Genius. Brilliant.

Doximity just announced they passed the 50% physician registration mark. I saw this coming a few months ago when they announced their partnership with US News for their “prestigious” hospital ranking list, and when Doximity started to create “Top Residency” lists.

And they did this without actually targeting physicians.

A decent number of investors and consultants periodically ask me off the cuff about which companies are “moving up” or doing interesting things. For the last few months the company I have told everyone to look out for is Doximity.

How they achieved over 400,000 physician registrations has been brilliant on so many different levels. How they did it should go down as case reports for MBA students. It’s the stuff of legends.

More physician registrations equals a bigger valuation for Doximity for when they sell their physician data (the company as a whole). But it’s hard to register physicains — especially to register “verified” physicians. You have to get physicians to “verify” by sending in their license or other identifiers — way too much work for myself and my physician colleagues. So Doximity pulled the shrewdest move I have seen in the physician technology space in the past few years.

They cut the physicians out of it.

Instead, they went to physician employers. They partnered with U.S. News, who produces a “best hospitals” ranking every year. A portion of the ranking is based on physician voting, and Doximity told me U.S. News would traditionally mail out surveys to physicians without getting good return rates. Doximity provided a nice avenue to do electronic voting by using “Verified” physicians.

But why would physicians want to vote in U.S. News’s best hospital rankings? We don’t. We all know the U.S. News ranking of hospitals is frought with confounding issues, and none of us (physicians) actually take it seriously. But Hospitals DO take it seriously. It’s a big deal to them, they like to plaster it on billboards and tell their patient’s how awesome they are. More importantly, they like to tell prospective patient’s how awesome they are. You can understand how that’s important to administrators as hospitals continue to struggle in new economic models that are constantly shifting and being redrawn. So instead of having to ask physicians to register, Doximity got the employeers and administrators to push Physician registration FOR them.

Brilliant.

I confirmed this from colleagues at hospitals as prestigious as Johns Hopkins to Northwestern. Also, we received emails about this from various academic hospitals from disgruntled professors and faculty. There were active Doxomity physician registration drives to help boost US News Hospital rankings.

Physicians at various hospital systems across the country were getting weekly to daily emails reminding them to register on Doximity so they could “vote their hospital up”.  Doximity representatives even came to hospitals to help with registration drives.

Again, administrators seriously care about this — I actually do empathize with them on this. More potential patients usually means more revenue, and hospitals have to make economic sense or they shut down.

But this was just phase one.

Phase two consisted of “Residency rankings”. No one has done a good job of providing a ranking list for residency’s because it’s hard to do. Unlike medical schools where you can look at the research dollars pouring in, residency doesn’t work the same way. Plus, the ranking list for medical schools itself is laughable, not news that comes as a surprise to any praticing physician.

So Doximity decided to create a ranking list based on the number of people who registered on Doximity and voted for their residency. Their ranking list is basically a popularity contest to see how many people vote for various residencies. I’ve been assured from Doximity that this will change in the future, and they will take different metrics in the future.

So if you’re the program director of a residency, and you caught wind that there is a “ranking list”, you want to win right? It’s the same concept as the US News ranking list. Everyone knows the ranking list doesn’t matter, but program directors across the country want love for their residency. So again, from residency programs from the east coast to the west coast, large “physician registration drives” were initiated so that the voting for your residency program could happen.

The Council of Emergency Medicine Residency Directors internally discussed this and is against the ranking system and doesn’t think it should be utilized in its current form, but no one really cares. Plenty of program directors at various Emergency Medicine residency’s have done their own personal voting drives.

Similar to the US News method, physicians have been registering in droves so that their residency will move up the “rankings”.

The common thread to both methods is the majority of physicians who are registering under these drives don’t really care to utilize the resources Doximity provides, rather, they are pleasing administrators and hospital systems.

I’ve had plenty of people e-mail or ask iMedicalApps how to unregister from Doximity once voting is complete. Most of the people who registered for these drives are not going to be engaged physicians for Doximity. But Doximity is truly after the number of physician registrations — that is where much of their valuation will come from when they sell the company and all the information they have collected. Whoever buys the company, such as LinkedIn or some private group, they will be doing so to exploit the physician information contained in the registration.

Whoever realized that you should forget targeting physicians to get physician registrations, and instead use administrators and voting techniques — should be considered the most valuable employee of Doximity.

Seriously. I would wager this strategic plan made the company two to three times more valuable for when they decide to sell the company and their physician data.

I say all of this with a great respect for what Doximity did. It doesn’t matter that physicians know that U.S. News Reports Hospital rankings are not really that useful, or that in its current iteration the “Residency Ranking” list is a popularity contest (I have hope they will improve it to actually make it more useful) — what matters is recognizing when a company pulls off a brilliant play in the mobile and physician world.

I cannot say enough things about the brilliant strategic moves Doximity has made in the physician world — their investors should feel very proud. Further, it should be a lesson to other companies on how you don’t actually need to target your perceived target demographic — target their need for validation and recognition in the public eye.

And for all the physicians who have e-mailed us saying how they don’t think it’s appropriate that academic centers who ban pharmaceutical companies should also be promoting these types of backdoor registration tactics, my answer is the following — meh, Ivory Towers don’t exist anymore.

Maybe pharma should start sponsoring “best hospital rankings”? (Just kidding?)