This document discusses the need to improve relationships with physicians to drive business and referrals. It notes that physicians today feel overburdened and pessimistic about the profession. The document then outlines Baystate Health's strategy to establish a physician referral program using a 3-pronged approach: 1) A physician relationship database to track referrals and provide analytics. 2) An Office of Physician Referral Management to resolve issues. 3) Physician Relations Liaisons assigned to territories to build engagement with physicians and ensure smooth referrals. The goal is to improve physician well-being, communication, and referrals to grow volumes and the health system's business.

1. A Data-Driven Approach to Build
Physician Relationships to Drive Business
or
How to Save Our Physicians
Corrigan Partners CMP Project Design Studio,
10/26/15
Catalyst Ranch, Chicago
Suzanne Hendery, VP Marketing & Public Affairs
Suzanne.Hendery@Baystate Health.org

2. Why This Work is Needed Now
Today’s physicians, see themselves not as the “pillars of
the community” but as “technicians on an assembly
line,” or “pawns” in a money-making game for hospital
administrators.” Sandeep Jauhar, MD
2012 survey: 8 of 10 MDs are “somewhat pessimistic or
very pessimistic about the future of the medical
profession.”
1973: 85% had no doubts about their career choice.
2008: 6% “described their morale as positive.”
Doctors today are more likely to kill themselves than
are members of any other professional group.

3. Problem: No Time
Today’s system: RVUs, 8 Minute Appointments, Paperwork (processing
forms, negotiating with insurance companies, reviewing labs, EMR
documentation, consults, Rx visits)
Physicians in non-hospital medical practices in the U.S. “spend 10X as
many hours on nonclinical administrative duties” as their Canadian
counterparts do, Danielle Ofri, an internist at New York’s Bellevue Hospital, reports in What Doctors Feel.

4. Time Wasted, Patient Wasted

5. Why This Work is Needed Now
Annals of Internal Medicine:
1 refers to 229 other MDs
NYT: MDs receive up to 45% of new patients by
referrals.
Average health system: 70% of patient referrals
from MDs
ACO, Shared Savings, Population Health, ROI
Smartest marketing dollars you can invest.
Creating a trusted relationship with the most
important customers– that you rarely see.
Despite consumer involvement
in decision making, physicians
are still the key drivers of volumes,
and as such, cannot be ignored.
Healthcare Strategy Alert, 2008
Physicians remain the single most
powerful lever in hospital volume
growth. Advisory Board. 4/14/06
Physicians are the key stakeholders.
Hospitals would not be in business
without them. The cultivation of
referral relationships is mandatory
to market development. Healthcare
Financial Management, May 2007

6. New Challenges= New Thinking
You must establish a Physician Referral Program now
How can we improve the health and well-being of our physicians?
How can we communicate more effectively with physicians to build
engagement, trust and lasting relationships?
How can we help ensure an exceptional physician referral experience?
How can we stop wasting time and money with inappropriate visits?
How can we better apply resources, data, analytics, and metrics to grow
volumes, revenue and relationships?

7. Baystate Health, Springfield, MA
Baystate Health, a Top 15 Integrated Delivery System of five hospitals,
including Baystate Medical Center, the largest hospital outside Boston.
Baystate is the health care leader in Western Massachusetts with 5
hospitals, an insurance plan (HNE w 160,000) and one of the largest
employers with 500 employed physicians/providers, 12,500 employees and
1,500 independent physicians in a 100 mile radius.

8. 2006: MD Communications Issues
“Referral process and admitting procedures both are in need of improvement.”
“ Scheduling is a source of frustration – physicians are sending patients to other hospitals because they find it easier
and quicker to get into a competing hospital.”
“ Physicians feel less connected to the hospital since Hospitalists were hired.”
“Don’t see benefit in the new EMR system. No time savings. Training efforts are lacking.”
“Leadership is viewed as distant and not engaging these physicians in dialogue about the direction of the
organization.”
“ Medical education attendance is down. Programs lack innovativeness. Looking not only for new things to learn but
also for new ways to learn.
“ Half (53%) would recommend Baystate to colleagues with some reservations. This lack of complete advocacy can
erode other physicians’ confidence in Baystate. Patient migration to other hospitals could be a problem over time.”
“ Most of these physicians see their admitting/referring patterns with Baystate staying the same over the next couple
of years. Much of the opportunity to gain more patients from these patients is in the control of Baystate.”
Rob Klein, Klein & Partners, 2006

9. 2011: New CMO Arrives
Growth & Financial Stewardship

10. Listen, Learn for Loyalty (L3 model)
#2 FILTER

11. Solicited Thoughts from Referrers
• Common themes during initial evaluation (Aug 2012)
– Long waits to see providers (variability by area, specialty)
– Difficulty navigating referral processes
– Poor communications back to primary providers
– Insufficient data/analytics re: competitive environment
• Leading practice shows the value of:
– Toll-free number for referring physicians experiencing
challenges
– BH liaisons to develop long-term, positive relationships with
referring physicians
– Database and metrics to monitor progress
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12. Solicited Internal Feedback
With Chairs, Chiefs and Regional CMOs
General Feedback
• Our success will be determined by our ability to differentiate ourselves on service
• Continue to focus on operational issues: OR block time, Access Services, capture
referring physician as mandatory field for auto-sending reports to referring physicians
Feedback on Office of Referral Services:
• Staff should facilitate coordinated recommendations for complex patients and
physician-to-physician conversations
• Build on existing internal processes including “Go To People” for questions/issues
Feedback on Physician Liaisons:
• Should focus on re-establishing relationships with physicians who are dissatisfied with
Baystate Health
• We need relationship-based field staff and a sales force, with
- Collaboration among reps even though serving different functions
- Formalized, systematic approach to meeting with physicians
- Standardized training for sales and customer service staff across Baystate Health
- Centralized reporting through Crimson Market Advantage database
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13. Researched Leading Practices
U Mass Memorial
Physician Referral Services
Center
Tufts Medical Center
Physician Network
Services & Physician
Liaisons
Dartmouth-Hitchcock
Physician Connection
Center
BI Deaconess
Care Connection
Emory
Physician Consult Line
Call Center
Staff
Manager & non-
clinical schedulers
Manager & non-
clinical schedulers
Manager & Nurses Manager & Nurses
Primary
Objectives
“One call, red carpet
service.”
Resolve scheduling
challenges, provide
missing documents
Schedule appts for ED
patients and second
opinions for health
insurers & patients
Initial point of contact
for problems & solve
simpler ones
Schedule
appointments and
coordinate multiple
appointments on
same day
Closed medical staff:
do not deal with
problems/ issues
Doctor to doctor
line: calls from
physicians
concerned about
care of complex
patients
Set post discharge
appointments for
some inpatients
Provide high level
clinical thinking to
provide most
appropriate referral
Advice: “don’t
become a complaint
line…”
6

14. Strategy: Physician Relationships
• Develop approaches that are “value added” for
referring providers
– Provide one “point person” in the field for ready access,
response
– Provide support for navigating the referral process;
– Expedite consults/appointments – particularly for new,
complex and/or acutely ill patients;
– Consistently communicate back to the referring physician
and primary providers
• And as a result, retain current referrals and earn
additional referrals

15. 1) Physician Relationship Database
• Analyst reports to VP, Strategic Planning & Business Development
• Provide database training, data reporting and analytics support
2) Office of Physician Referral Management
• Director reports to Chief Physician Executive for high-level issue resolution
and 2.0 FTEs responding to calls
3) Physician Relations Liaisons
• 2 FTEs report to VP, Marketing & Public Affairs to ensure integration of
growth and retention efforts
• Each has a territory with a maximum of 300 physicians
• Springfield and Northern Region (BJ)
• Springfield and Eastern Region (Kevin)
• Hand offs to other sales reps (BRL, BRI, BVNA&H, IR&S, HNE, etc)
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3 Pronged Structure