Business of Radiology: Marketing

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Editor's Note: It’s no longer enough for radiologists to be imaging experts. Health care is becoming big business and radiologists need to understand how to navigate the system. Diagnostic Imaging’s Business of Radiology series provides radiologists with the business education they need to succeed.

Ask any of your peers, and they’ll likely agree – health care as you’ve known it is changing. The patient population has ballooned under the Affordable Care Act. Larger practices and health systems are gobbling up competitors. And, reimbursement dollars are tighter. It’s never been more important to make yourself stand out from the crowd.

Maybe you’ve had a marketing plan for years. Maybe the concept is new to you. Either way, industry experts said, it’s a crucial – and mandatory part – of maintaining a successful radiology practice.

“Radiologists are continuously marketing themselves, whether they recognize it or not. We are at a critical crossroads in our profession, with health care reform and dramatic changes in the health care industry,” Reginald Munden, MD, DMD, MBA, chair of the Houston Methodist Hospital radiology department, wrote in the February Journal of the American College of Radiology. “Radiologic services are in the crosshairs because of the expenses to patients, hospitals, and third-party payers. Perhaps we have done a poor job of marketing ourselves and our profession.”

That’s why, he said, radiologists must improve their marketing for the specialty to survive and flourish.

Marketing Basics
The fundamentals of radiology marketing closely mirror those of most other marketing efforts, Munden said. The 5 P’s approach – product, price, placement, promotion, and people – can help solidify your efforts.

• Product: For all practices, the product is both the imaging services and the personnel who provide them. Accommodating, pleasant staff are equally as important as the high-quality images you provide.
• Price: The importance and focus on price can vary. In some environments, such as outpatient facilities, pricing yourself competitively per study can be important. Hospital-based practices, however, might focus more on helping facilities control total imaging costs.
• Placement: You must decide what you want your practice to be – are you the least expensive option for an MRI or CT scan? Or are you the practice that always has the latest-and-greatest technology?
• Promotion: Word-of-mouth can be an effective marketing technique, but you must also be proactive in telling your community about the services you provide, Munden said. Could you advertise directly to the community or send brochures to potential referring physicians? Most importantly, if you are hospital-based, are you keeping administrators up-to-date on your practice’s performance?
• People: This marketing component refers to your people – the ones you work with daily. Make sure all of your providers and staff have a pleasant, easy-to-work-with environment is crucial to the success of your practice. You could offer the best prices and best images in town, but a difficult or unkind employee can easily undermine your success.

Designing Your Marketing Plan
The most important aspect of marketing, Munden said, is knowing who your customers are. The easy answer is patients and referring physicians, but your customer base also includes the staff in referring physicians’ offices, patient families, payers, hospital administrators, and technologists. Any marketing plan you create must contain strategies for satisfying these groups.

Identifying your target audience goes beyond knowing their demographics, said Kim Longeteig, creative director for Ali’I Marketing & Design. You can benefit from analyzing their psychographics, as well. 

“You should find out about their wants and needs – what makes patients and referring physicians tick and what they need from an imaging facility in order to be your customer,” she said. “If you can learn their personalities, age, job, household status, parenting roles, where they find their information, the kinds of social media they use, what they’re involved in, what their objections are – it can help you identify the appropriate messaging to use.”

And, what type of practice you are – free-standing or hospital-based – will weigh heavily into where you target your energies. Independent imaging centers will benefit most, he said, from concentrating on providing an easy referral process to other providers. If you’re based in a hospital, keeping the powers-that-be happy will go far in maintaining your existing contract and safeguarding yourself from any outside practice’s efforts to unseat you.

But, before you do anything, said David Myrice, CPA, MBA, director of practice management at Zotec Partners, you must create a strategic marketing plan. Then, you have to follow it.

“Without a strategic plan, a radiology practice can still experience some success, but its fate is left more to chance because the practice may not be operating as efficiently or effectively as possible,” he said. “A radiology practice is a business, but many practices consider strategic planning as something necessary only when expanding the business or dealing with serious threats to its survival. While it is important to consider these matters when planning, there should be other considerations that include looking at the ‘business’ of the radiology practice as a whole.”

He suggested five steps to creating a workable marketing plan.

• Analyze Your Data: Examine your procedure, charge, and patient collection history, as well as your payer mix. Be sure to include any hospital-based revenue in your analysis.
• Observe the Outside Market: Your practice doesn’t work in a microcosm. Get familiar with overall health care trends by examining your competitors, other local employers, and major players. Take your location and your patient’s average income into account also.
• Survey Your Staff: Distribute a poll among your radiologists that gives them the opportunity to share their top three practice goals. Culling their ideas could improve your internal communications and help you identify existing strengths and weaknesses.
• Plan a Retreat: You’ll likely have several office-wide meetings about your marketing plan. At the first one, though, discuss what you’ve found with your internal and external research and how those findings will influence your practice goals and marketing strategy.
• Solidify the Plan: Schedule a time to finalize your marketing strategy. Create a mission statement, outline an implementation plan complete with deadlines, and establish accountability among your staff members.

Opportunities
The changing health care environment has made successful marketing even more critical in a time where distinguishing yourself from your peers and competitors can be difficult. Still, according to James Lipcamon, outpatient imaging services manager at East Cooper Medical Center in Mt. Pleasant, SC, there are opportunities for improvement you can grab.

• Strengths, Weaknesses, Opportunities, and Threats: Before you design a marketing plan, he said, you should take stock of what your practice has to offer and what has happened within the previous year. What makes you different from your competitors? What obstacles have you faced? Are there areas you can identify for improvement? It’s best to assess your status once a year, he said.
• Identify Your Business Sources: Know who your most consistent referring physicians are and cultivate those relationships. Set up a system to track where most of your volume comes from – it’s an easy way to determine whether your marketing efforts are effective. You can also use this tactic to launch new marketing efforts in areas where you see growth beginning.
• Know Where You Can Grow: Your practice might already be successful in some areas, freeing you up to focus your energies on aspects that could use improvement, said Nicole Faucher, associate vice president of professional services at health care information technology solutions company Allscripts. For example, if your referring physician and patient bases are robust, concentrate on hardware maintenance.
• Introduce Yourself: It’s an old-school method, but don’t discount the benefit of meeting your referring physicians face-to-face, Lipcamon said. Take the time to meet them in their offices to talk about the services you can provide. And, don’t forget to reach out to potential patients, as well. Mailing out postcards with information about your group or practice can be very helpful to new arrivals in the community in search of quality health care options. Be sure to survey your existing patients to get a feel for how well you’re doing.
• Screening Studies: Take advantage of screening studies that are now accepted and reimbursed by insurance companies, such as lung CT screenings, Longeteig said. Getting reimbursed for lung screenings still requires a physician referral, but it’s a service you can market direct to the consumer. You can also market 3D mammography in the same way.

Risks
The most significant risk you’ll face with your marketing efforts is non-compliance, said Adrienne Dresevic, Esq., founding partner with The Health Law Partners in New York. Being sure you follow all regulations regarding your relationships with referring physicians and patients has grown increasingly important as the Affordable Care Act has taken hold.

“Even though people are tired of hearing about it, they have to focus on compliance and make sure their practice has an effective compliance program,” she said. “The Office of the Inspector General created a voluntary compliance program, and it’s pretty much expected that you’ll have one now. If you’re investigated, the first thing the government will ask is whether you have a compliance program and why it didn’t work in that instance.”

To avoid any potential problems, she said, there are two legal statutes you need to know:

• Anti-Kickback: This regulation prohibits giving patients any type of incentive – monetary or otherwise – for coming to you for imaging services. Breaking this rule is a felony for which you can serve jail time. For instance, don’t offer discount coupons and avoid including “free gifts” for the first block of patients who schedule and undergo certain imaging services.
• Stark Law: Like the anti-kickback regulation, this law prohibits any enticements given to your referring physicians. But figuring out if you’re operating within the law can be sticky. Under the law, you can provide a certain amount of non-monetary compensation per referring physician. For example, if you wanted to have a pizza party or barbecue to show your appreciation for those physicians who consistently send you their patients, you can – as long as you abide by the 2015 maximum and limit your spending to $392 per doctor. The same monetary limit applies if you want to offer a continuing medical education event.

Assess Your Success
Don’t forget to build in methods for monitoring how well your marketing plan is succeeding or where you might need to make tweaks, Zotec’s Myrice said. Disseminating surveys to your hospital customers and patients and analyzing the results can give you a good estimate of your progress.

Knowing how your customers and peers are responding to your marketing efforts will help you tailor your future efforts, maximizing your capability to provide the best service possible, said Munden of the Houston Methodist Hospital radiology department.

“We must understand that marketing is not just Madison Avenue advertising but a complex interaction of all our actions, or lack of actions, and is critical to marketing effectiveness,” Munden wrote in the JACR. “We should always provide the best service, at the best possible price, with the best attitude. Additionally, radiology professionals must brand themselves as the profession of choice for delivering imaging services.”