Sunday, June 17, 2007

Hospital Physician Relationships - How Can Hospitals Simultaneously Engage Consumers and Doctors?

“The empowered and engaged consumers of health care – the passive ‘patient’ increasingly seems an anachronistic term – are a force to be reckoned with…The assertiveness and self-confidence that typify marginal consumers are evident in health care Internet users….More than 70 percent want online evaluations of physicians, and when they obtain the information, they use it.”

Regina Herzlinger, in “Why Innovation is Health Care is so Hard,” Harvard Business Review, May, 2006, and Who Killed Health Care? (McGraw-Hill, 2007)

Hospitals are looking for answers on how to simultaneously engage consumers and doctors. After all, without consumers, and without doctors who direct consumers to their facilities, hospitals would be nothing but empty shells.

The traditional answers to attracting consumers and doctors are,

•Beef up the hospital marketing department

•Set up referral services to doctors

•Run “feel good” ads in local media outlets – radio, TV, and newspapers –telling how the hospital “cares”

•Create messages saying how the hospital has acquired cutting edge technologies that make it a leader in the medical arms race

•Promote the hospital at one of the “top hospitals” in one or more of its centers of excellence

•Profile a leading doctor

•Stage a community event and bring in a national speaker on a hot topic

•Feature testimonials of patients pleased with hospital services
•Develop a hospital website

•Organize and Own ambulatory care or surgical centers

•Employ doctors, partner with them, build centers of excellence with their help, or become known as an integrated super clinic or health system with the hospital as the central piece

•Become a student of hospital marketing by buying books on the subject, subscribing to hospital marketing publications, or visiting websites like, which regularly features stories on hospital marketing.

All of these are sensible and sound approaches, but they may fail to allay the hospital CEO’s apprehension about such questions as:

•How do we develop strategies that engage consumers and doctors at the same time?

•How do we directly address patients’ fears about coming to the hospital?

•How do we persuade them our institution is “safe”?

•How do we shape pateints’ expectations and give them clues of how to deal with their admissions for a disease or an upcoming surgery?

•How do we inform them in a sensible targeted way with a predictable return of investment?

•How can we give the doctors something of value without appearing to be meddling in their practices?

•How can we build a sense of “virtual integration” within the community – of getting everybody – local citizens , surgeons who use our facility, employers, and others – the sense we are all singing from the same page while we are pursuing steps towards more formal integration?

•In other words, how do we get the entire community behind us in this environment of competition and shifting loyalties?

The long answer to these questions is that you use multimedia approaches to communicate your message – simply, plainly, and effectively.

The short answer is that you must begin to address multiple converging factors together. You must recognize that you’r now operating in a consumer-driven environment; that doctors are restless about declining reimbursements; that 90% of your revenues come from heart, orthopedic, and other procedural specialists, most of whom are surgeons or endoscopists; that the American public now reads at the fifth grade literacy level; that between 80% to 90% of the public now has broad band access to the Internet; that visual communication is crowding out verbal communication; and that people are most concerned about effects them in their busy and time-short daily lives.

Samuel Johnson is famous for saying, “Nothing concentrates your attention so much as a hanging in the morning.” Similarly nothing concentrates a patient’s attention so much as an upcoming surgical procedure. And nothing concentrates a surgeon attention so much as the fear that the procedure won’t go well and he/she will be subject to a malpractice suit due to some misunderstanding which is usually difficult to document.

Now , for full disclosure. I’ve been working with a Chicago-based company, Emmi Solutions, that has developed over 80 online interactive programs (translated into Spanish) designed to teach patients what to expert from surgical procedures or episodes of chronic disease. Evidence indicates patients forget 85% of what they are told within 10 minutes of leaving a surgeon’s office after being told they need an operation. My job is to arrange for Emmi presentations to key players in the hospital “C suite.”

These programs consist of videos featuring an empathetic voice and vivid animated anatomical drawings or illustrations – both presented in simple language a fifth grader would understand. Doctors “prescribe” these videos by giving patients an access code. Patients, in their turn, can download the videos at their convenience in the comfort of their homes. A number of prestigious institutions – Cedars Sinai, Stanford, Kaiser, The Cleveland Clinic, Evanston Hospital, the University of Pittsburgh, and Columbia-Presbyterian, among others are using the online interactive programs. The University of Pittsburgh likes them so much its surgeons are required to prescribe them.

The virtues of this online interactive approach are:

1) the videos are a powerful patient education means of overcoming health illiteracy;

2) patients like the videos because they now understand risks, benefits, consequences, and complications of surgery;

3) doctors like them because it simplifies and clarifies the informed consent process, make them “heroes” in the eyes of their patients, and leaves a documented record of what the patient was told;

4) hospitals like them because patients and doctors like them, because they have a tangible return on investment (fewer cancelled procedures, shorter hospital stays, lower chances of misunderstandings leaded to complaints or even malpractice exposure), and because they require no changes in the hospital IT system.

Hospitals are moving into a era requiring new strategies to please more demanding consumers, to keep doctors closer to the institution, and to achieve a sense of “virtual integration” across the community. These strategies will require new and innovative forms of communication that are “win-win-win” for consumers, doctors, and hospitals.

Richard L. Reece, MD
15 Banbury Crossing
Old Saybrook, Connecticut, 06475

No comments: