Smart, effective direct mail design comes from experience, and some times a lot of guts. The Mayo Clinic Health Letter subscription kit is a classic example. This masterpiece came to my mail box last month, and while the design may shake you, the numbers will knock you out. Here’s why:
A Whopping Big Envelope
This one measures 10 x 14 inches. Really?? Yes. Why send a little #9 package when

The envelope becomes the carrier for all the other letters delivered that day.
you can bury the mail carrier with a doormat? To reinforce the mailing’s impact, the paper stock is nearly cardboard–you could chip a tooth on it–and it’s printed to look like kraft paper.
Creating the kraft look is just the beginning though. The address label is not real, but it is varnished to look like it, and as a special touch, this mass-produced kit has a postage meter label, except–that’s printed too. The overall presentation says to the reader: “you need to open this now”.
My immediate reaction is:
1. The Mayo accountants are taking blood pressure tests on both arms in the cafeteria, jabbing at their adding machines, looking for answers.
2. USPS Postmaster Donahoe is toting up his winnings on this over-sized Flat mail piece.
Long On Words
The extravagance continues inside. I ripped open the zipper on the envelope to pull out the letter. 8 pages! That’s four, 8-1/2 by 12-inch

The letter: a lifetime of Tweets.
sheets, printed front and back. For you attention-deficient followers, that’s about 198 Tweets. The CFO is banging out numbers to see how much waste was incurred by using 16-point type instead of 10-point. Not to mention typing the letter on lined pages!
Nobody reads letters. Well just about nobody. Right?
Canary Yellow Reply Envelope
Subtlety doesn’t work in direct mail, even for Mayo. We can’t just hide stuff in white reply envelopes when we can tell the world we probably have an urgent itch in a better-left-unmentionable place. So there it is– a large bangtail order form I send back in this shout-it-out yellow BRE.

Yellow BREs never get mislaid. And they get action, too.

Stickers-just to keep it tactile.
Stickers!
The ad agency downtown would never place a sticky label in a mail piece. How corny. Yet Mayo does this prominently and proudly, knowing that we can’t resist the temptation. Does anyone really need to peel a “trial issue” label and stick it on the order form? Of course we do. There’s a sense of decisiveness and approval connected to the action, just like updating your car plate ever year.
It’s All About Me
What is irritatingly attractive is Mayo’s continual pandering to my ego. They have hijacked my name. Of course, they have it on the envelope, but it’s also on the letter. And at the top of the letter is a handwritten note addressed to me. Wow!

The P.S.–even after 8 pages, there’s still more to say!
Again on page 8, up to which, yes, I read, there’s a P.S. Also written to me.
As expected, the order form has my name, but they slapped it on the flaming yellow BRE just for good measure.
The Story Continues
To dispel any last doubts about the Mayo brothers, they have also included a brochure on the Mayo Clinic just in case I had been hiding in a duck blind too long. Plus a Post-It note stuck onto the letter quoting readers who bragged about how the newsletter fixed their swollen joints, their riled digestion and unbending digits.

The family story fills in the cracks.
It’s About Making The Numbers
Any cognoscente in the advertising world would roll their eyes at this piece and grab another canapé off the awards dinner banquet table. Mayo is not going to win a trophy any time soon.
That is because they are too busy depositing checks at the bank. This package works because it takes enormous advantage of our curiosity. If you are in the right demographic, you can’t ignore it.
Here are the numbers as I see them. I have not confirmed with Mayo, but then again, they didn’t ask me either.

It’s going to run into money!
List and production costs have to be at least $350/m. Postage for this Flat, $200/m. This could be a 55-cent package, all-in. By the way, while you thought the accountants might have been turning into jelly at that number, it is more likely they are quietly smiling while they top up the USPS Caps account.
Now, response rates. 1% is pretty much the norm, but this gargantuan kit, which includes a gift, could pull a 2% response, which again, I have not confirmed with Mayo. At 2%, a 55-cent kit delivers a $27.50 acquisition cost. ($0.55/2% = $27.50). Large, but actually about half of what any credit card sub would cost. In any event, they wouldn’t do it if it didn’t work.
The Final Number
Medicine aside, Mayo still needs to return a positive cash flow, a.k.a. profit. An annual subscription to this newsletter is basically $32.00. Assuming a contribution of $8.00 per sub, Mayo needs to keep the average reader for 3-1/2 years to pay back the $27.50 acquisition cost.
But maybe not. Because while these 50-year to 80-year-olds, approximately 500,000 of them, are perusing their newsletter, they are also biting on additional offers for Mayo’s entire library of publications. Enough to fill all the waiting rooms in Fort Myers, Miami and Scottsdale for years.
Even if the Mayo Clinic Health Letter program only breaks even, it is the gateway to a flood of peripheral revenues.
Mastering a standout program like the Mayo Clinic Health Letter didn’t happen over night. These savvy marketers have tested into the present format. In fact, it could be a test too.
But the numbers are still rewarding, if formidable. And that’s where the guts come in.
Thanks for reading along on this. Please let me know you liked it. And share, too!
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