Dr. Wagner & reconciling medicine with economics
Imagine a world, if you will, in which you visit the local supermarket, select a basketful of items sufficient to feed a family of four for a month, and at the cash register you pay a flat $20 for a total bill exceeding $300.
It’s then up to the supermarket’s management to collect the balance from a starvation insurance company, which has the obligation to its stockholders of reimbursing the supermarket for as little as possible. In other words, the buyer sets the price. Or, rather, the buyer’s all-powerful agent, a member of an industry cartel controlling billions of dollars in purchases.
Outrageous? In any other industry, we’d never tolerate the system that we now know as American health care. For doctors, it’s only getting worse.
Fortunately, physicians have options for remedies marvelously unique to their profession.
Swimming upstream in a torrent
The real shocker is that private insurers routinely pay more for the same health care services than the nation’s largest customer, the federal government. So it’s of no small concern to physicians when the federal government plans to cut Medicare payments to American doctors by nearly a quarter.
These cuts are planned to take effect December 1, unless Congress takes action to reverse them. Where this leaves many physicians is in the unenviable dilemma of whether to accept new Medicare patients.
“My frustration level is at a nine or 10 right now,” San Antonio breast-cancer surgeon Kathryn Wagner told the Associated Press in a November 13 news story.
“As a business person, I can’t budget at all because I have no idea how much money is going to come in,” Dr. Wagner said. “Medicine is a business. Private practice is a business.”
Increasingly, it’s a business of quantity over quality. Under Medicare, doctors are rewarded not for good patient outcomes but for sheer volume.
Here’s how one PCP puts it: “In 10 years my costs have gone up 20 percent. At the same time, my reimbursements have gone down 20 percent. The only way I can maintain the same income I had in 2000 is to see 40 percent more patients.”
Patient choice: the extra edge
Yet physicians do have choices. One very clear option is to find better-paying patients. It’s an ugly truth that such patients are usually employed and covered by private health insurance. This is what doctors are really talking about when they use the euphemism “payer mix.”
Let’s instead call these premium patients by their business name: premium customers. There are ways to recruit more premium customers to a business also known as a private medical practice. Most industries have being doing just this for decades. It’s called (ugh, here comes that word) marketing. (What did you expect? This is our business. Medical marketing ‘R’ us.)
The good news about marketing a private medical practice is that it’s often easier and more cost-efficient than marketing most other consumer services. In fact, it’s not so much about marketing as it is information and knowledge sharing.
Unlike needing an oil change for your car or a carpet cleaning for your home, when you need a surgeon, you need a surgeon right away.
Health care consumers are inarguably the most motivated buyers on the planet. The car can go another 1,000 miles before an oil change, but a woman who’s found a lump in her breast knows she has to take action NOW.
And what action does this woman typically take? She goes to the Internet to learn more. Not to find a doctor necessarily, at least not right away. But to explore her options beyond what her PCP may have told her in a 20- or 30-minute encounter in an exam room.
The good doctor’s delivery
The good news for physicians like Kathryn Wagner is that the higher a patient’s educational level and income, the more likely the patient will be a painstakingly informed health care consumer. Generally, the highly educated (and better insured) patient will have high-speed Internet access, will spend more time surfing the web for treatment options, and will be more likely to find a physician such as Dr. Wagner.
Why? Because Dr. Wagner is an active provider of not just health care but health care information. It’s all free, and it’s right there on her patient-centric website.
Our advice to Dr. Wagner: Do not despair. You will succeed in the long run as a business woman for several reasons:
- You recognize that private medicine is a business, making your more open to meeting consumer needs on their terms.
- Your knowledge is easy to find on the Internet, right on your own website. To test this, simply Google “breast cancer surgeons San Antonio” or even “breast cancer San Antonio.” Your website appears on page one of the results for the first query and page two for the second.
- The quality of this knowledge is very high, including topics such as “Breast Cancer Myths,” “Breast Cancer Factoids” and “Reduce Your Risk.”
You, Dr. Wagner, have admirably acknowledged that breast cancer is all about the patient, not about the provider. One telling sign: The URL, or web address, for Dr. Wagner’s website doesn’t contain her name. Rather, it’s about the patient’s needs.
Thus, a prospective premium customer can both find you easily and will form excellent first impressions of you.
Mind you, we’re not unsympathetic to vulnerabilities to politics and the free marketplace. Yet it’s important to remember that the uncertainty of revenue is every business owner’s cross to bear.
The upside in health care is that the specialty-physician’s customer pool is extraordinarily defined and driven. Premium customers are looking precisely for a professional like you, a doctor that cares as much about the patient’s heart and mind as her response to surgery.
And as we often say in marketing, that’s the kind of brand that money can’t buy.
About Vanguard Communications
Since 1994, Vanguard Communications has provided specialty healthcare marketing with a strategy focused on patient education guaranteed to bring new patients to specialist physicians, physician assistants, nurses and therapists in private, university and hospital practices. Through its MedMarketLink program, Vanguard combines the disciplines of online and offline PR, strategic marketing and information technology for healthcare providers coast to coast.