Read all about it: How to publish for your practice

A couple of times a year, Arthur Frank, MD, and his staff engage in some do-it-yourself journalism. The Washington internist's employees divvy up freshly-printed copies of Weight Management News, using time between patients to affix mailing labels generated from lists of current and former patients and people who've inquired about treatment. Employees then stick on stamps, pile the newsletters in boxes and drive them to the post office, which mails them to 6,000 recipients.

The stories in each edition, all written by Dr. Frank and colleagues, might not always be of interest to the mass media. Big stories in past editions have included, "A restaurant outing need not be a dining disaster," and "Whole grains: Why do we ignore this nutritional treasure?"

But Dr. Frank contends that the newsletter, published for more than a decade, is valued for just that reason: It targets overweight patients directly, providing practical information they might not find elsewhere. Like all good editors, he says he tries to stress objectivity. He doesn't shy away from what he views as controversies, such as comparing the Atkins and Dean Ornish diets, or exploring the pros and cons of bariatric surgery.

Practice newsletters can benefit you as a doctor, too. There is an altruistic reason to publish them, such as keeping patients updated on wellness issues and new treatments. But newsletters also can help build patient loyalty and goodwill, and increase referrals if patients pass them on to friends and family.

A good newsletter takes time and effort, and might be an expensive undertaking. But experts say a well-written and attractive newsletter is bound to enhance a doctor's relationships with patients and quite possibly the bottom line.

"It has to be viewed as an investment, as bringing in more business than [what you] are spending," says Ed Gorin, an editor in Miami who collaborates on physician newsletters. "You're not doing this just to inform people, but to get more business. Use every inch toward that goal."

Many newsletters are produced by specialists in competitive markets in an attempt to pique interest in cash-only services. But Gorin says a newsletter also can help family physicians and internists maintain low-key, friendly contact with patients between appointments. And loyalty is key to any practice in an age when many patients choose doctors based on ever-shifting managed care networks.

"It's a way to keep in touch without being intrusive, just reminding the patient you're there," Gorin says. "The most important message of any newsletter is, 'Word of mouth is our most important commodity. If you're happy with our care, please tell your friends.' Certainly that's true for any business, including a primary care physician."

Here's some advice from consultants, writers and doctors with experience publishing patient newsletters.

Delegate what needs to be done

It's the rare doctor who's proficient at desktop publishing or graphic design, or who has any extra time for those tasks. Starting a patient newsletter from scratch might seem overwhelming unless you find members of your staff with skills they can devote to the project, or unless you can find funds to hire a professional who specializes in newsletters, experts say.

Don't be tempted to produce something you won't be proud of. It's possible to hunt-and-peck your way through a one-page mimeographed or photocopied newsletter, but consultants say patients won't be impressed.

"The investment of the time and expense goes a long way," says Dean Draznin, a public relations consultant in Fairfield, Iowa. "If they're going to do it on the cheap, it's going to look cheap, and I don't encourage that. Things should look beautiful when sent out from an office, or else just don't do it."

To save money, look first at your own employees for expertise you may not know exists. Mike Batchelor, the marketing coordinator on staff at The Plastic Surgery Group, a six-doctor practice in Cincinnati, began using a desktop computer to design and lay out Rediscover last fall. Batchelor's skills were acquired in his college days, when campus groups would hire him to use graphics software to create T-shirt designs for parties.

The current newsletter has developed into a glossy, four-color publication that focuses on ancillary services such as hair removal and spider vein injections. It is mailed to about 1,500 current and former patients. About 2,000 additional copies are kept in the office for patients to read or take.

Often doctors will need to turn to outside professionals to help with newsletters. These could include a freelance writer or editor to assist with content; a designer/typesetter for layout; and one or more contractors to fold, collate, staple, seal and mail it. To simplify things, it's best to find a professional to oversee the project -- preferably someone recommended by other doctors -- and then trust that person to identify subcontractors, Gorin says.

The cost of a newsletter will depend on how much outside expertise is used. Other factors include the quality of paper and the number of colors of ink, the number of pages, the frequency of appearance and the number of copies.

Jeffrey Rawnsley MD, a facial plastic reconstructive surgeon in Los Angeles, this summer will debut a quarterly patient newsletter to be sent to 5,000 patients and doctors, an undertaking he predicts will cost about $5,000 per issue. Though it's costly, Dr. Rawnsley is hoping the newsletter will pay for itself by boosting demand for elective procedures. "I recognize the value of being able to market directly to patients -- telling them about what it is I do and keeping my name in front of them."

Write it yourself -- with help

Doctors can buy virtually endless professionally written content, and many companies will "customize" publications by adding a practice's logo and address to canned health stories. But experts say a newsletter best creates ties to patients when it's unique and reaches out to them personally. The way to achieve that is to write most of the articles yourself. This may not be easy: The content should be concise, simple to navigate, and as digestible for patients as stories in your hometown newspaper.

"You really have to take off your medical hat if you're writing for the public, even a sophisticated public," Dr. Frank says. "You don't write like you're writing an article for the Annals of Internal Medicine."

Writing for the average person is not hard for Dr. Frank because he formerly wrote a health column for Mademoiselle magazine, authored a consumer's guide to medical care and contributes columns to various consumer media.

If you struggle with the task, a professional writer can be a key part of the newsletter team. The ideal person would be someone with a medical background who understands scientific terms and can translate them into everyday English, Gorin says. The writer should begin by discussing story ideas with you and other doctors in the practice in detail, preferably in person at first and later by telephone or e-mail, he says.

It's important that a writer submit drafts of all stories well ahead of publication for you to review, correct and comment on. If there's time, seek others' opinions on how well the newsletter reads. One option: Make it a family affair. Cardiovascular Medicine Associates, a specialty group in Miami, retains Gorin to write its newsletter articles in conjunction with its doctors, but then turns the issue over to the physicians' spouses to gauge its readability before it's printed, says Yale Samole, MD, managing director of the physician group.

Determine the audience

A critical step of planning a newsletter is deciding who will receive it and how it will be distributed. The simplest approach is to use your database of current and past patients. But some practices might choose to be extra careful to ensure their newsletters are desired.

"We don't send anything out to anyone who doesn't want anything," says Batchelor, whose practice mails the publication only to those who have signed an opt-in sheet. "A lot of patients just want to protect their privacy. They don't even want their mailman to know they've had plastic surgery or are interested in plastic surgery."

Another common method is to provide an opt-out list in the reception area for any patients who would rather not get the newsletter, or to add a note in the publication itself telling patients they can call, write or e-mail the practice if they no longer wish to receive it.

Doctors or an office manager might want to scan the patient database as well, Draznin says. A newsletter with an aggressive marketing style, for instance, might not be right for a patient who is seriously ill. "That sort of sensitivity is important."

Newsletters also can be mailed to colleagues, business associates, vendors, drug company representatives and the media. A practice also can do mass mailings to entire communities, such as all households in a ZIP code, although naturally the production and mailing costs would rise.

Whether a newsletter is sent to patients or a wide audience, experts say, physicians shouldn't have grandiose expectations about what they can accomplish in the short term. Newsletters are a labor of faith. The effects will be gradual and cumulative, and in many cases doctors won't be aware it was the newsletter that led to a new patient or increased demand for a procedure.

"Don't view newsletters as advertising that can generate immediate calls," Deutsch says. "It's more of a practice-building tool to generate awareness, and over time to get the phone to ring."