Referring Physicians

How Much Influence Do Referring Physicians Really Have?

A patient goes to their primary care physician (PCP) for a new medical problem. The PCP believes that the patient should go to see a specialist. What happens next?

The Results Can Be Confusing

The Melior Group conducts numerous studies for hospital clients who have a vested interest in understanding how referrals are made. The results these studies generate, however, can be confusing. On the one hand, the majority of PCPs tell us that they always make specialist recommendations, and that their patients “almost always go where I recommend.” Yet on the other hand, patients tell us that their physicians are only one source among many (friends and family, internet research, etc.) of information about which specialists to use for a given problem.

What’s Really Going On?

After years of conducting qualitative and quantitative research for healthcare clients who want to insure that their institutions, and the physicians affiliated with them, receive their fair share of recommendations, we think we have an answer. Despite the apparent contradiction of what consumers and physicians say about selecting specialists, they are both right.

Defining the Decision-Set

Our work for several specialty hospitals and academic medical centers reveals that in the vast majority of situations, referring physicians provide one or several names of specialists for their patients to consider. In so doing, they provide the “decision-set.” Patients, in turn, use that list as a starting point: they might ask their friends and family (sometimes using social media) to learn what others think of the specialist(s), and they also might conduct some internet research to… learn about the specialist’s education, length of time in practice, etc.; see a picture (does he/she look friendly?); and/or read online reviews. Information gleaned during this process informs the ultimate action: the call to make an appointment, which is entirely in the consumer’s hands.

Using Information Developed from Research to Inform Physician Referral Strategies

There are a number of steps that specialty providers can take to insure that…

1) their physicians are included on the referring physician’s list of recommended providers; and

2) consumers ultimately select one of these recommended providers.

Such strategies can be informed by market research. For example, an evaluation of the referral mechanics of referring physicians can guide development of documentation, work flow, and referral forms: How – in writing or verbally, with pre-printed or handwritten information – do referring physicians prefer to give names of specialists? How, and how frequently, do they want to receive communications about individual patients that they have referred? On the consumer side, knowing what they expect can provide guidance for website development (what kind of information should be available about individual specialists), search engine optimization, social media presence, and overall positioning and messaging strategy about specialty physicians and services. In sum, understanding more about existing referral dynamics can inform both marketing strategy and tactical solutions for building referrals.


For over 30 years, Melior has specialized in conducting market research on behalf of hospitals and health care systems.  Please visit our Healthcare page to learn more.

For more information please contact Elizabeth Cohen at [email protected]/215-545-0054 ext. 103 or Linda McAleer at [email protected]/215-545-0054 ext.104.

The Soccer Field Sidelines: Ground Zero of Your School’s Brand, Part 1

I have spent most weekends the last few years on the soccer field sidelines (or, depending on the season, lacrosse or basketball). In between my fervent prayers for rain (just enough to cancel the game but not ruin the weekend) or a tiny clap of thunder (no play for 30 minutes! everybody go home!), I find myself talking to other parents. I barely know these people, so we stick to what we have in common: kids of similar age, most of whom attend school.

For the uninitiated, let me back up a moment. These sports teams that I am referring to are not school teams. Rather, these teams that play their games on the weekends are community teams. The kids typically come from a variety of different schools…many of which, in my area, happen to be independent.

Personally, I love these conversations about schools. My marketing research instincts kick in, and I sit back and listen. It gets particularly interesting when a family says that they are thinking about switching schools for their child. All of the parents jump into the fray, and a lot of really tantalizing information gets bandied about. It’s hard to separate fact from fiction, but it sure is interesting! You feel like a school expert by the end of the game.

Word–of-mouth has always been something that schools need to be aware of and manage. Yet, while a lot of attention has been paid to the role of social media in revving up the word-of-mouth engine, I believe that in some communities, the sidelines are equally, if not more, powerful channels. Participation in community sports teams has exploded in recent years; in some communities, the vast majority of kids under age 14 – regardless of their athletic prowess (or even interest!) – take part in at least one community team sport. That means that parents of kids from myriad schools have a lot of time on their hands to sit on the sidelines and “watch” (wink wink) their kid play.

The upshot? Every weekend, your school is a topic of conversation. Your school’s name and reputation get kicked around and headed more than the soccer ball.

This chatter can’t help but have significant impact on a school’s brand, which, in turn, is directly correlated with enrollment (and other) success. When prospective independent school parents, for example, are asked in surveys how they first learned about a school, “word of mouth” is by far the leading answer.

Given the reality of idle talk, ever-growing opportunities to spread information, and the importance of such information on consideration of independent schools, what’s a school to do?

I think the answer involves both reactive and proactive steps, simultaneously.

  • On the reactive side, schools need to understand what kind of information/misinformation is being kicked around about them. What is the current reputation/brand? How did it get there? How widespread is the information – both that which is accurate, and that which is pure rumor? The Melior Group often conducts these kinds of studies for our clients that allow them to get a handle on fact from fiction.
  • At the same time, schools need to develop a longer term, proactive strategy for shaping their reputation/brand for the future. A school needs to craft intentional messages that communicate its strengths, and to make sure internal constituencies, i.e., current and recent past parents, alumni, faculty and staff, can – and want to – repeat those strengths on the soccer field sidelines. Here, we use both qualitative and quantitative research to understand which messages truly resonate with intended audiences.

Part 2 of this post is now available here, where I present my thoughts on the impact of interscholastic sports – that is, school-based teams playing other school teams – on school brand.


For more information on Melior’s work with independent and religiously-affiliated day schools, please visit our Education page or contact Elizabeth Cohen at [email protected] / 215-545-0054 ext 103 or Linda McAleer at  [email protected] / 215-545-0054 ext 104.

Referring Physicians

Hospital Regional Appeal Improves Using Market Research

Without the resources to out-spend its competition, an in-city hospital sought a market research partner who could help them improve their image in their local community. In order to maximize the spend, they were in need of smart and efficient direction.

The Melior Group targeted both consumers and primary care physicians to uncover how to convey the hospital’s unique story and build its patient base. Research results helped to direct the hospital towards a new partnership plan, an improved referral process and a deeper focus on the people whose lives were changed for the good…read the full article here.


Elizabeth Cohen is Vice President of The Melior Group, and our lead consultant in our work in the health care sector.  For more information please visit our Healthcare page or contact Elizabeth Cohen at [email protected] / 215-545-0054 ext 103.

Healthcare Providers Face New Brand And Spend Challenges As Some Medical Procedures Become Commoditized: PART 2

If a given service line and/or procedure generates high patient volume and is profitable, hospitals and healthcare systems can be sure that there will be stiff competition for those patients. So, how do providers attract their fair share of volume?

In the previous post, Melior identified three broad question areas that healthcare marketers should consider before finalizing a marketing plan. Successful hospital marketers know that marketing research can answer those questions. In this follow-up blog post, we recommend some approaches to consumer research that can provide guidance for development and execution of marketing strategy.

Focus groups

To really understand how patients make decisions and their impressions of and willingness to consider area hospitals/health systems, Melior continues to recommend focus groups with consumers as a first step. In this intimate forum, where participants can be screened to insure that all have had some experience with, for example, cardiac care, we can ask questions such as “which hospital in your area is best for a given procedure/service line,” and “where did you/your loved one actually go for this procedure.”

As it so happens, the answers to the above questions are often contradictory. One of our clients — a regional tertiary care provider that has invested heavily in its cardiac service line — learned through focus group research that despite many consumers’ recognition of its capabilities and reputation, other factors such as perceived better access, and their personal physicians’ recommendations, trumped these positive impressions and drove patients elsewhere for cardiac services. Rather than going to what they perceived was the “best” option, many consumers chose a provider that was “good enough” to meet the need…and more advantageous in other ways.

In a focus group, we can explore these contradictions in a free-ranging line of inquiry, and develop evidence-based hypotheses to explain what we’re hearing. In a typical telephone or online survey – with predominantly closed ended questions – we would just have to accept these contradictions and rely on conjecture to understand them. After a series of focus groups, our client decided to focus more of its localized messaging on ease of access to specific physicians.

Quantitative survey of catchment area consumers

Many of our clients do need quantitative data in order to understand the prevalence of what was heard in focus groups, and to satisfy internal audiences who control marketing dollars. Qualitative findings can be used as the basis for a quantitative survey of consumers, the purpose of which can be to measure and track the standard concerns – e.g., awareness, impressions, decision-making priorities and inputs, etc. – as well as to test the hypotheses that were developed in the qualitative phase. Some clients even try out positioning statements or other creative approaches in such a survey.

This quantitative data can provide the additional confidence needed to formulate positioning and messaging strategy for the service line. These findings also allow for development of market segments – based on demographic, experiential, attitudinal, and other data – which can help providers identify specific groups to target based on common characteristics.

To learn more, visit our previous postHealthcare Providers Face New Brand And Spend Challenges As Some Medical Procedures Become Commoditized, PART 1.

In our next healthcare post we’ll explore the role of physicians in consumer decision-making, and make the case for why physician relations are an integral component of consumer marketing strategy.

For inquires, please contact The Melior Group at (215) 545-0054 or by email [email protected]

Healthcare Providers Face New Brand And Spend Challenges As Some Medical Procedures Become Commoditized: PART 1

In the face of so many changes in healthcare, competition among providers for healthcare dollars continues to mount. It makes sense that providers are targeting some of the most profitable service lines — e.g., Cardiology, Orthopedic and Oncology — in their quest to assure their competitive positions going forward. In order to win their “fair share” of patient revenues, providers ranging from community hospitals to academic tertiary care centers have developed the capability to perform once cutting-edge procedures such as cardiac catheterizations and joint replacements. The result is a leveled playing field, achieved through widespread training and the development of relationships with affiliated specialists.

In the eyes of consumers, there is a perceived “commoditization” of certain tried and true, no longer leading-edge services. Through focus groups and quantitative research, The Melior Group has learned that while consumers have a clear perception of which hospitals are “best” in their region — usually, large tertiary care centers with academic affiliations — they often prefer having these “commodity” procedures done at a hospital they may not perceive as the best, but as “good enough” to get the job done. Their preferred provider may also appear more advantageous in other ways, e.g., more convenient, cost-effective, familiar, etc. If their referring physician recommends the hospital, all the better and more confident patients often feel about their choice. The result is that medical pioneers in these now commoditized services can find themselves competing with community hospitals for the same patients and procedures.

The Melior Group believes that, given these new realities, all provider institutions — regardless of whether they are large multi-specialty healthcare systems, specialty hospitals, or small community hospitals — need to ask themselves the following questions in the lead-up to marketing planning:

  • Do I understand enough about my patients’ decision-making for healthcare services, overall and for individual service lines? Do I understand how priorities, impressions of providers, and information gathering about healthcare services have changed — or not — over the past few years?
  • For these high volume service lines and commoditized services, has my hospital identified the patients that we want to attract? Have we made the case, operationally and in terms of our marketing messages, for why we are the best option for those target markets?
  • Is my institution getting its fair share of patient referrals from the medical community, whose opinions can drive patients to or away from my hospital? Have we made the case, in terms of quality of care, ease of referrals, etc., – for sending referrals our way?

In light of the tightening competition for what are now readily available, standardized procedures, it is incumbent upon healthcare providers to gain a deeper understanding of their patients’ decision-making process.