Referral Network in the Digital Age, and the Affordable Care Act

How do you build your referral network ?

How can your practice stand out.  What is your HUMP DAY ?

Most of us when beginning a medical practice would contact established physicians, and meet them personally, handing out a curriculum vita and business cards, then sit, hope and wait for referrals.

Today young physicians immediately sign up for any health insurer or health plan to join  their network  of providers. They will accept plans that have good reputations and avoid the ones with less quality. Young providers may even seek out word of mouth from fellow practitioners to select those that pay promptly and fairly.

What Triggers Word of Mouth?

How important is this tested by time methodology for building a medical practice following? Your medical services are a  product, and can be marketed in many ways the same as merchandise. This of course is anathema to some professionals.  However given the current state of transition in the marketplace of health care, such as accountable care organizations, and the affordable care act it is still foolish to depend upon a laundry list of providers and their networks.

The Power of Word of Mouth

Word of mouth drives all sorts of products and ideas to catch on. It’s 10 times more effective than traditional advertising and shapes everything from the products people buy to the services they use. But why do people talk about some things rather than others?

Generating word of mouth or getting something to go viral sometimes seems like magic. Like catching lightning in a bottle. But it’s not. There’s a science behind it. Triggers are only one of the six key principles that drives all sorts of things to catch on. Understand that science, and you can make your own services and ideas more contagious.

Those who are new to a community will often ask social contacts, church members or get a referral from the local medical society. The truth is that most patients have no idea of who the preferred and/or best qualfied physicians are in the community.

The final decision may be the result of a combination of word of mouth, direct referral from a friend, accessibility and a prompt appointment. Demographics play a large role in obtaining health care. A geriatric medical clinic would use methods different from a pediatric clinic. Subspecialist practices can market to consumers directly, or if in a monitored network...social networking with referral sources directly may be more effective in building your network.

Generating Word of Mouth

The best thing about word of mouth is it is available to everyone. It doesn't require large amounts of capital, it just requires people to talk. The challenge is how to start people talking. It just requires people to start talking, and how to make your message(s) stand out from the noise.

Today, social networking includes social media using Facebook pages, Google + pages and Linkedin ( a network of professional colleagues), and their are medical interest groups to join that narrows your interest to your target population. There is a variety of lesser known social media platforms such as Digg, Pinterest, Delicious, or Newsana. A professional blog with RSS feeds and a subscription tab also can be a resource for your practice. Backlinks, which are links between different platforms also enhances your visibility. If you are using social media the understanding of hashtags and their use magnifies and focuses your audience.

There are a large number of tutorials and courses covering these subjects. Finding an expert in social media is not difficult.

What are the limitations of Social Media?

When asked, most will estimate that social media accounts for 50% (average) of chatter. However 50% is wrong ! The actual numbere is 7%. Research by the Keller Fay Group fins that only 7% of word of mouth occurs online. This figure may not represent certain demographics, such as an age group 11 to 30, where use of social media is greater than 7%. Now even that may be changing as older adults use social media much more in the past four years as social media platforms have expanded in quality and quantity. There is also significant churn ie, those entering and departing the social media niche.

These details are in much greater detail in a book by Jonah Turner, CONTAGIOUS, WHY THINGS CATCH ON

Networked Intelligence in Health and Medicine fueled by Social Media

Attribution given to Bryan Vartabedian, MD

How does a hospital or provider move into the digital space ? And what part of the space should you participate ?

Are you a part of it, and do you want to be a part of it? Is this a necessity, or just a fad ?

Do you have an overall marketing plan, or separate department for marketing?

You will need to assess your reasons for HIT and social media.  Electronic Health Records, Health Information Exchanges, mHealth, social media, all serve different needs, some elective and some necessary.

An important component is time and money, neither of which are an infinite resource. Given the current massive health reform that is being legislated practice resources must be aligned with regulatory mandates.

Reality plays a big role.  Many social media users do it for pure enjoyment as a break from conventional routines of their day.  Some do it for making new contacts, social or medical, based on current interests.  Others look for new vistas, hobbies, and activities one would never entertain,unless in the process of social media it happens spontaneously.  Some social media hobbyists transition into a vocation in marketing, education, or entertainment.

Your regional  social media politically correct standards may play a role in your decision making. Social media is just that…….voluntary.  Let’s compare social events such as medical staff meetings, part business, part pleasure, and a source of much information and communication.  If you think about your daily activities, meetings, learning experiences, creative thinking can create reasons for using social media.

You may want to expand your visibility either locally, regionally, nationally, or internationally.

There are choices:

1. Do it yourself.  This requires significant time and effort as well as a learning curve to

do it efficiently. There are many who are willing and able to teach you, some for free, and

others who charge a fee.  One example is the Social Media Residency offered by Lee

Aase and the Mayo Clinic.

2.Hire someone or a professional digital marketer to do it for you. Since you are in

the business of medicine, highly skilled and have a relatively high ability to generate

income. Why bother yourself with these tasks.

There are innumerable online companies offering software products to encompass

a marketing plan.

3. Like Real Estate the main concern is ‘location, location, location. So too is social

media.  Your choices and perhaps limitations will depend on where you practice ?

Factors such as the form of your medical practice, solo,group, specialty, or academic

will more than influence your options. Listen to this story from “33 Charts”, a well known

blog.

DECEMBER 14, 2013Albert Flexner, M.D. (courtesy, National Library of Medicine)

Last year was part of a small group charged with building a social media toolkit for medical schools.  An early conference call participant made it clear that if the project didn’t meet certain criteria for academic advancement, he’d be unable to participate.  It was the last time we heard from him.  Unfortunate but predictable.

There is a movement to qualify and/or quantify social media publishing by clinicians and scientists. In an article published on iMedicalApps, one pharmacist had this to say about this prospect,

“The movement to start evaluating blogging and tweets on par with academic publications”

by Timothy Aungst, PharmD

What counts is what brings value

New forms of knowledge creation and how they fit into a dated system of promotion is a growing preoccupation for many physicians.  And the question of what should ‘count’ toward academic advancement is one that’s received attention lately.  Some have approached advancement committees to have their blogs recognized as evidence of scholarship.  I haven’t decided whether these attempts are noble or laughable.

What counts is what brings value.  And what brings value in medicine are cameos in peer-reviewed publications.  This makes sense.  Because in the era of analog medicine, this was the only means by which physicians communicated ideas and findings.  Appearance in this 17th century tool of idea transmission has defined leadership through most of medical history.

Embedded habits are slowly eroded, as better solutions appear.

The age of networked intelligence will spawn a new kind of leader

But things have changed and doctors have new ways to share ideas and change minds.  Now every doctor, independent of institutional affiliation, tenure, pedigree or lineage is empowered with the capacity to grow, share and develop ideas.

And so the age of networked intelligence will spawn a new type of leader.  Expect to see regular doctors emerge as influential not based on lists of publications but on the strength and novelty of their ideas.  Leadership will be determined in part by the capacity to leverage new tools to build, communicate and influence.

But don’t expect them to be promoted.  For now.

Think much, publish little

Despite how we connect and communicate, peer-reviewed research will remain an important element in the advancement of medicine.  But it represents only one way to lead.  For those early in their career, there are some things you can do.

Perhaps we should think more before we publish our blogs, tweet or build facebook and/or google pages.  (or at least make our posts less often, and shorter.

Thanks to Dr. Vartabedian for his insights.