Pediatrician
We conducted validation interviews with doctors to find out their feedback and thoughts regarding Physician Liaisons. They provided insightful responses that will surely help better our services and what we can do for their practices.
Here are the questions that were asked:
1. What are the top specialties you refer out to most (ortho, OBGYN, Pain, ENT, etc), and for what (conditions/symptoms/treatment)?
2. Besides excellent patient care, when referring to a physician, what factors help you make that decision to send to that physician or practice? (examples: cell phone number, them meeting, you face to face, location, etc)
3. Is there something a physician liaison or medical rep that stands out to you in a positive or negative way, and why?
4. If a physician liaison comes to your practice to discuss building a patient-referring relationship between you and their specialists, what can they say/ do that would provide value for you or your staff?
5. What is the greatest value a physician liaison would be able to provide to your practice?
Written Validation Interviews:
Dr. Ronald A. - Pediatrician
1. Cardiology for chest pain, Ortho for joint pain(s), Neurology for headaches, Urology for elevated PSA or erectile dysfunction, and Ob-Gyn for abnormal cycles.
2. How soon they can be seen, the proximity of physicians' offices to patients' home/work. Sure if I know a physician personally it helps.
3. Friendly, not pushy, and add value.
4. Be friendly, non-pushy, or demanding especially to front office staff. If the liaison is not nice to front office staff I may never know they stopped by the office.
Dr. Maribel S. - Pediatrician
1. ENT – for ear infections/earache/ear tubes
Dermatology – for rashes/skin lesions/biopsy/creams or meds
Pulmonology – for asthma/cough & difficulty of breathing/meds & inhalers
Orthopedic – for fractures/falls pain/x-ray & cast
2. Insurance – in-network with patient’s insurance so that the office/labs/meds will be covered
Location – patients do not like to travel far
Fast appointments – patients want to be seen ASAP
3. Positive – friendly, knowledgeable, have handouts, flexibility/patience (waiting for me to finish seeing patients before talking to them)
Negative – none (possible – rude, impatient)
4. have not met any physician liaison or medical rep that I do not like
5. Be honest and straightforward and let me know about the specialist – name, office information, credentials
Dr. Mohammed M. - Pediatrician
1. Cardiology, dermatology, and orthopedics
2. Location and how fast the patient can be seen
3. The most important thing is knowing what insurances the specialists accept and if the patient will get a bill and if they do prior authorization. The last thing one wants is a patient getting a high bill for a visit that would have been covered by seeing another specialist
4. One of the best things that some specialists do is that they handle prior authorizations themselves with the insurance. So, all we need to do is fax them the referral and they do the rest. It makes it very convenient for everyone
Dr. Fredly B.
1. ENT
2. Ease of scheduling appointments and efficient consult notes being returned to us.
3. One that asks how to make processes easier for your practice.
4. The turn around to scheduling appointments, how consult notes are communicated, and insurance coverage.
Dr. Franchesca E. - Pediatrician
1. Peds ENT - the need for ear tubes
Peds Allergy/Immunology - allergy testing
Peds Endo - growth issues
Peds Psych - depression/anxiety
2. I have a tight-knit group that I refer patients to. Availability to patients, interactions with me, and patient feedback regarding their visit are the big ones. Obviously I also take their training into account.
3. Physician liaisons who ask how we can do better are much more effective than those that say "let me know if you have a problem." The former are proactive and help address small concerns before they become bigger. Also, understanding the preferences of the communication of the providers is helpful.
4. Do a meet and greet. Face time is the MOST important part. When I meet a specialist in person, it always changes the relationship.
Dr. Lara J. - Pediatrician
1. Ortho- fractures and sprains neuro- seizures cardiac- abnl EKG, subject sensation of palpitations, some syncope cases
2. Certain practices have a relationship with the hospital system, and we are supposed to refer to someone within the system being willing to take a call about a patient question will mean I will definitely refer to them meeting face to face to help whether or not they take Medicaid. Many of my patients are on Medicaid.
3. I want to deal with the physician directly, not a rep
4. Not sure
5. In the ER, I just need quick consults and to know who can take care of my patients after discharge
Dr. Carolyn R. - Pediatrician
1. Developmental Pediatrics: To ensure the achievement of optimal cognitive, speech, and motor skills for any infant or young child who:
exhibits delayed milestones
is at risk for delayed milestones (premature birth (especially before 28 weeks gestational age,) infant impacted by prenatal exposure to alcohol/illicit drugs
has had a neurologic insult due to hypoxia, infection, or genetic syndrome
The infant or child will be assessed, and a comprehensive plan of care will be developed to ensure the achievement of optimal cognitive, speech, and motor skills. Often involves coordinating care with sub-specialist physicians, therapists, and other ancillary medical providers.
Pediatric Behavioral Health (Psychiatrist, Psychologist, or Counselor): to manage using non-chemical evidence-based effective therapy techniques, counseling (individual and family,) and/or safe and effective medication to ensure the optimal mental health for children and adolescents.
Pediatric Allergist: To identify and minimize any environmental triggers that negatively impact the health of infants or children who have complex atopic conditions (eczema, allergy, and or asthma.) The complex atopic conditions have not responded to the usual standard of care. To ensure optimal quality of life for these infants, children, and their families.
Pediatric Cardiologist: To diagnose and to treat any congenital or acquired cardiovascular condition, including the assessment for safe sports/physical activity participation by children and adolescents.
Pediatric Endocrinologist: To diagnose and to treat any congenital or acquired endocrine condition, including Type I and Type II diabetes and thyroid disease. (Children who have Type II diabetes and complications associated with obesity may also need management by a pediatric hepatologist or gastroenterologist.)
Pediatric Otolaryngologists (ENT) is no longer on the top 5 list. Thanks to the pneumococcal immunization, chronic and recurrent middle ear infections have greatly decreased the need for ear tube placement. Preventing chronic and recurrent ear middle ear infections has resulted in the decreased incidence of conductive hearing loss caused by middle ear effusion.
2. Developing a reliable referral network involves:
My personal knowledge of the physician’s skill in the specialty
Recommendations from colleagues
Positive feedback from patients/parents after consultations
In-network with the patient’s health insurance plan
Office location (proximity to the patient’s home)
Timely appointment availability to obtain a consultation
Receiving written/electronic communication in a report for the consultation which will include findings, diagnosis, and plan of care
3. There have been times where a physician liaison or medical rep has helped to facilitate a timelier consultation, to resolve health insurance plan utilization review issues, or to arrange for a consultation with another physician in the same specialty to obtain a second opinion.
4. To identify a specialist who:
has timely consultation appointment availability
provides timely written/electronic communication for a report for the consultation
is in-network for most major health insurance plans
has a good rapport with patients/parents
has a cordial support staff
To identify/introduce any new specialists in the area
5. To identify/introduce established specialists of whom I am unaware
Dr. Shayna S. - Pediatrician
1. Psychiatrist
GI
GYN
Cardiology
2. Accessibility helps like cells and some open appointments for acute patients. Usually meeting the doctor face to face helps because I can tell the parents that I've met the families.
3. Being informative and to the point stands out. Giving their personal number to our referral coordinator also helps. Hanging around the office too long after information is given can be frustrating when the doctor or staff is busy.
4. When they give us updated information on their services, hours, best contact number for a fast call back for referrals, or numbers/ways that the family can get an acute or urgent evaluation it really helps them stand out.
5. Maybe make other doctors or groups know that we exist and how we can assist their patient population.
Dr. Alexandra P.
1. Top referrals ENT chronic Otitis media, hearing loss, orthopedics fractures and scoliosis, cardiology heart murmurs and dyslipidemia, neurology: ADHD, Autism, seizures
2. Location, top reviews, Creole and Spanish speaking Physician or staff
3. Liaison brought me brochures with wrong contact information for their practices.
4. Reliable, consistent contact information so it is easy for the patients to schedule.
5. A well-informed liaison who is knowledgeable about insurances, schedules, and scope of practice of his/her physicians.
Dr. Yolanda W. - Pediatrician
1. ENT- ear infections, snoring, sleep apnea, large tonsils.
Pulmonology- asthma, chronic cough
Allergist- allergy testing, food allergies, asthma, allergic rhinitis
Dermatology- severe eczema, unexplained rashes that won't go away
Psychology- anxiety, depression, trauma, bullying
PT/ ST/OT- developmental delay, obesity, scoliosis, back pain, autism, etc.
2. Quality notes and feedback. Many specialists don't communicate with the referring doctor. Many patients can't reiterate what occurred at their visit.
3. Haven't worked with many. Appreciate those who provide lunch, samples, bear gifts or leave helpful resources for patients.
Don't like it when they disrupt the patient flow and talk too long, This increases wait times for patients, and distracts me.
4. Save money and time, increase revenue, decrease workload, reduce red tape.
5. Add value to my operations
Dr. Kayla W.H. - Pediatrician
1. In my pediatric practice I refer out to ENT for recurrent ear infections or snoring with periods of apnea. I also often refer out to occupation, physical, and speech therapies for developmental delays in their respective areas. The next most common is probably asthma/allergy clinic for allergy and asthma management (as expected).
2. My referral office handles this, but mostly it’s by location, ease of setting up appoint or short wait times for appointments, and also occasionally more like if they have given our group a talk or forged a relationship with the group.
3. Connecting groups is helpful as well as connecting with community resources. Sometimes what is hard for me is I get contacted, but since I am one member of a group, I have no say and a lot of the communication needs to occur with my CEO/CFO or a higher person up the chain, so unfortunately sometimes finding the appropriate contact can be hard but important to ask who that person is, if not the person you contacted.
4. Providing patient demographics or (ages were seen, diagnoses treated, the scope of practice, etc). Providing a schedule of when the office is open but more importantly when the provider sees patients if there’s after hours or special hours. Length of time to surgery if surgical specialty, expected course of referral, etc so we can prep patients.
5. Helping smooth referrals. A lot of time it might not be only the physician you have to convince but also to change the referring practices or habits of the referral coordinators. Sometimes (often), I don’t specify the provider when I refer bc there are many options and I trust my referral coordinator to pick the closest, most convenient, and the best person for the patient, which may also include languages spoke.
Dr. Jeanne B.
1. Mental health is my top referral by far, for anxiety, depression, and eating disorders. Distant runners up ophthalmology (failed vision screens, problems with near work), allergy (food or environmental allergies), dermatology (acne, eczema), GI (recurrent abdominal pain), GYN (contraception, pelvic pain), orthopedics (fractures). Rarer: cardiology (heart murmurs, chest pain, syncope) and neurology (seizures, headaches).
2. Factors that influence my referral pattern: a) how easy it is to reach the specialist, b) how responsive they are to my messages and referrals, and c) their quality of care
3. Not really
4. Most helpful things: a compact list of specialists and contact numbers, a streamlined referral process, preferably online, and a contact person in case the first two don’t work out
5. The greatest value of a physician liaison: giving updated information on available specialists and their specific interests or strengths, and a streamlined referral process
