Use external voice and not internal voice. We do something that's really, really important, and it's more than doing procedures. We're screening for colon cancer. Every patient needs that. So please drop from your vocabulary, screening colonoscopy, and start talking about colorectal cancer screening. It raises the danger level, and patients understand why they need to come in. So we're going to talk about that nasty nine-letter word and talk about some things that are happening during COVID in terms of social media, why it's important, whether or not you have a brand, and also who is your customer. I've been associated with GI practices for well over 20 years, and I can tell you that when I first started, physicians didn't even like to talk about a medical practice as a business, much less talk about a marketing strategy. Traditionally, physicians and others in the industry have felt that if we build it and it's of high enough quality, they will come. There's a certain amount of truth to that, but there's also truth to the fact that, as I mentioned, in terms of internal-external voice, you need to convince people why it's important that they come and why it's important that they come to you. Oftentimes, practices, providers, even staff, confuse advertising with marketing. You know, back in the day, everything was word of mouth. You did things like put your practice location in a place that was mentioned in the physician's lab instead of doing marketing surveys. But today, we're hearing from a lot more mouths than just inside the physician's lounge. So basically, there are studies out there that show that 25% to 75% of patients check online reviews before they ever come to you. We used to think that we had a very solid referral line and that the referring physician would send a patient directly to our practice. What we found is that patients actually look up online reviews, and they may come to your practice, but they may want a specific physician for all kinds of reasons. Many years ago, a patient called in and said they'd been referred, but they wanted to go to that good-looking doctor. And of course, it was a laughingstock of the practice because nobody could figure out who that was. And to some degree, we were somewhat surprised when we did find out who that was. So beauty is definitely in the eyes of the beholder, but it does give you an idea about patients doing more and more homework before they ever come to you. And in terms of online reviews before they ever come, University of Michigan did a study, and even higher for millennials, check online reviews. So it's important. Do you have a website? Do you have photographs of your physicians and stories about the physicians? Most people have that. Do you have the hero stories? You should have on your website the hero stories. When Dr. So-and-so went above and beyond, or when the nurses went above and beyond, that's what people are really looking for. So think about that. Put heroes on your websites. Now one thing that we're seeing more and more is the adoption of smartphone-based technology. I have to say that two years ago, three years ago, when we started talking about integrating smartphone apps into patient flow, there was a lot of hesitation. The thought was that, you know, GI is a service that's basically 50 years and over. And you know how those folks just won't use their smartphone. Well, COVID has really changed all of that. Older generations now are using their smartphones more and more for everything, especially during COVID. Telemedicine, where did that even come from? Five years ago, how many of you guys were doing telemedicine? Nobody was doing telemedicine that I know of in GI, and now everybody's doing telemedicine. That's been a huge shift. And you know, there's a lot of folks that don't think it'll ever go away. You know, when you think about it, why do we see patients face-to-face? There are a lot of times when we see patients face-to-face taking up provider time when we don't really need to. What about a routine medication refill? Dr. Koufalos actually mentioned something about turning that used to be, I think most of us did it, we would turn phone calls into appointments. Well, now we have the opportunity of turning phone calls into telemedicine visits. I don't know, even after COVID, if telemedicine will go away, and especially telemedicine for routine things like medication refills, why wouldn't you implement that? There's so many times when a provider walks into the room and there's really going to be minimal or no medical decision-making during that visit. I mean, you might have a patient that's having a flare, and what you're really there for is to encourage them to get through the flare. Things are going to be okay. The question is, in the entire scope of practice, what are those things, what are those visits that you don't really need to see a patient face-to-face, and can you flip those over to a telemedicine visit? Patient appointment notifications. I think I mentioned, and you've probably figured out by now how much I like my primary care physician's application to where I'm not calling them, I'm doing everything off my phone. I will say I had a primary care physician in Columbus, Ohio, who is a fabulous practitioner, David Charcas. If you're living in Columbus, that's the doc you need, but I never, ever called his office. They have a web-based message system. I never had to call his office. I would send a message, basically an email. I would get, it's a little tighter than an email, a little bit more secure, but I'd get an answer by the afternoon. It was fabulous, and I think what we're seeing through COVID is more rapid adoption and more broad adoption of non-paper. We're looking at text messages. We're looking at apps on our phones. We're looking at web applications to where, are you going to keep your appointment? Do you need to reschedule? What's your contact history? What are your symptoms? Can you update those? Do you really need a human being asking those questions? We used to think that there was great value in talking to someone. The problem is there's not great value in getting through on a phone, getting through a phone system to speak to someone. That's where it breaks down. These text messages, these apps, these web-based applications in terms of marketing, they really make the patient experience so much better. Once again, I think I mentioned this before. When I go to my primary care doc, I get a message, a text message. I click on it, and am I going to keep my appointment? Do I need to reschedule? And then it goes into the COVID questions, and it tells you that when I arrive in the parking lot, click on this link. If that's how you do marketing, if that's your patient experience platform, what's the next logical step? It kind of goes back to what I talked about a moment ago, which is especially millennials, but many patients look at online reviews. On that app, you rate your visit. If you give a poor score, they contact you for a solution. If you give a good score, they ask if you would like to cross-post that to social media, and they actually do it for you. And keep in mind, the problem with social media evaluations of providers is you get people that aren't really a patient. These are 100% verified patients, so why not take that next logical step and facilitate an online review? It's also an opportunity for physician-level satisfaction. One thing we didn't talk about today is patient satisfaction surveys. Basically, everybody does those. They are designed to basically say, was your doctor fabulous or super fabulous? It doesn't really give you a good idea. It's designed to get a high rating. I go in for accreditation surveys. I look at a patient satisfaction survey, and you can tell from the device it's really designed to get above 95% approval rating. Well, that's not the purpose of those. What you're really trying to find are deficits, hopefully at the physician level, that you can go in and fix. This sort of opportunity is fabulous. If you're able to capture that patient, if they had a poor patient experience, find out why. Find out who they saw. Find out the nurses they saw, the text they saw, et cetera, and solve it. This is a great opportunity to increase the number of positive media scores. If you look at most social media, it's an average. What you want to do is increase the positive number of scores, which will rise or raise the others. These are some actual social media sites. It gives you an idea about how limited some of these really are. Remember, a patient typically might look at the number of stars. They may or may not read the rating. Here's health grades. I did all of these for Chicago because that's where this is being presented. Health grades. If you look at health grades in Chicago, the highest rated GI, the first shown on the page has eight ratings. Keep in mind, I did this about two weeks ago. Keep in mind, the best GI doc in Chicago according to health grades only has eight ratings. If you look at Yelp, remember that's not food anymore. That's everything. The highest rating GI in Chicago had 25 reviews. That's not bad. It was the highest rated and at least 25 reviews. Keep in mind, how many patients do you see every year? I'm going to bet it's more than 25, but the highest rated GI according to Yelp in the Chicago area only has 25 ratings. Can you do better? I hope. Vitals.com, best GI, five stars, first shown, three people, three reviews. The next one on the list, five stars, one review. Rate MDs, Chicago, top GI, first shown. They average four stars, 50 reviews. That's pretty good. The next one only had 14 reviews. The third only had five. I hope you see a pattern of this. The fact is you can get very high reviews with very few actual patients. If you're migrating your patients to some sort of non-face-to-face interface, whether it be a text system, whether it be a phone app, or even a web-based, take the next logical step and improve your ratings. It's actually fairly easy to do. Do you have a logo? Do you have a brand? You'd be surprised how many folks don't. If you look back at the Jackson, Mississippi group, one thing they do is logo, logo, logo. They do t-shirts. They do sweatshirts. They actually do races. They do advertising, and it's logo, logo, logo. That's great, but there are some rules about logos and brands. Don't diminish your own logo. Don't use it too much, and don't provide low quality. Also, protect your logo. That's number four. Guard its use. I worked for an organization when I first got out of undergraduate, and they were very proud of their license plates. They had a license plate logo, and everybody that worked for this organization, they encouraged them to put their license plates on their cars until one of the senior leadership drove by a gentleman's club, and it was full of those logoed license plates. The next week, nobody had a logoed license plate. That's a true story. If you're going to have a logo, be careful about how it's used. Be very careful about that, because you can actually be poisoned by your own logo. Also, don't use logo slang. Don't abbreviate your organization. We just did a presentation on accreditation. You know I'm associated with the organization AAAHC. You wouldn't believe how many people call that AAA. Well, AAA actually is an automotive travel organization. It's not an accrediting agency. We're trying to get people to actually say AAAHC, because that's logo slang, and it diminishes it. Also, if you're providing clothing with logos, it's kind of like that license plate. Who wears it, and where do they wear it? Does it show up in discounted clothing shops? What happens with that? So if you have a brand, make sure you protect it. Also, a rising tide does not lift all boats. Lots of folks do colorectal cancer screening advertising, believes that it rises all boats. Well, the problem is, if it's not tied directly to your organization, you're spending money to send patients to your competition, and that doesn't make sense. Also, keep in mind who really makes the referral. Primary care is busy. Oftentimes, what a primary care physician might tell his tech or nurse is, this patient needs a GI referral, and it's actually dependent upon the nurse that will make the referral. That's extremely important, because the job is to move patients through the system in primary care. Care throughput is a direct indicator of profitability. Years ago, I worked for a GI practice that expected the individual from the primary care physician's office to call scheduling and stay on the line until we schedule that patient. We thought we were doing a great job, and I actually went in to see that group, and one of the primary care physicians said, how much of my staff time do I have to take to send you a $2,000 colonoscopy? Let that sink in a minute. How much time are you taking up of the referral physician's office just to schedule your patient? It needs to be quick. It needs to be easy, and you need to distinguish yourself from their staff that are probably making the actual referral, as you give me the patient, I'll take care of everything. That's the last thing you do. You give me the patient, I'll contact them, I'll schedule them, and I'll let you know when we saw them. Make it easy. If you do that, you're going to get more referrals, and also there's a referral hierarchy of needs. I need a GI consult, and that's what we're talking about. I mentioned this just a second ago. We don't know if the referring physician actually says, send it to Dr. Smith, because there is a hierarchy of needs, and the hierarchy is appointment access. I just mentioned that. How much staff time does it take in the referral physician's office just to give you a patient? Brand awareness. Who is the person making the referral? Remember, it may not be the physician, it may be their staff. Do they know who you are? Are you differentiated from the others? Are you the easiest? Sometimes easy takes over being best. Is that practice satisfied with your services? Appointment access, brand awareness, but how do you treat the physician and the practice staff? A free lunch can't overcome ill treatment. Hopefully, every physician in your practice knows your top 20, top 50 referring physicians, so that when they're on call, and one of your best referring physicians calls at 2 a.m., you know who that is, and you say, thank you, because they're giving you a high volume of patients, and you need to treat them like they have a platinum card, because they do. Don't treat all your referring physicians the same. They're not. Some are platinum, some are gold, some are silver, and some are extremely occasional. You should provide services to those folks, especially late at night when they're calling, that are associated with how many patients they give you, because that's how you keep those patients. Feedback to the provider. Telling the provider, I saw your patient, here's what's going on. Also, is there anything missing from this list? If there is, please, we're going to talk about this in a minute. Let me know what I missed. Quality and the problem with differentiation. In a commodity market, quality is assumed, and unfortunately, in many areas, we're in a commodity market, and the question is, how do we differentiate ourselves in terms of quality, and how do you balance access and quality? You have to be careful about something that I call the quality trap, and that is, the referring physician is going to spread things around. They don't necessarily want to take a position, so everybody gets some patients, but you know what? Your group is top quality, so I'm going to send you my worst patients. I'm going to send you my most complex patients, because you're a top quality group, but I'm still going to send patients to these other physicians, too. That's the quality trap. Once you've established your brand, focus on market access and value, value to the referring physician and their staff. Let's talk about some pearls. Marketing is a requirement of survival, and by that, what we're talking about is how you treat referring physicians and their staff, and how they perceive you. Do you have a brand, or do you not? Also, if you're adopting electronic solutions, take that next step to social media. Remember, you can actually end up at the top of the list of some of these by having very few actual reviews. Establish and protect your brand is important, and the key is the key to better marketing. Are your marketing efforts targeted at the right people? Who's your patient? Who's making the referrals, and the endpoint of all marketing is a referral. Do your marketing efforts support the healthcare referral hierarchy of needs? Refer to those. Remember, it's important, and finally, we're no longer in a quality environment where if you build it, they will come. You have to build it. You have to have high quality. You have to have ease of access, and you have to treat your referring physicians and their staff like they matter because they do. Thank you.

colorectal cancer screening

marketing strategies

online reviews

telemedicine

logo and brand

referring physicians