When a doctor, a lawyer, an accountant or any other professional graduated from university, or moved to a new town, he or she would most often locate a nice little office, prepare it for the big day and hang out a shingle to let the world know that new services are available. The world back then consisted of the immediate neighborhood in the big city or an entire small town out in the country.  While waiting for the new shingle to do its thing, the new doctor would most likely join the country club, attend the pee-wee league games of his/her children, patronize local eating establishments and slowly the word of mouth would help build a new practice that would become a fixture in the community for years to come.

Fast forward to 2013 when nobody strolls leisurely where shingles are not hanging any more, and doctors rarely live and raise families within walking distance of their medical practice. Word of mouth has been largely replaced by text of iPhone and the enameled dangling shingles are now flashing electronic signs in the clouds. Heck even doctor services are increasingly delivered electronically from somewhere in the clouds. So when you push open the door to the coffee shop in the morning, chances are that nobody is going to ask you about their gout and nobody is going to say “morning doc,” and neither you nor they will give a damn anyway. So if you are, or aim to be, practicing independently, you will need to upgrade your shingle for the electronic times.

Shingle = website

First and foremost you need to hang your shingle where it can be seen by prospective clients. If you have an established practice with a waiting list from here to Armageddon, you can safely close your browser now, and go take care of your patients, at least for the next couple of years. If you are not exactly in this enviable position, read on.

You need a shingle on the web, a website. A Google Maps generic listing doesn’t count. A canned webpage with your name, address and hours of operations won’t do either, because the rules have changed. For the skeptical, harried and alienated modern person, your website should provide the same reassurance that a simple white rectangle with the word “doctor” on it provided 50 years ago. You need a nice website with a minimum of four or five pages to keep people looking at your shingle a bit longer. As to content, look around for other doctors’ websites, see which ones you like better, and model yours in a similar fashion.

A good place to look for structure is hotel websites. Yes, hotels. Hoteliers are trying to convey to customers that they are each very important and special, that they will be safe and comfortable, that the premises are clean and upscale, that staff is dedicated and highly professional, that booking is easy and extra amenities are abundant. If you have a sudden urge to throw up just about now, hire a kid to do this for you. A professional “medical websites” firm is not necessarily better and it will cost you ten times as much.

Location = search engine optimization (SEO)

It is pointless to hang your shingle on highway H between endless fields of corn and soybeans (although I know at least one such practice that is thriving). Equally useless would be to hang a shingle from a 5th floor window, or by the back door, next to the big trash containers. Unlike physical shingles, electronic websites can be made to appear just where they are most visible to people most likely to need your services.

Today, the equivalent of strolling down Main Street is searching for stuff on the Internet. Having your nice and readable shingle appear in just the right place, at the right time, for the right people, is called search engine optimization (SEO) in the Internet age. Frankly, it is a boring subject, even more so than designing your website, but if you want to read about it, here is a beginner’s guide.

You should peruse these references even if you let one of your kids build the website (kids know all about these things), and even more so if you plan to shell out a few thousand dollars for a professional. Your goal, in a nutshell, is that when someone in your service area is searching for a doctor of your specialty, or a condition that you treat (much more tricky), your website will be the first entry on the first page of Google results. It will take time to get there, but you will never get there if you don’t start. And, yes, this is about marketing, and yes, doctors today are supposed to actively market their practice, just like everybody else. Feel free to pour yourself a drink before reading on.

Word of mouth = rating sites

The means by which messages get from one individual to another have obviously changed. Actual “word of mouth” is still a useful communication channel for finding professional services, but most people looking for a doctor will ask Google first, and then proceed to review unsolicited recommendations from perfect strangers. The entire notion of new information being diffused through social networks has been turned on its head, unless you count planet Earth as one social network. You could argue that your practice is local and planet Earth is irrelevant. You could argue that your patients are older, sicker and that they don’t use computers. You could argue that only dumb people would trust anonymous advice on some random website.

However, your small universe is now indistinguishable from the whole, and perhaps the patients you have now don’t use computers, but those who influence their decisions most certainly do, and besides we are talking about attracting new patients. As to rating sites, think about your most recent important purchase, and honestly try to remember how much weight you placed on the little yellow stars at Amazon, or their low tech predecessor at Consumer Reports. Not how accurate these turned out to be, but how much they influenced your purchase. Since you are not selling gadgets to the entire world, how can you make those little yellow stars (all 5 of them) appear next to your name? If you search randomly for physicians, you will see that the ones with star ratings have between one and a handful of reviews. This in itself is reason to discard the information as statistically insignificant, but yellow stars are a very powerful visual cue. Let’s get the ball rolling then.

Do you have at least one friend/employee that is/was your patient at least once or twice? Is one of your patients a physician also looking for stars? Did you call in a script for Uncle Joe last Christmas? Find your comfort zone and get yourself one 5 star rating. Since there are many places people can rate doctors, pick the one where you have some ratings and link it to your website (e.g. “Dr. Jones on Healthgrades”), so people can easily find your ratings and continue to grow them.

Some would go as far as suggesting that you should personally solicit that patients recommend you on the Internet. What you should do though, is have social media buttons on your website (e.g. like us on Facebook, recommend us on G+). All people have to do is click a button, which most of us are willing to do, and there is no option to “hate us on Facebook,” so risk is minimal. Yes, it sounds humiliating, rather shallow in nature and a mega waste of your time. It is all of the above, except it shouldn’t take any of your time to get with the times (so to speak).

For completeness sake, we should mention another type of rating site that may be crucial to building a practice and obtaining referrals. Health plans are increasingly publishing “preferred provider” lists, or add some special designation to the preferred ones on their network listings. These preferences are based on much more complicated and time consuming activities (e.g. MU, P4P, PCMH), and we will address them in a future post. For now be aware that payers “recommendations” are coming and that this is not your grandfather’s word of mouth.

Community = social media

We cannot complete the electronic shingle discussion without addressing the new community concept, whether community at large such as Twitter, Facebook and blogging, or specific communities and forums for folks with a particular health concern. If you are reading this, then you are pretty familiar with social media, so we will dispense with preaching to the choir. Besides, if your practice is in trouble, there are better ways to spend your time and energy in the short term. Go back to the top and start with that electronic shingle, which is a prerequisite to anything you will ever do in cyberspace. If you are sitting idle waiting for patients to show up, you may want to consider adding a blog section to your website, but don’t even think about venting your frustrations there. If there’s anything left in the bottle, pour yourself another drink, or maybe switch to coffee, and write a short essay with the customary cliché advice on how to eat right and exercise. Your cyberpatients will love you for it.

Margalit Gur-Arie is founder, BizMed. She blogs at On Healthcare Technology.