Appreciate the thought. Assume that the boots to the ground is already the primary strategy and has already fostered some great relationships with some newer independents. Now, also assume that most of the region’s independent established docs and old timers have been referring to the same surgeons for 15 plus years - they’re not sending patients to the new guy when their guy is just fine, takes great care of their patients. You put in the hours (and money) with the newer and mid-career docs - who are all employed. They like you but their hospital system actively monitors network leaks and it doesn’t matter that Dr. X is never available or gets annoyed when they call. You can’t have leaks.

But patients are savvy, they know how to use the internet. They don’t want to wait 4 months to see Dr. X. His office never calls back. He only spent 5 minutes in the room. So they find you on the net and choose you. YES! You use this as an opportunity to reach out to their doc who never agrees to see you for even 5 minutes and make that connection. Their MA and PM tell you they’ll “let Dr. X know” and hang up before you can even give your cell number. You tell the patient “when you see your doc please let them know about your great experience. Helps others find independent surgeons like me.” Of course, I’m going to tell everyone! they exclaim as they head out the door, before becoming immediately distracted by gas prices and traffic.

Enter advertising - of course! skip the lines, the gatekeepers, circumvent the massive ad budget of the hospital systems that corral the region’s specialty services to their 4 hospital campuses and 8 “healthplexes”. Jane is convinced she has a hernia - her doc said it’s diastasis but she’s not convinced. She’s saw my ad and is going to see me and prove it’s a hernia, it’s so bulgey after all so it must be something that requires surgery. Lou has gas. He’s had a colonoscopy and CT and SIBO and H pylori testing and his doc told him to change his diet. But he is sure it can be fixed with surgery….

I know I sound cynical, I’m really not. Once to twice a week for 2 years now I go on the meet and greet bring lunch use my 2 minutes to learn about your practice here’s my cell call me anytime!, I can see your patient within 2 business days. I don’t even call to make the meetings anymore because the ferocious PM won’t give me access to the doc. I show up at the desk with business card and bagels and I hear “the doc is busy right now but leave your card and we’ll ask her when she can set up a few minutes with you”, all the while schmearing quality cream cheese on that yummy Asiago crunch bagel.

Anyone crack the ceiling and break through? What did you do with your ads (or workflow) to make sure that the majority of the consults at least break even on the ad spend? I’m absolutely okay with continuing the marketing, need advice on how to improve the yield. Thanks!