The practice of medicine has changed notably in the Internet Age. Although crucial patient management skills that were applicable years ago are still important, new skills are now necessary to build a successful practice.

As orthopaedic surgeons, we all seek to provide the highest level of care to our patients. However, outstanding care may not be enough. Patients expect compassionate, patient-centered care with short wait times, an excellent bedside manner, and a high level of service.

Forty years ago, medicine was often paternalistic; patients sought and respected physician recommendations. Although some patients continue to seek this model of care, many come to office appointments armed with Internet research (for better or worse) and a desire to be active parties in decision-making. Therefore, we must seek to understand what the patient desires from the office visit and provide the most appropriate type of care. An understanding of what the patient wants will enable the orthopaedist to better relate to the patient and more successfully educate him or her, using drawings, handouts, or Internet references.

Communication strategies
Communication remains a vital skill for all doctors, including orthopaedic surgeons. We must be able to communicate our thoughts, findings, and plans to patients in a manner that they can understand. Our goal should be to answer every question the patient may have—at times a real challenge. Effective communication usually leads to high patient satisfaction.

That satisfaction (or dissatisfaction) is more easily broadcast today than ever before. Keep in mind that social media (such as Facebook) and doctor rating sites (such as Healthgrades.com or Vitals.com) give patients a larger “megaphone” to share their doctor visit experiences.

Patients appreciate and expect honesty from their physicians in all interactions. These expectations have expanded beyond conversations on diagnosis, treatment plans, and prognosis to include consideration of office and surgical scheduling as well as billing. Most patients have little patience for extended office waits or operating room delays. The honest scheduling of office visits and surgery will not only make patients happier, but also increase nursing team and physician satisfaction.

All physicians have practice patterns or idiosyncrasies that contribute to their success. I believe in personally calling patients with test results. Although a nurse can complete this task, I believe my calling helps to establish trust and ensure patient understanding.

In addition, by calling rather than asking the patient to return to the office to discuss results, I free an office time slot for another patient. I also call outpatients the evening of surgery to check on their status. Again, I believe this conveys my sincere interest in their well-being and helps to head-off problems.

Marketing strategies
Advertising used to be taboo for doctors; practices were built via word of mouth, emergency department care, and joining the right group of doctors. Today, however, an effective marketing strategy is an important part of building and maintaining a practice.

Strategies include community outreach, sports coverage, and traditional outlets such as print and radio/television advertising. All approaches can be successful, but each physician must be comfortable with the selected marketing strategy.

Having an Internet presence is an essential component of a practice’s marketing strategy. Patients are increasingly using the Internet, not only for diagnosis and treatment information, but also for selecting physicians.

A strong web presence for a practice will attract the Internet-savvy patient and convey the image of a modern practice. It can also be a powerful marketing tool. An active social media presence, an updated website, and an awareness of doctor rating websites may result in a more prominent position in search results on search engines such as Google, Bing, or Yahoo.

Although not all Internet information on musculoskeletal diagnoses and treatments is accurate, it provides a strong starting point for typically well-educated patients. In my practice, I build on this knowledge, either by providing additional information or correcting misinformation.

To ensure that patients access reliable information on the Internet, supply them with links to reliable websites, such as the Academy’s patient education websites (OrthoInfo.org, anationinmotion.org, or saveyourknees.org) or to patient information on the practice website.

Communication and patient interaction skills remain important in 2015. They may be more vital now than ever, given the rampant sharing of doctor information and patient experiences through the Internet. To build and maintain successful practices, orthopaedists must also be ready to use the Internet to expand and safeguard their brand.

Charles A. Goldfarb, MD, is a professor of orthopedic surgery at Washington University School of Medicine, and a member of the AAOS Practice Management Committee. He can be reached at Goldfarbc@wudosis.wustl.edu