5 Key Practices to Help You Through This Recession

This is a tough recession--the worst I've been through certainly.  Only the fittest will survive this one.  Here are some survival tips that you can use:

1. Focus on collections: Obtain deductible information prior to seeing the patient and collect up-front if your contract allows.  If not, use a service like this. 
2. Scutinize all costs: Trim some and expand others--cost center vs profit center.
3. Smarten up your office hours: Avoid overtime while maximizing office visits.  Use your data to figure when patients "want" to be seen and staff heavily at these times, light at others.
4. Leverage technology: EHR, smart phones, VOIP, webforms, sms, etc
5. Answer your phones

Good luck.
Dr Schoor

My New Years Business Resolution

Someone in the Enteprenwur Group ask the question about business plans for next year. Here is my answer.

• reviewed and revised my business plan for 09.
• upgraded to EMR-PM system
• Hired coding consultant
• Hired lab consultant
• Plan to expand lab test menu
• Improve marketing: email, direct mail, targeted mail, blogging, adwords, twitter
• Increase referral base
• Outsource collections for deadbeats
• Improve collections: check scan, cc's, EMR-PM, cash
• Answering phones 24/7
• Making it easy for new patients to book and be seen

Anything else that I'm missing?

Dr S

Myth #6

Almost a year ago I wrote a post that dealt with some of solo vs group practice myths. That post had 5 myths regarding call issues, economies of scale, etc. Here is a sixth myth.

Myth #6: A specialist depends on professional referrals to grow.

If that was true, I'd be out of business. Professional referrals, while important, are no longer an essential for practice growth. Patients come from a variety of sources, and only one is the referring doctor. I recently analyzed from where my patients were coming. Here it is, not necessarily in order.

• Internet insurance lists--this is the modern age equivalent of the insurance book, only it is on the internet. It accounts for ~35% in my practice. Recently patients have found me on Cigna's site, Aetna's site, and even Medicare's. I did not know Medicare's site even had a physician search feature. Live and learn.
  
• Internet Search Engines--this has been a growing segment of my patient population, with the overwhelming majority coming from Google. Prospective patients type in any number of search terms, but "urologist smithtown" or "vasectomy doctor smithown" predominate. Male infertility patients will often find one of my other blogs, then hyperlink to Dr Schoor.com. I always ask people what keywords they used and which search engine. ~15%, but growing. And I have not even really started to web-market!
  
• Word of mouth: this is my one of my best sources of new patient business. And the best things about it is, one, it's free, and 2, WOM self-perpetuates. As the practice grows, more mouths talk, and more patients come to see me. Off course, so long as I remain a good urologist with good outcomes. About 30%, and growing.
  
• Professional referrals: when I first opened in April 2006, I concentrated most of my efforts on the cultivation of a cadre' of doctors who would refer to me often. While I have done well in this regard and now have several docs that send repeat referral business, the truth is that referrals even from these docs come infrequently and sporadically at best, and if I had no other sources of new patients, I'd be up the creek sans paddle. I'd say that professional referrals account for about 15%. Interestingly, WOM is the best way to cultivate professional referrals. When your happy patient tells their primary about you, that has more positive impact than a brochure and a box of coffee for the staff. In addition, doctors talk also and a "I use Schoor for infertility" said to a colleague is worth thousands of dollars to me, not to mention the personal satisfaction of peer recognition.
  
• Yellow Book and Yellow Pages: Less than 5%. Not even worth mentioning. Just get the free or cheapest listing, or better yet, none at all.
• Print ads: 1 patient, and his check bounced, twice. Money spent on ads into the thousands. Worse than worthless.
  
• In office free seminars: I held 2 on ED. 10 people came overall. I got one patient out of it, and he turned out to have a bogus Medicare card.

I have found enormous satisfaction from my success in the absence of a large professional referral base. It means that I am truly independent and beholden to no one for my next meal. It also portends well for me, since the professional referrals will come with time, and then imagine how busy I'll get. Until then, I'll focus my efforts on internet marketing and WOM referrals.

Thanks for listening, and send me some patients.

The IU.

More on answering the phone after-hours.

I know I risk sounding like a broken record, but it seems that 2-3 times a week I am rewarded just for answering the phone. Here are 2 of the latests successes:

• Last night a woman called at 7:45 PM to enquire about getting her husband an appointment for a vasectomy. The call was forwarded to my vonage line at home, which I anwered while trying to put my girls to bed, and booked the patient.
• A patient was given the numbers of 2 urologists for a vasectomy, me and another, established urologist. The patient called the established urologist first, but they did not answer the phone. He then called me, we answered, and I did the vasectomy yesterday. Not only that, he had such a good experience in my office, he let me know that he would tell others to come to me.

Answer the phones. It is really that important.

The IU.

The Flea saga and WOM

I want to throw my hat into the whole Flea thing. From the perspective of a solo practitioner in the start-up, practice building phase, who depends on positive word of mouth for his own survival, Flea's saga is a public relations disaster. First, he was sued for wrongful death and that law suit became, because of his actions and his actions alone, a very, very, very public matter. Isn't it enough to get sued and have to defend yourself in court. Do you have to announce it to the entire world and give the Boston Globe or NY Times a story? Now everyone of his patients, their families, friends, and referring docs knows that he had a wrongful death. Not the kind of thing you want to actively publicise.

Second, as Eric Turkewics pointed out, he and the defense were caught trying to manipulate the jury. Now this may happen all the time, I don't know. But from a public relations perspective, it doesn't look good for Flea. People don't like to be manipulated and you don't want patients, their families, and referring doctors to think of you as a callous manipulator. Just my opinion.

Third, his entire chronicle of his lawsuit experience was just plain reckless, stupid, and disrespectful and suggests that Flea himself possesses those qualities. He may be a nice guy. I'm sure he is. But only several hundred people, at most, know him as the nice guy-good doc, while several million now know him as the big mouth, reckless, manipulating blogger. And thanks to the Boston Globe, and KevinMD, they know his name.

Word of mouth marketing is the most powerful form of marketing, and when positive, can really help build a practice. When negative, it can kill. I bet Flea's cost him the limits of his liability policy, and probably his practice.

I wish him luck, I really do. And if you are reading this blog, Flea, give me call and I'll help you start over in your new solo practice in your new locale.

Best of luck.

The IU.

Need new patients? Put your money where the mouth is.

When it comes to marketing and marketing dollars, there seems to be no limit to the possibilities or the costs. Professional marketers will tell you that marketing "should" cost you nothing. By this, they mean that if done correctly, 1 marketing dollar should yield 3-5 in return.

Oh that it is was that easy!

After 14 months on my own, I have come to the conclusion that only one type of marketing works for physicians, with the exception of plastic and LASIK surgeons.

Word of mouth.

W.O.M.

Word of mouth is, and has always been, the best form of marketing for any business, but for doctors it is perhaps the only form of effective marketing. Far from a passive endeavor, word of mouth marketing is an active and continuous process. WOM, I have come to realize, is the most active form of marketing and while it may cost the least in terms of money, it costs the most in terms of effort and time.

There actually is a science behind word of mouth marketing and methods exist that allow marketers to enhance and maximize the effectiveness of the program and to track, scientifically, results.

So there you have it. Put your money where the mouth is!

The IU.

Need new patients? Write a book.

I always wondered how colleagues of mine were able to publish books on such seemingly boring topics in medicine. I know of an oncologist out here, in the stix, who has published several books. Just talk to him for a minute and he'll tell you about his books, and he'll give you a copy. Now I know how he did it.
The other day I received a letter from a publisher asking me if I wanted to author a book on male infertility. Actually, the publisher was not given my name and it was not a personal invitation, but a form letter from a mailing list. In any case, I have always wanted to write a book, so I emailed the publisher. He responded immediately and wrote that he would send to me a "packet" in the mail. It came today.
Here is how it works. I sign a contract and then professional writers, with my help, write the the book. My total time commitment would be 15 to 20 hours. All costs for layout, artwork, distribution, etc would be paid by the publishers. And I get royalties. Sounds great! What is the catch?
I have to purchase 1000 books. List price, $14.95 per book. I don't know what the discounted rate would be, probably $10.00 per book.
So there you have it. For $10,000 you too can be an author of a book.
Now the better question: why would I do that? Actually, it is not a bad idea, and the price tag may be reasonable. Being an author of a book, any book, is seen by patients and colleagues as a major accomplishment and helps in the "branding" of you and your medical practice. It helps in "word-of-mouth" marketing--the best type of marketing. It makes you be a true expert. Also, giving out copies to patients can be an effective form of marketing as well.
I'll think about, plug the numbers into Bayes Theorem, and decide.
Thanks,
The IU.

Need new patients? Go to talks.

I have written posts on the positive aspect of giving talks to groups of people, but there is an even easier way. Simply go to a talk. Choose a talk on a topic in which you have interest and t one that will be given by a speaker you like, or know personally, or who can "pack'em in." Then simply go to the talk with a smile, some small talk, and some business cards. It makes for an easy way to get some face to face time with other doctors and nurse practitioners; any one who may be in a position to refer. It does not cost anything, though it does take time away from family. I do it 2-3 times per year and have picked up a few new patients as a result. Nothing spectacular, but "not nothin neither."

Hope I helped someone with this post.



The IU

Need new patients? Beat their expectations.

When you first go solo, obviously, you do not have an established practice to build upon. This takes time. However, whenever this happens, you can use your existing patients to build your reputation and, hence, your new patient business by providing stellar, beat-their-expectations-service. Here are some tips.

• Call back when you said you would


• Run on time


• Call when they don't expect you it


• Open "special" hours, just for them


• Book a referral, such as for a CT scan, for them


• If they are having a problem, squeeze them in today or tomorrow, no matter what


• Have copies of articles you authored and awards in the waiting room


• Keep a copy of of CME certificates in a nicely bound book in the waiting room

Good luck and enjoy the growth.

The IU.

Need new patients? Look to your existing patients.

You want new patients, right? So do I. New patient business means everything--growth, success, stability, the future. But don't ignore your existing patients for they are your best source of new patient business. All you need to do is to figure out how to harness the power of your existing patients to generate new patient business. Here are some things you can do and some things you must do.

• Keep your existing patients happy (A Must!)


• Mail fliers periodically with new procedures you wish to promote


• Send them business cards or magnets periodically


• Publish a news letter quarterly


• Ask them to "tell-a-friend"


• Direct patients to your blog and tell them to refer others to it.

Thanks.

The IU.

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 1And1.com or the UrologyChannel.com 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, http://www.drschoor.com/ 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 http://www.vasectomy.com/ to direct potential vasectomy patients to my site, http://www.drschoor.com/. 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.

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.

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.

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.

Thanks,

The IU.

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? 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.

Thanks,

The IU.