Sunday, September 21, 2008

New website: Share medical space!

sharemedicalspace.com is a website where doctors can post and search medical space to share. You can search using fields like specialty, location, number of exam rooms, day-of-week availability etc. The searcher finds the contact info of the listing colleague. Right now it's free, but the site will be charging $360/quarter in fall - still a bargain compared with other classified ads.
Sharemedicalspace has been live for about 8 months now, and they have almost 1,000 listings already! They continue to market the site in medical newspapers as well as on Google. They also are happy about the response to a direct mail marketing campaign to some of the larger states. I really think it will be of great benefit to all doctors as we try to be more economical and practice more efficiently.
Here is the link: www.sharemedicalspace.com

Sunday, June 8, 2008

Extormity, a classic EMR

Finally someone who has illustrated my feelings on EMRs beautifully and intelligently by creating a tongue in cheek website adverstising what we all know so very well, the EMR company who tries hard, very hard to extort you, to sell you a "product" that is still underdeveloped, underperforms, yet is horribly expensive due to initial purchasing cost, training, installation, and especially due to (the big hope for additional regular income of all EMR companies) the cost of maintenance!

Take a look at this: http://www.extormity.com/

This is the right answer when all those "experts" on health care just state how flabbergasted they are that those physicians are sooo slow in adopting such a wonderful new and effective technology that promises soooo much improvement....Right?

Right! Speaking of personal experience, EMRs are immature, at the level of performace of MS DOS Word 2.0 as compared to WinWord today, they are a drain on performance, usually are designed and programmed by people as far away as possible from daily clinical practice and by far too expensive.
My personal hope is for Google or someone wiht enough smarts to actually listen to users (yes, us physicians) to come up with a really good electronic medical record that is easy and intuitive to use, fast, saves work instead of creating it.
Until then consultants, hold your opinions and maybe, maybe, do the unthinkable - actually try using one yourself. I know that this is a bad no-no for experts and consultants, but it might be worth a try once in a while....

Monday, July 23, 2007

Use Art to Improve the Appeal of your Office

What's on YOUR walls?
Those Mediterranean motives painted in fake impressionistic style usually sold to mass tourists on side walks, now available at your trusted Wal-Mart? That style of "art" that seems obligatory in medical offices if you believe your local decorator? You know, those pictures of Portofino, Lago di Garda, Lago di Como...

Try the following low cost – high style alternatives:Nicholas Nixon “The Brown Sisters”. Shows 4 Massachusetts sisters as photographed yearly by one of their husbands over a time frame of 27 or 28 years now, one photo each year. A wonderful series – very suitable for an Ob/Gyn office. Buy 2 books for $39, tear out the pages and frame them. Or pay 100 K for a signed original 25-image-series available in a NYC gallery.

Take a look at the following artist websites (and remember that taste is subjective):Photographies by Emerson Matabele http://www.emersonimages.com/

One great photographer, whom I happen to know in person, and whose art I have bought without regretting it one second is Martin Berinstein. Take a look at his photographies at http://www.berinstein.com/.

Dry pigment paintings by Diane French who has studios in La Crosse, WI and St. Augustine Beach, FL http://www.statestreetgallery.com/ and http://www.canvascompany.com/

Ansel Adams never hurts either.

Should you have an Ikea nearby, they have very affordable framed and unframed art…

For nature images of the Everglades and Florida wetlands look up Clyde Butcher, a photographer who for me comes close to Ansel Adams. He photographs South Florida and its beaches, the Everglades, and the Big Cypress Swamp. On his website http://www.clydebutcher.com/ take a look at the “posters” section - for $40 you get excellent images…

I have the privilege to live in Boston (a privilege for which I pay dearly with lower income and higher malpractice rates) and we have a fabulous thing called "open studios". These are events, usually weekends, where many or most or all artists in particular areas of the city open their studios to the public. They even offer wine, mineral water, crackers, sometimes music and always conversation. Truly a wonderful thing, I love it. I consider it one of the best sides of Boston. If you are anywhere near the city look in the Boston Globe or on the Boston Globe website or google the term "Open Studios Boston" and visit...

Put some real art, and even if it is only a copy or print, in your office. Be different!
And, of course, you could send me your ideas about this, but you won't anyway, I know that.

Marketing Your Practice - on the Web

Top 10 reasons to see an ObGyn in 2005

based on nationwide survey of about 198 ObGyns, done by Verispan

Supervision of normal 2nd or later pregnancy 16.6 %
Gynecological exam 13.6 %
Contraceptive counseling 5.7 %
Symptomatic menopausal state 4.6 %
Surgery follow up 3.4 %
Vaginitis 3.1 %
Contraceptive surveillance 2.7 %
Routine postpartum follow up 1.9%
UTI 1.7 %
Osteoporosis 1.7%

A few thoughts on this:

1. These numbers can be a good guide for your marketing, and for the way you present your practice on the web. You may consider declaring yourself a specialist in the most common reasons for people to see an ObGyn. You post this on your website in exactly the order of frequency, and a maximum number of potential patients may be attracted to your office.

2. Where is the dysfunctional uterine bleeding in this list? DUB has the potential to be the biggest money maker in any gyn practice. DUB means ultrasound, saline-infusion sonography, in-office hysteroscopy, EMB - which may be billed as D&C if you do it right, in-office ablation (HerOption, Novasure), myomectomy, hysterectomy. Given these issues it makes sense to become and advertise yourself as THE expert in dysfunctional uterine bleeding. We all may be experts, but your website says YOU are THE expert.

3. Where is the incontinence treatment in this list? A TVT pays as much in MA as 9 months of prenatal care including delivery - talk about fairness!? I ask all my patients during annual exams about incontinence in a gentle way "do you sometimes loose urine? Do you leak urine when you cough or laugh? That leads to some further testing and some procedures, but the majority of patients still come through PCPs as referrals. Incontinence treatment is another service you should advertise on your website. A urologist in my community recently told me that he used to do about 50 slings a year and now, "thanks to the ObGYns" he does only 2 or 3.

Saturday, July 21, 2007

Find and Hire New Physicians - without paying for a recruiter

The Internet brings new tools to everybody's desktop and has fundamentally changed how employers can search for a new physician associate. There are excellent new ways to recruit and I will explain some of them here in detail.

Consider sidestepping recruiters. Your human resources department or Physician Liaison or Network Development Department can do most of the recruiting unless they are hopelessly inept or understaffed.

Recruiters usually cannot tell you anything about physician candidates that you or your staff would not find out in a few minutes too. They hardly know the candidates - except for that 10-minute phone call and the reading of their CV.

Contrary to their marketing, they do not "select" or "screen" candidates, they sell them to you. A candidate that has been "screened out" does not pay the bills. Selecting does not make money - selling does. And recruiters are in the business of selling.

The $18-22,000 you have to pay the recruiter for a few CVs and a candidate have to come from somewhere! Many employers simply reduce the first annual salary of the newly hired physician by those 20,000. Unfortunately you immediately become less attractive to good candidates, since you pay less than the competition or maybe less than the average market salary. You would get better candidates if you offered a higher salary. Have you considered increasing incentives as a marketing tool?

Last, not least, the fact that you are using a recruiter raises a red flag for the good and savvy candidates. They wonder why you even need to advertise through a recruiter. Are you in a hurry to find an associate? Do you have sub-optimal working conditions? Do you have a high turnover of new associates? How come you are not popular enough to have candidates on a waiting list? Why on earth do you have to PAY to find a new associate?

And of course, recruiters are trained sales people with an arsenal of answers and some rethoric to remove your objections. The "Gopher recruitment software" from Blackdog has a few tips and tricks for recruiters how to overcome client objections - yes, the client is you and the objections is what you think and feel: Click here to read them, so that you are prepared for the attack!

It makes financial sense to actively market your position yourself. This is easier and more affordable than you may think. Here is a way to find a new associate for about $2000-4000, including all the time your colleagues, associates and secretaries will spend on it. You may delegate every single one of these activities.

Write an ad briefly describing your practice or hospital, including your philosophy and goals or your mission, characteristics of the practice, number of physicians, hospital affiliation, and number of deliveries each year, number of surgeries each week. Explain what responsibilities and how much work the position entails, for example how many work days a week, what the call ratio is, mention additional administrative duties, and –very important - what you are willing to offer in terms of payment. You should mention a salary range, for example "160-190 K depending on experience". And no, this will not lock you in into a certain salary! Describe benefits and future opportunities, such as partnership, and the time to partnership. And finally, describe the community in a few words - something that the local tourist bureau can help you with. This ad should be about half a page – and you can always modify it later. The 2 most important points for me have always, always been: location and salary. Make sure you mention these two points if you want your ad to have maximum impact.

Now, how do you get your letter to potential employees?

1. Advertise in print media (and here I assume you are searching for an ObGyn) such as "Ob.Gyn.News", "OBGmanagement", "Contemporary ObGyn", or in the Green Journal.

2. Post your position on the largest and most relevant job sites for ObGyns: NTNjobs.com, healthecareers.com, Practicelink.com. Do not forget to post the job on your own website.

3. Approach potential candidates directly through mail, fax, and email.





Here are a few more details to illustrate the above points:

1. Print media. You can also advertise for about the same amount of money in the three most popular "throw away journals" - OBGmanagement, Ob.Gyn. News and Contemporary ObGyn. They all have websites and 800 numbers. Their prices are reasonable and vary by size of the ad. Since these three magazines are for free for the reader, they are literally everywhere and get a lot of attention.

2. Advertise your job on the Internet! There are two great websites to reach a large number of ObGyns and physicians in general. Post your ad on NTNjobs.com for about $ 315 for 3 months and $215 for the following three months. NTNjobs is a great website, it has a clear design and is easy to navigate. It has been around for over 15 years and gets a lot of attention from job seekers. They are known to have numerous direct-from-employer ads and less recruiter ads. NTNjobs also gives you access to a list of physicians who are presently searching for a job in your geographical area and you could contact them directly.
Very important! A new excellent tool for finding physicians has emerged in 2008. SERMO.COM, a physician-only online community, now has a Job Board. AND IT IS FREE. And it will continue to be free. You register at sermo.com (for free) and post your job offer in the form provided on the same page as the registration. Since semro has 65,000 registered users so far, the exposure is quite good. They will not remove your ad, the posting time is not limited. You post the description of the job and leave a name, telephonenumber and email adress where an interested physician may contact you. Voila! You have the chance of reaching a large number of physicians for free....

I also recommend posting your ad on the new "ACOG Career Connection" section of the ACOG website, which is "healthecareers.com". A single posting costs $350 for 60 days.

A number of successful bloggers are trying to cash in on their popularity and have started advertising jobs. At the moment (July 2007) I do not recommend advertising there, since they are not established yet and the number of eyes that you reach are too small.


3. I would like to explain the direct mail approach in more detail, since it is less known and very underused.

For a direct mail or fax campaign you need the names, addresses, fax-numbers etc of the physicians you want to reach.

You can easily, quickly and comfortably buy addresses of physicians from a list-provider such as InfoUSA.com. You can do this online within minutes. Once you are on their website, look in the center, go down and click on: "Doctors, Dentists and other medical lists". In the window that opens click on "Physicians and Surgeons Database" then check the specialties you are interested in, e.g. "Obstetrics and Gynecology" and then, further down, check "office based" or "hospital based" or whatever you need. On the following page uncheck the specialties you are not interested in contacting, e.g. MFM, critical care obstetrics etc. Do not check the "fax number" box, since this will exclude doctors that have not listed a fax number. You want all the names and addresses and phone numbers! On the next page you can select the geographic area, which can be the whole country or just one zip code, or a radius of 500 miles around an address or just 10 miles. Then you get to review the list. Should the list be too large, then choose a smaller geographic selection, or change the selection by introducing age limits or gender etc. Of course, you can also increase the number of physicians this way.The price is 50-75 cents per address. There is no minimum to buy. InfoUSA will instantly email you a list in CSV format, which you can import into Microsoft Outlook, Act!, Excel or any other Contact Manager software program.

The American Medical Association has been collecting the contact information of all physicians in the US for many years and has made quite a few dollars by selling your good name, mainly to pharmaceutical companies. They have founded their own list provider company "MMSlists.com". They have very good and reliable data, but unfortunately they are very expensive. And they impose all sorts of restrictions, such as number of times you can use the data. Because of this, I do not recommend them.

A more economical solution is the following: Buy or borrow the American Medical Association book and the companion CD that contain the contact information of every single doctor in the US. The book plus CD cost about $1200, and it does NOT allow downloading and exporting of the data into a database! Yes, the AMA is expensive. But, there are some inexpensive and very useful alternatives!

Oh, well, but then there are Address Grabber and List Grabber, 2 most interesting software programs. They are very nifty tool to collect addresses, names, phone numbers etc for your lists! "Address Grabber" sells on the net as a download for $70. It allows you to "grab" and capture any address you see on your screen from any website, from any source - with a single click. If you can see it on your screen, you can transfer it to your database! You highlight the address with the mouse; the Address Grabber recognizes it and transfers all information into a contact manager such as Outlook or ACT! The info will almost magically appear in the correct place, address in address field, name in name field, fax in fax field etc. It is well worth the money if you search for a job in a metro area and are collecting contact information from yellow pages, from WebMD and other lists. Obviously it is good for many other things, such as building address databases for referrals, fund raising, other mailings etc. The more advanced version is called "ListGrabber". It imports not only a single address, but a whole page or list of addresses - hence the name. It costs over $250 and most likely it will not pay off if you do not use it a lot. It may be worthwhile for large multispecialty groups and hospitals.

You also could contact all the graduating residents in your specialty in the US. The best time is September – November of each year when they start looking for a job.
To reach the graduating residents you could send your one page ad to the residency program directors of all the programs you wish to see candidates from. Ask them to post your leaflet on their job boards and to announce it during morning rounds or weekly meetings.
You can obtain the addresses of all residency programs from the Graduate Medical Education Directory, the so called Green book. It is sold by the AMA to members for about $70 as a book or CD. Have your secretary fill in a database with all those names and addresses, or buy a database from the marketing arm of the AMA and import those data directly into Excel, which may save two or three hours of typing.

Then there is PracticeMatch.com, a data and recruiting company. On their website you can buy - online, fast, and with your credit card - the names and hospital addresses of all the graduating residents in the country - by specialty. For ObGyn you would get the names and addresses of about 1100 ObGyn residents about to graduate in June of that year. The price is a mere $250. Get the addresses, and mail them your ad or leaflet individually. I would choose mail over fax, since graduating residents would receive a fax in an office of the program director or the chief of Ob or Gyn. A letter on the other hand would go directly to their personal mail box. Voila, you have access to a whole year of graduates!

I should mention a very-low-cost list provider called "Doctorlistpro.com". They claim to sell the whole directory of physicians in the US for $500. The list of all physicians in a single specialty, meaning e.g. all ObGyns in the US, costs only $ 300. Click on http://www.doctorlistpro.com/ and see what they have. They also have a list of physicians email addresses! Emails campaigns are very inexpensive and will probably be the way of the future.

And now enjoy the CVs coming in. You can go through the pile yourself or you can set a few criteria such as level of medical school, level of residency training, years of experience, age etc. and have someone else go through the list of CVs. Your colleagues, your wife, your secretary, your office manager etc. all could help you.

Send a standard letter to the selected candidates and invite them for an interview.

Your Matthias Muenzer,MD

Thursday, July 12, 2007

Put your Practice on the Web - Practice tips 6

Have a web presence by setting up a practice website. It is your business card on the web. It allows your patients to get a view of your practice and a chance to evaluate your practice beforehand. This gives them a chance to build trust and gain confidence in you before they see you for the first time. It also saves phonecalls if you publish often needed information such as your prenatal information leaflet or package. Patients have access to it around the clock. Your leflet can answer the question if it is OK to e.g. take a certain medication during pregnancy. You can post office hours, telephone numbers, procedures you do, areas of specialisation, directions etc on your website.

Websites from MEDEM are reasonably priced, but look a little stodgy and dry. Medem is a corporation that unites many medical societies on the web. Their biggest plus are the great links that you can place on your website. For example, you can post links to numerous ACOG leaflets for free! Given the price of $18 for 50 leaflets that alone is worth the subscription for the website. ACOG’s “Physician finder” leads patients who are looking for a physician to your website. You have limited, but reasonable choices for customization.

The people from "Healthcare Success Strategies" will write and design your website in a very bice and possibly very succesful fashion - for about $7000. The websites from Healthcare Success Strategies that I have seen look excellent and are very well written. They also do write in the correct keywords that give you higher ratings right from the start. It seems expensive, but might be worth it.
My impression on ratings in the following: Content is key. If you have good content, you are better off. Skip the flash introductions, the spiders cannot read it and it slows down the loading of the site. Keywords are very important. When planning a website you should go to Yahoo and another website that shows you which words / keywords are searched the most. This could be prenatal care, baby, pregnancy, the name of your town etc. Use those words often and repetitively in everything you write.
I would be careful with "search engine optimization services" and possibly stick with those affiliated with and recommended by the web hosting service.

There are a number of services that offer ready-to-go websites for very affordable monthly fees. The least expensive and quite good one is: 1&1 web hosting. It gives you the biggest bang for the buck. It has numerous templates of good quality, although the better looking ones cost extra, and it gives you great control over your website.

Other similar services are : Yahoo, which has recently improved their templates, GoDaddy, and then the infinite number of smaller service providers.

1and1 webhosting, Google and GoDaddy have links to webdesigners that can customize your site.

Google has a service, which is in beta right now (12 06) called page creator, which allows you to publish your pages. This may turn into a full fledged website software (conveniently free, like most Google services).

You also can publish your information, your patient instructions, thoughts and links on "Blogger", which is probably the least expensive web presence you can get. You can set up the "favorites" as your index or as links to the most read info leaflets, and you can use the "profile" to direct your patients how to use your Blog as your patient information system. Insert many links and your patients will find what they are looking for.

Be careful with web designers and hosting services that "specialize on doctors", since they tend to charge more than others. After all doctors are rich, right?. Correspondingly they usually target colleagues with higher incomes such as dentists, orthodontists and plastic surgeons.

Should you be a bit more computer savvy, you could set up your website yourself or with some help. You could also hire someone form a nearby college to set it up for you or you could post your website project as a job on Guru.com. Guru.com is site that posts jobs for programmers and software people in general. You post the job, assign a payment and the programmers email you and offer their services. No obligation. Very helpful. take a look at it.

You could also ask your hospital IT department to give you recommendations about local software people that might help you set up and or maintain your website.

Should you want to do a good part of your website building yourself, you will find good website templates go to Allwebco.com. I especially like the "Graphix" series of templates - very cool! Also take a look at templatemonster.com. Templatemonster is a company that constantly develops and designs new website templates, from simple to fancy. You should know that they have a large number of resellers, so you may find their website templates on numerous websites under different names.

Learn about Google. Google is not only the gateway to the Internet, the way to find whatever you are looking for, the new phonebook and the closest thing to the "answer man". Google has a number of nifty and free tools: Gmail, "Docs and Spreadsheets", Blogger, Pagecreator (a web publishing tool) and Google Analytics. Docs and Spreadsheets is interesting and I use it daily. It is the equivalent of having Word and Excel online. It is especially useful if you routinely work on many computers (home, travel, office, hospital) and work on a project. With Google Docs and Spreadsheets you can continue writing on your text wherever you are. You can also allow others to collaborate on your projects, which is great when you have to write policies or consensus papers.
Also get to know Google hacks, learn ways to speed up your search and learn how to better find what you are looking for.
Don't forget to list your office on "Local Business" of Google and, if you want, on its equivalent on Yahoo. Go to their websites and follow the links.

Tuesday, July 10, 2007

Market Your Practice - Practice Tips 5

You probably already have maxed out the cost saving measures in your practice. The better way to more income is to increase the number of patients that you see and to get more of the patients that you LIKE, and do more of the procedures that you like and that pay well.
For that, you should market yourself. It would be by far too much to go into details, but I would like to point you in the right direction for good information that is worth reading and does not waste your time.


You must buy and or read this book:

Marketing Your Clinical Practice: Ethically, Effectively, Economically (Hardcover) by Neil Baum, Gretchen Henkel

Neil Baum's book contains the sum of all other advice that I had ever heard before I bought it and I was surprised how much more it contains. No wonder nobody recommended it to me. Every resident should receive it as a graduation gift from her or his program director. It is an absolute must for planning a private practice or if you already are in private practice. Consultants are not going to tell you more than what you will read in this book. Read this book for $89 instead of attending $ 2000 weekend courses - where you mostly will be solicited for more consulting services. This is hands down the single most valuable book for marketing your own practice.


"Guerrilla Marketing" by Jay Conrad Levinson. A classic on marketing creatively. The title suggests that it is possible for the little guy to succeed against the competing big guys. Interesting and stimulating to read, you get a lot of ideas and inspiration while reading it. Take notes! It is paperback, cheap, about $15. Levinson he has written numerous books on the subject in all its facts: guerrilla marketing handbook, marketing for free, marketing on the Internet etc etc. All book stores have his books. You can browse through his titles and look inot some of his books on Amazon and you will find an idea which of his books are appropriate for you.


The Book "Marketing to Women, How to Understand, Reach, and Increase Your Share of the Largest Market Segment" written by Marti Barletta, a female marketer. This was especially enlightening for me as a male ObGyn. It lays out in great detail what makes women tick, what motivates women, what gets their attention. Essential for an ObGyn.


"Healthcare Success Strategies" is a marketing company that specializes on marketing private physician practices. Lonnie Hirsch and Stewart Gandolf, the two founding partners, left "Practice Builders", the biggest national company for practice management and marketing and started their own company. They seem to have a lot of experience and success.
I recommend buying their 8 CD set on "Marketing your practice" from Advanstar, the publisher of Medical Economics. It gives you numerous insights, more if you listen to it more often. It also serves to subtly convince you that "marketing is more than a list of ideas" and that you should have "professionals handle it for you" - you know where this is going. They offer a reasonably priced (about $1000) two day seminar (with preparation and follow up home work) to come up with a comprehensive marketing plan tailored to your practice. I do not recommend it if you have the CD set, since it repeats verbatim what you heard on the CDs. Go to the seminar only if you think of actually hiring them to market your practice.
Take a look at their website, if you like it, buy their CD set for $200 and then decide if you want to go further. I think they are good and worth the money. They will soon publish the material of the CDs and their seminar in a book for about $100. It will come out the end of 2007 or early in 2008.

Otherwise follow the old rules:
The best marketing is word of mouth. Take good care of your patients and ask them to send their friends. Tell them that you are accepting new patients. Send them a nice thank you card when they refer someone. Inform your patients about what you do, they often do not know and will be surprised to find out.
Get to know the referring physicians. Fax them a short letter every time you see one of their patients. Ask them what you can best help them. Say good things about them to their patients - it will get back to the referring doctor.
Call patients that need more attention, call patients that you have operated, show that you care.