Although many physicians may focus on advertising as marketing or promotion, they recognize the importance of understanding and meeting or exceeding the needs of patients in their communities. Patients often follow physicians’ advice regarding where to seek care. Physicians need to know what services other physicians offer to promote their services. Hospital leaders can play an important role in facilitating information sharing, as seen in the following examples:

1) Encourage practicing physicians to articulate future clinical priorities

“I can’t believe it,” roared a Connecticut internist at a Medical Advisory Panel presentation, his fist pounding the table, after he heard a vascular surgeon describe 11 patients with weaknesses of the main blood vessel in the abdomen who were treated successfully with minimally invasive stent grafts rather than open operations.

“I have sent 4 patients with abdominal aortic aneurysms to an academic medical center in the last two months because I did not even know that we were doing minimally invasive vascular procedures here. We need to do a better job communicating!”

• On the strength of the internist’s recommendation, physicians gather quarterly for an evening medical staff meeting, of which the first order of business is an update on new services. Attendance has remained high at medical staff meetings for the last decade because this approach to new services continues to meet physicians’ needs.

2) Include doctors who are users of radiology, anesthesiology, pathology, and emergency services to draw up contract specifications and monitor performance

A hospital leader in Colorado listened when physician users of contract services complained that physicians providing contract services displayed suboptimal performance and responsiveness to patients’ and physicians’ needs.

• Rather than feeling trapped in the middle, the hospital CEO arranged for physician users to help him draw up the performance specifications, rewards, and penalties. This process has continued despite the CEO’s departure because it improved physician-physician communication as well as the hospital’s ability to market its contracted services to its entire population of physicians. Rather than lose-lose negotiation, in which everyone gives up something, this negotiation has been a win for patients, families, physicians, and the hospital.

3) Take waste out of the system by mapping steps of policies and procedures to improve effectiveness and refine handoffs

A Midwestern hospital leader learned that his leading orthopedic surgeon was considering building an ambulatory surgical center (ASC) to prevent losing patients to competing groups who offered faster time to operation. This sports-medicine specialist showed data that he could double his output over the next year with an ASC. The hospital leader engaged a multidisciplinary task force to analyze the process of care from preadmission to discharge and follow-up appointments, using a low-tech approach of writing every step on a large post-it note, posting the steps on a wall, removing unnecessary steps and rework, and simplifying burdensome processes.

• The task force was able to pinpoint how the current non-system actually worked and to redesign a more efficient process that did not require hiring additional personnel. The orthopedic surgeon decreased patients’ waiting time and increased his productivity approximately 50%. For the past two years, the orthopedic surgeon has been satisfied with the performance and has not built an ambulatory care center.

Seeking to establish a branded identity is challenging and expensive. Only by understanding patients’, physicians’, and hospitals’ changing needs can physicians and hospital leaders collaborate to improve care for their communities. Joint presentations to community groups by physicians and hospital leaders can improve communication, promote goodwill, and build business.

©2008 Kenneth H. Cohn, M.D., MBA, FACS