Order to Chaos. CHG helps hospital refine and structure its physician-relations approach to improve efficiency and cement relationships.

Background
It started at the weekly administrative council meeting. The CFO announced that revenue was down and data indicated it was because of significant losses in referral volume. The CEO was adamant in his statement; “We need to do something to get more referrals from the medical staff.” While many of the service-line leaders had strategies, and people were, indeed, calling on physicians, frankly there were no tangible results. One vice president thought sales training was in order so the team could close more deals.

Problem
Each service line had created its own physician-relations approach. Some senior leaders did occasional business lunches with their physicians. Others delegated it to clinical/outreach staff. One department started putting together informative luncheons for physicians’ office staff while another held a golf tournament. When CHG was called in to develop customized sales training, we told them it might not be the right place to start.

This was apparent as the first person we spoke with told us of the day she walked into the waiting room of a referring specialist and was surprised to see someone from the hospital’s cardiology department already there. The two of them were surprised when the hospital director of occupational medicine walked in 20 minutes later. The receptionist defined the problem perfectly, “Don’t you people talk to each over there at Acme?” Needless to say, the hospital and its representatives looked bad and there was no productive relationship building that day.

Examination and Diagnosis
The core issue for this hospital was structure. Where did responsibility for physician relations lie? Was it within the service line, and, if so, at what level? Was it with and between the physicians themselves, or maybe senior leadership needed to take the helm? What about a centralized team that represented the hospital as a whole?

With every department doing its own thing, the hospital projected disorganized chaos and they had no consistent message or methodology to measure response. Much of the time, physicians dumped problems on them, and their job was to be the fixer. When they did make calls, people doing physician relations were not building relationships—they were pushing one product. No one wanted to listen to the physician’s input or probe for unmet needs and opportunity. Each person went in hoping to sell what would bring business to his or her department. It created a competitive, win/lose atmosphere within the hospital, and the referring physicians saw little value in the approach. Acme was just another vendor.

Prescription
We showed the hospital how to centralize the physician-relations approach and build rapport with referring doctors. People calling on doctors functioned as relationship managers, not just salespeople. They carried the entire portfolio of the hospital and didn’t push product. They asked questions, listened, found hot buttons and opportunity. Based on the individual physician’s needs and interests, relationship managers would use a clinical expert within the appropriate service to provide in-depth response and technical or clinical support. This way, relationship managers didn’t have to be experts in cardiac testing or worker’s comp fraud. They just had to know whom to bring to the next meeting or how to connect the doctor to the right hospital expert. They could have focused strategies; use the correct internal expert; and track and measure the results.

Result
We did end up training the physician-relations staff. But we trained the right people – people who could listen, respond with authority and build trust with the doctor. Clinical staff didn’t have to learn a new skill that was often outside their comfort zone.
Relationship managers knew the structure and model were working when one doctor said in response to a suggestion that he bring the orthopedic director out the following week, “Great idea. I learn something new every time you bring someone with you.” And the hospital saw an increase in referrals from physicians who were targeted in the pilot implementation of the centralized structure.