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Use of Internet Marketing in Private Dentai Practice in Bosnia and Herzegovina Use of Internet Marketing in Private Dental Practice in Bosnia and Herzegovina Maja Martinovic\ Vedran Jakupovic^ Selma Jakupovic^ Zagreb School of Economics and Management, Zagreb, Croatia^ PharmaSwiss, Sarajevo, Bosnia and Herzegovina^ School of Dentistry, University of Sarajevo, Bosnia and Herzegovina^ SUMMARY. It is a modern practice of private dental offices and outpatient clinics to combine e-marketing and traditional business, which gives their clients more opportunities. These new channels primarily aim is so called „newer generations" that have somewhat different wishes related to services. They primarily seek practicality (convenience), whereas the older and richer clients seek a closer relationship. Many private dental offices and outpatient clinics that work online have recognised demands of various target groups (segments and market nichés). Today, in segmentation there is a trend of a total adaptation to the clients (customization) and adaptation to the wishes of the clients (customerisation), where the clients appear as proactive consumers (prosumers) who affect the offer creation themselves. Private dental clinics utilize e-marketing In various ways, namely: corporate or marketing website, web announcement and advertising, e-mail and forums. The Internet also has an important role with creating the brand name of the office. Online value factors, alongside with "classical" indicators have increasing importance for the total value of the brand. Today we talk about three evolution phases in accepting of the Internet marketing: one-way communication (informing clients about products and services), two-way communication (introducing a certain level of interaction, mass adjustment to the clients) and overcoming time-space obstacles (entering new (international) markets and in new business). Most private dental offices in B&H is not present on the Web, and the ones that have a web presentation are today in the first or second stage of application. The future foresees that the key question for those offices will not be whether to use the Internet or not, but how to use it' Although there are numerous advantages of e-marketing in health institutions, it is important to stress and use its biggest assets, and that is interactivity and "accuracy", so that Internet activities are not justan addition to other ad activities, but an essential part of strategic marketing efforts of the office. Keywords: Internet marketing, private dental offices, evolution phases in accepting of the Internet marketing, ways of executing e-marketing 1. INTRODUCTION The Internet is used by a 1.7 billion users worlcJwide, of which 400 million is from Europe (1). Most of them explore Internet when they make important life decisions. It is clear that offices that are involved in such a business environment will have to accept the Internet technology or expose themselves to underdevelopment risk. Modern offices have become skillful in gathering information, product, service and message individualization, and high speed information transfer. Most private dental offices combine e-marketing and traditional business and then we talk about a virtual-physical competition that gives the clients more satisfaction, makes a larger client loyalty and brings a better reputation to the office and doctors, which makes a positive influence on the clients' trust and their satisfaction (2). The aim of this paper is to point out to advantages of e-marketing as a part of strategic marketing efforts in the health sector and show the ways of e-marketing for offices. Also, its aim is to show the levels of various Internet use in dental office business in B&H. 2. INNOVATIVE STRATEGIES IN E-MARKETING USE The advantages of e-marketing use in health institutions are many and they can be observed from the clients' standpoint as well as of the office's. Apart of the practicality and constant accessibility of the Internet, it also gives the access to a large number of information and offers thus resulting in clients' larger sense of control. Other advantages can be summarized in the following: contributes to the reputation of the office as the innovation leader, meets the needs of the present clients' with higher quality, allows tracking on-line competition, allows a development of massive customerization, gives more flexibility (possibility of offer change), employers can dedicate themselves to specialized works, etc. It is considered that marketing in general, as well as e-marketing in the future will have a larger role in promoting health services (3). The Internet has an important role with creating of the brand of the office as well and it is used as a support in the building of a strong and recognizable brand (4). It is important to create an emotionV0L18 NOl MARCH 2010 Use of Internet Marketing in Private Dental Practice in Bosnia and Herzegovina al link between the office and the client because the products and services grow old and die, and the brand keeps living. Online value factors, together with "the classical" indicators have an increasing importance for the total value of the brand, and the online perception of the brand primarily depends on; the looks of the web site, navigation process through the site, various advantages, personal support to the visitor and content download speed. Private dental offices carry out e-marketing in four major ways, namely; corporate or marketing web site, online marketing and advertising, e-mail and online transfer and forums, but since there is an increasing number of "new generation" media users, there is an increasing number of different new media and their use in this field (5). 2.1. Reasons for use of new technologies Opportunities offered by new communication technologies have contributed in time to the development and offer of new products and services in health care. Advantages made by applying new technologies in this sector can be named as following; Cost reduction. Offering services such as online appointment reservation is cheaper than the classical way of reserving which includes staff. Market share increase. Health care institutions that introduce any online service can attract clients of those that didn't. Mass communication. Applying new technologies allows mass communication with very low costs (the Internet). Better communication with clients. New technologies allow developing marketing activities via website in a cheaper and more efficient way. Inovations. Newer technologies also allow introducing newer services and products. Developing new technologies. By using new technologies, private offices can also offer servicV0L18 NOl MARCH 2010 es of insurance and health turism that traditional offices couldn't. Apart from these advantages of the Internet, we should point out the most important ones, and that is; interactivity and "preciseness", that private dental offices need to use for achieving comparative advantages. The interactivity and precise selection and aiming at a particular client or group are Internet activities that not just an addition to other marketing activities, but an essential part of marketing efforts of the office. They are the foundation for innovative strategies in Internet marketing use, thus so offices can create portals where users can make their own sites (with private and public content). Interactivity allows research of specific wishes and needs and personalizing of the offer as well as building long-term relationship with the patients. When we talk about "preciseness" and offer personalizing it should be started with market research and its segmentation, as well as target market selection which is the key point of any successful business strategy. Private dental offices that are in the customerization (transactional) phase of Internet marketing, adapt their products and services even to individual clients. The opportunity to evaluate wishes and needs of the clients, particularly the possibility of a direct contact with the clients by giving them help and counseling, are the most important asset for the success of the Internet in private dental offices. But, since that online counseling and procedure are very standardized, the Internet contact can not meet demands of more demanding, sophisticated clients. 2.2.Market segmentation Segmented marketing foresees that the customers differ in their wishes, needs, perception, buying behavior, geographical location, buying power etc. Despite that, offices that use segmented marketing and not willing to adapt to every single customer, but choose large groups, segments that make their market. Since these customers still somewhat differ, this segmentation is not so precise as the one adapted to a individual customer. Since the demographic and psychological diversity of the target group mean different reaction to the offer, it can be said that these new channels are primarily meant to so called "newer generations" that have somewhat different priorities when selecting a doctor. Clients' wishes related to dental services can be; convenience, efficiency, security, familiarity with the client and respecting their state of being, privacy and reliability. Relative importance of these factors depends on the segment, thus, younger clients seek practicality (convenience), and the older and richer ones seek a more personal relation. Two major characteristics of modern markets are; the level to which they could be segmented (due to growing differences among consumers and their demands to be treated individually) and existence of superior technologies of communication and distribution that allow creating segmentation strategies that in some cases lead to "one on one marketing", where each customer is treated as a different segment. (6) It is actually about the customer adapted market or individual market that can be considered an extreme version of micromarketing. Adapting to the wishes of customers means that the office lets individual consumers create the offer which makes them active participants in the development process of the product, purchase and selling. Such offices give consumers exactly what they want and wish, and their clients are not just simple consumers but prosumers or "co-designers". (7) Mass adaptation concept consists of recognizing individual difference among clients and modification of the offer accordingly. The mass adaptation does not completely fit the "one on one marketing" that is related to creating a unique market- Use of Internet Marketing in Private Dentai Practice in Bosnia and Herzegovina phases in accepting Internet marketing by offices in general. The first stage, information presentation, includes an initial launch and a basic Internet presentation with the aim of informing the client. The information presentation can include the one-way communication (informing clients about services and products) and the two-way communication (which includes introducing a certain level of interaction and allows users sending e-mail with questions, suggestions and complaints). We can say that in these two phases the basic value of the Internet is the information one and is used for promoting of the image of the office and distribution of the information about products and services. It is not a particularly innovative strategy and those offices are in the initial phases of Internet use in business. The next stage is a customerization (transactional) one in which offices acknowledge needs and wishes of clients for more information, more interaction and transaction that can be done via 2.3.Evolution phases in the Internet. It usually includes a accepting Internet marketing website used most usually for baPrivate dental offices today resic transactions, bill paying, apsearch and to a certain point use pointment reservation, etc. It pays Internet potentials. In accepting more attention and takes more of the new technologies there are care about feedback from their certain phases and changes. So clients and uses them as input called cyber market tools are used when creating new products and in adaptation of traditional marservices. The office often cooperketing techniques and switching ates with other offices and partto the Internet as a medium (8). ners with the aim of innovating According to Parsons et al its products and services and cre(1996) (9) there are four evolution ating new ones that will solve the Fonn of problems and satisacceptance of Ihe Iiiteniet fy needs and wishTransfomiation pbase marketing tedeftning business and es of the clients. At office transfontiation the same time, serTransaction vice use becomes (ctistomerisation) pbase - online infomtation, more sophisticated interaction i transaction; because it is adaptInfontiation pbase - two-way cominuiticatiou (ititeraction, eed to the client and tttail sendiitg with questions, suggestions and complaints) their needs. It is ofInfonmtion phase -one -way ten related to new conuniuiícation (¡nforming about products and ser%'ices. technical perforsituple web page) mances such as connecting the Internet with mobile phones, which offers online Figure 1. Evolution stages in accepting Internet marketing of private dental offices service to the clients ing program for each particular individual, which, in most cases, is very difficult, even impossible and less profitable. Even dental practice specialization alone is a form of segmentation by services offered by a doctor. The segmentation gives a possibility of making of a completely new business model and strategy in which the doctor (or team) becomes a specialist for certain needs and can be the leader in service offering for a smaller or bigger market segment. In this model the office is focused on solving a particular problem of a patient. That gives them a possiblity of billing them high fees for offering very specific and sophisticated services. The dentist can choose a lower service cost strategy in which they offer standardized services to a large number of clients and make lower unit costs and lower service prices. In that situation the Internet is, for its specific characteristics of speed, adaptability and lower prices an ideal information channel. wherever they are. The fourth stage provides redefining of the core business and office transformation. The Internet is not used anymore as the full-fledged interface between the firm and its customers, but is used as the means for rethinking and transforming its core business. Depending on how much the Internet changed the business of the office, the role and image of a private dental office is changed as well. Today, in the Internet use offices undergo various phases of exploitation of the medium and from information presentation, interactivity, transactions, dynamic customisation move to the stage where the Internet business becomes a part of the strategy. Strategic guidelines of the office are changed and it redefines and transforms it business model (Figure 1). Having in mind these four phases and approaches to the Internet business this paper will treat private dental offices currently present in Bosnia and Herzegovina. It will give an insight to how much they are informationoriented and/or business transformation-oriented. 3. INTERNET MARKETING OF PRIVATE DENTAL OFFICES INBIH 3.1. Internet users in BiH In relation to the previous year, the research done by GfK BH in 2009, showed that the number of Internet users in B&H increased from 33% to 35%, and the number of households with Internet access from 28% to 29%. About a half of Internet users in B&H uses this service on the regular basis, with businessmen, experts and students in the forefront. The Internet is primarily embraced by younger generations, namely those 15-24 yrs old, of which % uses the Internet. The students are the largest group that uses the Internet (84%), followed by full-time employed (50%), whereas the retired people number only 4% of users. (10) VOL 18 N0 1 MARCH 2010 Use of Internet Marketing in Private Dental Practice in Bosnia and Herzegovina Nielsen agency conducted a global research that included Internet users in 47 countries of the world. (11) Nielsen Global Survey showed that of all named marketing (advertising) activities Internet users believe to the recommendations from consumers (78%), followed by newspapers (63%), consumer opinions posted online (61%), and brand websites (60%). Just after that the traditional media like TV, magazines and radio score points. As a recommendation of someone else is showed as the most trusted source of information when consumers decide which products and services to buy to speaks in favor of the fact that in Internet communities, i.e. forums as a promotional tool hide great potentials. 3.2. Levels of Internet marketing of private dental offices in B&H A research was conducted in order to determine the level of Internet marketing of private dental offices in B&H, in the beginning of 2010. It showed that of the total number of private dental offices (approx. 450), 43 offices can be found on the Internet. Communication with their clients via website that allows browsing of various data as services they offer was established by 37 offices (86% of offices present on the Internet). Nine offices give information about the number of employees. Number of 12 offices (28%) has a website in a foreign language, and the help with the most frequent questions and Information phase - one-way communication answers - FAQ is on websites of 20 offices (47%) (Figure 2) E-mail contact with the office can be made by users from 42 offices (that is in 98% of the total number of offices available on the Foreign language FAQ Services Internet). Questionsanswers, that is, the Figure 2. Information phase I in the accepting of the Internet option „ask the docmarketing tor - publicly" has five Information phase - interactive offices (12%). The of(two-way) communication (%) fered option of asking questions, advic120 es, commenting and aö 100 so can be found on 16 80 office (37%)websites 60 (Figure 3) 40 Six offices (14%) * 12 IHKI 20 have some sort of mar0 keting on their webQuestions Comments E - mail sites, and five of them answers (12%) have visible ads. Nine offices (21%) emphasize partners, while links for other relevant partner institutions are on websites of nine offices (21%) (Figure 4). Possibility of online orders exist in five offices (12%), which can be considered a customerization phase in the acceptance of the Internet marketing. Advices (questions and answers) generally fit into the interactive phase, but in a certain part can be considered an entry point to the customerization phase because the advice can be a part of the dental service. 4. CONCLUSION Nowadays the Internet creates a new type of consumers-patients. They are better informed, know what they want and where to get it. There is a present swift exchange of services, quality and satisfaction. The Internet allows establishing of a higher level of quality of relationship and speed of agreement about the service patients demand. Due to the partial insaturation by classical forms of marketing communication, the Internet marketing is taken as a unique refreshment in the marketing practice, an interesting distribution channel, that can catch on with newer generations. On the other hand, an increasing competition in dental care conditions a better segmentation and specialization for individual segments and fields (12). Marketing tools used by dentists nowadays are not in concordance with what the clients expect and what the clients consider efficient and desirable. (13). The conducted research shows that a small number of dental offices in B&H is present on the In- . ternet in the first place, and the present ones are found mostly in the information phase of using that medium. Not even all offices that are found in those phases use all possibilities known and present in the world, such as external blogs used for market_ research, creating better relationships with clients and brand development. —iMr- Figure 3. Information phase II in the accepting of the Internet marketing Networking (%) ATL Partneris Ads Links Figure 4. Marketing and partnership on the Internet VOL 18 NOl MARCH 2010 Use of Internet Marketing in Private Dentai Practice in Bosnia and Herzegovina The transformation phase is still not present at all, although there are indications since some offices have websites in English, which assumes business internationalization, some offices put out ads and name partners or add a new offer to the traditional one. Judging by the increase in the number of Internet users it is fair to expect that there will be a continuation of the improvement trend of width and quality of Internet services in B&H. One can conclude that, in the future, the key question will not be whether to use the Internet technology, but how to use it' Surely, its greatest assets should be used: interactivity and "preciseness" so that Internet companies will not be just an appendix to other marketing activities, but an essential part of marketing efforts of the office that can gain a substantial comparative advantage. This paper gives just some data that describe the state and processes of Internet marketing use in dental offices in B&H. For a better understanding and practice upgrading further research in this field is needed. Above all they relate to the research that will include possibilities for developing and offering their products and services, then, research on structure and number of current users and increase of their satisfaction by using Internet business services. 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Specialization and Competition in Dental Health Services; Health Economics, April 2009; 18(4): 457-66. Clow KE, Stevens, RE, McConkey C, Loudon DL. Attitudes of Dentists and Dentai Patients toward Advertising Health Marketing Quarterly, 2006; 24(1-2):. 23-34. Corresponding author: Vedran Jakupovip, DMD, MBA. PharmaSwiss BH, Fra Andjela Zvizdovica lB/7, 71000 Sarajevo. Email: vedranjaicupovicQgmail.com VOL 18 NOl MARCH 2010 Copyright of Acta Informatica Medica is the property of Avicena D.O.O. Sarajevo and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use.