Private or small group healthcare practices report different experiences compared with larger group practices or healthcare corporations on two key issues facing all practices. The most recent Star Life Sciences Medical Monitor™ found that, when it comes to attitudes about electronic health records (EHRs) and pharma sales rep details, practice size can make a huge difference.

Practice Size and EHR Adoption

The first finding we’ll discuss from the Medical MonitorTM study is how practice size impacts decision-making and opinions among physicians in adoption and perception of EHRs. Our study found that the bigger the practice, the more value respondents place on EHRs:

Importance of Electronic Health Records (EHRs) for Doctors of Practices of Different Sizes
Larger practices assign greater value to Electronic Health Records(EHRs)

While only about half of solo and private small group practices find EHRs to be important, 70% of large practices and 100% of corporations rate them “very important” or “important”.

Fifty-four percent of all physicians’ offices in the Medical Monitor™ study had switched to EHRs, but just 29% of solo practices had made the switch. For those that made the switch – across all practice sizes – the perception of EHRs became increasingly positive in direct correlation to the degree of integration of EHRs within the practice:

Electronic Health Records (EHR) Opinions Change During Implementation
As electronic health records (EHRs) become more integrated into a practice, physicians’ opinions of them improve.

So, while we tend to associate “small” with “nimble,” it seems that the opposite is the case among medical practices with regard to EHRs—the bigger the practice, the more willing they are to adopt EHRs and to see the benefits of adoption.

Medicare and Medicaid Incentives for EHRs

It is worth mentioning here that EHRs are not just a means to record patient information. The EHR Incentive Program for Medicaid and Medicare reimburses healthcare professionals that are eligible “as they adopt, implement, upgrade or demonstrate meaningful use of certified EHR technology.” ( The program asks providers to use EHR capabilities that go beyond simple record keeping to achieve benchmarks that can lead to improved patient care.

Smaller practices may resist integration of EHRs because of the initial financial costs (software, training, etc.) associated with EHRs. In addition, many physicians in small practices view themselves as offering more personalized patient care, and may be concerned that incorporating EHRs and other technology solutions will dehumanize their practice.

Larger practices and corporations also value patient care, but may have a more bottom-line focus. The direct economic incentives of these benchmarks, and efficiencies realized across the board via EHRs, are likely to push them toward investing in and integrating EHR systems.

Pharmaceutical Sales Reps Have a Role for All Practice Sizes

Although pharmaceutical companies continue to decrease the size of sales forces, our study indicates that sales representatives still play a vital role. This is especially true for smaller practices, and another way in which these practices have indicated a preference for a more personal touch in the Medical Monitor™ study.

Importance of Interaction with Pharmaceutical Sales Reps for Practices based on size
Pharma sales reps retain importance across all practice sizes, but personal contact with a rep is most important to smaller practices.

Smaller practices place a higher value on sales rep visits compared with larger practices. It seems likely that more restrictive policies on rep access within larger practices and institutions plays a role in this perception. It is simply easier for reps to create a meaningful relationship with smaller practices; small-practice physicians see value in that relationship, which is reflected in the data.

Get the Most Value from Your Physician Relationships

Our Medical Monitor™ data support the thesis that smaller practices tend to value face-to-face communication more than larger ones. This is clear in the case of sales rep visits, but somewhat less so in the EHR data. When we dug a little deeper, we found that a key reason cited for resistance to EHR adoption among smaller practices was the fear that EHRs would lessen the personal aspect of their patient relationship. Since a more personal relationship with patients is seen as a major benefit of care for those working in smaller practices, anything that appears to diminish that relationship, it seems, will be viewed negatively. Awareness of the role that practice size plays in decision making can help you allocate resources—especially sales reps—more effectively.

Changing Provider Perceptions

The bottom line is that marketers can help shape the perception of large and small providers on EHRs or any other healthcare topic of the day, but they can’t rely on a blanket approach. Based on the data from the Medical MonitorTM study, marketers must train their sales team and provide them with tools that will allow them to approach each provider differently – but more effectively. They must also make sure they allocate their reps appropriately, since reps offer more value to smaller practices. Remember, the approach to physician communications must fit the size of the practice and the practice needs.

By Joshua Spiegel, Associate VP, Search

About Joshua Spiegel

Joshua Spiegel has over 10 years of digital marketing experience, focusing on mainly search and content optimization for the last 7 years. He has worked with top pharmaceutical clients such as Johnson & Johnson, Teva Respiratory and Women’s Health, Aetna, and others to optimize their web properties and online campaigns.

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