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Further  thoughts  on  marketing NEMC nephrology: 1. I agree
that internists rather than nephrologists should be  market-
ing targets.  2. Patients commonly make decisions on the ba-
sis of conversations with physicians other  than  their  in-
ternists,  on  the  basis of conversations with their family
and friends. Consequently NEMC nephrology should  aim  at  a
high  profile  in  the medical profession at large and among
the general public, to the extent this is feasible.  3. In a
saturated  market,  one succeeds my differentiating oneself.
This is the principle of brand names versus  generics.   You
must  differentiate  yourself.  4. Differentiation may be in
appearance only, as in the case of proprietary drugs;  but I
consider  such  differentiatrion  basically fraudulent. Much
better to be _really_ different, within externally  and  in-
ternally acceptable social limits.  5. Deliberately fashion-
ing a nephrology service characterized by  a  (very)  strong
doctor patient relationship will will not be easy and uncom-
plicated, but it seems to me well worth your while, even  if
(not  all  of)  your  colleagues  are  willing or able to go
along: because with this type of differentiation you can  go
it  alone,  if  (some of) your colleagues cannot or will not
become real physicians.  I have known  a  number  of  Boston
clinicians whose charisma stood out among their non-descript
colleagues, James Howard  Means,  Conrad  Wesselhoeft,  Paul
Dudley  White, come to mind. I remember Gerhard Gabriel, the
Frankfurt-Abingdon radiologist who made rounds on his  radi-
ology  patients  in  their hospital rooms with great profes-
sional success.  6.  You  can  raise  the  profile  of  NEMC
nephrology  by the dissemination of truthful and candid dis-
cussions of political, economic, social, technical scientif-
ic  issues  entailed  in nephrology. Perhaps only a few will
understand what you have to  say,  but  _all_  will  be  im-
pressed,  and  will  keep  you in mind, especially those who
don't understand, or who understand only that you understand
and care.

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Copyright 2005, Ernst Jochen Meyer
