Five Common Problems Facing Physician Liaison Programs

By Richardson “Bricken” McKenzie, IV, MBA, FACHE, FACMPE

As primary healthcare providers continue to be overburdened with patient care and paperwork, and as hospitals acquire record numbers of private medical practices, the simple practice of patient referral is becoming more and more complex. While hospitals and specialty physician practices have always relied on the invaluable patient referral, they are coming to realize that they need to be more direct in their efforts, and enlist the help of others to stimulate referral growth. With the ultimate goal to improve patient care, hospitals and specialty practices are increasingly turning to professional Physician Liaisons to develop closer ties to physicians and drive patient referrals. The few healthcare organizations that are thriving in these uncertain times have established comprehensive referral generation plans, and have empowered Physician Liaisons within their facility to implement those plans.

When I ask medical administrators whether or not they think it is important to establish a Physician Liaison program to increase patient referrals, the majority of administrators answer with a confident “yes”. However, these same administrators have no clear plan for how to go about doing it. Most often, they pluck an employee out of the marketing department and appoint her as the new Physician Liaison. The new Liaison then makes herself known to hospital staff, and perhaps drops off a few business cards to primary care doctors in the area. But, what next? To gain proper ROI and make a Physician Liaison program effective, administrators and liaisons need to prepare for the roadblocks they will inevitably face, and prepare to deal head on with each issue.

Problem #1 - I’m not sure that the person I’ve hired is cut out for the job.

Physician Liaisons do not always need a clinical or pharmaceutical sales background, but it certainly helps. They must possess the intelligence to understand detailed clinical services. They need the confidence to recite clinical information to potential referring sources. And they should be diplomatic, having the ability to tactfully contend with big physician egos. Maintaining unity among the various departments and service lines is sometimes difficult. A Physician Liaison’s internal customers such as nurses, physicians, case managers, service line directors, and support staff each have their own agenda. Helping them understand how they all play a critical role in the success of the hospital can be hard work. Physician Liaisons must have selling skills as well as consulting skills. The job requires high levels of critical thinking, negotiation skills, and the ability to interact with a broad spectrum of individuals. Bear in mind that a talented Physician Liaison can only be effective if the information he or she shares with the C-suite is acted upon. Nothing kills a physician relationship faster than an unfulfilled promise of change.

Problem #2 - My liaisons keep visiting the same providers who are already referring patients to us. How do I create a priority list of the most important providers?

Analyze the data. As electronic medical records become the standard, hospitals and physician practices have access to mounds of patient data. Not only can they identify which services are most profitable, but they can also see where the facility is bleeding red ink. Medical records provide detailed information on the patient population. These include age, diagnoses, treatment, and the all-important payor mix. But frequently, one key detail of medical record data is missing – how did the patient arrive at the healthcare facility in the first place? On some occasions, a patient will self-refer to a specialist. Other times, a patient may arrive in the E.R. presenting symptoms that require they be admitted. Yet these cases are not the norm. Some healthcare facilities rely on Medicare claims data to try to gain a better understanding of who is referring patients, but that only reveals a small portion of the picture. This data reflects only a small share of the total population – Medicare patients over 65.

Healthcare experts have found the information to be inaccurate, with a disproportionate amount of physicians stating that they are referring patients to themselves, when in reality the actual referring provider is never identified. I know an administrator of a G.I. group who was eager to promote her new Endoscopy Center to referring physicians in the region. She retained a Physician Liaison to make calls and educate referring providers on the new multi-million dollar facility. She had a general idea of which zip codes to target, but the decision was made only by instinct. In order to determine his communication strategy, the Liaison requested previous patient referral data on each of the G.I. physicians within the group. The data revealed that over 50% of the patients seen in the last 90 days were coded as “self-referrals”, with no referring physician named. When in reality, the G.I. physicians in the group believed that number was closer to 5% or less. The sole way to remedy this problem is to insist that office staff capture referring provider information at every patient touch point within your healthcare facility. This means asking the patient several times who referred them to you; 1) at the time they call for the appointment, 2) when they fill out their paperwork, 3) when they are screened by a nurse, and 4) when they are seen by the physician. Do not expect your Physician Liaisons to do an adequate job if they only rely on Google maps to figure out which providers to visit. It is a recipe for failure. You need a program that reports accurate referral data. Only when you possess this information can you conclude which market area and providers are most important to focus upon.

Problem #3 - I’m having a hard time quantifying the investment in a Liaison Program to the C-Suite.

The really good Physician Liaisons are “doers”. They work best when communication objectives are actionable. Physician Liaisons will need more motivating factors than just a sales call number to hit each week. They need to understand the big picture. And they need clearly defined strategic communication plans. A liaison’s communication strategy is much like a long-term marketing campaign. They should work in tandem with external consumer outreach efforts, and call on providers within a specifically defined market area. Liaisons need to devote a specific number of hours toward each campaign, and set goals for measurable results. Suppose a Regional Medical Center executes a major consumer advertising campaign to support Breast Cancer Awareness Month. To complement the consumer advertising campaign, Physician Liaisons set a goal to increase digital mammogram referrals by 15%. Liaisons generate a list of all OB/GYN clinics within a 50-mile radius of the hospital. They create a route and visit schedule so that each clinic can be seen at least twice within the 30-day period. Liaisons share brochures and appointment cards with referring physicians and nurses, and educate providers on the hospital’s digital mammography services. Liaisons encourage providers to book mammograms through a direct appointment line while patients are still present at their clinic visit. The campaign results in a 20% increase in digital mammograms over the next 90 days, which exceeds the initial goal.

Results are much easier to report when a liaison’s efforts are based on sound communication strategy. Nevertheless, there are many days when a Liaison is merely maintaining open lines of communication with referring providers, and not specifically focusing on a cut-and-dried campaign. When I was a medical practice administrator in Mississippi, I was culling through some referral data, and I realized that one general surgeon had stopped doing procedures at my hospital about 9 months ago. It had ultimately cost my facility $2 million in lost revenue. We did not employ a Physician Liaison, so I went to visit him personally. I came to find out that he had gained a little weight, and he needed double extra large scrubs, a size that we currently did not provide. Instead of asking us for those scrubs, he decided he would take his business elsewhere. If I had the luxury of a reporting tool that alerted me to the downward trend, and a Physician Liaison who was consistently communicating with the surgeon, I could have been alerted to the issue long before it became a problem. By possessing a tool that provides quick analysis of referral trends and provider feedback, Administrators and Liaisons can easily show how their efforts are contributing to the bottom line.

Problem #4 - My liaisons are getting in front of the right people. But they aren’t making much headway with referrals.

Memorize these three words -- Information. Frequency. Response. Physician Relations Management is well beyond the feel-good days of a box of donuts and a pocket calendar. Physician Liaisons need to be familiar with everything going on at their facility if they are going to do their jobs effectively. The good liaisons are frequently calling on doctors armed with the latest information on how their facility is reducing hospital-acquired infections and improving patient satisfaction scores. And they are also sharing the not-so-good news if it relates to patient experience. Are you re-paving the parking lot in May? Is your best cardiac surgeon planning a month off in August? The goal is to get in front of these providers on a regular basis and share the most current information affecting patient care, be it positive or negative. There is an old saying, “nothing kills a bad product faster than good advertising.” The same holds true for liaison communication. I work with a Physician Liaison who represents a highly accomplished Reproductive Endocrinology group. She keeps a close watch on national data related to In Vitro Fertilization (IVF) success rates. She works directly with her physicians to slice and dice national data and compare it to her own clinic’s data. When she calls on OB/GYN groups, they are happy to receive a few pens and Post-it notes, but the real attention-grabber is the success rate with IVF. When she shares those facts with referring physicians, they can be confident they are sending their patients to the right place. Do not expect a strong patient referral pattern from a provider you visit once every 6 months. Doctors need frequent and meaningful information. If they have a question or a problem, they expect a quick response. Only then can you expect a lasting relationship to form.

Problem #5 - Liaisons are spending too much time determining routes and putting together reports.

By using web-based applications specifically designed for Physician Liaisons such as MDreferralPRO, Physician Liaisons can create marketing plans based on predictive analytics. MDreferralPRO lets Physician Liaisons geographically target specific market areas and identify untapped referral sources by name, specialty and location. They discover which providers should be a top priority to call upon, and where they should concentrate their efforts to generate more revenue. The program also identifies which outside providers have referred patients, and whether or not those referral patterns are increasing or tapering off. MDreferralPRO alerts Administrators and Physician Liaisons to the providers who need to be seen most frequently. As Liaisons enter notes from their visits, Administrators see their communication in real time, which prompts them to act on that communication.

Equipped with the right tools, Physician Liaisons are assured they are using their time in the field efficiently, thus allowing them to see providers with more frequency. Administrators will then quickly see the correlation between liaison efforts and patient referral patterns. Hospital and Medical Practice Administrators have seen the light when it comes to developing a Physician Liaison Program. But merely employing an individual to “build relationships” will not result in new referrals and higher patient satisfaction scores. Liaison programs must be well planned and executed. Armed with accurate data, a clear strategy, a priority list of providers, and the right reporting tools, the proper Physician Liaisons will become an invaluable part of the healthcare process, introducing their physicians to referral sources and patients who are otherwise inaccessible. Richardson “Bricken” McKenzie, IV, MBA is the founder and Chief Executive Officer of healthcare consulting firm AdvisorsMD. He is a member of the Medical Group Management Association (MGMA), a Fellow of the American College of Medical Practice Executives (FACMPE), and Fellow of the American College of Healthcare Executives (FACHE).