1. Direct-­To-­Patient Marketing: Analysis of a Prospectively
Maintained Database in a Multidisciplinary Heartburn and Acid Reflux Center
Olivia Urben, PA-SIII2, F. Paul Buckley III, MD, FACS1, Wendi Stewart, MS, PA-C2
Department of Surgery, Baylor Scott & White Clinic, Round Rock, Texas1
Baylor College of Medicine School of Allied Health Sciences2
INTRODUCTION
PURPOSE
METHODS
RESULTS
DISCUSSION CONCLUSION
• Surgical interventions (Fundoplications & LINX™) are underutilized when
considering the prevalence of GERD in the United States.
• One area of growth in new patient consult presentations is that of patient-
driven consult resulting from direct to patient marketing educating patients
about new advances in the surgical correction of acid reflux.
• Direct-to-patient marketing includes: website marketing, social media profile
pages, physician review websites, and more traditional forms of marketing
such a word of mouth, radio advertisement and television appearances
reported as “other.”
• Social media platforms reach ¼ of the world’s population daily and 40% of all
patients say that the information found on social media affects healthcare
decsiions.1-3
• According to the California HealthCare Foundation, 61% of American’s turn to
the internet for health information and The Social Lie of health Information
found that 59% of people interacted with healthcare search specific
information.4
• There is active need or organizations to evaluate which direct-to-patient
marketing outlets are most likely to affect a change in patient behavior and
medical referrals.
The purpose of the study was to determine the effect of direct-to-patient
marketing on patient demographics and patient-centered outcomes within the
Scott & White Heartburn & Acid Reflux Center General Surgery Department.
• A retrospective review of an IRB approved prospectively maintained database
was conducted on patients who underwent anti-reflux surgeries occurring before
and after institution of the direct-to-patientmarketing from March 2015 to
October 2015.
• Cohorts Defined:
• Cohort 1: Patient presenting to the Center due to marketing
• Cohort 2: Patients presenting to the Center secondary to direct
referral from physicians
• Reflux Operations Included:
• Laparoscopic fundoplications
• Laparoscopic LINX™
• Statistical Evaluation:
• Descriptive analysis of demographics, types of direct-to-patient
marketing (Cohort 1), and specialty of referring physician (Cohort 2).
• Multivariate analysis was conducted to compare demographics,
postoperative satisfaction, and quality of life before and after surgery
between the two cohorts.
• Direct-to-patient marketing participants presenting to clinic were more likely to
be male, younger than the patients presenting from physician referrals, and
were more likely to seek the LINX™ procedure.
• Unlike the Cleveland Clinic Study that found Facebook, YouTube, and Twitter
to be the most popular social media sites, our study found that , Facebook,
YouTube, and Google+ were the most frequently accessed social media
platforms.5
• More traditional forms of direct-to-patient marketing, reported as “other,”
including word of mouth, radio advertisement, and television appearances
proved to be the most efficient form of direct-to-patient marketing in this study,
accounting for 38 of the 57 direct-to-patient marketing participants.
• Direct-to-patient marketing participants had lower pre-operative HQRL and
RSI scores than physician referral patients There was a greater percent
change in HRQL scores than Cohort 2. Although RSI post-operative percent
change was greater in the physician referrals group, the post-operative value
for the direct-to-patient marketing group was less.
Direct-to-patient marketing captured multi-generational
patients not previously reached by referring physicians.
REFERENCES
1. Social
Networking
Reaches
Nearly
One
in
Four
Around
the
World.
2013;
Available
at:
http://www.emarketer.com/Article/Social-­‐Networking-­‐Reaches-­‐Nearly-­‐One-­‐Four-­‐Around-­‐World/1009976,
2015.
2. Timimi
FK.
Medicine,
morality
and
health
care
social
media.
BMC
medicine
2012;10(1):83
3. Jonathan
G.
24
Outstanding
Healthcare
Social
Media
Statistics.
2014;
Available
at:
https://www.linkedin.com/pulse/20140428161148-­‐39605227-­‐24-­‐outstanding-­‐statistics-­‐figures-­‐on-­‐how-­‐social-­‐media-­‐
has-­‐impacted-­‐the-­‐health-­‐care-­‐industry,
2015.
4. Thomas
Hess
C.
Social
media
collaboration
checklist.
Adv
Skin
Wound
Care
2011;24(7):336.
5. Sharp
J.
Brand
awareness
and
engagement:
a
case
study
in
healthcare
social
media.
Front
Health
Serv
Manage
2011;28(2):29.
Cohort
1
Cohort
2
P-­‐
Value
Mean age
(years)
49.09 58.42
Median
age
(years)
45 62
%
of
Patient
Travel
>30
Miles
to Clinic
40.35 41.28
Completed
LINX
surgery
(%)
72.73 31.11
Completed
fundoplication
(%)
27.27 68.89
Pre-­‐op
HRQL
score
(average)
27.33 34.83
Post-­‐op
HRQL
score
2.67 9
Pre-­‐op RSI 9.67 18.67
Post-­‐op
RSI 7 8.83
0
6
11
38
0 5 10 15 20 25 30 35 40
Physician1Review1Sites
Social1Media
Websites
"Other"1
Number1 of1Consultations
DirectGtoGPatient1Marketing1Type
Cohort11:1DirectGtoGPatient1Marketing1by1Type
5
1
3
11
18
0 2 4 6 8 10 12 14 16 18 20
Print
Special4Promo4Events
TV
Radio
Word4of4Mouth
Number4of4Consultations
"Other"4DirectItoIPatient4Marketing4Type
Cohort41:4"Other"4DirectItoIPatient4Marketing
4
9
17
1
3
21
1
1
5
1
0
3
0 5 10 15 20 25 30
Male-20.29
Male-30.39
Male-=/>-40
Female-20.29
Female-30.39
Female-=/>-40
Number-of-Inital-Consultations-v.-Completed-Surgical-Intervention
Age-Groups-by-Gender
Cohort-1:-Initial-Consultations- v.-Completed-
Surgical-Intervention-by-Age-Groupings
Initial-Consults Surgical-Intervention
0
7
33
3
3
61
0
5
10
3
1
25
0 10 20 30 40 50 60 70 80 90 100
Male/20029
Male/30039
Male/=/>/40
Female/20029
Female/30039
Female/=/>/40
Number/of/Initial/Consultations/v./Completed/Surgical/Interventions
Age/Groups/by/Gender
Cohort/2:/Initial/Consultations/ v./Completed/
Surgical/Interventions/by/Age/Groupings
Initial/Consults Surgical/Intervention
11
6
0
38
2
4
0
5
0 5 10 15 20 25 30 35 40 45 50
Websites
Social4Media
Physician4Review4Websites
"Other"4
Number4of4Consults4Generated4v.4Completed4Surgical4Intervention
Type4of4DirectMtoMPatient4Marketing
Cohort41:4Initial4Consults4 Generated4v.4Completed4
Surgical4Intervention4by4DirectMtoMPatient4
Marketing4Category
Initial4Consults Completed4Surgeries
2
2
5
68
1
1
23
4
1
35
1
6
0 20 40 60 80 100 120
Allergy/
Cardiology
ENT
GI
General/Surgery
OBGYN
PCP/ED
Pulmonology/
Number/of/Specialty/Referrals/v./Completed/Surgical/Intervention
Referring/Phsycian/Specailty/Type
Cohort/2:/Initial/Consults/ Generated/v./Completed/
Surgical/Intervention/by/Physician/Referral/Types/
Initial/Consults Completed/Surgeries/
Cohort 1 n=57 ;
Cohort 2 n=109 ; Total n=166
KEY
HRQL=Heartburn
Related
Quality
of
Life
Scale:
Score
0-­‐5,
Total=50;
0=No
Symptoms,
5=Symptoms
are
incapacitating,
patient
unable
to
do
activities
RSI=Reflux Symptom Index: 9 Questions ranked 0-5, Total=45: 0=No Problem, 5=Severe Problem