LAS VEGAS—At first glance, the topics of partnerships and marketing, as they relate to medical practices, would appear to have little in common, but closer analysis reveals that they are two complementary parts of practice management, according to a presentation delivered at the 18th Annual Meeting of the North American Neuromodulation Society. The formation of partnerships is a particularly important issue for practices that are growing or seeking to expand, while marketing—especially in the current digital age—can be an indispensable tool for attracting enough new patients to ensure that such growth occurs and continues.

Physicians should take care to enter into partnerships for the right reasons. Common rationales for seeking a partner include practical considerations such as sharing the clinical load or the cost of overhead, bringing in additional money to the practice without obtaining financing from a bank, gaining a source of moral support for decision-making that affects the practice, and providing motivation for an associate physician. Although such considerations may appear sound, they often constitute the wrong reasons for entering a partnership, said Eric Grigsby, MD, Medical Director of the Napa Pain Institute in California.

“What that translates into, from a practical point of view, is ‘I’m disorganized, I’m tired, I’m broke, I’m depressed, or fellows really have no idea how hard you have to work to be a partner,’” he said. “If you’re considering bringing in a partner, I’d say don’t jump to the reflex [response] of ‘I just want somebody to help me with this and share the misery.’”

Liquidating a Practice
Appropriate strategic considerations include succession planning and prospects for selling the practice. “If I’m in my late 50s or early 60s, there’s a long lead time for things,” said Dr. Grigsby. “How is it that I’m going to unwind this business or … pass this on to the next generation so that people in our community have continuity of care?”

For a medical practice, liquidation often means being acquired—with all the resulting consolidation that occurs at the provider level. A valid business rationale is the basis for bringing in an equity partner to ensure that a practice is growing steadily enough to attract the interest of a small health care system or of one of the proprietary and sometimes publicly traded companies now common in the pain management realm, according to Dr. Grigsby. “Those are the strategic questions that supersede a lot of those practical questions because if … you need somebody to share the overhead, maybe you shouldn’t have so many employees or maybe you should have a smaller space,” he said. “That’s not a good rationale for bringing in a partner.”

From the perspective of a younger physician, buying into a practice to become a partner may not always be the wisest choice. For an associate considering a partnership, benefits typically include fair compensation, the opportunity to profit from the growth of the practice, operational and strategic input, and return on investment. But the current uncertainty in the medical world makes the accurate evaluation of a practice difficult, in Dr. Grigsby’s view.

“If I was coming [along], I’d rather have a favorable compensation agreement,” he said. “I’m not sure I’d want my own money tied up in a medical practice with all the uncertainties at the moment…. I’d rather take that money and invest it in some other asset that might have a higher chance of appreciation.”

Physicians as Secondary Sources of Information
Dr. Grigsby’s view of medical practice marketing is informed by the fact that more and more patients are getting their health-related information from digital sources. He cited a survey showing that 72% of US adults living with chronic conditions use the Internet, and that such users are more likely than other adult Internet users to obtain medical information online. Meanwhile, approximately one in five Internet users have consulted reviews and rankings of healthcare service providers and treatments. These data suggest that practitioners need to familiarize themselves with the concepts of search engine optimization (SEO) and search engine (or targeted digital) marketing.

“That term [SEO] hadn’t been invented when I first started in practice, and there was no concept that people would go to the digital world for health information, said Dr. Grigsby. “But certainly they do, and we’re expected to participate because most patients now … go to the doctor when they need information that they can’t get from the Internet. So, we’re definitely a secondary source of information for our patients.”

Specialists in SEO can help tailor information on a practice’s website to boost search rankings, especially for specialty or location-specific searches (eg, “pain management in Napa”), but only if they know who the audience is, what they’re looking for, and how an individual practice fits the bill—insights that are best provided by the practitioners themselves. “Marketing is not necessarily the accelerator—you may have enough patients coming in your door already,” observed Dr. Grigsby. “But it is certainly the steering wheel, so that you can direct your information to patients—if you find that you can direct it to [the type of] patients whom you’d like to see.”

—Fred Balzac

How Do Partnerships and Marketing Relate to Practice Management?