The Marketing Imperative: It’s Not Your Father’s Radiology

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Over time, the forces that make an industry strong and predictable will change. Some of the new developments will help it to prosper, while some will force it to exist and compete in areas that may seem uncomfortable. Often, however, that is only because the uncomfortable is also the new and unknown. As a profession, radiology has recently been subjected to an evolution that is still in the early stages—an evolution that will force many practices to adopt strategies that were once unthinkable. The radiology practices that understand, early in this cycle, that conforming to the new business order is no longer an option will not only survive; they will thrive. Perhaps the most difficult concept for radiologists to embrace is that of marketing. Promoting one’s business is not second nature to most radiologists, some of whom are second-generation physicians and never saw their fathers or mothers marketing themselves. For these physicians, the thought of marketing—of actually promoting one’s talents and services, even to the point of personally calling on potential referrers—borders on the abhorrent. Not every radiology business, however, is finding that marketing is a necessary evil. Some of the most progressive practices, in fact, are embracing the concept and reaping the rewards that accompany innovation. For more than 25 years, Scottsdale Medical Imaging, Ltd, (SMIL) Scottsdale, Ariz, has had the talent, the technology, and the reputation to help it grow organically; that is, marketing was employed, but on the periphery of its annual strategic plans. SMIL has since grown to 45 radiologists and 10 outpatient imaging centers. It provides professional services for three hospitals. Three events caused SMIL to reevaluate its marketing efforts. As one may have guessed, the first was the passage of the Deficit Reduction Act, an event that SMIL saw not as the beginning of the end, but as an opportunity to solidify all of the random marketing activities in which it was engaged and put them into a strategic plan. Another event was the increased competition that SMIL faced as it became a mature business in an attractive growth market. The third was the enthusiastic participation of a core group of radiologists within the practice who organized and went out to call on referrers and potential referrers. This group became the catalyst for the formal program on which SMIL now relies for its continued success. Shannon Barrow, SMIL’s director of marketing and business development, notes that office visits by radiologists have been going on only since March 2006. She says, “Prior to that, there was a group of about six radiologists that formed a marketing committee. Their primary purpose was to put together a physician-directed newsletter.” Mark Keiper, MD, organized the effort to have radiologists visit referring offices. “At the end of the day, this is a relationship business. Building the relationships between the radiologists and the referring doctors is essential,” Barrow adds. Building Relationships Acknowledging the value and the power of those relationships has been the linchpin of the program. “Before this marketing campaign was started, and even before they started going out and meeting the referring doctors, they had a list of one radiologist from each of the subspecialties,” Barrow says. “Then they formed a list of referring doctors that they would see, and they would start building those relationships.” She continues, “It never really took off because it wasn’t really structured with a specific day on which they went out and committed to it. Now, there is 1 day a week dedicated to this. We’ve been doing it on Wednesdays, but starting in January, we’re going to start doing it on Tuesdays to accommodate our orthopedic surgeons.” The program is also successful because, from the start, it was designed to be more than just a series of meet-and-greets events. “We have it grouped by neuroradiologists, a couple of musculoskeletal radiologists, a cardiac radiologist, and a nuclear medicine radiologist,” Barrow says. “The schedule rotates, but generally, there are about six different radiologists who form the marketing committee, and they rotate into the dedicated marketing day.” By adding value to each visit, the SMIL program has promoted its practice brand in a positive, meaningful way. “These radiologists know the best way to position SMIL,” Barrow says. “We group their visits based on the most appropriate referring physicians for them so that it’s more category specific, although there are a couple who can go to just about any referring physician.” Keiper is one of those, she notes. “We can take him to any practice and he can talk about any area of SMIL, from the business standpoint as well as the clinical standpoint,” Barrow says. She continues, “At the same time, we’re also looking at growing our businesses, so we’re going to practices that may not be referring to us, or may be referring only a percentage of their patients to us. The objective is to build the relationships and make them as strong as possible. Sometimes it’s more of a maintenance visit, where they will go and review individual cases, but for the most part, we recognize it as a marketing initiative to grow referrals.” The SMIL radiologists who have embraced the enhanced marketing program do not operate in a vacuum. Behind them are the members of the marketing department, including Barrow, and the practice representatives, as well as the support of the other radiologists in the business. At SMIL, though, Keiper (a neuroradiologist) is generally acknowledged as the catalyst of the development of the office-visit program. Eroding the Zone of Indifference Keiper has been practicing at SMIL for 10 years and understands that maintaining the vitality of the program is paramount. “At first, we developed some questionnaires and surveys for our referring doctors, and we realized that we were becoming a commodity,” Keiper says. “Most referrers didn’t really know the SMIL difference and the special services we provided. To them, any radiologist would do.” The survey answers were a wake-up call for the SMIL radiologists. “We have learned that what we suspected was true: About 10% of our referrers are our fans, and about 10% had relationships with our competitors,” Keiper says, “but the remaining 80% were in the zone of indifference. In other words, they were people who just didn’t care. Then we learned, when we went out, that we could change that number very quickly. The most important thing we have achieved is adding value by educating the referring doctors and their staffs and establishing a direct point of contact for them.” With a market such as Scottsdale, which is large both geographically and numerically, it is impossible for the SMIL physician marketing team to cover all of the territory all of the time. Therefore, part of the plan was to enhance the value of the practice representatives and make their visits more meaningful. “We substantiated our practice reps,” Keiper says, “meaning that when our doctors go out with the practice reps, the reps become more important because the office staffs and the referring doctors associate them with us. Every day we go out, we are eroding that zone of indifference.” The one question that many radiologists will ask is whether the office visits replace the revenue lost by a radiologist who is not spending that day reading. At SMIL, radiologist visits are performed on what would otherwise be a day off, so lost revenue is not an issue. SMIL’s physician outreach program is now an integral part of its marketing program and may even be the most important component. As in all forward-thinking businesses, however, this program, too, will evolve. For 2008, SMIL is adding a more advanced computerized tracking program to help identify success, failures, and (perhaps most important) opportunities. The next phase is trying to measure what the program has done more accurately. Keiper explains, “We are going to do some more sophisticated data mining to see which practices are increasing their business, which practices are dropping off, and which practices are stable. In the past, it would have taken us 6 months to figure this out, but now we’re going to try to get this information in 2 weeks.” Radiology is evolving, and SMIL is evolving along with it. As with other new programs, there are bound to be mistakes, but it will never be said that SMIL can be found in its own zone of indifference.