Contemporary Surgery

The ‘M’ word … er, outreach:
What you should know

Editor-in-Chief, Chair, Department of Surgery, University of Wisconsin,
School of Medicine and Public Health, Madison

There was a time when marketing was taboo for physicians. Curing disease was a noble cause, and expert and capable physicians were in great demand. In fact, those who marketed during this more purist era where chastised for trying to commercialize medicine. Unfortunately, today even the older generation finds it difficult to remember a time when marketing was not a part of every physician’s daily life.

I am writing this editorial during a transcontinental flight using a well-known carrier. Faced with the usual prolonged wait on the tarmac, I am forced to read the in-flight magazine. To my surprise this was an informative experience! Thanks to a joint venture by this airline and Castle Connolly, I now know who are the best plastic, cardiac, and orthopedic surgeons in New York, San Francisco, and Chicago. I even have their pictures.

I’ve also learned that The University of x$#@ has the best cancer center in the country, and the best heart center in the country is located in x$#@. (Actually, I didn’t even know that state had a heart center).

  Commercialization is rampant

The marketing budgets of hospitals are substantial. Every hospital, every specialty, every town and city have multiple centers or an institute. I Googled “vein center” and found 38 pages of centers, with 10 entries per page. There were even advertisements for companies that could show me how to create a vein center.

For heart centers, I had to go to page 64 before I found the last one. It seems that everyone has a novel, minimally invasive, rapid-to-recovery treatment that provides the best results ever…and a center to provide this treatment.

Now you might surmise that I believe marketing is evil. Well, not the case. To the contrary, I believe that health consumers should be savvy and made aware of alternatives for treatment as well as the outcomes of the physicians to whom they are referred. But when a health-care professional engages in marketing, it is important that individual or organization be factual, honest, and straightforward. (I wonder if this is an oxymoron: honesty and marketing?)

  An Rx for outreach

Here is my prescription for physician/surgeon marketing done well.

• Start with a different term. How about outreach? Marketing implies you are selling something. Outreach implies that you are providing information—information that may help patients or referring physicians make an educated choice.

• Make sure you have something to offer. Is the technique you are promoting really new or novel? Does it work? Are there any data? Are the results better than the status quo? Are your outcomes really superior to those of the next surgeon? Do you even know your results? Have you really created a center? Centers imply multiple specialists working together with an infrastructure that allows optimal patient care. Is yours really a center or are you an independently functioning surgeon interested in a specific disease?

• If you have a great product, let the world know about it. Our primary responsibility is to provide the best care for patients. If we have a technique, approach, or a skill set that can improve care, then to some extent it is our responsibility to enlighten our referring physicians and their patients.

• Avoid generalizations. No operation or technique is best for every patient. Yes, the minimally invasive approach you offer may benefit the 80-year-old with congestive heart failure, but its lack of durability will be detrimental to the 55-year-old healthy patient with the same disease.

  Tailor the message

Assuming that you have something worthy of promoting, what are the best techniques to use? This, of course, depends upon the disease. For some surgical procedures (varicose vein treatments, cosmetic surgery, etc), outreach is best made to patients. Patient outreach is sometimes appropriate for more serious conditions: Most patients realize the importance of finding a competent heart surgeon. Nevertheless, for the majority of surgeons the most effective outreach is to referring physicians.

The venue for outreach can differ significantly depending upon the audience. If the target is the patient, classic venues used by consumer marketers are appropriate—newspapers, magazines, radio, direct mail, etc. Don’t underestimate the value of public relations. If you really have something novel, your local newspaper will tell the story for free.

If the objective is to reach out to referring physicians, the approach should involve personal contact if possible. Educational dinners, CME courses, and lectures are great venues. Referring physicians are a discerning audience. Show up for these events prepared to share facts, data, and your own experience. Little doubt, persuasion is a great tool; a surgeon with this skill can make a below average procedure seem superior. But in the end, integrity and competence are visible attributes that an educated audience of referring physicians can readily recognize.

  Reach out, don’t market

The moral of the story is, don’t market. Instead, provide patients and referring physicians with valuable medical information. These constituencies deserve to be made aware of the available options and the skill set of their potential surgeons. But make sure you get the order right. The emphasis should be first and foremost on creating a quality service. Then and only then, spread the word.