Start It Up: Patient Relations - Shout From the Rooftops

ABOUT THIS SERIES

Have you been pondering striking out on your own, making the leap from employed associate to practice owner? Or are you just starting out in practice, and wondering if it’s worth going even deeper into debt to start your own venture rather than getting “a job”?

Whatever your situation, Physicians Practice is here to help with our comprehensive six-part guide to starting a medical practice. In addition to the pre-opening day planning advice you may have seen in other such guides, we’ll delve deeper into the key milestones you’ll need to meet for success long after you cut the ribbon.

It’s a favorite daydream of many new practice owners: becoming “self-sustaining” so that they no longer have to spend time soliciting business and can really get down to patient care without distraction. And while no successful practice ever stops attending to patient relations, plenty of practices do eventually reach a point at which they don’t need to focus resources on formal marketing. In the beginning, you need to make connections with potential patients and sources of patients, marketing yourself and letting people know what you have to offer.

“People like my office, they like the experience, they refer their friends and family, and I don’t have to do any marketing,” says West Virginia dermatologist Beth R. Santmyire-Rosenberger. “We haven’t done much advertising for the past year, and we’re booked. Most of our referrals are word of mouth.”

But in specialties that were previously the domain of the well-connected super-doc with a stable of referral-funneling colleagues, patients are now shopping around a lot more, even with referrals in hand. “Things have changed,” says Marilou Terpenning, MD. “Today, many of my patients ‘interview’ me before deciding to receive treatment with us.”

Because of this propensity for doctor-shopping, many practices will need to begin building in time for extended consultations and simply consider them part of the cost of doing business, as in Terpenning’s Santa Monica hematology/oncology practice.

In general, now is the time to spend a little of your personal capital on precious extra minutes with patients. Make sure they have a stellar experience from the very first scheduling phone call to the final bill and beyond (patient satisfaction surveys, anyone?).

As Santmyire-Rosenberger notes, “An opinion of me and my office is formed before people even meet me.” How quickly the phone is answered, how pleasant the receptionist is, whether the plants in the waiting room are wilting - such seemingly trivial things make a big impression on patients.

To know you is to love you

Experienced practice owners’ top marketing suggestion is a classic technique that pays off even in a hyperlinked digital world: Give in-person presentations in your community.

“There’s no substitute for becoming known,” says Terpenning. “It’s a low-cost way of getting your name out there.” Libraries, larger employers, and schools are all likely candidates for hosting educational physician presentations. Find out who makes such decisions in your target organization - often HR directors in large companies, the principal or business manager in schools - and approach them with a proposition to offer a free seminar on, say, diabetes management or some other relevant health topic.

While you’re out there, ask attendees what they think they’re lacking in their own healthcare providers, and what they can’t seem to find elsewhere. Focus on making those things part of your practice; most likely, you’ll hear less about particular services than about the type of physician and practice people want. You can also offer yourself up to local newspapers and TV stations as a subject-matter expert; large-format display ads and infomercials are usually available, too, but these types of outreach can be too expensive for new practices to comfortably afford.

Consistently highlight your unique attributes in any messaging that leaves the office, whether it’s via paid or unpaid channels. For example, if you can offer patients more time with you than most physicians, because it’s part of your long-term strategy, then make sure people know it. “Seeing fewer people, for longer [visits], reinforces the relationship-forming and sustainability of the psychological component of practice,” says internist and pediatrician Chrissie Ott, who has adopted that strategy in her Portland, Ore., practice.

Or maybe you offer a full range of genetic counseling services, like Terpenning. Whatever it is, find ways to let people know. Shout from the rooftops if you have to. You’ll need to make sure your messages are understandable to the lay public, of course, so if, for example, you’re the only board-certified specialist in the region, you’ll want to think about what “board-certified” signifies to a potential patient.

Remember that all of this will take time to pay off. Think in terms of long-haul relationships with community contacts and with the audiences who attend your presentations - give tactics time to bear fruit before dumping them in favor of the next exciting idea.

Do, however, track results by asking every patient how they found you. That pricey phone book ad may not be worth it if it’s only netted you a few patients after a year. A well-considered sponsorship, on the other hand, might be just the thing. Terpenning’s practice, for instance, highlights its work in breast and ovarian cancer every year by sponsoring a team in the Revlon Run-Walk for Women to raise money for research.

What’s tech got to do with it?

When most people think of marketing, traditional media is usually what comes to mind. And it’s true that folks in many areas of the U.S. are today far more accepting of radio and billboard ads from physicians than in 1982, when the AMA lifted its ban on physician advertising.

In fact, members of the new generation of tech-savvy “healthcare consumers” expect to be able to easily find and compare information on medical providers and facilities. Witness the ads from individual practices increasingly popping up as sponsored listings on Internet search pages. When carefully deployed, such electronic advertising campaigns - which can be conducted regionally, nationally, or internationally, depending on your needs - are a relatively low-cost way of dramatically increasing a practice’s visibility.

And it’s not just wired youngsters and urban professionals who are eager to connect digitally. The vast majority of people with Internet access want the ability to e-mail their physicians: One survey a few years ago pinned it at 90 percent; others say the figure is in the high 70s and going up every year. According to AARP, 82 percent of baby boomers use the Internet for everything from e-mail to managing their finances and playing online games.

New technology tools are increasingly at the intersection of marketing activities and a sound patient relations strategy. There’s value, to be sure, in having your practice perceived as a leading-edge tech adopter, but most compelling for patients may be improvements in access to information.

“Technology enables possibilities for community health, for example, letting cancer patients share information with their siblings - and their siblings’ physicians - across the country so that they can obtain targeted genetic counseling,” explains Terpenning. Patients place great value on information-sharing, she says, and appreciate her practice for providing high-quality educational resources. Serving as a trusted repository for such tools makes patient loyalty that much easier to win.

Other physicians also cite technical prowess as important for patient relationship-building, with many saying that enhanced Web services, improved links between office systems, and even e-visit capabilities are near-term goals in their practices.

Ott, for one, has accomplished the dual aims of being tech-smart and increasing her patients’ responsibility for their care: She hired a Web designer to create an easy-to-use but highly functional online scheduling system. Because Ott knew what she needed from such a system, she was able to avoid pricey software packages and subscription fees by going custom. A certain amount of DIY effort is required, she says, “but it’s no big deal - I can adjust open hours and holidays on my own through an editing function.”

Her patients, too, are expected to put in a little DIY time by selecting their own appointment types (and, therefore, visit lengths) from a menu of options. Ott’s off-the-shelf calendar program syncs up with her cell phone, allowing constant access to a schedule that she can quickly update upon receiving an automatically generated new-appointment notice from the system.

Ott says 90 percent of her patients use online scheduling, with good results (not to mention low overhead). “So far I am not having trouble with patients overbooking themselves too much,” she says. “There may come a time when I feel more pressed for minutes, but so far it is working well.”

Don’t over-promise

If you go the technology-as-patient-relations route, those solutions had better deliver what they promise. Given increasingly difficult customer service interactions in other industries, at least some consumers are primed to be frustrated at having to use automated systems rather than getting live help.

Physicians who start with manageable technologies will be able to gradually increase the services they offer, incorporating new features into their practices as revenue warrants. And don’t forget that each new capability represents a chance for patient outreach - when you start offering a hassle-free scheduling option or secure e-mail communications, your community will want to know about it.

Terpenning notes that it’s far better to begin modestly than to make a grand announcement about, say, your new interactive Web site, complete with bells and whistles. This goes for other patient relations strategies as well. Think of the eager, energetic young doctor who sends out a splashy practice newsletter, promising monthly publication, but never again finds the time to work on the project.

Patients and colleagues are left to wonder about his follow-through in other areas, and future announcements are more likely to meet with skepticism. It’s OK to have a basic Web site and add to it over time - that’s eminently preferable to having a bunch of pages perpetually “under construction” and “coming soon!”

Be aware, too, of the ways in which you’ll be judged in the brave new interconnected world. Santmyire-Rosenberger recommends paying heed to physician rating sites such as DrScore.com or RateMDs.com. You can’t always control what ends up on these sites, but as of this writing, about 120 patients on DrScore had given Santmyire-Rosenberger near-perfect scores in overall exam, timeliness, treatment, and staff.

What constitutes a good “exam” or “treatment” to a patient may not align with your clinical judgment, but it’s helpful to know what evaluation criteria patients are applying: How long they sat on the table in that drafty gown, whether three people asked them the same list of questions, whether the nurse returned their phone call right away.

Often, a patient relations plan is simply a question of how best to show patients you care. Customer-service manuals oriented toward general business - Santmyire-Rosenberger likes “Raving Fans” by Ken Blanchard - can provide food for thought. Even a business school classic like “How to Win Friends and Influence People,” written by Dale Carnegie in 1936, offers plenty of pointers for those whose business necessarily includes winning over patients, payers, and colleagues.

Terpenning cautions new practice owners not to forget about those colleagues: Relationship-building with other physicians must be on any practice’s list of patient relations tactics. “Make referring physicians’ lives easier,” she says. “Show them why they’d want to send patients to you, with timely, high-quality reports and easy access to you. Let them know that their patients are getting top-notch care with you, which reflects well on them.”

Ultimately, says Santmyire-Rosenberger, “Patients want to feel that you’re interested in their best interest. The more they sense that, the more they trust you.” With a wide base of patient trust, your practice will be able to generate the community traction needed for growth and sustainability.

Laurie Hyland Robertson, BA, is a senior editor with Physicians Practice. She has been in the medical publishing field for more than 10 years, working editorially on both clinical and business-oriented healthcare topics. She can be reached at LCHRobertson@physicianspractice.com.

This article originally appeared in the September 2008 issue of Physicians Practice.