A STRONG INTERNAL MARKETING PROgram that communicates a patient-centered attitude creates loyalty in established patients, increases sales and generates new referrals. Customer service studies continue to remind us that if one patient leaves your practice with a positive impression, you stand to gain new business through a minimum of four new referrals over the lifetime of that satisfied patient.

Unfortunately, many practices that begin with a goal of implementing a strong internal marketing program are quickly diverted from this focus by the time and budget required to implement external marketing strategies designed to grow segments of the business. Frustration with high lead costs, however, has caused practices to take a fresh look at internal marketing to control expenditures and drive business through their own satisfied patient base.

In this article, we"ll look at how investing in new ways to create a positive impression before, during and after the patient visit are at the heart of a successful internal marketing program. We"ll focus on the fundamentals of internal marketing: service, education and communication.


Look at your practice through the eyes of a patient. At the core of internal marketing is the delivery of service. Since quality care and service are defined by the person living it, not the person giving it, the practice administrator should ask herself two questions that are at the heart of a successful internal marketing strategy:
  • Is your practice patient-focused or practice-focused?
  • Is your entire staff involved in marketing the patient experience?
In a patient-focused practice, your staff is concentrating on the patient experience at each point of interaction. During the average visit, each patient interacts with four to 10 individuals depending on the practice size and appointment type. Every member of the practice is responsible for ensuring a positive patient experience. Conversely, a medical practice motivated only by its own interests often ignores the signs of patient dissatisfaction only to wonder why new patient growth is stagnant, or worse, declining.

Establishing a well-educated, service-oriented staff is the first tactic in a solid strategic internal marketing plan. Smart practice managers understand that staff members who project a caring, professional image with a can-do attitude lead to high levels of patient satisfaction. These managers are willing to invest the time and budget required for staff development. Monthly staff training programs are planned and executed in accord with projected annual growth by service. Some ideas for these training programs are listed in Ideas for Improving Service Skills.

One key to managing the delivery of service is to benchmark standards for the overall practice, by department. To ensure consistency over time, I suggest using an unbiased "Mystery Shopper" program a minimum of twice a year. Several industry consultants offer this service with subsequent recommendations for improvement.


Written patient communication materials are the cornerstone of internal marketing. Given the competitive advertising seen in virtually every market, you want to make sure that your patients come to you first with any questions about their eye care (e.g. laser surgery, contact lenses). Educating your patients on all services at every opportunity nearly guarantees that they will see you as an authority in the field.

Developing a proactive communication strategy begins by reviewing the following questions:
  • What communications materials are in place? Are they delivered?
  • Are the electronic systems required to efficiently target communications in place?
  • Is there a defined plan to consistently communicate with patients and referral sources? 
  • How are new products/services that target specific patient demographics announced?
  • Is there a set budget for your internal communication strategy?
Practice Builders

Set up internal systems that will be your referral-building programs. Make it a regular practice to ask for referrals at the close of each patient visit, and ask patients to complete a survey regularly to benchmark patient satisfaction. If you find out (either by asking or via the patient information form) that the new patient is a referral from a current patient, set up a thank-you program to acknowledge that. You might send thank-you cards to referring patients, or make a note of it in their charts to be mentioned at their next office visit.

Ideas for Improving Service Skills
Medical practices that make customer service a priority invest in their employees and regularly evaluate their efforts. Set benchmarks for each department and keep records of goals met. Conduct an annual customer service training program for the entire staff, and hold monthly staff training programs on more specific topics for segments of the staff, such as:
Telephone Skills

Do we have standards for how the phones are answered? Are they adhered to? Does our staff know how to make a good impression over the telephone?
Interpersonal Communication Skills

Does our staff know how to identify what the patient is really asking for? Do they know how to show interest when they"ve heard the same question 100 times before?
Listening Skills

Does our staff know how to identify the "real" problem the patient is asking about?
Complaint Handling Skills

Do we have standards for how we handle complaints? Are they adhered to? Does our staff approach complaints with a helpful attitude?

Internal Marketing Basics
Get back to basics with your communications tools! Make sure that you have updated, attractive materials for your internal audiences ready-to-go, such as:
  • A practice brochure that outlines all services and
    products (general ophthalmic specialties, refractive options, dry-eye clinic, eyewear dispensary, etc.)
  • Practice brochures on key profit centers
    (refractive, oculoplastics, Botox injections, etc.)
  • A patient newsletter announcing "What"s New!"
    twice a year.
  • A newsletter to referral sources at least twice a year.
  • A website that educates and offers on-line ordering of contact lenses, appointment scheduling, e-mail questions to doctors and refractive counselors. Make sure your site is optimized on search engines.
  • Letters from the doctor(s) to specific target markets describing new products/services.
  • Special announcements on recall cards and patient invoices.
  • An optical/contact lens brochure with warranty coverage defined.

To develop this practice-building strategy, determine:
  • Do you have electronic systems in place that can efficiently track referrals?
  • Is there a defined plan to consistently thank and reward patients for referrals?
  • Is there a defined plan to benchmark patient and referral source satisfaction?
Many practices are uncomfortable asking for referrals. Tasteful signage in the waiting area and individual exam lanes can make a subtle suggestion. Also, a tactful close that offers the patient ongoing support once she leaves the office can effectively lead to future patient referrals. Simply hand the patient two of her doctor"s business cards and let her know that the first card is for her should she have any questions following her visit, and the second card is for a friend. Emphasize that your practice is always available to care for patients and their family and friends. RO

Ms. Wahlman is president of JD Healthcare Consultants. Reach her at (281) 589-2126 or visit jdhconsultants.com.