New specialist visits to primary care: Considerations to maximize impact

"Howdy Rounds" have long been a staple in getting new specialists introduced to primary care physicians in the market.

Most often it goes like this:

The physician liaison schedules a day out of their clinic with the new specialist. With a stack of business cards and a nervous new doctor in the car, the liaison chauffeurs the specialist to a targeted group of primary care offices to introduce the specialist. The rounding creates visibility, but has a relatively high cost of time for the specialist, the primary care offices, and the liaison. Employed practices typically feel it is their obligation to commit to the meet and greet, and in the late summer when many new physicians come on board, this can begin to feel like a parade.

It can be time well spent if it has a strong impact, but does it? In conversations with primary care doctors, many say this feels like a ritual of the past that generally has less value than it could. With that in mind, here are six ideas that can enhance the value for all involved:

  1. Prepare both parties. It's so logical and often so poorly done. Residency and fellowship does not include training on referral relationships. New doctors need to be supported in understanding that training, clinical expertise and new technologies don't stand alone in earning trust with referring physicians. To help focus and streamline the conversation, liaisons can assist this rounding process by meeting with the primary care doctors to learn of their interests. Sometimes, less is more.
  2. Tier the specialists. Take the time to understand when primary care doctors refer, why and where. Before doing rounds with the new electrophysiology doctor on the cardiac team, ask primary care if they ever refer directly to EP. In your community the EP may get referrals from cardiology rather than primary care. Know the referral chain and make sure you have the specialist talking with those who most need the services.
  3. Referral relations are more than a checklist. Getting results from "getting specialists out" is about connection, not just a smiling face. True connection comes from relevant conversation and that is usually about how this connection can be best for the patient. Sometimes, in the haste to get specialists introduced, liaisons can be guilty of executing by checklist. We checked the visit off the list, but did we learn the most important elements of interest and impact and schedule appropriate follow up?
  4. Memorability and momentum. Good physician-to-physician visits include techniques that ensure there is a way to capture momentum after the meeting. The specialists can do a personal follow up if there is something relevant from the discussion. The liaison should also have a role in ensuring the visit was memorable. Logic tells us that you can't meet a dozen new specialists through this type of visit in a week and have them all be equally memorable. Prioritizing and ensuring there is value for the primary care doctors is a difference-maker here.
  5. Different strokes for different folks. Face it, some doctors can't pull this off. While they may be fabulous clinicians and you recruited them because you feel like they can be successful in your organization, the social connection piece is lacking. Square pegs forced into a round hole are still square pegs and everyone knows it. Get creative and find other techniques to make introductions. Do you offer CME or Grand Rounds with the new doctor providing insights or presenting? The rounds have become the fall back, not because we are measuring near-term impact or comparing the effectiveness with other techniques, just because it's the way we have always done it.
  6. Measure the impact of your visits/efforts. The most obvious measure is seeing referral volume after the meeting. What we often don't know is whether the patients were referred to the new doctor or to a senior member of the group who was busy. While it may not matter, it is worthwhile for the liaison to follow up with the primary care practice to learn more about the impression made by the specialist and to make sure the practice referral coordinator has the contact information for the specialist. Over the next six months, the liaison should ask about the referral experience with the new doctor. Learning real-time impressions is critical to coaching new doctors in their referral communication.
  7. As we work harder to earn in-network referrals, our methods of connecting the right specialists to the right referral source will evolve. Howdy Rounds have a role, but they will serve the organization better if there is a plan beyond showing up and assuming that builds trust. The new specialists certainly need practice growth support. Doing this right makes for success across the board.

Kriss Barlow, RN, MBA is a principal with Barlow/McCarthy, a healthcare- physician consulting firm. She specializes in physician relations and can be reached at kbarlow@barlowmccarthy.com.

The views, opinions and positions expressed within these guest posts are those of the author alone and do not represent those of Becker's Hospital Review/Becker's Healthcare. The accuracy, completeness and validity of any statements made within this article are not guaranteed. We accept no liability for any errors, omissions or representations. The copyright of this content belongs to the author and any liability with regards to infringement of intellectual property rights remains with them.

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