Marketing based meritocracy

I was recently speaking to one of the therapists working at Salus Wellness and she was surprised about different prices charged by various practitioners offering similar therapies.  According to her logic, prices should be proportional to therapist’s experience. I had to explain that, in private practice, very often good marketing is what determines prices for a therapist; this is what we can call marketing based meritocracy.

When working in the NHS, or a large private health organisation, salaries are often determined by qualifications, experience and seniority.  When working in private practice usually therapists set prices within a range of market prices acceptable for a particular area, e.g. the same service in rural Norfolk will cost less than in Cambridge city centre.  However there is no strict rule about linking experience and prices which states that someone with less experience must charge lower rates than his/her more experienced colleagues/competitors.  So it happens that more junior therapists with a nice and broad online presence, working for respectable premises, are charging fees which are much higher than professionals with 20+ years’ experience and perhaps more senior academic roles.

In marketing based meritocracy the person who is most visible is the one that will be seen first and will attract the first enquiries.  Although many people might be sensitive about the fees they pay, many of them will automatically be prepared to pay a higher fee for a person who looks very professional and ticks all the boxes.  When the demand for this person’s services becomes very high he/she can set his/her prices higher and still get enough clients to have a busy practice.  It’s a kind of self-adjusting mechanism although sometimes increasing prices just drives more clients in.

For the above explained reasons it’s important to invest in a well thought and designed image, e.g. a good website and high quality marketing material, as well as publishing significant articles and other papers to create a very professional image.  All of the above will help you climb the ladder of marketing based meritocracy.

The dilemma of spending money to make more money

For people with any corporate experience, particularly those with an understanding of management accounts, the concept of cost of sales is given for granted.  When you run a business you (should) know that in order to sell you must spend some money.  Cost of sales might include the cost of purchasing a product or service, the cost of distribution and cost of marketing and advertising for that product or service.

When we consider this concept within private practice we can mention, among cost of sales the hire of a venue to supply your therapies and the direct cost of advertising.  Most people in private practice would love to have a queue of clients waiting in front of their door but, most of them, don’t have it.

I was chatting with one of our therapist earlier this week and she was complaining, despite having a fully booked schedule, about the cost of her online advertisement.  I was curious so I asked how much the advertising costs was and how much income the advertising was generating.  The answer was respectively £240 and £2400 per month, while working one day per week.  My immediate answer was that I would love to play a game where I get £10 every time I spend £1.

From her point of view a 10% direct cost of sales was too high and she would love to earn the same amount of money without spending a penny; fair enough, but unreasonable.  So I explained that with adequate marketing and the correct image she could probably raise her prices by £5 or £10 per session and further increase her profits.  By the end of it she was satisfied that having a medium-high net income, without costs, would be great but it’s just no practically possible and agreed with me that she is in a good position from a business point of view.

The importance of knowing your market

Steve Jobs, founder and CEO of Apple, used to say that he did not need market research as he was always planning products and services which people did not expect. I can see his point and it worked out well for him as he introduced to the world personal computers, smart phones and streaming music.  I believe that practitioners in private practice, who are usually offering well defined and known therapies, should have a basic knowledge about the market in which they operate.  What are the key points of a market research for a private practitioner, e.g. a massage therapist?

Market size and demographic

If you consider the city, town or geographical area (later called just area) where you want to operate you should know or find out how many people live there and their demographic, in terms of age and gender distribution, level of education, income and so on.  It’s useful to have an idea about how affluent these people are, e.g. how many of them are already using and can afford services similar to yours.

Competitor analysis

  • How many other professionals in your area offer services similar to yours? You should really have an idea, however approximate
  • Who are your 3-5 best known competitors? You should know them, at least by name, know how much they charge and how busy they are
  • Where are your competitors? You should know where they work and how do they operate e.g. home visits, working hours
  • How active are they with their marketing? You should see whether they spend time and money networking, advertising, using social media, blogging and so on

Where to start

For someone approaching market research for the first time it can be a daunting activity but the important thing is to get on with it and collect some data.  You can start by simply searching what a client might be looking for (e.g. massage in Cambridge) and that will give you a basic idea about how the market is, how many people operate in it and so on.  The next step is to ask the same 2-3 questions to a number of people in different social contexts (e.g. colleagues, friends, parents of your children school mates) and see what answers you get.  Try to be realistic and pragmatic with the results you put together and always test them against new information you get when speaking to other people.  It might also be useful to repeat the exercise every 6 to 12 months just to check whether things are changing dramatically during that time frame or just a bit.


Having an idea about the market you are in will allow you to take educated strategic decisions about your prices, your working days, how much money you should be spending in advertising or whether you should rely entirely on networking and word of mouth and so on.  It’s always better to take decisions based on data, however imprecise, rather than based on assumptions which are likely to be very optimistic or wrong.

Four key marketing tools for mental health professionals

This post shares my experience in helping mental health professionals with their marketing and business development.  It’s important to be aware that mental health is affecting a very large percentage of the population and, with the funding cuts in recent years, an increasing number of people cannot get the attention and treatments they need from the NHS.

For this reason I noticed in Cambridge, over the last 5 years, a strong increase in demand for private mental health treatments like counselling, psychotherapy, clinical psychology, CBT (cognitive behavioural therapy) and psychiatry.

Among the therapies we offer in our clinic some of them are suitable to be marketed to the general public in a similar way to other products and services.  When offering mental health therapies it’s important to remember that there are both ethical and legal reasons to regulate how these therapies are marketed, mostly because they affect vulnerable people who should not be taken advantage of.

In decreasing order of importance the four most important marketing tools for mental health professionals are:

  1. A professionally designed website
  2. Relevant and active presence on social media
  3. Professional directories
  4. Private insurance companies

A professionally designed website

It’s important to have a good website with good SEO (search engine optimisation).  Unless you have previous experience in web design refrain from making one yourself as the result will look amateurish; a professional looking website will payback many times over its investment within weeks or months.  When someone is looking for a solution to their mental health issue they are likely to search online; if they can find your website and it’s a good one, they can realise within a short time you are the right professional to treat them and they can easily make contact with you.

Social media

Many people confuse the use of social media to keep in touch with friends versus the professional use of social media as a marketing tool.  The latter is about creating a presence for yourself as an authority within the mental health profession (e.g. psychology or counselling) and publish or re-publish relevant content about how you can help your patients.  Typical social media that can work for mental health are Twitter to share links of articles from yourself or other professionals, Facebook to collect and share relevant content and Youtube to share videos of yourself or other professionals who are experts  in your profession.

Professional directories

Considering that all of the professions mentioned in this post are heavily regulated you should enlist yourself within professional directories.  These are websites which will check your qualifications and accreditations before accepting you so they offer an extra level of reassurance for patients who can have the peace of mind of using a fully qualified and accredited practitioner  who has been professional vetted.

Private Health Insurance Companies

As I mentioned at the beginning there is reduced availability of mental health treatments from the NHS therefore many people who have private health insurance often decide to use it for their mental health issues.  In these cases, once they have a referral from their GP, and the go-ahead from the insurance they will check the insurance website for a list of local professionals.  While working in similar way each insurance company have their own set fees and minimum requirements to accept a mental health professional within their directories.  It’s worth checking with all of them and decide whether working with all of them or just a few.  Despite the fees paid by insurance companies  usually being below standard market value by 10-30%, I suggest working with them as the cost of acquisition for these patients is minimum and can be used to fill up gaps in the calendar.


For many professionals in mental health, particularly those who just left or are still working  in the NHS, the concept of doing any kind of marketing is awkward.  Mental health, similarly to the medical profession is for many a vocation about helping others.  However as most of us have bills to pay it’s essential to understand what can be done to quickly build up a successful practice which is busy enough to make a living.  The tools and techniques described above can help with that.