A few months ago, I decided to try an experiment—I hired a company to put together a cold email outreach campaign.

They made some lofty promises: automated systems, message development, copywriting, AI-driven campaigns, and most importantly, a booked calendar of potential leads. They handled everything, soup to nuts. Email marketing at scale.

The cost was less than $500/month, all of which would go to the technology platforms needed to run the campaign. This included two subscriptions to Instantly for delivery and list building, Mailscale for adding additional email inboxes, and a Whop subscription for ongoing training.

The company offered these services for free (they made money off affiliate agreements with the platforms). And I would own the system. What wasn’t to like?

I decided to give it a try.

Now, three months later, I have the results.

I. How my business has grown until now

First, a quick history.

I started RMS Health Advisors in 2019. My first clients were physicians who had moved on from the large physician services group for which I’d been Director of Content Marketing. These doctors either moved companies or started their own practice, reaching out to me for help with marketing.

These initial clients led to more clients. Referrals came in from old colleagues. I offered two main services: strategic marketing consulting and full-service content marketing services, i.e., inbound marketing strategy + writing. More recently, I’ve added AI consulting and training to help clients use LLMs and other AI tools more effectively.

The point is, every client I’ve ever won has come either directly or indirectly from my existing professional network.

Some clients are B2C—physicians who have started their own practices—while others are B2B—physician groups aiming to win hospital contracts.

II. Why I think content marketing is the way

In both cases, my advice has always leaned heavily toward doing content marketing.

I realize that’s my expertise, and that makes me biased. But I also believe inbound marketing—where you publish things, it creates visibility and builds trust, and that eventually leads to new business—is and will always be superior to outbound marketing, where you make cold calls or send cold emails and hope for a hit.

I think content marketing is better for your brand, a more ethical way to do marketing (the whole world hates email spam), and more effective in the long run, if you give it space to work. Trust takes time.

Still, I consider myself a tactic-agnostic strategist; whatever helps build the business is the right strategy, regardless of my priors about what I think will work. If I think you should be on TikTok, I’ll recommend TikTok (and refer you to someone who does it well!) If I think you should be running ads, I’ll help you do that.1

My agnosticism on tactics is why I was open to trying something new. And if a cold email campaign at scale could work for me, I would bring it to my clients, especially the B2B ones, for whom meetings booked with new potential hospital clients are like gold.

III. How the cold email campaign went

We did two campaigns. One was targeted at smaller, direct-to-patient medical clinics that I help with full-service marketing strategy. The other was aimed at larger B2B healthcare companies.

Here’s how it went:

As you can see, one of these campaigns was more successful than the other at generating replies, although after three months, neither resulted in an actual meeting.

For the first group, the small medical clinics, I sent each person who replied a customized analysis of where their low-hanging content marketing fruit was to earn more market share in their local area. I honestly thought delivering a bunch of value up front like this would lead at least a few of them to want to discuss the opportunities further, but alas—they all went dark.

Overall, it’s hard to point to these results and call it any kind of success.

Keep in mind, this campaign was designed by a company that specializes in this. Also, keep in mind that I have a historically high close rate after someone emails me for help, something like 50%. Normally, I’m quite good at closing warm leads.

So why didn’t it work?

IV. Takeaways

The fact is, I think most of what I learned only reinforced my preconceived ideas about effective marketing strategy. I’m aware of the well-known cognitive bias, whereby we use new information to tell a story about how we were right all along. But also, I’ve been in marketing for almost 15 years—I think it’s safe to say I have some expertise on the subject.

So here’s what I think happened:

• No one likes cold emails. Literally all cold email campaign copywriting technique is designed to trick the recipient (and their email server) into thinking it’s not a cold email. We’re all so attuned to what these emails look like, I think it’s nearly impossible to break through. ‘Tried and true’ techniques soon wear themselves out precisely because they are tried so often.

• These are tough audiences. Physicians are some of the most marketed-to professionals on the internet. So are marketing executives. Combine a natural aversion to cold emails with sheer fatigue at the deluge of marketing messages being thrown at them day in and day out, and it makes for a tough group to break through with.

Both of these are structural problems with cold email outreach in general. They’ll always be there if you try this tactic.

That said, it’s also possible that there was something wrong with my offers specifically, even though the campaigns were A/B/C/D/E testing different messages the entire three months. Still, maybe they just weren’t resonating.

It could also be that I haven’t let the campaigns run long enough. Perhaps three months and more than 7,000 emails sent still isn’t enough emails to know if it’s working? I find that hard to believe, but I’m sure there is some cold email expert out there who might say as much.

V. Content marketing & thought leadership for the win

The problem with letting the campaign run longer is that cold email as a tactic comes with very real drawbacks.

First of all, spamming people with marketing messages can do active damage to your brand.

True, sometimes you hit the right person at the right time, and they need what you’re selling. But for everyone else, it’s just annoying.

I’ve sent a lot of automated emails over the past three months. I tried very hard in reviewing the copy and the campaign structure to make genuine offers that I thought would help the target audience. Still, for any readers who may have been on the receiving end of those emails, I’m sorry if they annoyed you!

In any case, I’m glad I tried it, and I’m kind of glad it failed (otherwise I’d have to grapple with the fact that I’ve been giving bad advice for years!). The campaign reinforced my belief that content marketing is the best kind of marketing.

And the best kind of content marketing is thought leadership. I have a whole post about how to develop thought leadership and what it means, but the TL;DR is that thought leadership is a critique of the existing order.

Ultimately, content marketing just feels right. It is a genuine attempt to put useful material in front of your audience. It is more likely to build confidence and trust than any other tactic I know. And it is an investment for the long term, in that the things you publish today will still be doing their work years from now.

P.S. Clearly, I’m interested in growing my business, so if you’re interested in a discussion, feel free to reach out! Here’s a little about my business.