Direct marketing is one of many elements constituting the broad discipline of marketing, formally defined as “a management process that involves the assessment of customer wants and needs, and the performance of all activities associated with the development, pricing, provision, and promotion of product solutions that satisfy those wants and needs” [1], p. 288. Promotion, as evidenced in this definition, is a core feature of marketing, earning inclusion as one of the Ps in the classic expression known as the four Ps of marketing (i.e., Product, Price, Place, Promotion). The promotion aspect of marketing essentially entails any and all elements associated with engaging audiences, with the core pathways for engagement being depicted in a descriptive model known as the marketing communications (or promotions) mix [1, 17].
Classically illustrated, the marketing communications mix contains five principal avenues of communication; namely, advertising (i.e., the paid use of mass media to deliver messages), personal selling (i.e., the use of sales agents to personally deliver messages), sales promotion (i.e., the use of incentives, such as contests and free giveaways, to encourage patronage), public relations (i.e., the use of publicity and other unpaid promotional methods to deliver messages), and direct marketing (i.e., the delivery of messages via mail, the Internet, and similar routes directly to consumers) [1, 7]. Healthcare providers examine each of these communicative avenues, selecting one or more believed to be most capable of reaching target audiences, with the ultimate goal being to encourage patronage or compel some other desired action [1, 9].
Direct marketing is characterized by its conveyance of information directly to individuals. Unlike advertising, which uses mass media to deliver messages to broad audiences en masse, hoping to entice interested parties into some form of desired exchange, direct marketing engages individuals directly by sending, for example, a promotional brochure, email message, or similar conveyance straight to the intended recipient. It is a highly targeted form of communication and, as such, is highly measurable, as responses to various solicitations can be tracked with relative ease [14,15,16, 18]. Historically, direct marketing often brought to mind telemarketing or direct mail, but times have changed. Today, telemarketing has been deemed by society to be so undesirable that its use is now highly regulated, diminishing opportunities and associated presence considerably. Even though direct mail often is characterized by recipients as junk mail, it continues to be used quite heavily, although shifts to electronic forms of communication have diminished its popularity. The Internet indeed has ushered in numerous direct marketing opportunities, ranging from email appeals to newsletter distribution to social media engagements. This particular avenue is evolving rapidly and almost certainly represents the future of direct marketing methods [1, 14, 16].
One of the most critical tasks associated with direct marketing pertains to building lists of prospects who will be targeted with associated solicitations [5, 14, 15]. Prospect lists often are purchased from vendors who specialize in the provision of such, permitting healthcare establishments to designate recipient characteristics (e.g., ZIP code, gender, age, interests, etc.) and request lists of candidates meeting associated criteria. Although more labor intensive, health and medical institutions can opt instead to build their own lists. Assembling these lists typically begins by asking current customers if they would like to receive collateral, such as monthly newsletters, invitations to special events, promotional messages detailing new healthcare options, and so on, adding those desirous of such to a direct marketing database. Invitations to join mailing lists, subscribe to social media news conveyances, and the like also can be inserted into other marketing communications, with those opting in being added to associated direct marketing repositories. With concerted efforts over time, custom lists will grow and become true institutional assets, typically exceeding the value derived from their more generic, purchased counterparts [5, 7, 14,15,16,17,18,19,20,21].
How lists are used arguably is just as important as quality of given lists. Simply collecting contact details and sending solicitations whenever healthcare institutions please is decidedly poor form and likely will engender the animosity of recipients. This practice historically has been used by many organizations and unfortunately continues to this day, perpetuating negative feelings regarding direct marketing [5, 7, 14,15,16,17,18,19,20,21]. Such animosity can be reduced or eliminated entirely by practicing what is known as permission marketing, requiring that institutions request and be granted permission before forwarding solicitations to intended recipients and, for those granting permission, offering easy methods to opt out of future solicitations [16, 22].
Delivery without permission to do so can damage institutional reputations and lead to senders being labeled “junk mailers,” “spammers,” and the like for directing unsolicited and often unwanted correspondence to individuals. As tempting as it might be to send promotional messages without an invitation, it should be avoided, as the main aim of healthcare communications rests with establishing a productive dialogue, a mission immediately destroyed by intruding on the personal space of audiences [5,6,7, 14,15,16,17,18,19,20,21,22]. Of course, beyond the assembly of lists and their proper use, the information contained in direct marketing pieces must have value to recipients. If healthcare providers develop direct marketing programs that fulfill these mandates, they can expect good things from their associated programs.
