Feet on the Street: Physician Liaisons Build Referrer Relationships

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Annmarie MauroA key referrer had not referred any patients to a New York radiology practice in more than a week. This highly unusual circumstance prompted a visit by the radiology practice’s physician liaison, who left the referrer’s office shaking her head in disbelief at the cause of the downturn: The referrer’s staff members had tried to fax orders to the radiology practice, as they had been doing for years, but had encountered a technical problem on the receiving end—so they faxed the orders to a competitor instead. Had it not been for the diligence of the liaison, this costly trend could have continued indefinitely. Whether you regard the medical-imaging community as in transition (at best) or under siege (at worst), the physician liaison has assumed a position of greater importance in organizations across the country. Today, the physician liaison has emerged as a linchpin in the development and maintenance of a healthy medical-imaging enterprise—particularly as some payors have begun to steer patients to locations where costs (and sometimes, quality) are lower. Consequently, the role of the physician liaison has become more vital to the radiology practice. Referral Challenges Great Lakes Medical Imaging (GLMI), a 17-physician practice based in Williamsville, New York, is not experiencing the extreme price pressures seen in many markets, but it is not without its referral challenges. The practice serves four hospitals and operates six imaging centers. Sherri White, chief business officer, has been with the practice for five years (and with the founding partners for seven more). During that time, she has witnessed substantive changes in the competitive landscape. “We are in a market that now has an MRI on every corner,” she reports. “It is very competitive and very aggressive, but we have succeeded because we believe in quality. Our number-one priority is patient care. We do everything we can to make sure that we are doing the right thing, not only for each one of our referring physicians who sends a patient, but more important, for the individual patient.” As needed, White employs whatever and whomever it takes to maintain the practice’s position in the marketplace, including a full-court press from the physician liaison (and beyond). “People here get involved as necessary,” White says. For AnnMarie Mauro, who holds the titles of business-development manager and physician liaison, getting involved doesn’t mean sending tweets or making Facebook-page updates. Everything is done the old-fashioned way. ““In our business, staff is highly involved in the process of facilitating referrals,” she reports. “All things being equal, staff members will choose the path of least resistance. Since patients can go to any corner and get an MRI exam, for example, the relationship building has to be personal.” Loyalty Tools Mauro’s referral-building and relationship-maintenance activity is based almost entirely on live interaction with the decision makers in the referring physicians’ offices. “For example, at the offices of all referring physicians, I take the time to load the software from our Synapse PACS (FUJIFILM Medical Systems USA, Inc) onto their computers,” Mauro notes. “That software leaves our icon on their desktops, which makes it very easy to pull up all the images for a particular patient.” Mauro calls the PACS a loyalty tool. “With the Synapse PACS, referring physicians (particularly orthopedic surgeons) can look at all of the images at the same time as a radiologist,” she explains. “If our radiologist needs to consult with a referrer, he or she can do it instantly, remotely, and in real time. It is not only a great medical tool; it’s a loyalty tool as well.” For physicians who do not wish to review images, reports are delivered with the utmost speed. “It all comes down to optimal patient care combined with exceptional service,” White says. GLMI has developed a full-length brochure with a page describing every modality and with patient-preparation information for procedures—what Mauro calls the do-and-don’t rules, explained in plain language. The brochure often is given to patients at the time of referral, along with an order written on a prescription pad on which a staff member can circle one of GLMI’s five imaging-center locations. “It is our goal to assist our referring physicians in their efforts to educate their patients and to involve them in every facet of their care,” White explains. Loyalty is a two-way street, and access is key, White believes. She explains that everyone is available to support referring physicians, from the secretaries at the front desks to the technologists working directly with the patients, the administrative staff, and the radiologists. “Communication among all of these individuals is key to ensuring that we are delivering a high-quality experience for the patient, as well as the referrer,” White says. Tracking Referrals and Building a Brand GLMI has relationships with thousands of referring physicians within a 30-mile radius, and its radiologists interpret around 400,000 procedures per year. To track referral patterns and identify the relationships that require attention, the practice mines the data by generating reports from its Synapse RIS (Fujifilm). “Tracking numbers are generated for me every single night,” Mauro explains. “I look at the schedule and create a report with total numbers, and when I see a pattern where referrals have dropped, it gives me the opportunity to go in and visit, month after month. The Synapse RIS has a way for me to pull up all activity, including cancellations and no-show patients.” The GLMI brand is based on high quality and responsiveness, so when Mauro makes referring-physician calls, those are what she promotes. “Equipment is equipment,” she says. “There is always going to be someone who has something better. I talk up the fast turnaround times and the fact that we read for hospitals, as well as professional sports teams in the area.” Her primary selling point is the expertise of the radiologists—a key defense against the commoditization threatening some markets. “Price is not as much of an issue here,” Mauro says. “It is important that the referring physicians realize the depth on our bench. Our physicians are all accomplished radiologists within their own subspecialties, and they have vast amounts of practical experience (coupled with exemplary training): a one–two punch, as far as quality is concerned.” The Right Fit Mauro’s success is based squarely on her abilities to listen and to read people. “She understands that we are in a market where we can be easily replaced, and it is the little things that matter,” White says. “What sets AnnMarie apart is that she is real.” For Mauro, the relationships that she maintains for GLMI are a point of pride, based on customer service and mutual respect. “Once, when something went wrong, I had an office call me and say, ‘If it were anyone else, you’d be gone.’ My job is to find what needs fixing and fix it. The referrers make or break your center,” she says. As medical imaging’s marketing matures, so will the role of the liaison. As the face of the practice, the liaison will bear a greater burden, but will also benefit from the greater satisfaction of making even more important contributions to the enterprise. Steve Smith is a contributing writer for Radinformatics.com.