Email is a cost-effective and convenient way to communicate with your patients—but it doesn’t work if your messages are getting caught in your patients’ spam folders.
To determine which emails land in the primary inbox and which land in the spam box, email service providers like Gmail, Outlook and Yahoo consider a variety of factors such as:
- The contents of the email: Do you use spammy words, attach large files or link to suspicious sites?
- Whether or not the sending domain is authenticated: Setting up your domain establishes credibility with inbox service providers.
- The sender’s typical email volume and frequency: Are you emailing more patients more often than usual?
- Historic engagement rates: Do users typically open your emails, click links, forward or reply to your messages?
- Spam complaints: If more than 0.1% of your emails are marked as spam, inbox service providers may throttle your emails, sending a larger portion to spam boxes. Higher spam complaint rates can jeopardize deliverability for your entire domain.
What Happens to a Domain When Users Flag Emails as Spam?
Inbox service providers like Gmail, Outlook and Yahoo (ISPs) have a very low tolerance for emails that are identified as spam. The industry-standard acceptable spam complaint rate is 0.1%, or one out of every thousand emails.
If your email campaigns consistently exceed this threshold, some of your emails may land in spam, “other,” or “promotional” inboxes.
A spam complaint rate of 0.3% or higher, only three in every thousand, can result in your domain being blocklisted, making it nearly impossible for messages to make it into the inbox. When a domain is on an email blocklist, all emails coming from that domain are impacted, not just marketing emails.
While you can’t completely control where your next email lands, here are a few tips to keep your emails out of spam boxes and protect your domain’s reputation.
Warm Your Sending Domain & Ensure Your Contact List Is Engaged
If you don’t already send regular emails to your patients, sending an important clinic update to all patients, including those you haven’t seen or communicated with in years, is likely to result in many spam complaints. The sudden spike in emails can also look suspicious to the inbox service providers.
Instead, start by emailing only patients you’ve seen recently and increase from there. Provide helpful, informative content and avoid product-heavy marketing in the initial emails. When emailing patients, you are building a relationship. Starting the conversation with a product update or service offer can be off-putting and more likely to result in an unsubscribe or spam complaint.
Keep Your List Active
Send emails regularly to build a good sender reputation. ISPs watch for consistency. They are more skeptical of domains and IP addresses that experience sudden spikes in email frequency and volume than of domains that email regularly.
Sending emails at least monthly is best practice to keep a list warm. In a recent Fuel case study, a member cut back on their e-newsletters, opting to send them once per quarter instead of every 30-60 days. Their open rates dropped from 40-45% to just 10%. When they returned to a 30-60 day cadence, their open rates rose to 50%.
A well-warmed list will usually tolerate up to weekly sends. Monitor your unsubscribe rate and spam complaint rate to find the cadence that’s best for your practice.
Authenticate Your Sending Domain
Set up your Sender Policy Framework (SPF), DomainKeys Identified Mail (DKIM), Domain Message Authentication and Reporting Conformance (DMARC) and Brand Indicators for Message Identification (BIMI). These tell the inbox service providers that you are who you say you are and establish credibility.
Make It Easy to Unsubscribe and Honor Unsubscribes
If a patient doesn’t want to be emailed, you’ll want them to unsubscribe instead of marking your email as spam. Including an unsubscribe link at the bottom of your emails can help prevent spam complaints. Since there is a very low tolerance for spam complaints (best practice is to keep your spam complaint rate below 0.1%), you’ll need to prevent as many as possible.
Once someone has opted out of specific types of emails, it is important to stop sending them that content. In addition to triggering spam complaints, emailing patients content they have opted out of violates the CAN-SPAM Act, which can result in penalties of over $53K per recipient.
Email marketing platforms can track unsubscribes for you and help you maintain separate lists. They will also help you comply with other inbox service requirements. While Outlook and Gmail/Workspace are great for one-to-one emails, avoid using these services for any bulk communication.
Need Help With Your Email Strategy?
When you partner with Fuel Medical for email marketing, we deliver customized campaigns based on insights backed by data. Our team is here to help you make the most of this valuable patient touch point. Contact your regional team today to get started or learn more.
