MIAMI BEACHBeing a good doctor with a good reputation for
delivering quality care should be enough to get all the patient
referrals a physician needs. Right? Wrong, Dr. Eric
Berkowitz said at the Network for Oncology Communication and Research
(NOCR) meeting. Youre no big deal; there are thousands
like you, he said.
In his high-energy talkthe marketing equivalent of the antidrug
film Scared Straight Dr. Berkowitz cajoled the NOCR
members to face up to the realities of the medical profession today
and the need for marketing.
Dr. Berkowitz, of the University of Massachusetts School of
Marketing, said that practices must define their competitive
differential, ie, the factors that make one practice stand out from
another. Expertise, technology, and quality of care are the most
common answers. These are aspects of what he calls the primary
product oncologists are selling.
The next question is how to get this message of excellence across to
the public, and this requires a consideration of how customers (ie,
patients) really evaluate a physicians practice.
Dr. Berkowitz drew an analogy with shopping for a car. No one buys a
car because it has four wheels, an engine, and gets a person from
point A to point Ball cars do that. What kind of car do
you own? he went around the room asking. The answer ranged from
Volvos to Jaguarsfrom safety to flash.
People do not buy specific cars because they serve them differently.
Rather, they buy a particular car because they perceive it as being
different from other brands. These perceptions have to do with what
they feel is important to them, he explainedsafety,
reliability, versatility, status, or flash.
How does this relate to an oncology practice? When a patient
agrees to come to your practice for care, the primary product is
technology and expertise or getting from point A to point B, he
said. How can a patient judge the primary product, ie, the expertise
of an oncologist, hematologist, or radiologist? They
cant, Dr. Berkowitz said.
Customers Infer Quality of Care
He explained that an oncologists customerwhether it be a
patient, a managed care company, or a referring physiciancan
only infer quality of care. They do this by looking at patient
procedures, how easy it is to access the practice, how the office
looks and feels, waiting time, and interpersonal relations.
Dr. Berkowitz said that every office should have a sales
staff to ask referring physicians what they need to make it
easier for them to refer patients to the oncologist. Lets
not call them salespeople, lets call them key physician liaison
representatives, he quipped. These representatives should do
missionary work, making at least four calls a year to
referring or potential referring physicians offices, being sure
to talk to the nurse.
The doctor doesnt really make the referral, the nurse
does. The main question that should be asked is always, What can I do
to make your life easier?
The sales representative should issue a quarterly
physician tracking report that will show if referrals have gone up or
down. Any change should be followed up. If the tracking reports shows
that referrals from a particular doctor have fallen off, for example,
the salesperson can address this point head on and ask
where the office went wrong.
Dr. Berkowitz explained that patients who have bad experiences will
complain to their referring doctor, and an oncologist has to know
about this. The only way you will get doctors to trust their
patients in the hands of another clinician is through personal
contact, he said.
Patient satisfaction surveys are also important, he said. Not only
will they let the oncologist know how he or she is doing, but they
can also be used if the referring physician reports a problem.
Dont keep your referring physicians out of the loop,
Dr. Berkowitz said. Network your computers, issue the patient
satisfaction surveys. This way, if a patient does have a
problem, the referring doctor can explain that the experience was not
typical of the practice.
Another way to boost patient referrals, he said, is to be noticed by
the patients themselves and get them to demand that their primary
physician refer to you. How many of you advertise? he
asked. A few members raised their hands. Customers need access
to your business, he said. You have competition that will
steal your business; some of them even advertise on billboards. I saw
the Cleveland Clinic billboards when I drove on I-95 today.
Patients are not always comfortable talking about their problems and
so they will seek out alternative sources of information, often
turning to the Internet. How many of you have websites?
Dr. Berkowitz asked. A few raised their hands. About 80% of
medical webpages are terrible, he said. Sheer drivel and
full of useless information. He suggested that a good website
would allow patients to set up an appointment on the webpage, find
answers to frequently asked questions, and e-mail a question to the doctor.
Oh, you dont want to do that, a doctor in the
audience said. We dont get paid for that. Dr.
Berkowitz replied, Oh yes you do. The offices nurse
can answer 95% of the questions that will be asked, he said. Plus,
the value of an intangible service can be just the edge that puts an
office above the competition.
The same doctor felt that if a doctor puts something in writing it
would remove the ambiguity we rely on. Dr. Berkowitz
responded that these are your customers. Telephone calls
at the end of the day take an inordinate amount of time, he said, and
e-mail, if used effectively and judiciously, can cut down time on the
phone. You wouldnt put into writing anything you
wouldnt say in person, he reassured the audience.
Dr. Berkowitz hammered home his points: You need to understand
what your customer is buying from you, and add value beyond the