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Certified athletic trainers (ATCs)—the fourth customer group—are also receptive to educational programming. Physicians serving as team physicians need to build relationships with the training staff at individual schools and let the ATCs know that their students will receive prompt injury evaluation.


Published 2/1/2008
Frank A. Pettrone, MD

Know where you want to go—and you’ll get there

Fundamentals for successfully marketing the orthopaedic practice

Marketing—a word that was once associated primarily with business courses and retail industries—is now a necessary function of any innovative orthopaedic practice seeking to grow or maintain its presence in today’s competitive healthcare marketplace. Although some practices have marketing plans and initiatives, others may be unsure of how best to develop a plan that works. Successful orthopaedic marketing can be straightforward and effective—regardless of the size of the practice—when you follow these guidelines.

Data, a strategic plan, and a vision
Any orthopaedic practice—whether a sole proprietor or a group of 50 or more—should center all marketing efforts and promotions on a strategic plan and vision. Without a calculated plan and an agreed-upon vision for the practice, marketing efforts may prove disjointed and ultimately ineffective. A unifying plan that guides decision-making throughout the year ensures that all marketing initiatives are intentional and cohesive. A well-conveyed vision also encourages a group’s team members to support the initiatives and embrace the plan.

A marketing plan should also be data-driven. Although the data needed depend on factors such as size and budget, basic data gathering is essential to accurately analyze a practice’s standing. The following data should generally be obtained: market share, competitor analysis, and customer satisfaction (including patients, referring physicians, and employees).

Marketing research has levels of sophistication, depending on what a practice can afford. Information such as demographics and population growth statistics is available for free on the Internet; for an example, see the Fairfax County Web site at http://www.fairfaxcounty.gov/government/about/

Satisfaction surveys for both patients and referring physicians, whether done electronically or in hard copy formats, are usually very low-cost. Proprietary databases with more specific zip-code–based data can also be purchased.

With data and a strategic plan, a practice can segment its specific marketing tactics for each customer group, such as existing patients (including the community at large), referring physicians (which may include primary care physicians, rheumatologists, oncologists, neurologists, and chiropractors), large companies that refer workers’ compensation cases, and certified athletic trainers (on both the high school and college level). An emerging target group—insurance companies—also merits attention.

Building relationships with patients
Relationship building—rather than advertising—is an essential tactic with patients and the community. Although popular in many other industries, advertising is typically not a priority for orthopaedic practices. Directory advertising in local phone books should be viewed as a resource rather than as an advertising tool.

Instead of costly, flashy ads, orthopaedic practices should focus on investing in and strengthening existing relationships. Advertising may aid in building image and brand awareness, but most of the budget should be spent on more targeted efforts. Orthopaedic practices that do advertise in a directory or otherwise should follow the AAOS Standards of Professionalism (SOPs) on Advertising and ensure that any advertising is neither false nor misleading.

For example, creating a capabilities brochure (which also serves to brand a group) can help communicate the full scope of what a practice is and does and can be used in several ways. The cost to produce such a brochure can vary widely depending on size, photographs, design, and quantity. Simply designed, professionally produced brochures may be less than $1 a piece; larger, more involved brochures are more expensive.

Coordinated, professional patient education materials also help a practice and its physicians connect with patients. For a minimal cost (approximately $0.75–$1 a piece), a practice can have information pads, modeled after prescription pads and printed with a list of Web sites directing patients to more information on various procedures. This helps ensure that patients use trusted Web sites and further enhances the physician-patient relationship. Practices with a limited budget can collect e-mail addresses of patients and send regular updates and e-newsletters.

Engaging with the community
Practices can engage directly with patients and the community by serving as team physicians for community schools and attending “Meet the Coach” events at local high schools. To complement this type of community involvement, low-cost ads in high school sports programs may be beneficial.

Promoting new office openings with mailers and open houses further builds practice awareness among existing patients and the community. Well-executed, well-timed special events and educational programs can be very effective. Because these events are often labor-intensive and costly, they are best done annually with targeted audiences in mind. For example, the practice could host a collaborative workshop for certified athletic trainers and team physicians to provide current medical information on sideline management of athletic injuries, or hold a reunion of total joint patients and their guests interested in joint replacement to present new modalities and procedures.

A current trend in branding practices that specifically applies to the patient/community group is the use of patient testimonials in marketing initiatives. Testimonials are both popular and effective. When existing and potential patients are exposed to the stories of real patients on Web sites, in print, and through other media, they more immediately relate to a practice and its promises. In every service industry, especially in a competitive field such as orthopaedics, the power of real testimonies and word-of-mouth advertising should never be underestimated. Again, practices should be aware of the AAOS SOPs on Advertising, which prohibits false or misleading testimonials.

Referring physicians are key
Relationship-building is also a critical tactic for the second customer group—referring physicians. With this particular group, perhaps nothing is as important as exposing orthopaedic physicians to referring physicians whenever possible. A well-designed, coordinated physician-visitation program may include office visits to deliver collateral materials and other leave-behinds, luncheons, and social outings, all designed to develop and nurture relationships.

A group can send referring offices a creative announcement—including a photo, brief biography, background, and specialties—whenever a new member joins the practice. Established physicians should personally introduce the new member to local hospital physicians and staff.

Other ways to promote a practice include sending direct mail pieces on various subjects, producing a magazine (underwritten by advertisers) that discusses current orthopaedic topics, printing referral pads, promoting physicians who have fellowship training in areas of specialization, and creating a physician referral tab on the practice Web site. Because volume data is used as a proxy measure for quality, mailing an annual report each year may be beneficial. The audience for such a mailing can include primary care physicians, neurologists, oncologists, chiropractors, insurance carrier representatives, large employers or municipalities that might refer workers’ compensation cases, athletic trainers, urgent care centers, and the chief executive officers of local hospitals.

Printing and distributing postcards with a list of participating insurance plans also can be useful. Of course, participation in the managed care plans of a practice’s referral base is critical. Longstanding referral patterns can be interrupted or shifted if a practice opts out of participating in the same plans as its referral base.

Targeting other groups
Basic tactics can be used to target the third customer group—large companies and municipalities that may refer workers’ compensation cases. They, too, should receive the practice’s annual report. If possible, a practice can hire a liaison to work with the companies one-on-one, giving them a point of contact. Educational programming, such as having a physician address company employees, can be effective as well.

Certified athletic trainers (ATCs)—the fourth customer group—are also receptive to educational programming. Physicians serving as team physicians need to build relationships with the training staff at individual schools and let the ATCs know that their students will receive prompt injury evaluation.

To reach the fifth customer group—insurance companies—practices need to collect outcome data to use in future negotiations. Although academic groups may have the research advantage here, nonacademic orthopaedic practices need data to maintain a place at the negotiation table. As mentioned earlier, an annual report outlining services, volumes, and quality measures may be effective because customers are demanding more information about providers.

The practice Web site—an essential tool
Practices of all sizes can benefit from an attractive, professional Web site, which can be developed for a reasonable price. The AAOS offers online assistance for practices to design their own Web sites (
http://orthodoc.aaos.org/pows.cfm). An orthodoc.aaos.org site is an excellent option for practices that may not have the budget to hire a professional Web master ($10,000–$45,000 or more, depending on the level of design and maintenance desired).

Each Web site should include physician biographies and photos, general office information, contact information, and patient education resources. Many larger practices have added patient satisfaction surveys and special links for referring physicians, community involvement, volunteer information, and testimonials. Links to orthopaedic societies, such as AAOS, are beneficial for patient education resources. Some practices even have patient portals. Regardless of the scope of the Web site, a practice must avoid outdated, stagnant pages by performing or paying for ongoing updates.

A practice Web site can be a tremendous marketing asset when appropriately maintained. The tracking data obtained from a Web site can help determine what information is important to potential patients and what key words are being used to search for your practice. Tracking reports can also be used to measure the effectiveness of Web features, such as online patient forms, and to determine how patients are referred to a practice. For example, first-time visitors may be asked to complete a short “how-did-you-hear-about-us” survey.

Coming full circle
In summary, the overall scope of a marketing plan will be determined by the number of physicians in the group, the number of specialists, the number of office locations, ancillary services such as physical therapy, surgery, and urgent care, and other factors that characterize the practice. An academic medical group, which may have established branding initiatives, may need to reinforce a compassionate, caring perception in the patient’s mind. A smaller, private group may spend more time and energy on the branding process. Whatever its character, a healthy practice will be able to identify its strengths, weaknesses, and areas of opportunity in marketing.

Ultimately, whether a practice is academic or private, has a limited or infinite budget and a modest or extensive plan, the effectiveness of its marketing depends on the data that are gathered and analyzed and the strategic plan that is established. Successful marketing in orthopaedics need not be intimidating or complex. Any practice can reap the benefits of marketing endeavors backed by careful research and planning and coordinated, thoughtful action steps.

Frank A. Pettrone, MD, of Commonwealth Orthopaedics in Arlington, Va., is a member of the AAOS Practice Management Committee. He can be reached at fpettrone@c-o-r.com