Medscape article

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Docs:

Here is an interesting article from Medscape.

Lyndon McGill, D.C.

Salem, Oregon

www.SalemSpineClinic.com

www.EvolvingDaily.com

From Medscape

Business of Medicine

Five Steps to Growing Your Practice: What Works, What Doesn't

Mark E. Crane

Posted: 07/28/2010

Introduction

With waiting rooms already overflowing and the promise (or threat)

of 30 million formerly uninsured patients lining up for appointments

thanks to healthcare reform, marketing to build your practice may seem

pointless. Most doctors, especially in primary care, already have too

many patients and not enough time or resources.

That attitude is shortsighted, say practice management consultants.

"Doctors should be on the lookout for new patients," says Gray Tuttle,

a principal with the Rehmann Healthcare Management Advisors in Lansing,

Michigan. "People move. They die. People leave areas that are in

economic crisis. So even in a mature busy practice, doctors should look

to add a patient or 2 per week to replace those who leave."

More important than simply attracting new patients is the chance to

attract desirable patients. Marketing can help practices attract the

best patients, whether defined by ability to pay or the kind of

conditions you most want to treat.

"I know of many heavily booked practices but most of the patients

are on Medicaid," says J. Denning with Practice Performance

Group in La Jolla, California. "The doctors are barely earning a

living. They need to market their practices to attract better-paying

patients."

Where your practice is today may not be where you are tomorrow.

"That's why some marketing is beneficial, if only to help brand your

practice so you maintain a good reputation," says T. Hertz, a

principal for the Medical Group Management Association Health Care

Consulting Group based in Pineville, Louisiana.

Some physicians confuse marketing with advertising and think it

unseemly. That's an assumption that can hurt your practice. Marketing

is a broader concept that involves determining what you want your

practice to be; who you want to attract, and how to target those people

through many methods, of which advertising is only one.

"Advertising is just one tool of marketing," says Denning.

"Advertising is where you pay to control the message. Marketing can

sometimes get your message out in an unpaid form."

Marketing may also include some aspects of patient relations. "It's

how your staff answers the phone, how they are dressed. Is your office

clean or cluttered? Do staffers apologize to patients when you're

running late?" says Hertz. "It's the little things that show how you

welcome patients or drive them away."

Step 1: Find the Strategy That's Right for You

Before embarking on a practice-building campaign, physicians need to

decide what they're trying to achieve. Do you want more patients? What

types? How many more can your practice handle efficiently?

Start with what you know about your current patients. "Check out all

the demographics: age, household income, geography, payer mix, services

desired," says Hertz. "Then do a gap analysis. What do we want?

So if insurance company A pays more and faster than insurer B, how do

you get more As? Who are their employers?"

For example, if you know who the employers are, you can target that

employer or focus your efforts geographically around the employer's

location. You can try to develop a relationship with the employer and

offer to give talks at the company, adjust your hours to promote that

you have good access, tell patients of that company to tell their

friends and relatives about you.

Sometimes, marketing strategy means turning away patients who don't

help you achieve your goals. "We had an ophthalmologist client who was

always overbooked," says Denning. "But he wasn't seeing enough patients

with the kinds of conditions he really enjoyed working on. We had him

train his appointment schedulers on how to spot the patients he wanted

and discourage those he didn't."

"Saying yes to all patients just clogs the schedule. This can be

done tactfully, such as, 'gee, I'm awfully sorry but the doctor is

fully booked up for the next 3 months. Let me give you the number of

another physician who can see you earlier.'" You may feel conflicted or

uncomfortable about turning down patients because of their insurance or

financial status, but many practices find this is the only way they can

survive.

Step 2: Practice-Building Activities That Pay Off

Giving informal talks to civic, school, and other local

organizations isn't a new idea, but it's always been an effective

practice-builder. The same applies to volunteering for health

screenings and fairs where patients can see you in action.

"Making yourself available to local reporters as a health expert is

even better," says Hertz. "Appearing on the 6 o'clock news as the

expert on influenza, poison ivy, whatever, has far greater impact than

a paid ad in a newspaper. If you can establish yourself as an authority

on a health topic, it adds great credibility."

Sending out press releases can get your practice known. Major

broadcast networks are rarely interested, but local media such as

weekly community newspapers and radio stations are receptive to short

stories about you adding an associate with particular expertise or

hiring nurse practitioners or physician assistants. These news

organizations are eager for simple human interest stories, such as an

employee who is retiring after 30 years in your practice or how your

staffers participate in a charity race, says Hertz. One physician who

rode his bike across the country was featured on the front page of his

town newspaper.

If your practice offers nutritional counseling or an illness support

group, a press release can drive patients to you. "Educational stories

and heart-warming anecdotes about patients do well," says Raef,

of WordPower Communications in Chicago. Be careful about patient

privacy; always get signed permission to use any patient's name

publicly. "You can send them out on PRWeb, or PRNewswire and even have

them go to a bilingual market. With some outlets, you can get feedback

statistics in real time of how many people are getting your message. We

did one for a plastic surgeon a few years ago about smart liposuction

tips. We're still getting inquiries from that release."

Writing a column on a health issue for a local newspaper also is an

effective way to reach new patients.

Make sure you let everyone know about your practice strengths. For

example, in primary care, one area to promote is availability. How easy

or difficult it is for patients to get a quick appointment can mean the

difference between a successful practice and one that is leaking

patients.

"Urgent care centers do an incredible amount of advertising, and

that's direct competition to primary care," says Gray Tuttle. "Letting

it be known that patients can get in to see you without much delay is

important."

The way you describe your availability is crucial. "If I put up a

sign, or take out an ad that says 'no appointment necessary,' it sounds

a bit like a barber shop and the patient may think I'm not a very good

doctor," says Hertz. "But if the message says 'same-day appointments

available,' it has a more professional tone."

Step 3: Word of Mouth Is Powerful

"The best thing any practice can do is to exceed a patient's

expectations," says Hertz. "There is nothing more powerful than a

patient who is impressed by the care she received and tells her friends

about it."

A personal touch impresses patients. Having the physician call the

patient after surgery or a severe illness to inquire about how he or

she is feeling builds tremendous rapport.

Encouraging referrals from satisfied patients should be part of the

practice routine. Simply asking them to tell friends and family that

you're expanding your practice and would welcome new patients is

effective. One Michigan family practice has a sign that says, "The

highest compliment our patients can give us is the referral of their

friends and family. Thank you for your trust."

If a patient refers a friend or relative to you, it's important to

promptly thank that patient with a handwritten note, says

Denning. "Thanks so much for referring Ken as a patient and for having

confidence in our practice. If there is any way we can be of assistance

to you, please don't hesitate to call."

Ask every new patient how he or she learned of the practice.

Registration forms can ask, "How did you hear about us?" or "Who can we

thank for this referral?" If the answers are nonspecific such "a

friend" or "I saw your name in the newspaper," a staff member should

follow up to get more details.

Step 4: Pay Key Attention to Referral Sources

Practices that depend on referrals need to keep track of which

physicians are sending them patients -- and which ones have stopped.

"With computerized billing systems, it's easy to identify the

sources of your referrals," says Gray Tuttle. "Look for trends,

especially any reduction in the volume of referrals. Are big primary

practices absent from the list? Ask yourself why. Ask them why. Often,

the issue is how long the patient has to wait before he or she can be

seen."

Specialists used to bump into their referral sources at the

hospital, but with the advent of so many hospitalists, that's less

likely. Physicians may see each other at social functions or medical

society events. "That can trigger a follow-up phone call," says Tuttle.

"You might say, 'I enjoyed seeing you again at the benefit last night.

Can I talk to you about referrals? I've noticed they've declined

lately. Is there anything we can do to change that?'"

Sending out a survey of referral sources is a great reminder about

your practice and a subtle message that you're looking for more work.

You can also learn of deficiencies in your practice that stop primary

care doctors from referring to you, he says. Even if your practice is

busy, you can let referring doctors know that you can always squeeze in

a patient if they let you know about the person.

Hertz recalls a cardiology practice that was concerned

because referrals had dropped off. "I asked when was the last time

they'd spoken to the other doctors. They said they hadn't in years

because they were busy enough and didn't see the need to. So I

encouraged the cardiologists to take their referral sources to lunch

every few months," he said. "They learned things, such as their nurse

almost always said they were unavailable to talk on the phone, or that

reports didn't get back to the other doctors in a timely fashion. Then

they were able to fix those problems."

When sending out a report to the referring doctor, ask how he or she

wants to receive the information, says Gray Tuttle. "Sending voluminous

reports [the physician] doesn't want isn't helpful. Asking if [the

physician would] like to receive the information via fax, email, snail

mail, or phone shows respect for the doctor's time."

In addition to the report, send a quick handwritten thank you note

as well, says Denning. "Little things make an impression."

Step 5: What Doesn't Work

Some marketing methods have outlived their usefulness and may be

counterproductive, say the consultants we interviewed.

If you send emails to patients, always ask for permission before

adding them to an email list, says Hertz. Otherwise, they could find it

intrusive or consider it spam.

Marketing tricks like raffles, giveaways, and free first visits

aren't seen as professional. "Novelties like refrigerator magnets,

mugs, and pens are too common to be effective and I don't think they're

dignified enough for medical practices," says Denning. "Image

is important. Dentists may have a happy tooth at their reception area,

but physicians don't want to cheapen their product that way."

Lavish open houses sponsored by specialists to attract referral

sources "have served their day in the past but aren't effective

anymore," says Gray Tuttle. "They just don't drive a lot of business."

Every consultant we spoke with said a professional Website is

practically standard for any medical practice these days. Medscape will

discuss Websites, along with whether it pays to advertise, in our next

installment.

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