Successful marketing of interventional radiology requires a distinct strategy: one that takes into account not only the particulars of interventional radiology but also the attitude of the local medical community.

Medical marketing itself is a relatively new concept. Twenty years ago, few physicians actively marketed their practices; however, increased competition among healthcare providers, the advent of specialties and sub-specialities, and a growing number of health-savvy consumers mean marketing is no longer a dirty word in the medical profession.

Still, medical marketing is tricky. There is a fine line between providing information and creating demand for a procedure that may or not be suitable for a given population of patients. For interventional radiologists, marketing becomes more complex. Why? First, interventional radiologists truly depend on referring physicians for patients. If a marketing strategy offends, annoys, or overlooks referring physicians, it could backfire because physicians could cease referring patients. Second, interventional radiology represents, to a certain degree, competition to surgeons where interventional procedures supplant surgical procedures. In a sense, when a surgeon refers a patient to a radiologist, he is giving business away.

Paula Dowdle, director of Radiology, Cardiology and Respiratory Therapy at Saint Vincent’s Hospital in Billings, Mont., explains that interventional radiology is marketed differently than other specialties. “At Saint Vincent’s, we don’t actively market interventional radiology, or at least, we don’t market it in the traditional sense.” Nonetheless, a marketing plan is necessary to develop, maintain, or expand an interventional radiology practice, and there are a number of issues that need to be considered before developing and implementing a marketing plan.

Some, if not all, of the responsibility for marketing an interventional practice falls into the laps of the interventional radiologists. “You can’t rely on other radiologists or physicians to market interventional radiology,” explains Andrew Wu, M.D., chief of the Angiography Section at Wake Radiology, (Raleigh, N.C.). “Interventional radiologists have to generate it [business] themselves.” Hospital public relations departments, internal marketing professionals, and outside consultants also may be involved in the marketing mix. Regardless of the who’s and how’s, Dowdle says, “Interventional radiology is an important modality, and we have to get the information to the right people.”

Thus, marketers of interventional radiology need to determine their target audience. Is it physicians? Which physicians? Are you marketing directly to patients and/or their families? Which procedures are suitable for marketing to patients? What is the best venue for reaching patients?

These questions are joined by other marketing dilemmas. In fact, one of the challenges of marketing an interventional radiology practice also may be its biggest selling point. “The problem with interventional radiology is that we’re all hospital-based,” Wu says. Since interventional radiology is usually connected with a hospital, it is difficult to independently market an interventional practice. On the other hand, Wu points out, “Being connected to hospital is a selling point in and of itself.”

This hospital-interventional radiology symbiosis does not, however, relieve a practice from its marketing duties. It may even necessitate additional creativity. At Wake Radiology, one of the staff interventional radiologists, Carroll Overton, M.D., collaborates with the hospital public relations department to spread the word about interventional procedures. In fact, he says the Wake Medical Center public relations department spearheaded contacting the local media to spotlight interventional radiology procedures. Wu points out that these types of collaborative arrangements are a win-win situation; a positive presence in the local media pays off for the hospital as well as the interventional radiology section.

Marketing basics, of course, remain important. “A lot of marketing interventional radiology is word of mouth,” says Wu. Quite simply, radiologists get the referral from the referring physician and then deliver the promised goods. Dowdle adds, “We are really beholden to referral physicians to use us. If nobody refers patients to us, then all the skills in the world won’t matter.” It is important to consider the impact that proposed marketing activities might have on referral physicians. If referral physicians respond negatively to direct patient marketing, it is probably wise to delay or cease patient marketing until physicians feel comfortable with that type of marketing.

Varying the strategy
When it comes to marketing interventional radiology, many healthcare organizations adopt a cautious stance. This type of approach focuses on providing information rather than aggressively soliciting patients. At this point, physicians are the target audience, for example, for Saint Vincent’s interventional radiology marketing efforts. Dowdle says, “We have marketed more to physicians, especially surgeons, so they know what’s available for their patients.”

The strategies employed for marketing to fellow physicians at Saint Vincent’s are really quite simple. According to Dowdle, radiologists and surgeons are working more closely than in the past. Radiologists and surgeons are talking more and they also are attending training workshops together. The strategy has paid off; Dowdle says surgeons have been very open to interventional radiology when it can truly help their patients. Given the potential competition between surgery and interventional radiology, this is significant step. While surgeons are an important audience at Saint Vincent’s, they are not the only professional medical audience. Emergency room physicians and neurologists are kept in the marketing loop because of the role interventional radiology can play in stroke detection, among other areas.

Wake Radiology is the largest multi-specialty practice in the state of North Carolina, says Penny Pence Smith, Ph.D., president of Medical Marketing Management (Chapel Hill, N.C.), which is Wake Radiology’s strategic marketing consulting firm. The practice’s success is not derived from a reliance on Sales and Marketing 101. “It’s really well-managed,” Smith says. “The management team at Wake Radiology is far in front of the curve. They have had their finger on the pulse of radiology development, and it’s really helped them.”

That “finger on the pulse of radiology development” comes in the form of solid strategic planning. The practice contracts with Medical Marketing Management to examine demographic projections, growth potential, competitive availability of other radiology centers, and the proximity of referral physicians with a need for radiology services. This way, when the practice opens another office or makes a capital investment so that it can offer a certain procedure, it is relatively assured that there will be demand, for example, there will be patients who need the services and referring physicians to direct patients to Wake Radiology.

Medical Marketing Management is a type of silent partner for Wake Radiology. The practice also has formed more formal strategic partnerships with a number of organizations, including the local hospital, university, and a medical equipment company. On the application side, Wake Radiology is affiliated with Wake Medical Center. This relationship translates into referrals from physicians at the hospital. On the other side of the coin, Wake Radiology has developed a relationship with the Radiation Oncology Department at the University of North Carolina Medical Center (Chapel Hill, N.C.). This relationship allows for an exchange of technical expertise. The practice also has partnered with Siemens Medical Systems’ Oncology Division (Concord, Calif.) and is committed to research in the field.

Although Medical Marketing Management provides big picture, marketing expertise to Wake Radiology, it does not handle the day-to-day management or marketing for the practice. Wake Radiology employs a physician-based management philosophy; every section has one or two physicians in charge of managing the program. Physician-managers develop marketing timelines and determine what type of marketing approach is most appropriate for their audience or for a given procedure. Physicians in the interventional radiology section have collaborated with the public relations department at Wake Medical Center, and, of course, they have continued to emphasize relationships with referring physicians.

In general, Wake Radiology adheres to a three-step marketing timeline. “The doctors wait until they have a handle on procedures before marketing to referral physicians,” Smith explains. Next, a procedure is usually marketed to the referring physicians. At Wake Radiology, which is a 45-physician practice, two internal marketing professionals handle a large part of this marketing effort. For any practice, says Smith, this internal marketing job is critical. “It should be referral intensive, and it can be the difference between success and failure. Developing and maintaining relationships with referral physicians is the single most important piece of external marketing you can do.”

The internal marketers typically spend much of their time calling on practices. During a call, they might answer questions, provide materials such as referral pads, and share information about new equipment or technology. The marketers also may develop patient literature about the practice or procedures. The ideal candidate for an internal marketing support position is a people-oriented former technologist, suggests Smith. It should be someone who can discuss the technicalities of procedures and equipment and can competently and completely answer questions from physicians. Ultimately, Smith reminds radiologists and marketers, “There should be no surprises to referring doctors. You have to treat them with respect and look at them as partners.” After all, she points out, “They are the best gatekeepers. They know their patients.”

Marketing to patients
Consumers form the final leg of the marketing of Wake Radiology’s marketing strategy, and interventional radiologists have played a role in the consumer marketing effort.

Unlike Saint Vincent’s Hospital, Wake Radiology has included patients in the marketing mix. Smith summarizes Wake Radiology’s consumer marketing efforts. “They have gone in very gently and with a great amount of circumspect. The practice has tried to take a cautionary approach and remember that referrals doctors are consumers, too. It’s one thing to make people aware [of treatment options] and encourage them to ask their doctor about alternatives. It’s another to promise that this is the be-all and end-all.”

Wake Radiology, in conjunction with the public relations department at Wake Medical Center, has tapped into the local media to spread the word about interventional radiology procedures and has developed a presence in a variety of mediums. Interventional radiology procedures have been featured on local television. The practice also maintains a Website.

In fact, it is not only the practice’s own Website that attracts prospective patients. “Patients find us through the Society for Cardiovascular Interventional Radiology (SCVIR) Web site [scvir.org] as well,” Wu notes. (Interventional practices can take advantage of the Grand Rounds program developed by SCVIR. The Society has developed information about different disease processes and procedures and can send it to local physicians.)

Overton has authored several articles in WakeMed’s in-house publication and a local medical journal too. These also have proven to be a successful marketing venue. “We do get calls from these articles,” Wu notes.

Although Saint Vincent’s Hospital has not marketed interventional radiology to patients in the past, Dowdle does foresee a change in the future. It won’t be, however, a large-scale consumer marketing effort. “The only area I see marketing to consumers is in stroke detection because time is of the essence,” she says. Dowdle predicts a simple approach, perhaps posters or brochures with bullet points listing symptoms and advising patients to get to the hospital as soon as possible. The SCVIR patient Website, for example, offers brief explanations of interventional procedures that may be used to determine if a patient has had or is at risk for a stroke.

Another interventional procedure that could be a candidate for future consumer marketing efforts is vertebroplasty, in which an adhesive cement is introduced into an osteoporotic spinal fracture to reduce pain. This fairly new procedure is highly utilized at both Saint Vincent’s and Wake Radiology. At this point, Wake Radiology has not started promoting vertebroplasty to patients. Still, Wu says vertebroplasty is a prime example of a procedure that has been marketed successfully to referring physicians. After Overton published a feature about vertebroplasty, the radiologists began receiving calls from hematologists and rheumatologists who had been unaware of the procedure.     

There are potential pitfalls in marketing to patients to be aware of too. “It can be a touchy situation,” Overton warns. For example, patients are learning about uterine artery embolization, a new treatment for fibroid tumors, and approaching radiologists directly. This can create a conflict with the patient’s Ob-gyn. “There is a happy medium between getting the word out and going over the head of the referring physicians,” he says.

Overton urges radiologists to remember consumer marketing is not a one-size-fits-all approach. Marketing to patients, Overton summarizes, depends on your environment. Relationships with physicians are all different, so a tactic or approach that is welcomed in one community may be frowned on in others. What works in Chapel Hill, may not work in Denver. A practice that has built solid relationships with referral physicians may be able to take a more direct approach than a new practice that doesn’t have a solid referral base.

Growing your interventional practice
A successful interventional radiology practice requires a significant commitment. The first requirement is a substantial capital outlay. The bare minimum on a procedure room is between $800,000 and $1 million, and the upfit on a room can cost another $250,000 to $350,000. Inventory is another $50,000 to $75,000. Finally, there are personnel costs. Wu says, “To make this succeed, there has to be a high degree of specialization. Interventional radiology can’t just be a rotation.”

The interventional section at Wake Radiology includes five full-time interventional radiologists. In addition, five technologists and five nurses are dedicated to interventional radiology section.

Smith of Medical Marketing Management offers some guidelines for newer or smaller practices. The model she suggests begins with as good strategic plan; it can be worthwhile to utilize a consultant when writing the strategic plan. She offers a synopsis of the elements in a solid, strategic marketing plan.

• Be very clear about who has decision-making power before spending a lot of money on public promotions.
• Make sure you have the ability to serve your target market well before promoting something.
• Do not ignore the referral base. What type of attitude does your referral base have about radiologists communicating with the public? Talk to physicians and educate them before trying to create a demand among their patients.
• Promote services people can understand and identify with. Advertising stents and shunts will confuse and frighten people if they don’t need the service or don’t know what you are talking about. Procedures like vertebroplasty or uterine fibroid embolization are subject matters that both physicians and the public can learn from.
• Make appearances at women’s group and civic organizations to mark specialized months such as National Osteoporosis Month. It allows a practice to educate and create a relationship with potential patients.
• Write educational articles for the local newspaper.
• Do a cost-benefit analysis on how much should be spent on marketing and what type of benefits or return the investment might bring. For example, suppose a practice seeks to increase its referral base by 10 percent. How much new revenue would new business bring? How much should the practice invest in marketing to gain the revenue?

Smith recommends finding a part-time person to handle marketing for the practice. The primary focus of this position should be calling on and developing relationships with referral physicians. Her final bit of advice? While a large practice can afford to hire an advertising agency or marketing consultant, such a move is not likely to be cost-effective for smaller practice.