Despite the proliferation of managed care and government health contracts, and even if a universal care single payer health system is established, most doctors will still have some private fee-for-service patients in their practice.
The reason for this is that no plan is likely to ever cover everything a patient could want. Where there is a demand there will always be non-covered and elective medical services. It still will make financial sense for physicians to provide these services on a cash basis to patients, even though the volume may be small in any one practice.
Even with restrictive plans such as Medicare, elective care is being provided. With Medicare, as long as a visit or procedure is a non-covered service and you disclose that to the patient in advance in writing, you can provide any service the patient requests. Common examples are flu shots, screening sigmoidoscopies, weight control programs and visits over a certain number per year for a particular diagnosis.
With the expansion of managed care, and especially with the squeezing out of specialists in at-risk contracts such as capitation, we are already seeing an expansion of marketing of elective care. In addition to the typical cosmetic surgery procedures by plastic surgeons, we are seeing blepharoplasty, radial keratotomy and eye wear dispensing by ophthalmologists. Dermatologists are advertising collagen injections, facial peels, tattoo and age spot removal, hair transplants and are selling retail cosmetics. Gynecologists are doing sclerotherapy, urologists are emphasizing impotence, infertility and incontinence programs and specialists of all types are doing more second opinions, medical-legal and expert witness exams and testimony.
There are a few basic marketing tools which you can use to promote more elective care in your practice. The first is to prescribe it to the patient individually. To remain ethical about it , make sure it is no more than you would prescribe for yourself or a family member if cost was no object and you were moving to a remote area without medical care available. There is often no better way to increase prescription than to have the prescribed care yourself. In my consultations to plastic surgery practices I always encourage the doctor and all the staff to have cosmetic surgery of some kind for themselves so they can better communicate with patients. Even in internal medicine, doctors that have not had a screening sig exam themselves usually won't prescribe it much to their patients.
The second promotional tool is to provide a book of services in the reception area and exam rooms where patients wait. This can serve as the equivalent of a "menu" that patients can educated by and select care from. The services book should be supported by a nice display of patient information brochures with your name on them that patients can take for themselves or for family and friends.
You might find it an interesting exercise to find out how much your staff knows about elective services you offer. You should require their reading every piece of patient education literature in your office then discussing those topics together.
The last approach of promotion is to do external marketing, which may include advertising, direct mail, lecturing or any number of other techniques. To do this step right you really should engage a specialist in medical marketing because an error can not only not work, but can also damage your image.
In any case, if patients can elect non-covered care in your office, it is your duty to insure that it is presented and performed correctly, and that the patient is satisfied with their expenditure. The reward to you is their repeat visits and the referral of their family and friends.
Author Keith Borglum is a consultant and medical practice appraiser with Professional Management and Marketing, 3468 Piner Road, Santa Rosa California 95401.
Member National Association of Healthcare Consultants, Society of Medical Dental Management Consultants, American Medical Association's Doctors Advisory Network, American Academy of Family Physician's Network of Consultants, California Academy of Family Physician's Consultants on Call, and the Institute of Business Appraisers. Phone for consulting information. Permission is granted to reprint or quote any portion of this article provided that both the author and publication are named and two copies or the quoting journal are immediately mailed to the publisher.
Phone for consulting and appraisal information.
Permission is granted to reprint or quote any portion of this article provided that the author, firm, phone and city are named and two copies of the quoting journal are immediately mailed to the author at 3468 Piner Road, Santa Rosa CA 95401.