The goal of making a hospital pediatric program a greater presence in the community hinges upon two areas, building community and alliance with local pediatricians and creating more visibility in the public arena. Both are not mutually exclusive, and each affects the other. The goal is to create a positive experience for both areas that will enhance each individually as they connect with one another.
Unfortunately, if not done correctly, negative experiences can have the same effect and will destroy a program’s attempt to grow. The combined positive experiences of the pediatricians and the public will boost a program’s reputation and build reliance on it as a trusted pediatric partner and resource for the community.
With all of this said, attempts to achieve this greater community presence need to be authentic. People can sense if outreach is not genuine or if the intention is to not provide collaboration or mutual benefit.. If those are trust isn’t present, then all attempts to achieve a greater community presence will fail.
Creating a pediatric community and alliance
Pediatricians in the community want to be a part of something. They want to have an alliance with something bigger than themselves and feel supported. Private practice is lonely sometimes, and it is nice to be a part of a community. Large, academic medical centers are wrapped up in their own work with research, faculty recruitment, and many other large system issues. They tend to overlook those outside their “ivory tower.”
When the pandemic hit, our community pediatricians banded together to help themselves. Being in the community, running the only pediatric urgent care center in the San Fernando Valley, I became an integral part of their discussions.
A text chain was created with about 18 pediatricians in the area to share knowledge, experience, and ideas for resources. Protective masks became hard to come by in the early times, and the group supported one another to help obtain supplies. The pediatricians did not go to the large centers initially. This is just a single example of what happens outside the hospital to show that there is more self-reliance within the community of pediatricians than reliance on the larger hospitals.
So, how does one shift this reliance to the larger hospital to grow a hospital’s pediatric program?
There are several ways to do this.
First, raise the voices of the local pediatricians by promoting them on appropriate hospital platforms to have them showcase their expertise and experience. Most hospitals push their own faculty and specialists into the community to show how great their programs are but rarely look to acknowledge the local pediatricians for how great they are at what they do.
If a pediatrician is going to be on a hospital platform discussing their experience or expertise, do you think that they won’t let the families in their practice know?
The hospital respects and values the local pediatrician enough to showcase them on its platform. Everyone wants to feel heard, providing local pediatricians with a stronger voice and validating their expertise. Validation, appreciation, and connection establish the familiarity and alliance that is necessary to build a community.
Next, providing free resources, like continuing medical education (CME) credits and obstacle-free services for pediatricians, is a way to prove that the hospital program has value for them. Physicians appreciate educational resources to maintain their licenses. As you provide this free service to them, they accrue CME credits, and you get to showcase your faculty and subspecialists whom they will likely refer to in the future.
It is a win-win scenario. Obstacle-free services are also an important amenity that hospital-based pediatric programs can provide. Making things easy for the community pediatricians will not only foster more of a reliance on the services but also earn their appreciation for your presence in their community.
An example is providing easily accessible radiologic services.
For a local pediatrician to get an X-ray to rule out pneumonia or a finger fracture may involve sending the child to the emergency room, a hospital-based radiology suite, or an independent radiology facility to obtain the imaging.
Most of these destinations involve registering, making an appointment, and waiting in line for the services. What would happen if your pediatric hospital program could streamline the process, decrease the waiting time and not require an appointment?
Do you think that you would get more referrals for X-rays?
Do you think that you would get more referrals for other things because you made things easier for your local pediatricians?
You would be correct if you said “yes” to more referrals for X-rays and things beyond just X-rays. A partnership is forged by providing personal value and convenience to the local pediatricians.
While pediatric practice is a calling and something that pediatricians do because they want to help the community, a medical practice is still a business. With insurance companies providing suboptimal reimbursement for pediatric services and only willing to negotiate better reimbursement with larger facilities, the solo pediatric practice or small group practices of pediatricians get left out in the cold. They have no negotiating power.
Having worked in the community and struggling firsthand with insurance carriers and their reimbursement, I have experienced medical insurance’s burden on a practice. One is not just trying to achieve better reimbursement. One is also just trying to get reimbursed.
With the number of claim rejections and confusing coding/billing procedures that often differ between different insurance carriers, additional staff is required to help with claim filing, bill coding, refining, and reaching out to insurance companies to simply obtain reimbursement for the services that the pediatric practice already provided.
Anyone who has called a medical insurance company for anything knows how time-consuming the process is. An inordinate amount of resources of an office are wasted on getting paid by insurance companies. One service that would provide the pediatrician community with great value would be creating a collective bargaining group that is spearheaded by the hospital pediatric program. The more pediatricians involved with this hospital-led program, the more bargaining power each pediatrician will have. This will translate to better reimbursement and assured value of the mutually beneficial relationship.
Finally, communication is something that should not be overlooked. Communication is a highly valued commodity. It is easy to do, but not well done by many. Working in the hospital setting, real communication with local pediatricians about their hospitalized patients is not commonly performed.
Yes, everyone gets a note faxed to their office. But, a fax is not the same as a personal call to update them on their patient’s medical condition, ask them questions about the patient’s history because they’ve known the patient and the family for years or discuss management plans and seek their opinion.
The patient will eventually leave the hospital, and follow-up with the primary pediatrician is inevitable. Collaboration with the local pediatricians is a way to establish a personal relationship with them and ensure patient care continuity after they leave the hospital. Earnest communication does take time, but it also pays dividends through the connection it makes and the appreciation it instills.
What about giving out company pens and donuts to pediatrician offices? The short answer is that everyone does that.
Companies set out their tables at conferences and give away free “bling.”
It is easy, doesn’t take much investment, and builds no true connection. These advertising methods may enhance brand recognition but will not create a true alliance, partnership, or trust. Don’t get me wrong, pens and donuts have their place and are greatly appreciated. But, their impact is only as large as the relationship that was built previously on the validation, reliance, trust, appreciation, collaboration, and communication mentioned previously. Building a foundation that can grow a hospital pediatric program for a community takes a significant investment placed into that community. Pens and donuts are not a significant investment.
Building more visibility in the public arena
There are many standard marketing techniques, from billboards to social media, to create visibility in the public arena. This is not something new for hospitals or burgeoning pediatric programs. Most large organizations or institutions have their own public relations team. Nevertheless, there are modalities to consider that extend beyond routine advertising. Probably one of the most important is the old tried and true method of “word of mouth.” Having a strong reputation goes a long way and will facilitate true public visibility and create customer loyalty.
Outstanding service and outcomes need to be obtained to garner a reputation that stimulates “word of mouth” advertising. Health care outcomes depend not only on the medical team’s expertise but also on the system put in place to harness and accommodate first-class medical care. One can recruit the best physicians in their specialties, but their true excellence will not shine through if there is a poor system in place to accommodate their patient care, teamwork, education, and communication.
Outstanding service has to be built around a system as well. When we think of patient or family satisfaction with services, most of us will have a flash of the Yelp application image racing through our minds. While Yelp serves a purpose, it is mostly either a validation response tool for things performed well or a punitive instrument when things go awry.
Private businesses are traumatized by the effects that Yelp can have on their livelihood. Not every positive or negative Yelp comment truly reflects the efforts and encounters of businesses. However, it does tell us something important. Communication and engagement are critical elements of satisfaction. While there will always be discrepant perceptions of the monetary value of a service or commodity between owner and client and seller and buyer, most reviews focus on service interactions between humans.
Interactions between humans involve communication and listening. Much of what can be misinterpreted comes from inadequate explanation, poor listening, and rushed interactions. The interactions hold the key to satisfaction or dissatisfaction in most cases. And, when you want the spread of your reputation by “word of mouth,” the good and bad extremes travel quickly.
To optimize communication and engagement with patients and their families during encounters with your facility, a keen awareness of opportunities to establish a rapport are important. How is the communication with the patient and their family before a planned admission or surgery? Do they have adequate instructions about what is needed? Do they have proper directions to your facility? How is the communication with the family during the visit to your institution (either planned or unplanned)? Are their needs considered during the admission? Are their fears and concerns addressed? When a patient and their family are discharged from your facility, is there a planned follow-up with someone on your team to check in with them (even if they are planning in-person follow-up somewhere else)? Is there a genuine attempt to explore what went right and what went wrong with the visit?
At every stage of the hospital encounter (before, during, and after), there are opportunities to listen to the answers to these and many other questions.
Only by eliciting the responses and truly listening to what is being relayed can an institution begin to model, systematize and improve its community’s care. Mirroring what the local pediatricians value, patients and their families also want to feel heard.
It is what gives us validation and satisfaction, even under the most difficult circumstances. If any business or hospital pediatric program, for that matter, makes a patient and their family feel heard, you better believe that they are going to relay that experience to their friends, family or others. These are the feelings that spark positive “word of mouth” advertising. The investment that is put into communication during in-person interactions is something that outlasts a billboard or a commercial because the “word of mouth” advertising usually comes from a trusted source (i.e., family, friends, primary pediatrician, etc.).
If growing a hospital pediatric program was this easy, all programs would be doing it. However, creating a pediatric community and alliance and building visibility in the public arena are not easy charges. Establishing these types of engagements takes work, investment (financial and non-financial), time, and energy to successfully institute. While there are other aspects to creating a hospital pediatric program, the creation of a community around your program is critical. To create a community around your program and become a trusted resource for pediatricians and families, you need to genuinely invest and integrate into the community that you serve.
David Epstein is a pediatrician.
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