Quality Medical Care Forms Basis for All Marketing

There is no single key marketing tool that is going to drive patients to your office-other than good medical care, said otolaryngologist Martin L. Hopp, MD, PhD, a member of Tower E.N.T., the premier private otolaryngology group practice at Cedars-Sinai Hospital in Los Angeles. Dr. Hopp’s encapsulation of the basis of good marketing aligns with the views of three other otolaryngologists from different areas of the country who also recently spoke with ENT Today. Each has a different practice configuration and deals with different market realities. Some have one-stop complete service operations, whereas another focuses on one area of expertise. Nevertheless, they agree that the key to a healthy patient volume and a thriving practice is good word of mouth. And the most sure-fire way to generate good word of mouth is to maintain quality of care, and to ensure that patients and referring physicians are treated well.

Match Message to Audience

Most of the physicians interviewed reported that they have done many of the usual marketing activities: giving talks to educate referral sources about the practice’s areas of specialization and state-of-the-art treatments for specific diseases; producing brochures; updating and designing a user-friendly Web site. Preceding those activities, however, otolaryngologists should honestly assess the types of conditions the practice would like to treat. They should ask themselves: What sort of case mix do I want to have for a balance in my practice? Are there any treatment niches I can fill by focusing on specific conditions? Marketing campaigns will then flow from those decisions, Dr. Hopp believes.

For instance, if an otolaryngologist determines that he or she would like to treat snoring, the marketing campaign to boost calls to the office will likely be directed to patients. On the other hand, a marketing program to increase the numbers of cases of head and neck cancer seen at the practice will be directed to referring physicians, and might include making personal contacts as well as hosting informational seminars. It’s very important in your marketing campaign to understand what type of condition you’re going for, and how to reach that population, said Dr. Hopp. If you’re going to mail brochures to everyone’s house, you should be sending a brochure for a disease about which patients can call you directly, like snoring-not one they don’t know they have, such as a skull base tumor.

A One-Stop Shop Model

More than 60% of otolaryngology patients seen in a regular office or clinic setting have head and neck problems that are allergy-mediated, said Gavin Setzen, MD, President of Albany ENT & Allergy Services, PC in Albany, NY. Given this reality, his practice saw an opportunity to concentrate on offering complete management and care of allergic rhinitis and sinusitis, and allergic disease affecting the head and neck region. Albany ENT & Allergy Services is a large group operation, with four physicians, two physician assistants, a full-time speech pathologist, and close to 50 support staff members, including a practice manager, a human resources manager, and an information technology manager.

In the traditional outpatient medical setting, care of chronic rhinitis/sinusitis often becomes disjointed, said Dr. Setzen. After patients have been treated by their primary care physicians or other referring doctors, they will have an initial workup by an otolaryngologist; may be referred for sinus CT scans to a hospital or other facility; will often then seen by a medical allergist; and perhaps eventually return to the original otolaryngology practice for further follow-up and treatment, including sinus surgery, if needed. The logistics associated with seeing a number of different practitioners at different locations potentially delay the diagnosis, as well as initiation of treatment. In addition, this process can be costly and time-consuming for patients, often causing them to miss appointments and testing-and possibly be lost to follow-up-especially in the current economic environment.

Albany ENT & Allergy acquired a CT scanner several years so that patients could have sinus CT scans at their initial consultation, if indicated. Clinical evaluation and sinus endoscopy can also be performed at that visit. Patients leave the office with a treatment plan, which improves patient compliance and the continuity of care. The practice has continued to build its range of services beyond allergy, said Dr. Setzen. Albany ENT & Allergy also has hearing, sleep, speech and swallowing, testing, and surgery centers, and has concentrated considerable efforts on a unified business strategy. The practice implemented an electronic medical record that enables coordinated care for patients from the moment they arrive until they leave.

Dr. Setzen said, Patients and their referring doctors love the idea that they can get comprehensive, effective, timely, efficient, and cost-effective care under one roof with a consistent message that’s not diluted by lack of communication or fragmented care due to having to see multiple providers in multiple locations. And that satisfaction, he said, generates positive word of mouth, a major contributor to practice volume.

Communicating with Referring Physicians

Sufficient patient volume has not been a problem for Mary Talley Bowden, MD, a member of Memorial Northwest Otolaryngology, a practice affiliated with Memorial Hermann Northwest Hospital in Houston. Memorial Northwest Otolaryngology does not market directly to the community, although some marketing efforts are directed toward primary care physicians (PCPs). Most of these efforts fall into the category of personal outreach, she said. The practice sends a gift basket to new PCPs who set up practice in their office building, sends gift baskets at Christmas, and treats new referring physicians to lunch or dinner.

Dr. Bowden noted that prompt communication with PCPs is far more important than gift baskets or dinner invitations, however. She faxes the dictation of her report, as well as every lab result, to the referring physician. If the diagnosis is serious, such as a suspected malignancy, Dr. Bowden will then call the PCP personally to discuss her findings.

I think it’s very important to communicate with the referring doctor, agreed Dr. Hopp. The problem is that they generally have different desires as to how much they want to hear from you. Some referring physicians like long, detailed reports; others like short, to- the-point reports.

Rather than survey each referring physician-which he finds awkward-Dr. Hopp has settled on his own style of referral letter. But whether the letter is long or short-and you can’t do everything right for every referring doctor-at the end of the day, timeliness is the most important feature of that letter, he noted, echoing Dr. Bowden’s comments. Dr. Hopp’s office computer system allows him to send a referring letter the same day he sees the patient. The letter is faxed to the referring physician’s office, and a hard copy is mailed. Dispatching the report the same day also significantly improves the flow of office paperwork, he said.

The Work Speaks for Itself

John D. Donaldson, MD, a pediatric otolaryngologist with Ear, Nose and Throat Associates in Fort Myers, FL, takes an entirely different stance toward marketing. When asked to enumerate his marketing strategies with ENT Today, Dr. Donaldson responded, Does the number zero mean anything to you?

Some people think marketing goes back to the three A’s: affability, availability, and accessibility, he continued, but that is the not the way Dr. Donaldson ensures referrals to his office. He scorns the idea of marketing his skills in the public arena, and doesn’t even use Yellow Pages ads. He believes that advertising and marketing began to take precedence over ethical conduct and doing the right thing after a series of Federal Trade Commission rulings in the 1980s, upheld by the Supreme Court, that physicians should not be prohibited from advertising. As editor of the Lee County Medical Society’s journal, Dr. Donaldson published an article 15 years ago explicating what he called Donaldson’s Law of the Yellow Pages-that the talent of the practitioner was inversely proportional to the size of the ad in the Yellow Pages. The most unreliable source of information that you can get about a doctor is in the Yellow Pages, and much of the advertising with extreme claims tells much about that practice, he scoffed.

I think what you want to do is do good work, said Dr. Donaldson. [As a pediatric otolaryngologist] you want to be known as being honest and ethical and doing the right thing for kids. If you do that in the pediatric world, if you give referring pediatricians an honest, scientific, evidence-based answer, and you have good outcomes, then they are going to keep sending you patients. And word of mouth will bring you patients who share your child-centered values.

Dr. Setzen reinforced the notion that optimal patient care and ensuring quality outcomes is always the basis of all practice efforts. What we’ve found with our model of unified care is that it lessens the burden on the patient, facilitates better compliance, and ultimately improves outcomes, he said.

There’s nothing better as a marketing tool than good patient results, Dr. Hopp reiterated.

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