The Department of Veterans Affairs wants to make it easier to implement a nationwide telemedicine program. To do this, they need to override state licensing laws.

Sounds scary, but representatives from all but one state support the VA’s efforts. That lone state: California.

According to Kimberly Kirchmeyer, Executive Director for the Medical Board of California, her organization is concerned that the VA’s rule would undermine California’s ability to protect healthcare consumers, because it couldn’t discipline VA providers that don’t hold a California license.

“The board believes that it is very important for physicians treating patients in California to be licensed in California,” she wrote in dissent of the VA request. “Without this licensure, enforcement for allegations of wrongdoing would be impossible to investigate and public protection would not occur.”

Despite her concerns, the VA’s effort was overwhelmingly supported. Health IT Now Executive Director noted how “artificial geographical restrictions” have limited the use of telemedicine at the VA. The rule, he said, would increase access to veterans. Particularly those in rural parts of the country.

This rule put forth by the VA is a key feature to its “Anywhere to Anywhere” program unveiled in August, 2017 (and passed by Congress in November). “Anywhere to Anywhere” allows veterans to connect with physicians using a mobile app. It also includes the roll out of VA Video Connect, a system to make it easier for providers to see, and speak with, veterans regardless of location.

We’ve known about, and have monitored, the progression of telehealth in the industry over the last few years. But California’s lone dissent of the VA’s proposal does have us wondering how the health industry will maintain its progressive growth, while ensuring the safety of patients.

In other words, should out-of-state doctors be able to treat patients?

The benefits of telemedicine for your practice

By now it’s pretty clear how telemedicine helps patients. The VA’s proposal highlights the key benefits:

  • Reach patients in rural areas
  • Connect with patients on their time
  • Make it easy for folks who struggle to travel to “see” their doctor

There are also the benefits of expanded use of medical specialty expertise and prompt access to medical records.

But there are an incredible number of benefits to doctors and practitioners as well. Unnecessary visits can be reduced, or altogether eliminated. Doctors can get more involved with their patients. And, of course, they can reach a wider patient base.

Or can they?

Regulations that limit a physician’s ability to reach across state lines

Under Article 10 of the US Constitution, the Federal Government gives states authority to “regulate activities that affect the health, safety, and welfare of their citizens including the practice of healing arts within their borders.”

Each state has laws, licensing bodies, and regulations that describe requirements for education and training, and define scope of practice. And, as a result, any doctor looking to treat patients in another state, via telemedicine, needs to abide by state laws.

Take Iowa’s laws. In 2015, Iowa created a new set of standards specific for physicians who use telemedicine.

For starters, the Iowa Board of Medicine made it clear that:

  • Technological advances have made it possible for licensees in one location to provide medical care to patients in another location with or without an intervening health care provider, and
  • Telemedicine is a useful tool that, if applied appropriately, can provide important benefits to patients, including increased access to health care

But they also made clear that out-of-state physicians will be required to have a valid Iowa medical license if they diagnose and treat patients located in Iowa.

Most (but not all) states follow a similar standard.

Crossing state lines is just about the hottest topic in telemedicine today. Many practitioners note that state and federal laws simply do not match up with the 21st-century digital realties we live in today.

But it’s a careful balancing act. There is no national telemedicine license because Congress is reluctant to preempt the states’ right to license health professionals.

Which leads us back to square one. If technology makes it possible for your practice to help patients across the country, should you be denied this opportunity due to a law enacted in the 1800s?

At least one endeavor is looking to make the medical field catch up to modern times.

Understanding the Interstate Medical Licensure Compact

The Interstate Medical Licensure Compact allows qualified physicians – who wish to practice in multiple states – a streamlined way to get licensed in multiple states.

“While making it easier for physicians to obtain licenses to practice in multiple states,” the IMLC states on its website, “the Compact strengthens public protection by enhancing the ability of states to share investigative and disciplinary information.”

In other words, the IMLC wants to make healthcare more accessible, without compromising a state’s individual ability to monitor and discipline physicians that “practice” in their jurisdiction.

The IMLC is an agreement between 22 states and the 29 Medical and Osteopathic Boards in those states. Under this agreement licensed physicians can qualify to practice medicine across state lines within the Compact if they meet the agreed upon eligibility requirements.

It’s not a perfect solution, but it’s certainly a step in the right direction. Modern technology allows you to offer your services across the nation – from the comfort of your own offices. It’s nice to see that some organizations are trying to make it easier for you to cast aside state borders, without compromising patient safety.

And so, the next logical question is, if and when your practice is capable of reaching across state borders, how do you market yourself to broaden your reach?

Marketing your medical practice across state lines

For this, let’s assume that you are legally set to practice – via telemedicine – in several states.

What can you do to reach prospective patients in these states? Do you create micro-websites for each location? Do you make separate social media profiles? How can you use ad targeting to get your message across?

These are the questions we’ll answer now, so that you can confidently expand your practice regardless of geographic restrictions.

What to do with your website?

If your medical practice has targeted just one location until now, there’s a good chance your website reflects that. Take, for example, this site we found by conducting a search for “pediatric eye doctor in San Francisco”:

If you practice telemdicine, you dont have to clone your website for multiple locations. Create a landing page for each specific location with a relevant content.

As you can see, the site screams San Francisco, which is good, if Pacific Eye were only targeting patients in San Francisco.

But with the help of telemedicine, they don’t have to. So, is it a case of their having to revise their website completely to cater to a wider audience?

Not necessarily. And, to be honest, not preferably. If your practice is like our example, then your primary audience is still, of course, your local prospects. Your main website should reflect that.

So, does that mean you need to create tiny websites for each of your locations?

No, not at all. While these types of sites (often referred to as micro-sites) are powerful, they also require individual monitoring and maintenance. Chances are, you’d prefer to keep things simple.

The best way to get the same benefits of a micro-site, without the hassle, is to create individual location pages on your main website.

Here’s what our plastic surgery marketing company means. For starters, list out all of the locations you aim to target. You’ll end up creating a page for each location, and adding them to your main website. That way that location will get its own URL and you can update it with location-specific information.

Here’s an example from an NYC-based plastic surgeon targeting folks in nearby White Plans.

Location optimized Landing Page. Target audience from a certain location

While this example demonstrates two locations in the same state, the premise is similar. Aside from being able to create location-specific copy, Dr. Schwarcz is also able to create a page with a location-optimized URL:

Location Optimized URL

In addition to doing that for each of your locations, you’ll also want to add a “Locations” menu item in your navigation bar, as seen below:

If you are cloning your landing pages to target audience from different locations, be careful to avoid duplicate content as you can get penalized by google

When producing your location pages, be wary of duplicate content. While you’ll almost certainly repeat information on multiple pages, you want to create some unique content per page so you’re not penalized by Google.

Over time, you can build off these location pages. For example, if you’re a plastic surgeon like Dr. Schwarcz, your “White Plans” location page might eventually link to service pages specific to White Plans, including “Face Lifts in White Plans” and “Rhinoplasty Surgeon in White Plains” and so on.

But for now, a good start is to create a main landing page for each of your locations that discusses all of your services. Think of these as mini home-pages.

These location pages are great for organic traffic, but organic traffic isn’t enough

Your newly created location pages should give you an uptick in organic traffic. And they’ll make it easy for you to point prospects to a relevant page (vs. say, pointing a patient in Chicago to your home page, that has a photograph of the Golden Gate Bridge).

But if you’re looking to make these pages a true marketing powerhouse for you, then you need to implement paid advertising. Fortunately, half the job is done: you’ve created your landing pages.

Now it’s just a matter of creating campaigns in Google AdWords that target your prospects based on location and keyword usage with Google AdWords PPC Management.

Beside for Google AdWords, you can use already created landing pages if you are running ads with programmatic advertising.

The good news is, you probably can use the same keywords for each location. But you might want to do some research to make sure your target audiences in one location use the same phrases, and search habits, as prospects elsewhere.

But aside from that, you want to create individual campaigns for each location. Or, in other words, one campaign for each location landing page.

You can choose locations by typing in a city or town name, or you can draw a radius around a certain designated area.

You can use existing location optimized landing pages for your Google AdWords Campaign

The choice is up to you. Below is an example of an ad our orthopedic marketing department found when we entered the search term: plastic surgeon in Philadelphia:

Use an existing Google AdWords ad across multiple locations

In reality, this doctor could duplicate that ad for each of his targeted locations, whether it’s Philadelphia, Atlanta, or L.A. (little nod to the Steve Miller Band there). By doing this, you’re capitalizing on the work you invested in creating your location pages.

Just keep in mind that whenever you create a paid search campaign, you want to make sure you:

  • Bid appropriately
  • Include negative keywords to keep costs down and target the right traffic
  • Constantly monitor your campaigns

Learn how to create your first PPC campaign here >>

What about social media for a multi-location medical practice?

OK, we’ve talked about your website. We discussed using paid search to build qualified traffic. But what about social media. Do you need to create separate social media profiles for each of your locations?

No. Again, it goes back to this: do you really want to have to manage several Facebook pages?

If the answer is no, then we’ll show you how to make the most of your one Facebook page below. Even if you don’t mind managing several Facebook pages, you likely don’t need them.

Here’s why:

Your practice still only has one actual location. So, for every new Facebook page you create, you don’t have a local address to add to help you show up in local searches (see the image below, which shows the map that’s on a Facebook page of a Santa Fe sleep doctor):

Though one facebook page allows only one physical address, you can still address to clients in multiple locations

Unless you’re willing to secure addresses in each jurisdiction you hope to cover, it’s easier just to stick with one page.

Don’t worry. You can still get your practice in front of your potential patients, no matter where they live.

One of the first steps you can do is make it clear on your page that your physical location is in one area, but that you serve a variety of areas through telemedicine. You can do that in your description section, but also in your cover photo.

In the image below, Detroit doctor Sohrab Arora uses his cover photo to show a variety of images from his practice:

Compose your facebook cover photo out of locations where you can offer telemedicine services

You could, instead, highlight each location where you practice telemedicine. That way, prospective patients will know that you can, in fact, treat them.

But just tweaking your Facebook page isn’t enough. You need to get the message out there that you’re available for patients via telemedicine.

How do you do that?

That’s where paid social media ads come into play. Facebook makes it incredibly easy for you to create ads for your Facebook page, and target them based on location and other parameters. What we want to focus on here is how to manage your ads properly so you target the right people, without flooding your page with irrelevant content.

For this, you need to know the difference between Boost Posts and Ads.

While the final product of both these strategies is an ad, they differ in one very important way:

Use boost post option to target certain audience with your facebook post

Boost posts are posts you publish on your page (so all of your followers can see them). You then “boost” or promote that post to a targeted audience.

In the image above, we have a post we published onto our page. That means, all of our followers can see that post. If we want to, however, we can also boost that post to target it to a specific audience (including to make sure our followers see the post).

An ad, however, never shows up on your main page. It will only appear in the news feeds of folks you specifically targeted. This AT&T post isn’t on their page; it’s an ad they targeted to specific audiences:

Reach out to your customers with facebook paid ads

Here’s how you can use that knowledge to your benefit:

If you create general content that anyone, regardless of location, would benefit from, then post it to your page. This could include:

  • General health tips
  • News about your practice (like how you offer a new service)
  • Live stream Q&A’s with your staff

You could boost these posts, as well, to various audiences. The reason you’d boost a post is because, to be frank, organic reach in Facebook is at an all-time low. If you want prospective patients to actually see the posts you add to your page, you’re going to have to boost them.

So, when do you use ads instead of boosted posts?
You would use ads when you wanted to target a specific location only. For example, let’s say you just got licensed to practice telemedicine in Ohio. So, you want to target folks in the Greater Cleveland area. Great! Rather than flood your Facebook page with an announcement, create an ad, and target folks in the Cleveland area.

That way, you reach your intended audience without posting something on your page that doesn’t affect most of your followers.

Making the most of telemedicine technology

We live in an exciting time where borders are beginning to become irrelevant. As rules and regulations sort themselves out, more and more doctors will find themselves able to quickly set up a “virtual” shop anywhere in the country.

Are you prepared? While above we discussed such strategies as your website, paid advertising and social media, there’s so much more to consider.

Do you create multiple Yelp pages? Do you need to create more than one Google My Business page?

Fortunately, the Cardinal flock is well versed in helping practices like yours capitalize on this exciting time.

If you’re looking to expand beyond borders, but aren’t sure how to get started, give us a call. We’d love to help.

Alex Membrillo Cardinal CEO

Alex Membrillo

Founder and CEO

Alex Membrillo is the CEO of Cardinal, a digital marketing agency focused on growing multi location companies. His work as CEO of Cardinal also recently earned him the honor of being selected as a 2015 and 2016 Top 20 Entrepreneur of metro Atlanta by TiE Atlanta, Atlanta Business Chronicle’s 2016 Small Business Person of the Year (Rising Star), and the 2015 Digital Marketer of the Year by Technology Association of Georgia (TAG).