From the previous publications [7e10,13,14], it can be concluded that patients and parents of patients are seeking treatment from practitioners who offer flexible payment plan options, convenience, attention to detail, good communications skills, a caring attitude, and a feeling of comfort while maintaining professionalism as per the American Association of Orthodontists’ code of conduct. These characteristics of a practice and practitioner can be portrayed through a creative marketing campaign that involves the benefits of social media. The findings of this research agree with those from other similar projects, notwithstanding the few that truly share similarities allowing for direct comparison. Consumers have indicated that they value the addition of a Facebook page and have clearly indicated the elements that they look for while accessing this component of the online presence. Social media marketing is less about marketing and more about interaction. The practice can not only communicate with patients but
Fig. 1. Comparison of the influence of online presence components.
Please cite this article in press as: Cox T, Park JH, Facebook marketing in contemporary orthodontic practice: A consumer report, Journal of the World Federation of Orthodontists (2014), http://dx.doi.org/10.1016/j.ejwf.2014.02.003
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Fig. 2. Most influential aspect of a Facebook page (percentage of total respondents).
also engage them in, and harness the power of, social media interactions [17e20]. A purpose of this study was to determine which aspects of a Facebook page are most important to consumers and, therefore, most effective from the perspective of the orthodontic practice. A consumer survey was designed to determine whether Facebook marketing can benefit an orthodontic practice. It can be concluded that the respondent consumers believe that there is value in Facebook marketing above and beyond the benefits derived from other sources of marketing, namely, the traditional Web site. The limitations of the study lie in the fact that there is limited research in the body of literature as it pertains to how consumers perceive social media marketing to build upon. This is a preliminary study that attempts to give an orthodontist a better idea of how to more fully build his or her online presence through the feedback of the consumer. Responses from an increased number of subjects representing a larger and broader demographic would be an
Fig. 3. Respondent opinions on educational material. The degrees to which respondents: 1) feel that links to oral healtherelated educational articles reflect better care at the practice; 2) feel that links to oral healtherelated educational articles indicate that the orthodontist is more concerned for the well-being of the patient; and 3) are more apt to seek treatment from an orthodontist who posts links to this type of article.
improvement on the study at hand. Areas in which future research would be helpful for the orthodontic practitioner could include a consumer survey that investigates how a consumer would rank different marketing interventions comparatively. A larger and broader scope of consumers’ opinions relating to marketing would better direct the efforts of the contemporary orthodontic practice. Despite the marketing potential of Facebook, the hub of a practice’s online presence will still remain the practice’s Web site, at least for the time being [21,22]. Additionally, the consumer cited orthodontists’ credentials and before-and-after photographs as the two most important additions to the Facebook page [22]. This surveybased research successfully determined the aspects of a Facebook page that can be used to maximize marketing potential and attract patients to the orthodontic practice. Although the extent to which Facebook advertising can be deemed advantageous is still debatable, it is clear that currently, it can make a difference. A balanced approach using various marketing modalities should be tested and validated by practitioners in their respective markets. Although this study shows that social mediaebased marketing through Facebook is beneficial in today’s market, this does not indicate that Facebook will always serve as a valid or beneficial tool. Social media is a volatile and ever-changing world as new forms are created and increase in
Fig. 4. The degree to which respondents were willing to seek treatment from an orthodontist if the orthodontist has more Facebook “likes” compared with other practitioners.
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popularity. This will undoubtedly reflect the amount of time that each practice devotes to social mediaemarketing efforts. 4. Conclusions A Facebook page can be a useful marketing tool and a valuable addition to other marketing approaches. The major difference between Facebook social mediaebased marketing and a practice’s traditional Web site, and the reason why social media marketing is such a useful tool, is its high level of interaction and ability to engage consumers. The majority of consumers (76%) report the likelihood of visiting a practice’s Web site before receiving treatment from an orthodontist, with a significant portion (39%) also indicating that they would visit a Facebook page. Approximately one-third (35%) of individuals indicated that they would use a Facebook page when making a decision about which practice to use for treatment. The consumer has indicated that the following components of a Facebook page attract their attention: a link to the practice’s Web site, the orthodontist’s credentials, a photograph of the orthodontist, before-and-after treatment photographs, and consumer content such as oral healtheand education-related articles. Although Facebook may serve as an effective marketing tool in today’s market, this may change if or when Facebook popularity declines and is replaced by more relevant venues. Acknowledgment The authors thank Dr. James D. Seward for assistance with the statistical analysis. References [1] Facebook: trends and statistics. Available from: https://www.facebook.com/ press/info.php?statistics. Last accessed: October 14, 2012. [2] Clark LA, Roberts SJ. Employer’s use of social networking sites. J Bus Ethics 2010;95:507e25.
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[3] Dunay P, Krueger R. Facebook: marketing for dummies. Indianapolis, IN: Wiley Publishing; 2010. pp. 10e1. [4] Holzner S. Facebook marketing: leverage social media to grow your business. Indianapolis, IN: Que Publishing; 2009. pp. 5e17. [5] Paquette DE. Use of technology in the orthodontic practice: a day in the life. Am J Orthod 2009;136:607e10. [6] Burbary K. Dispelling the youth myth: five useful Facebook demographic statistics. Web Business by Ken Burbary. Available from: https://www. kenburbary.com. Last accessed: October 16, 2012. [7] Walley EK, Silberman SL, Tuncay OC. Patient and parent preferences for orthodontic practices. Clin Orthod Res 1999;2:110e23. [8] Elgin CR. Factors affecting patient selection of an orthodontic practice. Available from: http://etd.ohiolink.edu/send-pdf.cgi/Elgin%20Craig%20Ross.pdf? osu1330704747. Last accessed: October 16, 2012. [9] Bedair TM, Thompson S, Gupta C, Beck FM, Firestone AR. Orthodontists’ opinions of factors affecting patients’ choice of orthodontic practices. Am J Orthod 2010;138:1e7. [10] Jorgensen G. Social media basics for orthodontists. Am J Orthod 2012;141:510e5. [11] Research Methods Knowledge Base. Likert scaling. Available from: http://www. socialresearchmethods.net/kb/scallik.php. Last accessed: November 20, 2012. [12] The Merck Manual: capacity to make health care decisions. Available from: http://www.merckmanuals.com/home/fundamentals/legal_and_ethical_issues/ capacity_to_make_health_care_decisions.html. Last accessed: October 16, 2012. [13] Hillstead MB, Park JH. Marketing in orthodontics through social networking (Facebook). J Clin Orthod 2013;47:321e5. [14] Wallin W. Does your web site draw new patients? Am J Orthod 2009;136:746e52. [15] Greco PM. Truth in advertising. Am J Orthod 2011;139:429e30. [16] American Board of Orthodontics. Guidelines for the diplomat. Available from: http://www.americanboardortho.com/about/policy/guidelines.aspx. Last accessed: November 28, 2012. [17] Haas J, Park JH. Orthodontic marketing through online social networks. J Clin Orthod 2012;46:159e64. [18] Televox.com. Survey uncovers Facebook trends in practices. Available from: https://www.televox.com. Last accessed: October 19, 2012. [19] Pattinson K. How to market your business with Facebook. NY Times, Nov. 11, 2009. [20] Revankar AV, Gandedkar NH. Effective communication in the cyberage. Am J Orthod 2010;137:712e4. [21] Thompson LA, Black E, Duff WP. Protected health information on social networking sites: ethical and legal considerations. J Med Internet Res 2011;13:e8. [22] Anderson C, Wolff M. The Web is dead. Long live the Internet. Available from: http://www.wired.com/magazine/2010/08/ff_webrip/all/1. Last accessed: October 16, 2012.
Please cite this article in press as: Cox T, Park JH, Facebook marketing in contemporary orthodontic practice: A consumer report, Journal of the World Federation of Orthodontists (2014), http://dx.doi.org/10.1016/j.ejwf.2014.02.003