A seasoned physician leader reflects on the evolution of practice promotion—from word of mouth to comprehensive Internet strategies.
IN THE MORE THAN 40 YEARS I have been in practice, I have seen marketing and practice promotion go through a metamorphosis: from adding your name to the telephone directory and placing an announcement in the paper that your practice is open for business to posting on social media, financing highway billboards, and placing radio and TV ads.
When I moved to New Orleans in 1978, I was one of 14 urologists at my hospital. After six weeks, the filing cabinet in my office had more dividers than patient charts. I knew I had to do something to build my practice or I was going to starve. I didn’t have a marketing budget and I certainly didn’t want to go against the conservative grain of the medical community — in the 1970s, marketing and advertising were prohibited by the medical establishment.
I learned quickly that creating a successful practice is not a matter of putting your name on the door, installing a telephone, and opening up shop. Building a practice requires going the extra mile for your patients and your referral sources, finding out what the patients want and fulfilling their needs and desires. It’s also about finding out what they don’t want and designing the practice accordingly.
What patients didn’t want, I learned, was to wait two to three weeks for an appointment. Because my schedule had holes in it that looked like Swiss cheese, I could promise same-day appointments. Patients didn’t want to wait 60–90 minutes in the “waiting room” to see their doctor either. I changed the name to the “reception area” and promised to see patients within 15 minutes of their designated appointment time or there would be no charge. Consequently, I developed a reputation as the “on-time doctor.”
In the Amish community where I grew up, we had a family practice doctor who made house calls. He was a high-touch physician and developed a close bond with his patients. (With COVID-19, telehealth has limited physicians’ ability to touch and even examine patients.)
After World War II, doctors became more dependent on diagnostic and therapeutic technology and as the time spent with each patient became shorter, they lost some of the art of communicating with patients. A recent article reported that the average doctor interrupts a patient after only 11 seconds during the doctor-patient encounter.1
My next marketing strategy was to start speaking to lay audiences about healthy lifestyle behaviors. Nearly every service club I approached welcomed me. I did a 20-minute talk and provided a handout with my contact information. As a result of the public speaking, I received one or two patients every month.
I also distributed a sign-in sheet at the speaking engagements and collected the names and mailing addresses of everyone who attended the program. I then created a one-page newsletter focusing on additional areas of interest and expertise and sent the newsletter to my mailing list once a quarter. These newsletters came to the attention of the editors of a local health and fitness magazine, and they asked me to contribute monthly articles. This also generated a few patients every month.
Next came an invitation to host a weekly call-in radio talk show. I thought I was going to be the next Sanjay Gupta (it was Art Ulene and Dr. Timothy Johnson at the time). I loved doing the program until the day they called me during my office hours to come to the radio station to do the promos for the weekend program. When I told them I was with patients and it would be difficult to come to the station, they responded, “If you can’t come, we will cancel the program!” Although I adjusted my appointment schedule, I decided that being a media star was too high a price to pay and terminated my relationship with the station after two years.
These strategies were helpful in attracting new patients, but I also wanted to reach out to referring physicians. I wanted to make my name and the name of my practice cross the mind and desk of referring doctors as frequently as possible. One of the easiest approaches was prompt reporting to any referring physicians.
Referring doctors, especially primary care physicians, appreciated hearing from specialists about their patients as soon as possible. The cardinal rule is to “never allow the patient to arrive back in the referring physician’s office before your report does.” I developed a “lazy man’s referral letter” (requires no dictation) which was a fill-in-the-blank letter that outlined the patient’s diagnosis, medication prescribed, and the treatment plan. The nurse completed the letter at the end of the day and faxed it to the referring doctor. (Today, this is easily accomplished using the EMR that captures the same fields and is emailed immediately to the referring doctor.)
American Medical News, the newsletter of the American Medical Association, asked me to write a monthly column on practice promotion. I accepted this position and after three years, gathered the articles into a book chapter and wrote Marketing Your Clinical Practice — Ethically, Effectively, and Economically. This book sold over 200,000 copies and was reviewed by the New York Times. The rest is history, including my relationship with the Journal of Medical Practice Management and their editor, Nancy Collins, as I joined the editorial board and submitted an article for every issue for the past 20 years.
In the end, I stayed within the restrictions of the medical establishment, but I was not willing to wait two or three years for word-of-mouth to develop a reputation and a practice. I learned that exceeding patients’ expectations and providing more service than I was paid for was the not-so-secret sauce to build a practice.
Unfortunately, doctors have no training in medical marketing, and medical schools rarely spend time educating doctors on how to ethically promote themselves regardless of the practice they start or join.
What I learned over the past three or so decades is that marketing does not require hiring a high-priced consultant, creating a five-color brochure, or paying a designer to create a practice logo. And, you don’t have to wait years for word-of-mouth to create a marketing buzz and become recognized in the community.
THE FUTURE OF MEDICAL MARKETING
The marketing and promotion strategies of the past are not enough to promote practices in 2020 and beyond. The Internet is leveling the playing field in the area of medical knowledge. Several decades ago, the doctor was the holder of the medical knowledge and patients came to physicians for advice. Today, a motivated patient with a computer and Internet access can learn as much about the pathophysiology and treatment of heart disease as a physician. Physicians once viewed as the royal dispensers of specialized knowledge now see patients who have researched their medical condition and arrive with a briefcase full of studies and a course of action from credible websites.
Since it is possible that physicians don’t have more information than patients anymore, it is our caring and compassion that will be important in helping patients follow our advice, be compliant in their follow up, and improve their medical outcomes. Our new mantra should be “Computers (algorithms) will not replace us!”
Physicians may find the following trends useful to market and promote their medical practice today and into the future.
Perhaps the biggest game-changer for medical practices is telemedicine. The use of telemedicine has increased significantly since March 2020 when CMS waived requirements that limited telemedicine to distant site communication between patients and physicians and now includes all patients who have Medicare and Medicaid Medicare. In addition, CMS agreed to compensate physicians for virtual visits at the same rate as person-to-person visits.
There has been a paradigm shift such that physicians are able to provide safe and effective care without examining the patient. For example, we estimate that nearly 60 percent of urology patients can be managed using telemedicine. However, limited physical interaction with the patient likely will trigger professional regulation and increase liability.
Many patients, especially millennials, will be looking for healthcare providers who offer virtual visits using telemedicine. Practices that don’t communicate with patients by way of telemedicine probably will lose patients.
Mobile Connections and Internet Searches
We know that many Americans use their smartphones to contact medical professionals. Therefore, it is imperative that your practice website is mobile-friendly in order to maintain current patients and attract new ones.
It’s also beneficial if your practice website is at the top of the results when someone does an Internet search for a medical practice. You can pay to have your name and the name of your practice at the top of the Google search. However, keywords, clever titles, and new content appearing on a regular basis can make your website attractive and ranked on the first page of search engines. Your rankings on the popular search engines will be enhanced if authoritative websites link to your website and reference you and your practice as an authority.
Social Media and Video Marketing
Facebook, Twitter, and YouTube offer many opportunities for physicians to connect with patients.
Video marketing has been gaining a lot of steam on social media, especially with regard to healthcare companies. It’s one of the healthcare marketing trends that’s generating the highest levels of engagement. A majority of the public prefer watching videos about content rather than reading about it.
Because healthcare isn’t an attention-grabbing topic on its own, video marketing can help create interest for your practice's services. When done well, videos can help attract and hold the attention of viewers and improve your reach.
Short, content-rich videos of less than two minutes are the most effective. Videos can focus on the topics on which you differentiate yourself and your practice from others in the area. Another effective type of video for healthcare marketing is testimonials from existing patients and staff, which help build trust and credibility with current and potential patients.
If a picture is worth a thousand words, a video is probably worth 10,000+ words.
Demographic information, such as age, gender, race, address, and occupation, can be a starting point for targeting new patients, but it doesn’t shed light on these potential patients’ attitudes and mindset.
Demographics explain “who” your patient is; psychographics explain “why.” Psychographic information includes your potential patients’ habits, hobbies, health-related experiences, and values — information you need to promote your services to a particular segment of the population.
To reach ideal patients you must know what and who they value most, where they look for their medical information, and what content appeals to them. With that information, you can target specific messages about your areas of interest or expertise.
Cybersecurity is also a consideration in digital marketing of the healthcare practice. Healthcare faces greater cyber risks than other sectors because of inherent weaknesses in its security posture. Many providers think that they are capable of defending themselves from cyberattacks, but that is folly.
The healthcare sector is an attractive target for cyberattacks for two simple reasons: It is a rich source of valuable data and it is a soft target.2 Cybersecurity is not just about protecting data; it is fundamental for maintaining the safety, privacy, and trust of our patients. Effective cybersecurity must become an integral part of every medical practice.
Shifting from Illness to Wellness
Nearly 20 percent of the U.S. GDP is spent on healthcare—estimated at $3T per annum--some suggest that $1T is wasted with duplicated tests, services, and defensive medicine. Unfortunately, a huge gap exists between spending and outcomes. In fact, Americans lag near the bottom when it comes to health outcomes among wealthy countries.
One problem is that today’s health care system focuses almost exclusively on responding to symptoms and illnesses. In the United States, we spend 97 percent of our health care resources on disease care.
But another vision for health care is emerging—one that is focused on wellness rather than illness. One that is proactive instead of reactive. One that focuses on population health rather than managing just a single patient.
Within the past decade, big data, analytics, and social networks, as well as advances in technologies such as wearable health tracking devices, are giving us the ability to learn more about wellness. That’s the premise behind Scientific Wellness, which starts with a systems approach to analyzing highly specialized large datasets of individual human biomarkers such as genes, proteins, and microbiomes, combined with personalized health coaching to influence the health of our nation.
Just as the Hubble Telescope provided a new view into the universe, personal, dense, dynamic data sets will be transformational for providing new insights into both human biology and disease.3
This approach can help us better understand the genetic and environmental factors that determine our health status. Over time, this will enable us to identify the earliest transitions from wellness to disease, which is the key to both predictive and preventive care for individuals.
Precision medicine and precision marketing
With an emphasis on personalized medicine, patients expect to be cared for to meet their individual needs. In addition to personalized medicine, I suggest you consider personalizing marketing to ensure the right patients are receiving the right messages. I recommend that the same theory of precision medicine be applied to the practice’s healthcare marketing efforts.
Dr. Alexa will see you now
Alexa, Amazon’s virtual assistant, is primed to perform healthcare-related tasks. “She” can track blood glucose levels, describe symptoms, access post-surgical care instructions, monitor home prescription deliveries, and make same-day appointments at the nearest urgent care center. Alexa can look at a picture of a wound and give advice if additional care is needed.
Alexa can also assist with your insurance claims. Liberty Mutual Insurance launched the first of its kind Alexa service that allows insurance buyers to navigate the policy purchase and management process purely by using their Amazon Echos.4
A new Alexa skill will help furnish patients with all the detailed information about the hospital before they leave from their home. This will enable users to gain access to real-time information about the hospital, including:
- Parking information
- Visitor information
- Important contact information
- Bill payment information
- Directions to the hospital and the closest urgent care facility
- Info on how to view medical records
- Important things that you need to bring for your hospital stay
Online Reputation Management
Physicians live and die by their reputations. We spend our entire medical careers polishing and protecting this status. The Internet has dramatically altered the way people gather information. It is sad but true that a single comment that takes only a few seconds for a patient to create and a single mouse-click to post on the Internet can be seen by thousands of visitors and ruin a physician’s life-long reputation.
Never forget that your most precious asset is your reputation. Online physician reviews are positive 70 percent to 90 percent of the time.5 However, physicians need to know the process of managing negative reviews. The best advice is to make sure you have many more positive reviews than negative reviews. That way an occasional negative review will not significantly detract from your online reputation.
SHOW ME THE MONEY
A reasonable investment in marketing is 3–5 percent of the practice’s gross revenues. However, marketers must be able to show that the money invested by a practice or a hospital demonstrates a return on the practice's investment. It is reasonable to ask a marketing firm about the expected increment in new patients or how the marketing firm plans to position the practice on the first page of Google.
Bottom Line: By transforming the attitude regarding marketing in healthcare, marketers can help their practices and hospitals not only meet the challenges they are facing, but help them thrive and grow. It’s never been a better time to engage in marketing, as it is an opportunity to learn, grow, and contribute to your practice in a way that was never possible before.
Modern healthcare marketing trends are all about connecting with your customers online and then intensely focusing on what these customers want. Harness the tools to ensure that the practice is visible, is well-known in the community and the region, and has a stellar reputation.
Neil Baum, MD, is professor of clinical urology at Tulane Medical School, New Orleans, Louisiana, and author of The Three Stages of a Physician’s Career-Navigating From Training to Beyond Retirement.
1. Groopman J. How Doctors Think. New York: Houghton Mifflin; 2007.
2. KPMG. Health Care and Cybersecurity: Increasing Threats Require Increased Capabilities. KPMG; 2015.
3. Hood L and Price, N. Turn Healthcare Right-Side Up: Focus on Wellness Not Disease. Psychology Today. March 19, 2018. www.psychologytoday.com/us/blog/the-social-brain/201803/turn-healthcare-right-side-focus-wellness-not-disease
4. Insurance Journal. Liberty Mutual Giving Consumers a Voice in Insurance via Amazon’s Alexa. Insurance Journal. September 13, 2016. www.insurancejournal.com/news/national/2016/09/13/426162.htmhttps://www.insurancejournal.com/news/national/2016/09/13/426162.htm
5. Hall SD. Providers Responding to Yelp Reviews Must be Mindful of HIPAA. FierceHealthcare. www.fiercehealthcare.com/it/providers-responding-to-yelp-reviews-must-be-mindful-hipaa.
This article was published in the January/February 2021 Physician Leadership Journal.