A Medical Economics Web Exclusive

To build your practice, speak up–and speak out

Giving speeches in your community, says the author, affords a great sense of satisfaction–and unexpected perks.

By Gail Clifford, MD
Internist/Belleville, IL

I’ve discovered a low-cost way to boost my practice and my visibility in the community: giving speeches. In addition to generating a surprisingly large amount of business, this endeavor helps me meet what I feel is my responsibility to teach in both medical and community settings. It also motivates me to stay up to date on an array of topics.

I began my lecture circuit by providing high school kids with pointers on avoiding sexually transmitted diseases. Because I had some fairly graphic clinical slides of STDs, I had no trouble keeping the students’ attention.

I soon learned about a program called Doctors for Adults (DFA), sponsored by the American College of Physicians-American Society of Internal Medicine. I acquired the group’s speaker’s kit, which describes what an internist does and how her function differs from those of other primary care physicians. It also stresses the importance of seeing an internist, especially after age 40. In addition to educational material and a sample speech, the kit contains a variety of useful and entertaining slides.

Once I had my speech rehearsed, I called my hospital’s education department for help finding an audience. A diabetes support group was my first engagement.

After that first speech, I asked community-active patients about potential engagements, and I had no trouble lining up lectures. There are so many local groups yearning for a physician’s expertise that filling my dance card was easy.

After I’d been speaking for a few months, I got the chance to appear on a local radio show. Not long after, my hospital’s public relations department helped to set up another radio interview.

Speaking on the air was a lot more nerve-racking than speaking face-to-face with a group; in person you can judge the audience’s reaction and tailor your talk accordingly. What’s more, both the radio programs were Q&As with local deejays–and I had no idea what questions they’d throw at me. (Turned out I got all sorts, from why women have more body fat than men to how the latest HIV treatments are working.)

Nevertheless, I’ve kept appearing on radio shows from time to time. Just when I was growing accustomed to the idea of talking to tens of thousands of "patients" motoring down the highway, one of my real patients, a fibromyalgia sufferer, recommended me to a local newspaper reporter who also suffered from fibromyalgia. Suddenly, I found myself on the front page of an insert in the daily paper.

While the interview was fine, the bulk of what I said had been paraphrased, meaning that my comments were filtered through the reporter’s interpretation. For this reason, I prefer radio or live talks, where people can hear what you actually say and interpret it themselves.

I discovered you can get pretty well-known for almost no money. The only expenses I had were for telephone calls and gasoline, which were relatively inconsequential. Promotions for the lectures consisted of my name in plastic letters on a marquis–at no charge, of course.

There is one "cost" I’ve had to pay, though: time. I spent 30 hours preparing for my first engagement (with 15 hours just for retooling the DFA speech to fit my needs). Prep time goes down with experience, however. I now spend an average of only an hour before each lecture, though the time can vary considerably depending on the complexity of what I’ll be discussing and my degree of familiarity with the topic. For one talk, I was able to take only 15 minutes to prepare, and yet, because I had gained experience by this point, the speech still came off well.

I don’t allow myself to get into a one- or two-topic rut. With a brief review of the latest literature, I feel comfortable discussing a broad array of medical topics. I try to pick subjects that interest me as well as the audience.

I’ve discovered several near-guaranteed crowd pleasers. For instance, both men and women are interested in various aspects of cardiovascular disease, cancer (especially lung and colon), and sexual dysfunction. Also, men tend to be particularly interested in diseases of the prostate and women in diseases of the breast. For both groups, fibromyalgia is becoming a topic of increasing concern. Treatment of depression and overall preventive care are also becoming more popular.

Either during or after my speech I take questions. Though most people pose a clinical vignette, then ask for medical advice, other questions broach a broad array of subjects. For example, I was once asked about the evolution of male versus female physiology. I’m often asked about the role of exercise, nutrition, and behaviors in preventive care. And women generally want to know whether they need to see an internist even if they regularly see a gynecologist. Older folks want to know whether they should have regular screening for particular diseases.

The business of medicine is increasingly coming up. People ask why so many physicians are leaving medicine and why HMOs are starting to fail. Some have inquired what question to ask and what qualifications to look for in screening a new doctor.

I also get more pointed inquiries, such as "Why do doctors make so much money?" and "Why does it cost me so much to go to the doctor?" I remind people that only a fraction of the health care dollar actually goes to the physician, who must then pay her staff and run an office. I point out that we’re in the hospital before we go to the office, that we still have to fit in nursing home rounds, that we’re active on many committees, and that we frequently deal with emergency care in the middle of the night.

In spite of all the time and energy I’ve invested in taking my knowledge on the road, it’s unequivocally been worth it.

Yes, it’s certainly helped me build my practice. But, also, I’ve helped many of my patients adopt the mantra of preventive health care, lose weight, control their diabetes or hypertension, or quit smoking. They have accomplished many of these things, they say, partly because they see me speaking about disease and practicing what I preach. They tell me they feel an obligation to be a better patient.

I’ve also enjoyed the response of audiences. It’s been rewarding to get the immediate reaction of a crowd and to see the light go on when folks grasp the point of the speech.

I’m amazed that I started out not long ago giving speeches locally, and now I’ve given a national speech at the ACP-ASIM’s annual meeting. But the most gratifying aspect of all of this is my newfound awareness of how an individual physician can make a widespread difference.

The do’s and don’ts of public speaking

Want to try public speaking? Internist Gail Clifford, author of the accompanying article, suggests you consider approaching schools, illness support groups, local festivals and health fairs, religious and church groups (Ladies’ Sodality, Knights of Columbus), women’s groups (Junior Women’s, Business and Professional Women/USA, the American Association of University Women, garden clubs), and men’s groups (Elks, Moose).

Patients can also clue you in to speaking opportunities. For example, the recently retired are especially likely to join new groups or expand former hobbies to meet new people. And folks in these groups are eager to learn about medical topics–and perhaps to enlist you as their physician if they like what they hear.

Many groups schedule their speakers up to a year in advance, so start booking dates long before you want to be up on the dais. Don’t wait until your material is completely ready. You’ll have a long time to prepare and polish your podium-side manner before the actual lecture.

Here are a few more tips from Clifford:

DO …

Get started

Choose a target audience

Prepare a pamphlet about yourself and your practice

Bring business cards to your speech

Practice your speech in front of your staff or spouse

Dress professionally

Invite your colleagues to join you in a collaborative effort

DON’T …

Be afraid of stage fright (work through it)

Talk over your audience’s head

Forget that your first goal is to educate–all the rest is icing

The write way to promote a practice

In 1984, Lakeville, CT, internist Peter H. Gott contributed an article to Medical Economics detailing how he’d successfully promoted his practice by writing a local newspaper column. At the time, he was syndicated in five local papers, but wrote: "I’ll probably never achieve my heady goal of national syndication."

Today, Gott’s daily writings appear in nearly 700 newspapers worldwide. He still practices full time.

How did his work become so well known? Gott presaged how in his 1984 article: "I’ve … developed a reputation for being something of a gadfly who rarely misses a chance to deflate fellow physicians’ ego balloons."

Shortly after the Medical Economics article appeared, Gott "tried to expose doctors who do nothing but complain and whine, whose children go to private school, and who have summer places–you know, the usual [negative doctor stereotypes] that people hear about." It didn’t help that, according to The New York Times, he also referred to the ease with which doctors secure loans by writing that "the MD degree is a license to steal."

In response to Gott’s columns, the president of the local medical society in Dutchess County, NY, home of one of the newspapers that carry Gott’s writings, asked the columnist’s own medical society to reprimand him. Recalls Gott: "He felt the articles were ‘seditious and vicious.’ "

Gott’s editor quickly alerted the paper’s readers to this now-roiling issue. Ultimately, says Gott, "CBS News picked up the story. Charles Osgood came out here and did an interview, and it was the last segment on the evening news. That was a million dollars’ worth of free advertising!"

The Dutchess County group eventually withdrew its complaint. "Two days later, I got a call from United Feature Syndicate to fill in for a doctor who’d jumped ship. I said, ‘Sure, I’ll do a weekly column.’ And the guy replied, ‘We want you to do a daily column.’ "

Over time, Gott increasingly based his column on answering readers’ mostly clinical questions. He still occasionally ruffles colleagues’ feathers with such columns as "Doctors for dollars," "Call doctor’s bluff," and "Snappish docs." "If you’re going to keep them reading," observes Gott, "you can’t be mealy-mouthed or shy away from controversy."

Gott says physicians shouldn’t get into writing for the money. He wasn’t paid for his first column, and even a syndicated physician columnist generally earns only $50 to $100 per column. Gott earns more than the typical columnist, but his main motivation is simply his enjoyment of writing. Notes Gott, "All these [perks]–the money and what tiny bit of celebrity I have among my patients who travel to China and find me in the Shanghai paper–are just gravy."

–Barbara Klink

 

Gail Clifford. To build your practice, speak up—and speak out. Medical Economics 2001;19.