WAFF 48 Investigates: Medical Marketing - WAFF-TV: News, Weather and Sports for Huntsville, AL

WAFF 48 Investigates: Medical Marketing


The likelihood your primary care doctor refers you to a specialist for medical treatment is increasing. But how your physician may hear about specialists and new procedures may surprise you.

It's not from medical journals, rubbing elbows on the golf course, or even bumping into other docs in the hospital – but from paid representatives who visit their offices.

Sabrina Alexander spends most days visiting different physicians' offices, armed with brochures and headshots touting the qualifications of doctors in the orthopedic group where she works. Alexander is her group's director of marketing and physician relations, and a meeting with persons in her profession may be the reason your doctor recommends the next specialist you see.

"The things that I can do really help my specialists shine to other primary care physicians and help them stand out against our competition," she said.

She is part of a growing industry of client liaisons. Front-line go-betweeners like Sabrina - and even entire marketing firms – are hired by specialty physicians to hit the road and let primary care doctors know their expertise is available.

"Often times that is the only way that we learn about a new doctor in town," said pediatrician Dr. Matthew Cepeda.

That is because health care has changed dramatically over the last decade. A study found the number of patients referred to specialists nearly doubled. Busy primary care doctors like Cepeda do not spend as much time in the hospital meeting other specialists. Instead, they're booked solid in their offices with patients, charts, and follow-up care.

Dr. Cepeda said he is happy to meet with specialists' reps. "Whenever I need another resource, they're the best way for me to find out what else can be done for your health care," he said.

Critics worry these office-to-office pitches could pose an ethical health hazard. Bioethicist Lawrence Nelson hopes primary care docs are basing referrals on qualifications only.

"I don't think patients have the vaguest idea their referral might have been the result of a marketing campaign," Nelson said. "The best protection for patients is physicians who are following their ethical obligation to make referrals based upon the patient's need… and not on slick marketing or any kind of other inducements."

The American Medical Association said there are strict ethical guidelines and laws regarding patient referrals, similar to rules regulating pharmaceutical sales reps. Physicians have to be knowledgeable about a specialist's experience and cannot accept referral fees.

Sabrina said her office visits are just one step in initiating long-term professional relationships between primary care doctors and specialists –and, she points out, if a patient is steered the wrong way, it affects the doctors too.

"[Their] reputation is also on the line. So they have to be comfortable with the specialists that they're referring their patient to," she said.

Experts said patients should always ask any specialist they are referred to basic questions, things like:

  • "Have you seen problems like mine before?"
  • "How many patients have you treated for this condition?"
  • "What were their outcomes?"

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