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May 24, 2004
Referring
Doctors Are Your Customers
By J. K. Bucsko
Vol. 5 No. 11 p. 17
How much money does one referring physician represent
over a 25-year period to an imaging facility, whether a hospital
department or a private setting? The answer, according to Cecilia
Tweedy, physician relations director for Englewood Hospital and
Medical Center in New Jersey, is $200 million.
“It doesn’t matter what kind of physician
or what kind of tests the physician orders—[lab tests], diagnostic
imaging—that figure has been statistically proven,”
Tweedy declares. “And that’s net income.”
Think of that $200 million, advises Tweedy, as adding
digital mammography, or a VPN (virtual private network), or any
other technology advance. Or, think of it this way: “It’s
also your paycheck, your retirement.”
Market Longevity
Addressing the New Jersey Society of Radiologic Technologists in
Atlantic City in March, Tweedy advised imaging administrators and
technologists to remember, “Physicians Are My Customers.”
Paraphrasing Freud’s famous question, she urges asking, “What
do my referring physicians want?”—and then making certain
you are providing whatever it is. “The only way you and your
doctors are going to stay employed is if you keep the relationship,”
she says. The way to do that is to meet each doctor’s expressed
and unexpressed needs.
“You are the key to making the physician more
efficient and more effective, to making his job easier.” You
do that, Tweedy states, by providing three important items:
• immediate access to critical clinical information, which
leads to…
• healthier interactions with patients, which ultimately results
in…
• more time for the physician to see more patients whom, hopefully,
will be sent your way.
Multidiscipline experience
In her career, Tweedy has learned what physicians want through direct
experience. She started in long-term care, managed a skilled nursing
facility, and then trained as a social worker. Her current home,
Englewood Hospital and Medical Center, provides primary, secondary,
tertiary, and acute care, as well as being a major academic site.
It incorporates a Breast Care Center, Post-Polio Institute, Neonatal
Intensive Care Nursery, Radiation Oncology Center, Chest Pain Center,
and schools for radiography and nursing. A member of the Mount Sinai
Health System, Englewood’s residency programs encompass critical
care, surgery, pediatrics, podiatry, and pathology, as well as a
fellowship in vascular surgery.
Englewood’s radiology department is staffed
by 11 board-certified radiologists who provide angiography, digital
mammography, diagnostic and interventional radiology, breast MRI,
cardiac scoring, CT and PET scanning, lung cancer screening, nuclear
medicine, virtual colonoscopy, uterine fibroid embolization, and
ultrasound services. Tweedy works with some 700 on-staff referring
physicians, drawing her “customer base” from across
the organization’s many disciplines, including family practice,
oncology, orthopedics, OB/GYN, and internal medicine.
Know Your Physicians
Regardless of individual market or practice factors, you can pretty
much know that all referring physicians want—in fact, expect—a
diagnostic imaging department or facility that will provide them
with the data they need to make key medical decisions, delivered
in a timely and convenient manner. They want ease of use, user-friendliness,
accuracy, speed, and high-quality care for their patients. And although
you may not always be able to tell, doctors also want your recognition.
“They want you to know who they are, who their patients are,”
says Tweedy.
Citing a number of marketing research studies, Tweedy
points out that “it is six to 10 times easier to keep a good
customer than to get new ones.” Make no mistake—an unhappy
patient will complain directly to his or her doctor, whether about
difficulty getting an appointment, long waiting time, unfriendly
or unorganized staff, or any number of other issues. And an unhappy
doctor will not only withdraw his or her business but will also
discourage others from coming to you.
Think Retail
To illustrate her point, Tweedy draws the simple analogy of two
competing delicatessens on opposite ends of a city block. “Say
one is Italian and one is Asian,” she says. Each caters to
a different subset of people living in the same neighborhood, although
both offer basically the same services. If you want to draw customers
from all possible populations, you must learn to “think retail,”
says Tweedy. “Make sure there’s plenty of parking, be
open early, greet people as they arrive, know which newspaper they
want.” Do the same for everyone “and they’ll bring
you 10 more customers.”
Translating that to physicians means targeting individuals
as well as community statistics. “Offer doctors a wide welcome
into your world,” says Tweedy. “Every new physician
in any facility is credentialed in many other facilities. You want
them to choose you. Even one more patient could mean a net profit
to your facility.” For that reason, in Tweedy’s view,
there is never a good excuse to turn down any doctor’s business,
“no matter how difficult they may be sometimes.”
Know Your Objectives
An imaging center administrator’s main goal is to retain as
much current physician business as possible while also attracting
new referrals and expanding the range of services. To attain both
objectives, “know your cases,” advises Tweedy.
Closely monitor your leading, age-adjusted caseload
and be sure you are positioned to respond to changes when needed.
Then, profile your doctors in terms of age and specialty. Perform
a “community assessment” that takes into account morbidity
and mortality rates for key specialties, such as primary care physicians,
oncology, and surgery. And be poised to recruit new “customers”
as morbidity and mortality rates change in your region.
For instance, in Tweedy’s metropolitan New
York City/northern New Jersey area, heart disease, stroke, and respiratory
infections are the most common reasons for doing diagnostic imaging.
However, she notes, “over the past ten years, we’ve
seen many more sports injuries and orthopedics cases than we might
have predicted a decade ago.”
Create Your Market
“Find your customers and build your practice around the customer.
Look outside for expertise if need be,” Tweedy suggests. In
her own area, when the community attracted large numbers of Asian
immigrants, one hospital network hired a banking executive from
the Korean community. The new staffer helped establish the network
in this largely untapped market by going into Korean churches, exercise
clubs, specialty groceries, and other neighborhood businesses to
reach people who otherwise wouldn’t be aware of its services.
Tweedy recommends the same approach to getting the
word out for diagnostic imaging, whether hospital-based, networked,
or free-standing. To grow your business and reputation, get involved
in your community. Very simple things, such as x-raying candy on
Halloween, can open the doors to a larger presence. Her other recommendations
include the following:
• Liaise with schools. Start at the grade school level with
educational presentations and question-and-answer sessions. In high
schools, be sure to participate regularly in career days and hiring
fairs.
• Create a speakers’ bureau. With a few weeks’
notice, Englewood provides a variety of healthcare professionals
to address community organizations on an array of topics—from
new research findings to state-of-the-art medical technology to
job opportunities.
• Investigate grants. Check with the American Society of Radiologic
Technologists, as well as with Health and Human Services, to see
whether or not your facility qualifies for federal funding to help
establish one of a number of community-based training and education
programs (see Box A).
Recognize Your Role
Most importantly, recognize and acknowledge your own place in the
healthcare chain. “[The imaging department] is the most highly
producing, revenue-generating department in a hospital,” says
Tweedy. Stand-alone centers that perform the same function for external
practices can have the same stature for their referrers.
Remember, says Tweedy, “you are the key to
the data that drives good health. You are the only ones who can
take charge of doctors in your setting and let them know that you
can help them do what they need to do, without question.”
Don’t shy away from calling attention to your role as lynchpin
in the “interdepartmental integration of the total care of
the patient” (see Box B).
You can slowly but simply gain recognition, says
Tweedy, even if your hospital or network has a culture of taking
imaging for granted. Her advice to administrators includes the following:
• Attend monthly decision-making meetings outside radiology.
Your message: “You can’t exist without us. Without the
x-ray staff, there is no data. Every film makes a difference.”
• Volunteer for committees. “Add your voice. Develop—or
be—a strong leader for your department.”
• Interface as often as you can with as many departments as
possible. That includes some you may not deal with regularly, such
as “risk management, pharmacy, case management, even security.”
Become immediately identifiable.
— J. K. Bucsko is a freelance healthcare
writer and editor based in Westville, N.J.
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