Commentary

Be involved in the marketing of your practice

Marketing an orthopedic practice remains a challenging issue often influenced by an unofficial code of ethics that suggests the behavior violates medical professionalism. Until the 1970s, marketing for hospitals, physician practices and individual physicians was often illegal. Today, hospitals and health care systems spend significant funds to market the services that separate them from competition. However, concerns of violating moral principles, even if not illegal, remain with individual physician practices.

Anthony A. Romeo, MD
Anthony A. Romeo

In physician group practices, there is often overlying concern that marketing needs to be equal among physicians, so the practice is promoted. The result is often like a hospital or health care system effort, in which the patient is led to believe the institution or “brick and mortar” is responsible for the quality care.

One-on-one relationship

The key component of health care, especially in orthopedic surgery, is the one-on-one relationship between physicians and patients, including personal hands-on delivery of surgical skills. While modern technology helps deliver surgical care in a consistent and reliable manner through the hands of many surgeons, ultimately the technical skill, dexterity and decisions based on experience provide the individual patient with his or her result. Although it is difficult for many to accept, some colleagues’ manual skills cannot be taught and cannot be equaled.

Unfortunately, there currently is no universally accepted method to provide health care consumers with the information to select the best surgeon for their needs. The health care culture is consistently moving toward the concept of physicians as “commodities.” The view that surgeons are interchangeable, and the provided services are the same is beneficial to a health care system or group practice. The commoditization of surgeons does not provide the ultimate consumers of health care, our patients, with a realistic and honest appraisal of the surgeon who will be trusted to deliver a personal, hands-on intervention that will affect them for the rest of their lives. As institutional health care is not bound by the same ethical principles of marketing or the financial constraints that influence individual physician marketing, health care consumers are exposed to efforts to promote the system, no matter which physician is involved in the care, as the best option for their concerns.

Despite the behemoth marketing programs at many institutions and the lack of individual physician marketing, social, economic and technological advances are beginning to depreciate the impact of institutional promotion while revealing the attributes of individual physicians and services. Many patients will seek care initially based on availability, convenience and affordability. Affordability is often related to the patient’s health insurance plan, although this boundary is eroding with increasingly high deductible health care plans. The CDC reported that high-deductible plans increased from 26% in 2011 to 40% in 2016 for Americans 18 to 64 years old.

Decision process

When faced with the possibility of surgery, there is an even greater shift in the decision process. Patients will look for “proof” that their surgeon is their best option. Social proof, or learning from others’ experience, is not new. However, in addition to speaking to family and friends, patients use online resources, including physician websites, physician-ratings websites and social media. Leaving these marketing responsibilities entirely to the hospital or health care system is not a reasonable choice unless the surgeon is comfortable with being a commodity for the system. For employed surgeons who are restricted in their ability to independently develop marketing plans, including a strong social media presence, a close working relationship with the employer’s marketing team is a valuable investment.

In group practices or in the employment model, a frequent belief is that separating one surgeon’s skill set from another creates disruptive behavior among colleagues. However, a team approach can be enhanced by highlighting certain experts. This process can increase the influence of one member of the group, however, it does not need to be at the detriment of others. The most well-recognized members often comment on how “the team” makes success possible and the talent of all is why they succeed at a higher level. These sentiments should be cultivated and encouraged to increase the visibility and recognition of the entire practice. The ability to harness and use the full potential of surgeons is highly dependent on the group leadership to understand group dynamics, recognize and promote team members and encourage the expansion of workloads.

Be involved

Orthopedic surgeons need to be involved in the marketing of their practice. Marketing should follow all principles of professionalism, including honesty, demonstration of competence, defining resources, transparent revelation of conflicts of interest, and documentation of leadership roles and special skills.

The foundation of health care from a patient’s perspective remains the personal relationship with their physicians. This relationship is more powerful and influential than anything the health care system can provide. We owe it to our patients to provide information to help them make decisions that will lead to their desired satisfaction and outcomes.

Disclosure: Romeo reports he receives royalties, is on the speakers bureau and a consultant for Arthrex; does contracted research for Arthrex and DJO Surgical; receives institutional grants from AANA and MLB; and receives institutional research support from Arthrex, Ossur, Smith & Nephew, ConMed Linvatec, Athletico and Miomed.

Marketing an orthopedic practice remains a challenging issue often influenced by an unofficial code of ethics that suggests the behavior violates medical professionalism. Until the 1970s, marketing for hospitals, physician practices and individual physicians was often illegal. Today, hospitals and health care systems spend significant funds to market the services that separate them from competition. However, concerns of violating moral principles, even if not illegal, remain with individual physician practices.

Anthony A. Romeo, MD
Anthony A. Romeo

In physician group practices, there is often overlying concern that marketing needs to be equal among physicians, so the practice is promoted. The result is often like a hospital or health care system effort, in which the patient is led to believe the institution or “brick and mortar” is responsible for the quality care.

One-on-one relationship

The key component of health care, especially in orthopedic surgery, is the one-on-one relationship between physicians and patients, including personal hands-on delivery of surgical skills. While modern technology helps deliver surgical care in a consistent and reliable manner through the hands of many surgeons, ultimately the technical skill, dexterity and decisions based on experience provide the individual patient with his or her result. Although it is difficult for many to accept, some colleagues’ manual skills cannot be taught and cannot be equaled.

Unfortunately, there currently is no universally accepted method to provide health care consumers with the information to select the best surgeon for their needs. The health care culture is consistently moving toward the concept of physicians as “commodities.” The view that surgeons are interchangeable, and the provided services are the same is beneficial to a health care system or group practice. The commoditization of surgeons does not provide the ultimate consumers of health care, our patients, with a realistic and honest appraisal of the surgeon who will be trusted to deliver a personal, hands-on intervention that will affect them for the rest of their lives. As institutional health care is not bound by the same ethical principles of marketing or the financial constraints that influence individual physician marketing, health care consumers are exposed to efforts to promote the system, no matter which physician is involved in the care, as the best option for their concerns.

Despite the behemoth marketing programs at many institutions and the lack of individual physician marketing, social, economic and technological advances are beginning to depreciate the impact of institutional promotion while revealing the attributes of individual physicians and services. Many patients will seek care initially based on availability, convenience and affordability. Affordability is often related to the patient’s health insurance plan, although this boundary is eroding with increasingly high deductible health care plans. The CDC reported that high-deductible plans increased from 26% in 2011 to 40% in 2016 for Americans 18 to 64 years old.

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Decision process

When faced with the possibility of surgery, there is an even greater shift in the decision process. Patients will look for “proof” that their surgeon is their best option. Social proof, or learning from others’ experience, is not new. However, in addition to speaking to family and friends, patients use online resources, including physician websites, physician-ratings websites and social media. Leaving these marketing responsibilities entirely to the hospital or health care system is not a reasonable choice unless the surgeon is comfortable with being a commodity for the system. For employed surgeons who are restricted in their ability to independently develop marketing plans, including a strong social media presence, a close working relationship with the employer’s marketing team is a valuable investment.

In group practices or in the employment model, a frequent belief is that separating one surgeon’s skill set from another creates disruptive behavior among colleagues. However, a team approach can be enhanced by highlighting certain experts. This process can increase the influence of one member of the group, however, it does not need to be at the detriment of others. The most well-recognized members often comment on how “the team” makes success possible and the talent of all is why they succeed at a higher level. These sentiments should be cultivated and encouraged to increase the visibility and recognition of the entire practice. The ability to harness and use the full potential of surgeons is highly dependent on the group leadership to understand group dynamics, recognize and promote team members and encourage the expansion of workloads.

Be involved

Orthopedic surgeons need to be involved in the marketing of their practice. Marketing should follow all principles of professionalism, including honesty, demonstration of competence, defining resources, transparent revelation of conflicts of interest, and documentation of leadership roles and special skills.

The foundation of health care from a patient’s perspective remains the personal relationship with their physicians. This relationship is more powerful and influential than anything the health care system can provide. We owe it to our patients to provide information to help them make decisions that will lead to their desired satisfaction and outcomes.

Disclosure: Romeo reports he receives royalties, is on the speakers bureau and a consultant for Arthrex; does contracted research for Arthrex and DJO Surgical; receives institutional grants from AANA and MLB; and receives institutional research support from Arthrex, Ossur, Smith & Nephew, ConMed Linvatec, Athletico and Miomed.