Orrin I. Franko, MD – East Bay Hand Medical Center in San Leandro, CA

Presented at the American Society for Surgery of the Hand (ASSH) 2019 Conference in Las Vegas, NV


  • Online reviews are important for attracting new patients to a hand surgery practice
  • The monetary value of different referral sources is unknown
  • This study determines the value of Internet-referred patients compared to other traditional referral sources for building and growing a hand surgery practice


  • Two years of billing data were analyzed
  • Data was cross-referenced with referral sources
  • Calculations were made for
    • average percent collection
    • dollars per visit
    • dollars per patient
  • Internet-referred patients are those who made appointments after reading online reviews


  • 5,071 patients’ data were analyzed
  • Average collections/visit was $202
  • Average collections/hour was $626
  • Average total collections/patient was $692
  • The most valuable referral sources were:
  • Surgeons > Workers Compensation > Former Patients
  • value of internet-referred patients was below average at $541/hour and $442/patient
  • Internet-referred patients were mostly PPO insurance (75%) despite the overall practice mix at 29% PPO insurance

Summary Points

  • Different referral sources have varying amounts of revenue per patient or per time
  • Internet-referred patients represent a higher % of PPO payors, but below average $/visit, $/minute, and total $ collected
  • Enthusiasm for pursuing online marketing referrals may depend on a surgeon’s practice mix and availability

Online Marketing ASSH 2019.pdf