Hospitals hire reps to sell doctors on patient referrals

— -- In northwest Indiana, Carrie Sota visits five or six doctors' offices every workday as part of her new sales job.

But Sota isn't selling the physicians on a prescription drug or a medical device. She's promoting her hospital — the University of Chicago Medical Center.

Sota, 30, is one of four employees the academic medical center has hired in recent months to make "sales calls" on physicians in the hope that they will send more patients to the hospital. "We are trying to build meaningful relationships," said Sota, who was previously a saleswoman for a small medical device company.

The University of Chicago Medical Center is one of a growing number of hospitals nationwide hiring former drug and device sales reps to visit doctors' offices to persuade them to use their services over competing facilities.

Rather than handing out samples of prescription drugs, the sales reps call on doctors armed with the latest information on how their facility is reducing hospital-acquired infections and improving patient-satisfaction scores.

In visits that can last five to 20 minutes, reps try to win doctors' loyalty by helping them get better times on operating room schedules or easier patient referrals to hospital-based specialists. The sales reps can also carry messages back to the hospital, such as a doctor's request for a new medical device to be available in surgery.

While hospitals have always tried to woo doctors to refer patients to them, the institutions are growing more direct in their efforts. The hospitals mine data to see which doctors have the most profitable, well-insured patients, and then they assign those doctors to a sales rep.

'Physician liaisons' on the rise

Convinced the sales-call strategy is fueling higher admissions, Tenet Healthcare, the nation's third-largest for-profit hospital chain, has doubled its sales force in the past two years. It now has 152 "physician liaisons" at its 49 hospitals, most of which are in California, Texas and Florida.

About two-thirds of Tenet's liaisons are former drug and device sales reps, and they can make tens of thousands of dollars in bonuses if doctors increase their referrals to the hospitals. "These people are really good and really assertive and very sophisticated," said Stephen Newman, Tenet's chief operating officer.

But they do have critics.

Paul Ginsburg, president of the non-partisan Center for Studying Health System Change, said, "When you look at the health system, this is a waste of resources. It's a zero-sum game."

He added: "The net results of changing physician-referral patterns is that one hospital gains at a cost of others, and all the hospitals burn resources to pay (sales)people who take up the doctor's time."

While federal law prohibits hospitals from paying doctors to admit patients, hospitals paying salespeople to influence doctors can get the same results, he said.

Newman said Tenet's liaisons have strict guidelines so they can't "game the system" to reach financial bonuses. For example, their bonuses can't be tied to just one doctor's referrals.

As a result of major cutbacks by pharmaceutical and medical-device companies in the past decade, hospitals have thousands of former medical salespeople to draw from. Tenet's roster of sales associates includes alumni of pharmaceutical and device giants Sanofi-Aventis, GlaxoSmithKline, Johnson & Johnson and Novartis.