How to Launch a Practice in the Millennial Age

For Northern Virginia otolaryngologist Christopher Chang, MD, it was YouTube videos and a website showcasing procedural skills that helped.

For facial feminization surgery specialist Laura Garcia-Rodriguez, MD, at the Henry Ford Health System in Detroit, it was community outreach events, Facebook groups, and following the right people on Instagram that gave her a boost.

And for University of Colorado generalist Andrew Johnson, MD, making the rounds of local primary care providers still tops the list.

Three approaches, three different ways to launch an otolaryngology practice. There is no one way to navigate that process in 2020. But to do it well in the millennial age, otolaryngologists interviewed by ENTtoday said physicians are best served by a healthy mix of old-school techniques like local networking events and newer-school social media platforms like Facebook, Instagram, and YouTube.

“It’s definitely a combination, but you can’t do without the technology component,” said Nikita Gupta, MD, assistant professor in the department of otolaryngology–head and neck surgery at University of Kentucky Medical Center in Lexington, Ky.

Establish an Online Presence

Dr. Chang, owner of Fauquier ENT in Warrenton, Va., joined the practice in 2005. Things started slow, he said.

“When you first come out of residency, you’re a nobody,” he said. “Nobody knows you and … in order to create your name as someone, you have to self-advocate and self-market. And the cheapest and easiest way to do that is through social media.”

For Dr. Chang, that meant filming procedures and building a practice website. His YouTube channel now has 116,000 subscribers, some 40,000 daily views, and 334 million lifetime views. He also has 2,400 Twitter followers, 3,100 Facebook friends, and a blog with more than 1,700 articles.

“If someone is searching for information, especially limited to a geographic area, and if you put the appropriate keywords and information in, your video will pop up,” Dr. Chang said. “You put yourself out there, you show expertise, and you start getting some name recognition, which is really important. Because if someone is sick, or if it’s a parent with a sick kid, they want a certain level of trust that they’re going to see someone who knows what they’re doing.”

Dr. Chang related the importance of a physician’s website or social medial platforms to a homeowner seeking an electrician and sifting through results on Google.

“I go to each and look at the website and I’ll probably call the one that has a nice website, that seems to have a nice presence,” Dr. Chang said. “I will probably call that electrician as opposed to another electrician who doesn’t even have a website, or they have a website, but it’s like looking at a MySpace page from the late 1990s.”

In order to create your name as someone, you have to self-advocate and self-market. And the cheapest and easiest way to do that is through social media. —Christopher Chang, MD

In a digital world, otolaryngologists agree that having a sophisticated online presence is paramount.

“A lot of our specialty is elective, which means that patients are empowered with time and the ability to choose their provider,” said Leslie Kim, MD, MPH, division director of facial plastic and reconstructive surgery in the department of otolaryngology–head and neck surgery at the Ohio State University Wexner Medical Center in Columbus and a founding member of the Association for Healthcare Social Media.

Take Dr. Garcia-Rodriguez, who has been in practice for about two years and works with the transgender community. To reach patients, she attends community events and has joined two facial feminization groups on Facebook. She also follows leading national transgender advocates on Instagram.

Dr. Garcia-Rodriguez explained that many members of the transgender community will use social media to spotlight doctors they’ve had good experiences with. “In terms of the trans community, a lot of the outreach and connections are through social media, through secret groups on Facebook and open groups on Facebook. For most of these groups, the leader of the group has to accept new people, and that’s where they recommend other doctors to each other.”

Dr. Garcia-Rodriguez sees Facebook as a virtual referral ground.

“People can have a gathering online and it fulfills some of the same things that word of mouth does,” she said. “People will openly talk, especially if they are incognito and have a different name; people will openly ask every embarrassing question they have, and then really scrutinize the surgeon, too, if they’re upset about something, because people don’t know who they are. It’s almost like if you went to a meeting and you never met a person, they’re more likely to tell you more information.”

Create Content

Being online means having to create content that potential patients are interested in, according to Dr. Chang.

“Blog articles are to support the information that should already be on your website,” he said. “Twitter, Facebook posts should support the content that is in your blog articles or website. In other words, all roads lead to the website.”

But if content is king, that crown can be heavy, Dr. Kim warned.

“While social media is a powerful strategy for personal branding,” she said, “you have to be thoughtful and careful about digital content because it stays potentially forever.”

Dr. Chang cautioned that the same rules of privacy and disclosure that apply in the medical sphere apply to the online world.

“Don’t commit any HIPAA violations,” he said. “Don’t say on social media, ‘Hey, I just did a sinus surgery on such and such.’ That’s a given. Don’t put up pictures of you partying at a nightclub in Paris. Things like that should be a given…. All that stuff totally doesn’t fly.”

Consider Consistency

Aside from using it smartly, another wrinkle of social media is that it needs to be used consistently. Some believe that if a social media account is not updated on a regular basis, users are discouraged from interacting with it. That’s one reason that Dr. Gupta has focused on developing face-to-face relationships and hasn’t yet fully developed an online profile, besides what the University of Kentucky provides for its physicians.

“That’s still an online presence, but not necessarily something I’m creating myself, where there are several posts a week kind of thing,” she said. “And I think part of my delay in social media is that to really get anything out of it, you have to be very active on it. I didn’t want to start it and then let it be, because I think that doesn’t look good, either. If you’re going to do it, you have to really commit.”

Dr. Kim said frequency of social media usage is up to individual physicians.

“Not being able to be consistent should not be a detractor from usage,” she added. “The caveat is that when you’re consistent with posting on any of these platforms, you’re going to gain followers a lot more readily. Therefore, if increasing the number of followers is important to you, then posting on a near-daily basis can be an effective strategy. But otherwise, I believe that social media provides an opportunity to reach your audience well beyond the actual time you post something.”

Remember, Old School Still Works

Dr. Johnson, an assistant professor in the department of otolaryngology–head and neck surgery at the University of Colorado Anschutz Medical Campus in Aurora, understands the value of social media. But as a generalist building up a practice in suburban Denver, he suggests otolaryngologists not lose sight of the bedrock of business: referrals. He schedules as many talks and lunches with local practitioners as possible.

“I still rely a lot on reaching out to primary care providers and word of mouth for that,” he said. “Being a generalist, a lot of stuff I do probably wouldn’t be well-documented on social media. Seeing people for ear fullness, there’s not much I can do to make that look good on Instagram.”

Dr. Chang agreed that there is room for both new-school and old-school techniques in building a practice.

“Doing face-to-face meetings does help,” he said. “Even if one or two (primary care physicians) add your name to their referral list, that’s good. That referring pattern will then last years, if not decades.”

---

Richard Quinn is a freelance writer in New Jersey.