Editor’s note: This three-part series will feature case studies of marketing strategies employed in three different practice settings: the academic practice; the large multispecialty practice; and the private practice. All have unique as well as common challenges in our current economy. Otolaryngologists in each of the three settings will share the principles that have worked best for them to attract new patients and new referrals, as well as maintain their established patient base.
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April 2009Academic otolaryngology-head and neck surgical practices often have a built-in draw for referrals of new patients. With their emphasis on research, education, and clinical excellence, these practices become known for their expertise, and colleagues in the community and around the country may refer their complicated cases.
But is scientific and educational excellence enough to buoy the academic practice through these challenging times? Myles Pensak, MD, the H.B. Broidy Professor and Chair of the Department of Otolaryngology-Head and Neck Surgery at the University of Cincinnati College of Medicine, and current President of the Triological Society, does not think so.
Although the science, education, and clinical services, as they relate to tertiary and quaternary work as a regional resource, have been the best marketing tool for the department’s patient clinics, this reality does not negate the necessity of instituting a well thought-out and executed marketing plan.
Dr. Pensak is very clear on one point: We are running a service business, he asserted, and while our product may be different, at the end of the day, one very satisfied customer is going to beget several new patients. And one dissatisfied customer may turn off 100 potential future customers.
That is why Dr. Pensak has led a department-wide marketing strategy aimed at patient retention, while also boosting the numbers of new patients seen in the clinic at his institution. After 18 years of education-based outreach to referring physicians and colleagues, University ENT retooled its marketing strategies in 2006, with the help of dedicated marketing specialist Angie Keith. As a result, the practice’s volume of new patients increased from 3% over a three-year period between 2003 and 2005 to 25% from 2006 to 2008.
University-Specific Barriers
Although academic practices have a built-in draw, they also have institution-specific challenges when it comes to increasing their patient base, noted Ms. Keith. For instance, patients may associate a university practice setting with trauma, and be fearful of visiting; they may generalize one unsatisfactory encounter at the university to all prospective visits to other specialty practices; or they may simply find the physical campus difficult to navigate.
Cleave to Core Mission
The Department of Otolaryngology has seen patients under different names and settings since the 1960s; University ENT was established as a practice in 1990 specializing in otolaryngology-head and neck conditions. The practice includes attending physicians, physician assistants, fellows, and residents, and also has a Voice and Swallowing Center, a Hearing and Balance Center, a Sinus and Allergy Center, and a growing Adult Airway Reconstruction Program.
All the practice’s marketing efforts revolve around the core mission: optimizing the care of patients. At University ENT, this core mission translates to myriad steps the clinicians and office staff practice continually. Dr. Pensak says that his practice has incorporated a hybrid version of the Ritz-Carlton or Nordstrom’s mindset: We recognize that, at times, having the surgery or seeing the doctor may not be the most important part of the patient’s visit. I’ve always maintained that some of the most important people are our front desk personnel. They’re the ones putting out the fires when we’re running late; they’re the ones that have to make the decision to fit in patients who are really ill. Dr. Pensak added that the practice never dismisses patient complaints without follow-up. Dissatisfied patients hear directly from the office manager or the physician involved, he said.
Personnel have been empowered to optimize the patient experience, and office-wide policies also underscore this emphasis. For instance, the office does not use a telephone routing service. When patients call, an office staff member answers. These staff members are equipped with multiple information sheets in order to answer patients’ questions. If the question is outside the office person’s bailiwick, he or she researches the question, finds the answer, and calls the patient back within a short time. The clinic’s office hours are designed to accommodate patients’ busy lives, with late afternoon, early evening, and Saturday office hours. University ENT also maintains a satellite clinic for patients who prefer to visit a smaller office.
Referral Relationships All-Important
Dr. Pensak and University ENT managing partner Allen Seiden, MD, are attentive to maintaining and building reciprocal referral relationships. They recognize that community-based physicians may sometimes be reluctant to refer patients to a university practice, and may fear that once patients have been seen for a specific problem, they will not be returned to their own practices. University ENT does not put itself in a competitive situation with area otolaryngologists in private practice. We are very fortunate to have a talented group of gifted general otolaryngologists in the Cincinnati area, Dr. Pensak pointed out. Many of these physicians trained at UofC. We rely on these guys to be supportive of the mission of the residency program in the academic department, and have been the beneficiaries of their referrals, he reported.
For the past 10 years, the department has hosted ENT Update programs for area physicians, designed to acquaint them about new and growing programs offered at the university. Physicians are encouraged to ask questions about the specialized expertise these programs offer, and are reassured that their patients remain their patients.
Nor does the emphasis on fostering referrals relationships end with community physicians. Within the institution, University ENT partners with other related specialties, such as neurosurgery and endocrinology. For instance, Dr. Pensak noted, the department’s thyroid/parathyroid surgeon, David Steward, MD, is well known as a teacher and educator in the endocrine community.
Educational outreach to allied health care providers and paraprofessionals comprises another fruitful referral source. University ENT conducts seminars for hearing aid dealers in the Cincinnati tristate area, which includes Kentucky, Indiana, and Ohio. Once familiar with the university practice, the dealers refer patients who might need surgical intervention. The practice then sends patients back to the hearing aid supplier for their devices, so each is careful not to tread on the other’s turf.
Practice physicians frequently present at national specialty society meetings; speak at local medical society meetings; and interact with patient support and advocacy groups, such as the Lost Chord Club and the Acoustic Neuroma Association, at the local and regional levels. All these efforts combine to raise awareness of the clinic’s areas of expertise.
Ramping Up Visibility
Cultivating contacts with local print, radio, and television outlets can be an invaluable additional asset, said Ms. Keith. The practice can pitch story ideas to the university public relations department, or hire its own marketing specialist to make the pitch directly to the media. Physicians can be alert to topics relating to national news, or may suggest a human interest story about a successful new treatment.
One particularly successful story for University ENT was the situation of Father Gene Wilson, a retired Catholic priest who had moved to Ohio to start a Spanish-speaking ministry, who was referred to the practice with vocal cord paralysis. Following treatment under the direction of otolaryngologist Sid Khosla, MD, Father Wilson’s voice was restored, and he was able to resume his duties as a priest. The story first broke in May 2008 and not only resulted in local and national coverage, but also generated a flood of calls to the practice.
The advantage of media coverage, noted Ms. Keith, is that it is free, and assignment editors and producers are always in need of good stories. Although she encountered some reluctance from the practice’s physicians at first (they had never appeared on camera before), they now see the benefit of such a strategy. Ms. Keith also instituted a physician luncheon program, when practice doctors meet with other physicians in the community over lunch to educate local physicians about practice programs, foster good physician relations, and generate referrals.
We are running a service business, and while our product may be different, at the end of the day, one very satisfied customer is going to beget several new patients. And one dissatisfied customer may turn off 100 potential future customers.
-Myles Pensak, MD
The practice does not advertise, per se, says Dr. Pensak, who distinguishes marketing from advertising. They continue to bring a multipronged approach to their marketing efforts, which are centered on communicating to the patients, referring physicians, and public what they do best.
These techniques will not likely change in the coming months. Dr. Pensak believes that if other academic otolaryngologists operate from the foundation of good customer service, that they too can boost the bottom line. At the end of the day, said Dr. Pensak, It’s important to be flexible and fluid-not rigid and parochial-in our thought processes so that we don’t lose the ability to take advantage of all kinds of new opportunities that pop up.
Tips for Improving Patient Service in a University Practice
- As much as possible, structure your practice based on the user-friendly suburban office model. It can be intimidating and confusing for patients to visit a large university hospital setting. Make it easy for patients to navigate parking and to check in and check out. Provide clear signage, and maintain communication with patients prior to their visit to give directions and address any questions they may have.
- For referral patients traveling from elsewhere to your region, set up a complete program of office visits and consults to minimize delays and downtime; assign an office person to navigate the system with them.
- Keep a bank of what University ENT calls patient partners. These are patients who have agreed to talk about their successful procedures, such as tumor removal, with new patients who are currently faced with similar diagnoses and treatment decisions.
- Periodically survey and update patient education materials, making sure they are user-friendly. This can include translation of materials into languages reflective of your changing patient population.
- Invest in your Web site.
- Institute a tracking system to identify how new patients have heard about your practice. In that way, you’ll learn which efforts are most effective.
Source: Myles Pensak, MD; Angie Keith, Marketing Specialist, University ENT
ENT Today contributing writer Gretchen Henkel is coauthor, with Neil Baum, MD, of Marketing Your Clinical Practice-Ethically, Effectively, Economically, Third Edition, published by Jones & Bartlett Publishers. The Fourth Edition, now in production, will be available in August 2009.
©2009 The Triological Society