Professionals such as doctors and lawyers often end up walking a tightrope between not having enough customers and resorting to image-cheapening self promotion.

The balancing act can make many of them uncomfortable when talk of marketing goes beyond personal contacts and referrals, even when they realize that they need to attract more business.

"A lot of people prefer the term 'practice building,' " said Laura Sax, a local small-business marketing consultant who wrote a do-it-yourself guidebook to help professionals market their practices.

The techniques she refers to in her book include careful market analysis, mailing newsletters, brochures and press releases, giving seminars and public speaking.

Rhona Saunders, president of the Saunders Co., a District public relations firm, agreed.

"It's image," she said. "It's convincing people that you know your business. It's not hard sell at all. You're trying to get across a professional expertise."

David Goldberg, an optometrist with offices in Alexandria and Dupont Circle, has been publishing an annual newsletter for more than five years.

Ostensibly, the publication keeps his patients up to date about staff changes and developments in the contact lens industry. Since sales of lenses are the mainstay of his business, he said, the articles about new products help him to advertise and move more merchandise.

He said he never tried direct-mail coupons, which many companies use, offering two-for-one deals or other discounts. "I didn't like the image of it, mainly," he said.

Speaking in public is another favorite marketing technique for professionals who prefer not to appear as if they spend their time dreaming up ways to make more money.

Marcy McNellis, a consultant with Multistate Associates, an Alexandria firm that coordinates state and local lobbying efforts across the country, said that participating in conferences and seminars are among the best ways to increase a company's exposure.

This year, because of an analysis of its marketing efforts, the firm also overhauled its graphic image, contracting a designer to create a logo and reprinting all the stationery and business cards with a uniform theme.

"When you start a small business, and you are so interested in starting it and building it, you might not pay attention to image," McNellis said.

Targeting women in particular, personal financial manager Chloe Wentz participates in seminars and publishes a newsletter, but she also does some traditional advertising.

Wentz, who looks for women who feel vulnerable or intimidated when it comes to money matters, participates in seminars at women's groups to publicize her expertise and her specialty. She also runs ads in Junior League publications.

Running display ads in larger publications would bring too much attention to the firm, she said, and it would not be able to grow as cautiously and selectively as she would like.

To find such controlled growth, word-of-mouth referrals are the preferred advertisement for most professional practices.

And many companies resort to what Sax calls "internal marketing" to encourage referrals and more business from an existing client base. Providing high-quality service is not always enough, though, to stir up such word-of-mouth promotion.

"People usually don't talk about dental work at cocktail parties," said Ikars Lans, a dentist with offices in Manassas and Alexandria.

He decorated his Manassas office with customer comfort in mind, hoping to attract the attention of uneasy patients who do not visit the dentist regularly.

He said he tries to take the edge off the experience to make the patient want to come back, and his efforts include making sure his staff is informed and friendly.

"I believe you should practice the golden rule, treat people like you like to be treated," Lans said.

"I'm the biggest baby in the world, I hate going to the dentist," he said. "Knowing that the fear factor keeps people away, I thought it out and I decided that the bottom line is: Once the patient sits in the chair, take their mind off where they are."

He thinks it takes more than friendly staff to do that. He arranged two of his examination rooms around an eight-foot triangular glassed-in space containing an aviary, along with a forest scene, including birch trees, bushes and rocks.

With a cassette deck and room air fresheners, he recreates the sounds and smells of the woods to help patients forget about the machines in their mouths.

His additional two rooms are arranged the same way, with a tropical beach motif.

By putting his clients at ease and making a trip to the dentist less than the traumatic experience it is often perceived to be, he said he has built up a good-size practice.

Still, many professionals find that old advertising gimmicks can work for them, too, if they're done tastefully.

"I have a pen that I've given out for a couple years," said Aaron Stein, a local real estate attorney. "People tell me they see them all over the place, and when they see them they think of me. It has my address on it, and my fax number.

"I almost gave up on the thing and one person called me up one day and said I got your name off of a pen," Stein said.