Most surgery centers aren't sure where to devote their marketing time, energy and money. Toward advertising? Gifts for patients? Sponsorship of a Little League team? Think of your facility as a distributorship that delivers a very high-end service rather than as a consumer brand. A billboard at a busy intersection downtown isn't going to drive patients to your facility because patients rarely decide where they're going to have their surgery. Their physicians do. Here are four steps you can take to improve your chances for success.

Know where to aim before you fire.
The biggest mistake most marketers make is believing that the first step in marketing is setting objectives. This may sound like a good way to go, but setting objectives without understanding what the market needs and wants, and how competitors are meeting those needs, is a waste of time.

When most surgery center managers think of "the market," they think geographically. This is only partially correct. Focus on your clients, the physicians who bring cases to your center.

Create an extensive list of physicians who qualify to refer to your center but aren't currently doing so. Putting together this list requires identifying who's out there. Look at your local hospitals' Web sites for physician lists; check the Web sites of practices in your area; and look at your competitors to see which physicians are affiliated with them.

The list's value will increase once you survey your current and potential surgeons and identify their real needs and wants. Interview as many physicians as you can. What do they like and dislike about the facilities where they take their cases?

You'll be surprised what you find. Sometimes it's efficiency. Or it may be scheduling. For example, you may learn that a surgeon no longer brings cases to your facility because he lost his 7 a.m. block. Often, it's something completely different, such as a friendly staff and pleasant environment. Maybe it's even something you haven't thought about. By doing a little research, you can identify an approach that will make it easier for physicians to choose your center.

Compare your facility with others.
The next step is to identify your competitors. This means all surgical options — hospitals, ASCs and physicians' offices. Think about your competition. Identify the strengths and weaknesses of those facilities through the eyes of your area surgeons. Ultimately, you're looking for all the reasons surgeons may choose your competitors and all the reasons they may choose you. It's very important that you remain objective throughout the process and make an effort to see all the competing facilities through the physicians' eyes, not your own.

In most cases, the list of reasons why physicians prefer one facility over another is quite varied, but it's only through this evaluation that you'll be able to move forward and differentiate your facility from the competition.

Establish your brand and objectives.
At this point, you've identified the needs and wants of the market and evaluated how competitors are meeting those needs and wants. With this information in hand, you're now in a position to identify both what's necessary to become more attractive to surgeons and to determine your objectives.

For most centers, the goal is to increase the volume of surgical cases. Having good information — such as the current physician volumes and a total capacity number — is important. Good reporting will give your goal some context. It's a completely different objective to increase volume by four patients a day versus 40 a day.

Once you've done your homework, you'll most likely see several opportunities. They usually fall into one of the following three categories. These are relatively broad, but should help you guide the specific tactics that are needed.

• Employees. Most surgery centers think that marketing is an external effort, yet when you look at the research regarding what contributes to positive patient experiences, engaged and motivated employees are at the top of the list. When patients have a positive experience, so do the physicians who brought the patients to the center. In some cases, your strategic advantage will come from hiring and engaging the best people.
• Internal operations. Most physicians support surgery centers for two primary reasons: They're more efficient and their patients have a better experience than in the hospital. Focus on these two areas. Becoming more efficient and creating positive experiences for patients and physicians will not only improve your business, it will ultimately shine a positive light on the physician for recommending your location. There's no question that ownership of facilities is a big attraction, but not for everyone. For many physicians, convenient scheduling, a quality of life issue, is their motivation to bring their cases to a surgery center. Time is often just as important as money for many surgeons. Concentrating on scheduling, for both efficiency and physician preference, will help strengthen your relationship with your physicians.
• New physicians. Target new surgeons who may not yet be affiliated with a center or have yet to establish a preference for their cases. After a while, recruiting physicians to use your facility becomes harder and harder because your market has a limited number of physicians. Once you know all the players, that's it.

Leverage current docs.
After you've addressed these approaches, most centers realize that for growth to continue, it will need to come from current physicians. You're not looking for more surgeons; you're looking to help your current ones get busier. This is an entirely different approach and requires that you and your supporting physician practices research your own markets and competitors.

There are nuances and pitfalls to this approach, especially when competing practices support your surgical center. For example, if you're holding patient education seminars, make sure that they benefit all the physicians, not just one practice or specialty. Look for things that you can do that will help all the surgeons who use your facility, such as post-surgery gifts for all patients, with the name of their surgeons on them.

Do what you say
Successful marketing starts with research and becoming familiar with the needs and wants of your market. Spending time doing this will pay dividends. At the very least, it can help you avoid spending money needlessly. Marketing isn't always an external effort. Some of the best marketing is what you do within your facility and with your employees. As many senior physicians will agree, good marketing is usually more about what you do than what you say.