Key points

Introduction

Establishing a strong local reputation is essential for growing your clinical practice. Sports medicine can be a competitive field to enter, as it is the most popular fellowship selected after orthopedic surgery residency. Many urban and suburban communities may also already have established general orthopedists and sports medicine specialists providing care. However, as maintaining an active lifestyle remains a focus for the American population, demand for sports medicine and musculoskeletal care will continue to rise. Therefore, building visibility for your sports medicine practice and developing a positive local reputation are important tenets to establishing a successful practice. The tenants outlined in this review, however, are not isolated to sports medicine alone and can be helpful for anyone attempting to build a new practice or bolster an existing one by increasing their local and national footprint to drive patient traffic.

Build rapport

The first key to establishing a strong local reputation is to build rapport with physicians in your area. While this should include your individual practice, it can also extend to the community and surrounding area. Introducing yourself, providing your direct contact information, and educating other providers about your specialty leave a lasting impression. If you are a new fellowship trained hip arthroscopist, for instance, it is paramount to inform your partners and practitioners in the community, especially if your “niche” is in an area that may be considered challenging to others. Additionally, if you are establishing your practice in a smaller town or more rural area, educating local providers regarding your subspeciality training can ease a great burden in the community, and likely prevent patients from needing to travel to major metropolitan areas for care. This becomes a win-win for both patients and referring providers alike and it can be a valuable source of patients.

Educating the local practitioners (physicians, surgeons, physical therapists, and so forth) can be accomplished by giving lectures to referring practices, such as primary care practices, in your network and local community. Lunch and learns, or even introductory emails, can be incredibly valuable and do not come with a major time investment. Demonstrating your expertise in a subject by providing in-depth lectures on up-to-date best practices will allow referring providers to know your interests and specializations. Local talks and lectures can also be valuable for referral sources to both put a face to a name, as well as to educate providers regarding appropriate types of referrals. You can also establish a reputation of reliability, responsiveness, and thoughtful patient care by providing follow-up on patients to referring providers. Simple tasks such as copying the referring provider on your consultation note or operative report is very well received. These are areas that can best be implemented early on in ones practice, as you may not be as busy with clinical work, and may potentially have more time for talks, lectures, or impromptu lunch meetings, however even after you have become an established provider, these methods can be helpful in continuing to grow your practice into new arenas.

Referral basis

Although primary care practices may be a common source of referral, other physician groups, including other orthopedic specialists, may refer patients to you if you have experience with a new technique or procedure that other orthopedists have not used. Therefore, meeting specialists from other practices in your area may also be valuable in introducing yourself and your areas of expertise to your community. As a rule of thumb, all physicians (surgeons, and nonsurgeons alike) are extremely busy, and have the common goal of wanting to provide high-quality comprehensive care to their patients. By “making their life easy” when it comes to referrals, especially for complex, challenging patients, this can pay great dividends. For instance, taking on complex patients from your spine, or arthroplasty partner will also lead to straightforward referrals. Once a referring physician finds a qualified specialist that they can trust, referrals will flow, helping to foster a strong professional relationship. If an outlying general orthopedic surgeon discovers that you specialize in hip arthroscopy, the vast majority will be thrilled to refer these sometimes-complex patients to you for further care. When it comes to being a physician and surgeon the best ability is availability. By making yourself available to partners and referring physicians, you will set yourself up for success in the short and long term, not to mention patients will appreciate this first and foremost.

Additional important nonphysician sources for referrals include local physical therapy practices and athletic trainers who provide care for team sports and/or athletes. Physical therapy practices provide care for patients with a wide range of musculoskeletal injuries. Introducing yourself to local PT groups and providing lectures on topics germane to your specialization can be very beneficial for referrals. Establishing a rapport with these groups by sending patients to them for PT will also build your name recognition. Additionally, when you send patients to various physical therapists, whether they are in your hospital system or not, it can help increase their practice and increase the likelihood of them sending other patients your way. Provide your PT protocols either via printout, or a website, and make two-way communication easy. We also recommend sharing your personal or work email, or even cell phone, with trusted therapists, as often a quick text message or email can be invaluable for ensuring the plan is being followed or helping alleviate any concerns. If also helps build rapport, and gives both patients and therapists alike a feeling of security knowing you are always just a quick call away. Essentially, this helps offer a VIP, or concierge, type approach to medicine that is rarely seen and will quickly set you apart from other surgeons in the area. Consider how many therapists may work at a single location and how many patients go through said location. A glowing review of a therapist will pay dividends 10-fold in word-of-mouth referrals. Additionally, making the therapist feel like a valuable part of the team is essential for good outcomes and positive results.

Beyond physical therapists, local athletic trainers, both at a high school and collegiate level, are another great referral source. General practitioners and sports medicine specialists often can work with athletic trainers to cover local schools. This does not have to be isolated to sports medicine specialists, especially in smaller communities, and this can be another valuable method for growing your name in the community. Urgent access to care is important for athletes, so providing a direct line of communication for athletic trainers will yield many referrals. We recommend to seek team coverage opportunities from local high schools as your start your practice. Covering games and potentially training rooms are important in building trust from the training staff and athletes. Higher level sports coverage such as for collegiate or professional teams, are less common but should be sought after should any opportunities arise. For nonsports medicine trained surgeons, it is important to remember that by being a team physician, not only are you placing yourself in a position to care for a student athlete, but also their parents. There is an obvious time commitment involved with team coverage, but it can be incredibly valuable for your community involvement and practice growth, regardless of subspecialty.

Marketing

Your practice can further introduce you to the local community through marketing initiatives. This can be in the form of old-fashioned flyers in the mail announcing your new practice to the community or more commonly in recent time, it may be in the form of digital marketing through website and email announcements as well as online advertisements. Practice and/or hospital websites, as well as social media, may be useful platforms to amplify your interests and showcase your professional brand. In today’s era of medicine, having a website is mandatory. This should be easy to navigate and should clearly state your areas of interest and expertise. Listing research initiations and achievements are also a nice touch. Patients also love videos, especially of you explaining your practice or approach to their care, and in our experience, this is frequently mentioned by patients in a positive light. Other “extras” that can enhance your professional website are PDF uploads of you PT protocols, or links to professional society websites, or educational material. For some physicians, you will be lucky enough to have a health system or practice who will build out a website for you, however if not there are numerous reputable companies that you can consult to build a website tailored to your needs. Once again, this is an extremely valuable, and essentially a mandatory tool to help build a successful practice.

Social media is another crucial component of marketing a new practice, and best of all, in most instances the only cost involved is your time. As usage of publicly available information such as social media and the internet grows, it is expected that health care consumers will continue to take an increasingly active role in selecting their care team based on internet data. Tools such as Facebook, Instagram, and Twitter (X) are a great way to market your practice to various demographics. Older patients may be more familiar with Facebook, while younger patients, therapists, or other medical professionals may use outlets such as Instagram, or Twitter. This gives another way for you to appeal to patients on a personal level, provide education on common conditions treated, or share complex cases, and patient success stories to build your overall brand and practice. If social media is used, physicians should consult with their practice compliance group to ensure full understanding of appropriate and acceptable content for posts, especially for potentially patient sensitive information.

Community engagement

Whether in a small or large community, word of mouth remains potentially the most important referral source when establishing a new practice, especially considering every patient has a network of friends and family who likely also suffers from an orthopedic ailment, for which said happy patient could refer to you for treatment. This is at times a difficult concept to grasp when beginning one’s practice, but one that is essential to remember. Think about the sheer number of encounters you have in each day as a physician that are not even patient related: practice partners, administrative staff, nurses, circulators, scrub technicians, x-ray technicians, patient support staff, schedulers, phone room employees, residents, fellows, device representatives, janitors, and likely more. All these people are potential patients, and all these people have friends and family who are potential patients. By carrying yourself as a professional and demonstrating that you are compassionate and provide expert level care will go a long way to building successful relationships that will grow your practice. A referral from a trusted friend or family member will always be a more valuable and sure-fire way to build a practice than relying on someone to find you on their own.

As an extension of being involved and forming connections at work, this can extend to your local community as well. Volunteering to coach youth athletics, being involved in local community service or religious groups, playing recreational athletics, or joining a social club. These are all ways to plant your roots and grow your local reputation within a community, which will lead to the organic growth of your practice. Once again, this makes you accessible and visible and can help you display positive personality traits that people seek out in a physician and surgeon.

Ultimately, each time a patient seeks care they make a choice regarding their care, some more knowingly than others. Harris sought to examine the process in which patients search for and choose a physician, and found that patients mostly remain passive consumers of health care. A key finding was that having a personal doctor, and rating one’s current physician highly reduced the willingness of the patients to switch providers, even regardless of quality of care. This highlights the ongoing importance of building a satisfied patient base first and foremost, as a referral from a happy patient, whether it is to their friends or family members or through an online review site, can carry tremendous weight. One strategy recommended by the authors to highlight patient satisfaction is the use of “patient review cards,” in which a QR code-enabled postcard can be given to satisfied patients to leave exemplary reviews online for others to see. This can be a simple, yet efficient way to increase visibility to one’s practice. Positive online reviews accessible via a search engine, and so forth can be another easy way to drive patient volume. Whether we as physicians want to admit it or not, the first thing people often do when referred to a new doctor is to “Google” them. This highlights the importance of a clean, easy to use website, positive patients’ reviews, and an overall strong message of confidence and professionalism to help patients choose you both consciously and subconsciously before even meeting you.

At the end of the day, and above all else, remember that the patient is first. Whether it is your first year in practice or your thirty-first, it is important to remember the basic reason why we all chose medicine, and ultimately surgery in the first place: to help people. Little things go a long way in our field, and ultimately treat patients the way you yourself would like to be treated. Sit down for patient encounters and do not rush people out the door, call patients to review imaging or answer questions, check in on them after surgery, confront your complications head on and make these patients your closest patients, and most importantly, be honest with your patients. If you do not have an answer, or their problem is out of your area of expertise, guide them to someone capable to solving their problem. If you do these things your practice will grow naturally and your patients will think the world of you for it.

Summary

In conclusion, direct contact with referring practices as well as online marketing using patient reviews can help increase visibility of your practice, but it is most important to remember that treating patients and referring providers with kindness and respect goes a long way to building a successful and self-sustaining practice. Ultimately, you are a walking embodiment of your values and of your practice, and displaying positive, professional character traits will go a long way in organically building a practice and local reputation.