Field Marketing Command
Everything about the field role in one place — the plan, the four-week assessment, the questions waiting on you, and the ammunition the call center works from.
The finding, stated plainly
She is a strong operator pointed in a direction she chose herself. Volume is not the problem — 12 stops in a single day is a real pace. Across two weeks, cold-PCP anchor completions = zero, and that is precisely the standard the PIP measures. Warm, known ground gets worked well; cold ground doesn't get worked at all.
Corrected economics put her book at roughly break-even (~$134K over 2 years vs a ~$71.5K salary ≈ 94%), not the ~2× the retired 32.5% arbitration basis implied. So the Sep-28 question is no longer "is the book valuable" — it's "will the assigned cold work get done."
Week 1 — Aug 3–7
36 stops assigned.
| Outcome | Count | Detail |
|---|---|---|
| Visited | 11 (31%) | Stefanides, Polaris ×2 (off-plan), CCC lunch, Prestige NoMad, Spear UES, NYPT |
| Contact only | 8 (22%) | Phone/text/email, most with a documented reason |
| Deferred | 6 (17%) | Big Apple (Tue/Thu only — our routing error), Soma (they set 8/12), Webber |
| Not done, not addressed | 11 (31%) | The entire Friday Plainview corridor — Desai transition, Central Ortho, and all four cold-PCP anchors |
Reporting compliance
| Required | Status | Note |
|---|---|---|
| Friday 8/7 weekly report | Late | Delivered Monday 8/10, 11:41 AM |
| Injury Sync — 10 names w/ status | Missing | Required in the 8/7 report |
| The four dashboard numbers | Missing | No PCP capture rate, MA calls, intros, or conversions |
| Desai transition conversation | Not done | Highest-value stop of the week; moved to "next week" |
| Four cold-PCP anchor log entries | Not done | Sacred Heart deferred; Northwell/Optum/PMA unmentioned |
| Provenance on each new contact | Partial | Done narratively, not in the required format |
Week 2 — Monday Aug 10
0 of 9 assigned Merrick-corridor stops. She worked 12 Manhattan primary-care stops instead — 5 on a target list, 4 in no file at all.
Skipped: Central Ortho/Seidman (dark since March), Express Medical Care (Patrick's intro), Suris & Associates, Mount Sinai Bellmore, PRINE Bellmore, Sisselman, Dr. Morrison (CRPS Tier S, inside Total Ortho), Total Orthopedics, Cohen & Jaffe — the second consecutive miss for Cohen & Jaffe.
Knock-on: two Week-2 stops depended on visits that never happened — PRINE Hicksville referenced the Bellmore visit; Block needed the Central Ortho letter delivered first.
What she did genuinely well — don't lose this in the PIP
- Material intel: Stefanides sends referrals by text, directly — a live attribution leak that may be crediting his referrals to nobody. He also wants reciprocity ("we do not send patients to him").
- MOTION lost its NYC marketer (Elise). That likely explains the entire cooling of that account — not a Sara failure.
- Prestige: all four founders are on-site Thursdays at NoMad. Actionable routing intel.
- Big Apple is Tue/Thu only — she was assigned Wednesday. Our error, and she caught it.
- Escalates decisions properly — five numbered questions on 8/3.
- Documents absence reasons (Bahlani out, Gohal on vacation two weeks, Soma rescheduled).
Fairness column — what belongs to management
- Four of her five escalated questions sat unanswered. Two are yours. A PIP where management left blockers hanging is contestable.
- A standing instruction from you ("don't interact with…") conflicts with stops on her own route — either correct the instruction or remove the stops.
- Big Apple was assigned on a day the office is closed.
- Two Week-2 stops were sequenced behind visits that hadn't happened yet.
Open questions Sara raised
These came out of her 8/3 and weekly emails and are still unanswered in the record. Type an answer to log it — saved in this browser; Export from the Hub to hand off.
Three things before Sep 28, so the review is clean
- Answer her open items — especially Stefanides reciprocity and the Hausknecht introduction. Both are yours, and leaving them open weakens the PIP.
- Deb reconciles Stefanides' texted referrals against attribution data. His texts prove referrals that may be credited to nobody. This is a live instance of the intake-attribution gap — and it could move her ledger in her favor.
- Make Week 3 binary. Pass/fail, no substitutions counted.
Week 3 — the binary test
One clean data point on exactly the PIP standard. Nothing else counts toward it.
| Required | Why this one |
|---|---|
| Northwell Health IM — Plainview | Cold PCP anchor, skipped Wk1 |
| Sacred Heart Primary Care | Cold PCP anchor, deferred Wk1 |
| Optum Primary Care — Plainview | Cold PCP anchor, skipped Wk1 |
| Primary Medical Associates of LI | Cold PCP anchor, skipped Wk1 |
| NY Spine Institute — Desai transition | Named succession item; he relocates. Highest-value stop, skipped twice |
| Friday report, on time, all four dashboard numbers | PCP capture rate · MA/call-center calls · intros · conversions |
⚠ A doctrine conflict you should settle
The marketing doctrine on file says "call work is MA-facing — Faith has no capacity" (corrected 8/2). You've now routed call-center verification to kkrauss, akrauss, and Faith. Either the capacity finding changed, or Faith is about to be over-committed again. Worth one line to resolve before the hit list goes out.
Standing division of labor (unchanged)
Call center verifies → books → Sara visits. Phone-first for cold leads; walk-in only after two failed call attempts. Sara never mines data — the office builds the ammunition. Anchors get a full log entry (who met, what was asked, what was committed, next step with a date); drop-ins get one line and never count toward the anchor number.
Targeting doctrine
- Dollar-weight, never volume-rank. Score = diagnosis count × collected-per-patient × zone factor, competitors excluded.
- Two tracks, measured differently. Track A (spondylosis / sciatica / Medicare panels / attorney-facet) pays now, measured in referrals. Track B (CRPS) builds an $11–12K/patient line, measured in patients acquired. Mixing the metrics is how CRPS stayed at 3 patients for three years.
- Stratify physicians from therapy providers — different coding behavior, different role. PT/chiro/OT inflate ~20× because they re-code at every visit.
- Warm overlays promote, they don't score. Lists without diagnosis codes ride on top and raise priority; never scored, never dropped for lack of a claims match.
- Bench promotion: a dead row is replaced by the next-highest-scored name in the same zone; the scored bench reissues monthly.
The PCP pitch — language that works
"Send us your chronic axial back pain over 55, plus opioid inheritance with a full compliance workup — and you get a note back within 48 hours."
Never say "send us spondylosis." PCPs bill essentially zero M47 — they code symptoms; the facet diagnosis gets named downstream at our fluoro suite. Search their symptom codes, pitch in symptom language.
Point-of-care PCP capture
Every patient is asked their PCP and whether we may send a note — roughly 150–200 data points a month at current volume. The consult-note offer is the conversion mechanic: it turns a referral relationship from a favor into a workflow. Treatment-purpose disclosure, verified secure channel only, logged in Athena, no patient names in any tracking file.
Sharing tiers already exercised
Sara's package contains no PIP mechanics, no attribution history, no ledger. Deb's package mirrors Sara's exactly so what-Sara-has is always known. Held back from both: Goldberg history, the Total Ortho building physicians as a deal fact, the Sherrie Glasser question, and the attribution ledger rulings.
The hit list — rebuilt 2026-08-17
Regenerated from the Definitive claims pulls (51 files, 32,870 rows, 13,387 unique providers) because the original scored output was never saved — the corpus recorded it as "scoring intermediates GONE but regenerable from the zips."
Full spreadsheet with all 200 + call-outcome columns: 40_DATA/Maywell_Referral_HitList_2026-08-17.xlsx. Top rows shown here for review.
Track A — dollar-weighted (top 40 of 200 shown)
Track B — CRPS pipeline (volume-ranked, deliberately NOT dollar-scored)
Maywell has only 3 CRPS patients in billing — a sample-size artifact, not CRPS economics. Ranked by CRPS/causalgia diagnosis volume so the strategic pathway isn't buried by its own small n.
Collected-per-patient by diagnosis pathway
The middle term of the score, computed from your billing data (Patient Master: Primary ICD-10 × Paid $, 2,929 patients, 898 mapped to a pulled pathway).
This is the whole argument for dollar-weighting. Radiculopathy has by far the most patients (620) but pays about half what spondylosis pays per patient. A volume rank would put radiculopathy referrers on top; the dollar weight correctly puts spondylosis referrers there.
Held out of scoring — verify before spending a visit
| Category | Count | Why |
|---|---|---|
| Competitor specialties | 1,029 | Pain mgmt / interventional pain / anesthesia / PM&R / CRNA |
| Competitor zips | 233 | 11372 / 11373 |
| Therapy + midlevels | 3,964 | ~20× coding inflation — separate track, never ranked against physicians |
| "Other" / blank specialty | 292 | Doctrine warned a probable HSS competitor hid here — Daniel Richman is in fact in this bucket at 10021. The filter caught him. |
| Radiology / ED / hospitalist | 1,792 | High diagnosis volume, but not referral originators for us |
Zone factor
True distance from each provider's ZIP to the nearest Maywell site (Plainview 11803 · Manhattan 10016 · Astoria 11102), geocoded, then banded: ≤3 mi ×1.00 · ≤7 ×0.85 · ≤12 ×0.65 · ≤20 ×0.45 · ≤35 ×0.25 · beyond ×0.15. Unknown ZIP ×0.30 — penalized, never dropped.
Method notes & honest limits
- Deduped on normalized name + address before summing — the corpus warns rows are diagnosis-counts per provider per pull, so naive summing multi-counts.
- Where a provider appears under several anchor ZIPs for the same diagnosis, the maximum count is kept, not the sum.
- Three source files carry no diagnosis-volume column (osteo_M80, Podiatry_all, DM neuropathy e10.40) — excluded and stated, not silently dropped.
- Only 31% of patients map to a pulled pathway; the rest have primary diagnoses outside the Definitive pull set. Per-patient values are computed on the mapped subset.
- Sciatica (n=1) and Disc disorder (n=9) are thin — treat those per-patient figures as indicative only.