Practice Building

Maddox Casey

A generation ago, every city had a daily newspaper. Everybody watched network TV. Every home was hard wired with a phone and had a copy of the yellow pages.

Now people can find out about anything immediately with a quick Google search on their smart phone. They are more likely to use their screen time streaming video, watching YouTube, playing games or web surfing.

How people get information has changed, and their expectations have changed as well. If they can't get an appointment soon enough or at a convenient time; if they take off work to make their appointment, and then spend an hour waiting to see the doctor; if the parking lot is always full; if an insurance clerk is rude or a lab tech is rough; or if their bill comes with surprises--today's patients are much faster than their parents to pick up their smart phone and look for a health care solution that's a better fit for their lifestyle.

So, in today's world, how do you build and expand a practice while retaining patients and protecting your flow of referrals?

"Even for specialists who get referrals from other physicians, marketing is something to think about. Many younger patients don't even have primary physicians. If they need a dermatologist or allergy specialist, they simply do a search on their phone. They may read a couple of quick reviews and take a look at your website, but if you didn't come up near the top of their search, they may not even see you," Maddox Casey of Warren Averett said.

"Practices need a web presence along with someone who understands search engine optimization and how to move to the top of the search list. It's not enough to build a website and leave it untouched for years. Keeping it updated, adding content related to topics in your field gives search engines something to find when patients are looking for information. Social media sites like Facebook can engage both patients and staff and improve communication. Professional sites such as Linked In can help you connect with colleagues."

PR and other forms of unpaid media can be valuable tools in building awareness among potential patients and referring physicians. Send press releases when you have news. Look into adding your name to lists of expert sources that media can turn to for quotes when stories arise related to your field.

If someone in your practice is comfortable speaking to crowds, list a speakers bureau on your website, or offer to speak to community groups, particularly during awareness months related to your specialty.

"As an alternative, if you don't have someone who is naturally adept at public speaking, look into having members of your practice volunteer in health fairs or screenings at community events," Debi Waldrup, administrator for Pulmonary Associates of the Southeast said. "We do COPD day in November and lung screenings at other events."

Screenings and participation in community events also offer the potential for media coverage as well as bringing representatives of your practice face to face with potential patients you might otherwise not meet.

When considering paid advertising, look for online media that can be targeted to match your patients. If your objective is building referrals, look for professional media targeted to physicians and health care professionals.

"Our patients are our best advertising. Around half of our new patients are referred by former patients." Lisa Warren, CEO of Andrews Sports Medicine, said. One of the best investments we make is putting an extra effort into making sure our patients have a good experience. That's why they recommend us to people they know who could use our help.

"The old saying is true. If people have a good experience, they tell one person. If they have a bad experience, they tell ten. You have to hire good people and train them well. From the front desk on, anyone in contact with patients should understand the need for building positive relationships."

How does your practice look through a patient's eyes? It may be time to take a tour, starting with the parking lot. If you are in a large building with a number of practices, there may be times when the lot is so busy that it's frustrating for patients to park. What is it like walking from parking to the last exam room with a cane or a breathing condition? Would benches along the way help?

"If your office is located in an area where traffic and parking are difficult, you might want to look into a satellite office in a less congested area, or the possibility of expanding parking," Casey said. "Uber might become an option. Some practices are considering sharing costs on an Uber ride from a less congested nearby area for patients who need to be dropped off at the door. The cost to the patient for their share of a $10 ride would be near or less than what they would pay for valet parking. For a patient who needs a major procedure, it makes sense and it's a consideration patients would appreciate."

It's also what advertising agencies call a USP, or unique selling point, that sets businesses apart and creates a preference for their services.

"Some practices are offering a concierge service, express check-in, an information desk and other amenities," Sae Evans, CPA of Warren Averett said. "The next big service is telemedicine. Blue Cross offers coverage with a $10 copay for patients to consult with a physician by videophone for simple things like a cold. The physician can ask questions to confirm a diagnosis, check the patient's medical records, then call in a prescription, if needed. The patient gets help without having to take time off work or get out of a sick bed to come to the clinic. They aren't spreading germs in the waiting room, or picking up another infection from someone in the next chair."

If you were a patient calling your office to ask about possible side effects of a medication, how many rounds of telephone tag would it take to get an answer? For the growing number of practices who offer an online patient portal, the answer is that it wouldn't take a call at all.

"Patients don't have to wait for someone to call back, or stay by the phone if they need to talk with someone without risking another round of missed calls. They can communicate by email or chat online with a nurse who can check with the physician," Tammie Lunceford, CPC with Warren Averett said.

A record of the query is on file to add to medical records or discuss at the next office visit. Medications can adjusted or changed without delay, and symptoms that could be significant can be reported so interventions can begin sooner, which could make a difference in outcomes.

"To get patients comfortable with using the portal, it helps to introduce them to it when they come into the office," Lunceford said. "You can set up the patient portal on a computer in the waiting room. When they register at the desk, if they say they haven't signed on yet, a member of the staff can walk them through the features and show them how to log in while they are waiting to see their physician."

Waldrup said, "Many of our patients are older. One of the big advantages of a patient portal is for family members who are helping to manage the care of an elderly relative. Our portal is HIPPA compliant, but the patient can give access to a care giver who can help them keep up with their appointments, medications and get answers to their questions online."

In addition to saving phone time and postage, portals can post the results of routine labs immediately. Patients can compare their levels from the most recent visit with several visits back, which helps when they are working to track and improve their blood pressure, A1C, cholesterol and other measures of health. This continuity is a point in favor of staying with the same practice.

As one patient put it, "When they moved, I thought about finding another doctor. But through their patient portal, I can access more than five years of my labs, vital signs and medications and check my appointment times. Being able to track my health feels empowering. I can see I'm doing better on blood pressure, blood sugar and weight. That's a good reason to stay and recommend my doctor to friends."


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Andrews Sports Medicine & Orthopaedic Center, Debi Waldrup, Lisa Warren, Maddox Casey CPA, medical practice marketing, online marketing for medical practices, patient portals, Practice management, Pulmonary Associates of the Southeast PC, Sae Evans CPA, Tammie Lunceford CPC, telemedicine, Warren Averett CPAs


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