Thursday, April 26, 2007

Need new patients? Get a website.

Let me just start out by saying that I think websites for doctors are highly over-rated. Just having one does not increase the likelihood that you'll attract patients. In order for this to happen, you must have a nice looking, informative website and you must try to get your website noticed using SEO--search engine optimization. Even then, the website is just another tool for prospective patients to find you with, not a money-maker in its own right.

Let's start first with the site itself. I believe your website should reflect you, and be unique, like you. I therefore, don't feel that standard template websites, like those available on GoDaddy or or the are any good and any prospective patient that goes to one of those sites will see "business as usual" as their first impression. Almost anyone with any computer experience can design a great looking, unique site using 1 of these 3 programs: Dream Weaver, FrontPage or iWeb. I use iWeb for mine, host on .mac and have my domain name, point to the .mac site. Total cost $57 per year.

Now lets talk about SEO. This stands for search engine optimization. This is how your site will be found amongst the billions of sites already out there when people, for example, Google vasectomy. The easy way is to pay people to do it for you. This type of service can range from several thousand dollars to 10's of thousands of dollars. I finally caved in and began to use a service called to direct potential vasectomy patients to my site, So far, it has worked quite well. Another way is to blog, provide good content on your blog, and link your blog to your site. If your blog content is good, people will notice it, and they will start to link to the blog and tell other about it as well. Thanks, Seaspray! All these incoming links will prop-up your blog, and ultimately your website, in the search engine rankings. There are other ways to do it--raise you site's ranking--such as adding meta-tags, and key words, and word density, etc, but I find that the best approach is with good content and a couple of good incoming links. And it is free. Since I started blogging in March 2006, I have added several thousand dollars to my bottom line.

The website can also be a good tool to educate your own patients plus prospective ones, and give patients an alternative method by which to contact you and make an appointment. Again, these types of services can range in complexity and cost but actually are quite simple. I have a blog on blogger and iWeb for my urology specific posts. Cost: zilch. I provide ample email links on my website and blogs for prospectives to reach me by, and I give my phone number and fax, as well. I have had a handful of new patients request appointments via this method.

The moral of this post. DO NOT SPEND BIG BUCKS ON YOUR SITE. One, it ain't worth it. Two, it is unnecessary. Three, it is more fun to DIY.

Hope you enjoyed this post.

The IU.

Tuesday, April 24, 2007

Need new patients? Take a contrarian approach.

I like being contrarian. I always have. A contrarian is someone who goes against the grain, not because he or she is being difficult, but because they see opportunity. In a new medical practice, taking a contrarian approach can really pay off. If your competition does not have Saturday hours, see patients on Saturdays. If you are told to go with an answering service, answer your own phones after hours. If everyone has strict office hours, make your hours flexible. This way you can adapt and grow and capture patients that think like you and can't just conform to another's convenience. You'll find that you will pick up a surprising number of new patients that you may not have otherwise obtained. Plus, you'll do it your own way. And you'll have fun. I've always been one to question everything, think for myself, and do my own thing. And now I have found a way to make it pay off with new patient business and overhead reduction.
Try it out.

Monday, April 23, 2007

Why shouldn't doctors be second guessed? Everybody else is.

I am doctor and I get second guessed. It is simply part of life. It doesn't bother me. It keeps me on my toes. I expect it and am never surprised by it. I also give every patient my best effort, I suppose, like most of us. So go ahead, do it.

Other professions get second guessed even worse than doctors. Governor Corzine's State Trooper driver is being criticized for the way he drove. He'll probably lose his job. The Governor himself is being criticized for his lack of seat belt use. When he returns to office, no doubt that every single one of his gubernatorial decisions will be second guessed.

Any politician gets second guessed as a matter of business. No, they don't get sued personally or professionally, as we doctors do, but they get voted out of office and have to find new employment. Especially the President. And you think it is good to be an unpopular ex-president? Just talk to LBJ, Nixon, and Bush 1. They all spent their post-office days in a sort of exile. Though, on the balance, doctors have it worse than ex-presidents.

Cops have it worse than doctors. They have high pressure jobs, have to make split second decisions, and can make mistakes that have disastrous consequences. Just like doctors. In addition to doctors, the police face constant second guessing from internal affairs, politicians, and citizen's rights groups. And they can get sued, civilly, as well. In NYC, the police make < $40K per year. Yeah, cops have it worse than doctors.

How about teachers? They have it rough as well. They get tortured by administrators, parents, and politicians. They can lose their jobs, get passed over for promotions, and, yes, be physically injured. They do get their summers off. Otherwise, teachers have it worse than doctors.

How about ad-executives? Seems glamorous, if you watch the movies. I don't think it is. High pressure, dead-lines, and results oriented. They won't get sued, they'll get canned.

So basically, everyone has got it rough. Suck it up and move'on!

The IU.

Friday, April 20, 2007

My real fear.

I have never writen about med-mal, nor will I. I do think that doctors fear law suits more than they fear cancer.
If you want to know where your priorities and fears ought to be, click here on the Pulitzer Prize winner for photography.
Thanks to Kevin MD for the link.
The IU.

Tuesday, April 17, 2007

Need new patients? Donn the bow tie.

One day I just got bored wearing the same old thing day-in/day-out. But I do believe in professional dress and showing patients respect with, among other things, the clothing you wear. So one day, I went to Brooks Brothers, bought a bow tie and got a lesson on how to tie it. After 1 week and 10 unsuccessful attempts, I began wearing bow ties.
The response was actually unbelievable. Somebody commented on the bow tie each and every day for 1 solid year. Patients who I saw in the hospital would call my office to request to be seen and would say, "I can't recall his name, but I want to see the young doctor in the bow tie."
Though I did not do it as a marketing gimmick, it turned out to be one of the best marketing tools I have ever used.
Yes I still wear a bow tie. Yes I hand tie it. Wouldn't do it any other way.
Donn the bow tie.
The IU.

Monday, April 16, 2007

A tale of two ureter stones.

An election year must be coming because universal health care is back in the news. . .and the bloggers are having a field day. I believe I have written on single payor universal health care before, so my views are probably known, but I am going to write here, right now, about 2 real patients that I saw this week in an affluent part of Long Island, both with kidney stones. One has insurance, one does not. Both are tax paying, US citizens. These 2 cases epitomize the good and the bad in our system.

Patient 1 (with insurance): She came to me with severe left flank pain x 5 days, tenderness in the flank, and blood in the urine. She had not been able to keep anything down by mouth. I sent her for a CT scan, and since this is the good'ole USA, she was able to get one that morning. The CT showed a stone in the middle of the ureter that was approximately 8mm in size. Again, because this is the good'ole USA, we were able to send her that day for a lithotripsy (non-invasive stone procedure), and she was stone free and pain free 6 hours later. Her out of pocket costs: $20.00. She had NY States insurance plan that government officials and police get. That, I believe, represents the best health care in the world, no doubt.

Patient 2 (no insurance): He came to me after 10 days of severe flank pain. He was referred from an urgent care center, which he went to twice ($300 for the 2 visits). He had a CT scan, done the day it was ordered (good'ole USA) that showed a 6mm stone in the upper ureter. The CT scan set him back $800. Then he came to me, only without the ability to pay. Now here are his treatment options. He can, A: wait it out. Cost $0.00, except for lost wages and possibly lost job. B: Go to the ER and get pain meds, and maybe, if he is lucky, a urologist will see him (probably not). Cost, $3500 for ER visit. Up to $15000 if he needs urologic intervention such as a stent or ureteroscopy or lithotripsy in the hospital. Option C: He can have a lithotripsy electively as an outpatient. Cost $5500 (we negotiated this one for him.)

Now here is the kicker, he is out of money, having spent it on the CT scan and the urgent care center. He is SOL. So here are his real options. He can lose his job, because he can't work through the pain or the narcotics. He can go to the ER, get admitted, and stented, and then have the hospital place a lien on his personal assets (yes, this happens every day in the good'ole USA) as they try to get paid. Or he can place the $5500 on a credit card and go hopelessly into credit card debt (happens every day in the good'ole USA). Of course, he can wait it out and if he is lucky, he won't do irreparable harm to his kidney.

So these 2 cases are illustrative in that they really represent the best and the worst that US health care has to offer. Had he been English, Canadian, Cuban, German, French, Dutch, Greek, Israeli, or Japanese he would have been treated without risk of personal financial ruin. Our Canadian bashing friends are always quick to note that in Canada he would need to wait months for treatment. Not true. Just ask any of my Canadian urologist friends, and I have a few. Anyway, as I see the increased frequency of anti-health reform blogging, I thought I would just add my own personal experience with our system. Not myth. Not exaggerated. Just how it is in my little corner of the world.

Sunday, April 15, 2007

Need new patients? Go with a post-it.

You know what a post-it is right? You know; those ubiquitous yellow pads that everyone uses to jot down what ever needs jotting.
I had some made with my practice name, logo, and phone number printed on them. Cost me $40 for 20 pads, each with 50 sheets, and I gave them out to doctors’ offices whose business I was courting.
No fan-fare; just dropped’em off with a business card, a Babka, and a thank you.
The goal: keep me in mind.
Does it work? Sure.
The pharma reps do this type of stuff, and they have companies that pay millions to marketing firms that tell them to leave behind post-it notes and pens.
Cheap and easy.
The IU.

Thursday, April 12, 2007

Need new patients? Give a talk.

You don't need to be good at public speaking to give an effective talk that will result in new patient business. Often, a talk to 2 or 3 people can result in new patients. A well respected, reconstructive urologist I know used to say that he would get more business from taking out and speaking to 3 doctors than when speaking at a national meeting. I don't know about that. I think the more, the better.
My chiropractor friend has found success speaking on health food store symposiums to as few as 5 people. I have given many talks and have not had great success with increasing new patient business, though I have had some success. I still do it because there really is little downside to doing public speaking, other than my time and some pride.
Here are some good venues:
--Support Group Meetings
--Grand Rounds
--In Office Seminars
--Local Medical Society Meetings

Need new patients? Be available.

I have a friend in start-up. He is chiropractor and he works banker’s hours. He takes Thursdays off and seldom works on weekends. He feels he “should” get to work what ever hours he wants and patients can wait; even if they are in pain. I wonder what the founder of 7-Eleven would think of this approach to convenience and availability.

In my view, he has not grown as fast as he could or “should” have.

Now contrast that to STAT Health, a start-up urgent care center in Smithtown NY. They have been open for as long as my friend has. They are open from 8AM to 8PM, 7 days per week. It is owned by 2 guys, and they are always—I mean always—there. And they are mobbed.

I know comparing a chiropractor to an urgent care center is probably not a fair comparison, but the point stands. Be available.

Everybody is busy. Everybody has a job. Everybody has family. Everybody has prior obligations. If you want to grow, be the one who accommodates. If your patient base commutes into the city, have early morning or evening hours or weekend hours. If your patient base is retirees, have mid-day hours. Nothing wrong with working on Saturdays if that is what it takes. My Dad saw patients every Saturday for 30 years in his dental practice. It never bothered me. In fact, I admired it. Your family will understand also.

If you want to grow, be available when others will not be.


The IU.

Tuesday, April 10, 2007

Need new patients? Hit the pavement.

Nothing works quite so well or has as much bang for the buck as dropping by a referring source's office and saying hello. Rather than being on annoyance, it is seen as a sign of respect. It is actually quite easy, not very time consuming, and aside for gas and perhaps some donuts, costs nothing. In my experience, one in ten visits results in immediate new patient referrals. Whenever things slow down, the first thing I do is start to visit my referring doctors.

Caveat: Never demand to see the doctor. I typically will bring coffee for the staff and say" don't bother Dr Smith, just enjoy the coffee and give him my card." Never be pushy.

Easy. Effective. Inexpensive.

The IU.

Need new patients? Answer the phone.

This is the first in a series of posts relating to practice building.

And as I have said before, if you want your practice to grow with constant new patient business, answer the phones. I just can't emphasize this enough. Just the fact that the patient selected your name is incredible and is the goal of all your other marketing efforts. But if they can't get through on the phone, it is all for naught.

Answer the phones during the day, in the morning, in the evening. Make it easy for new patients to speak to a live voice. If you must have a call service or an auto-attendant, make sure you have an option that allows patients to immediately reach a live voice, most preferrably you. Trust me, you won't be annoyed. It is all for you.


The IU.

Sunday, April 08, 2007

Patients like the solo guy.

I have written in the past about the advantages of solo practice from the perspective of the provider. Well, here are some advantages for the patient.

1: A stronger doctor-patient relationship: Solo docs develop very strong bonds with their patients. Perhaps we view a patient's business as a privilege instead of a chore.

2: Better care: Solo practitioners control every aspect of the practice, and this makes for better outcomes.

3: Happier patients: When patients have a problem, they want to see "their" doctor, not Dr Whoseinwhat that is covering for him/her.

4: A more pleasant environment: Staff and patient alike enjoy the predictability that only a solo practitioner can provide and that translates into a more pleasant experience for the patient.

Of course, you can get lucky with a doctor that is in a group, but the odds of this happening are better with the solo doc.

What do you think?

Saturday, April 07, 2007

Great News!

Wow!! That IS great news. New attendent options. Jeeze-Louise! Awesome.

I just can't seem to wipe the smile off of my FUCKING FACE!

New phone attendant options. Now that really takes the sting out of tracking down dead claims.


The IU.

Friday, April 06, 2007

When it gets slow, look inward.

It must be because of the holiday week, but despite 5 "rocking" weeks, my volume has dropped by 40%.
No need to panic. Instead, go to the "No worrries log", find out who has been non-compliant, call them, and get them back in. Next week is already looking good.
I guess that is one reason why being "established" has its benefits.
The IU.

Tuesday, April 03, 2007

The Record Request: A Simple and Fast Way.

A patient called me today requesting that his records get sent to an IVF group that his wife will be seeing. I offered to have them faxed, but instead wanted the records mailed to him.

Simple: Burn record onto a CD-R.

Total time of phone call to completed burn: 60 seconds.

Critical: CD must be R, not RW, to prevent any possibility of the patient's altering the record.

Any questions or comments?

The IU.

Sunday, April 01, 2007

I miss working for someone else.

I have been on my own now for exactly one year and I must admit, I miss being an employee. Here what i miss.

1: I miss being told when I have to get to the office and when I can leave.
2: I miss being told which days I can take off.
3: I miss my yearly "performance" evaluations.
4: I miss the mind numbing routine.
5: I miss taking call on Holidays.
6: I miss having to request time off.
7: I miss that feeling of anxiety when one of my partners was in a bad mood.
8: I miss being on employee.

Happy April Fools Day.