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Chronic Care At Walgreens? Really? 

5/1/2013

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Walgreens, the country’s largest drugstore chain, announced on April 4th that its 330+ Take Care Clinics will be the first retail store clinics to both diagnose and manage chronic conditions like asthma, diabetes, high blood pressure, and high cholesterol. The Nurse Practitioners (NPs) and Physician Assistants (PAs) who staff these clinics will provide an entry point into treatment for some of these conditions, setting Walgreens apart from competitors like Target and CVS whose staff help manage already-established chronic illnesses or are limited to testing for and treating minor, short-lived ailments like strep throat.

A one-stop shop for toothpaste, prescription drugs, and a diabetes diagnosis? The retail clinic phenomenon has its appeal: it allows patients convenience and better access to care through longer hours and more locations than our health care system now provides. Walgreens leaders bill their latest offering as a complementary service to traditional medical care. They envision close collaboration with physicians and even inclusion in Accountable Care Organizations, according to reporting by Forbes’ Bruce Japsen (though it’s not clear how the retailer would share the financial risk or savings in such a model).

But the Walgreens announcement was met with skepticism by physician groups like the American Association of Family Physicians (which has responded defensively in the past to non-physicians’ growing roles as primary care providers). And there are certainly causes for concern, at least based on what we know so far: Such expanded clinics exacerbate the fragmentation in our already piecemeal system. Providers at retail store clinics don’t have access to patients’ medical records, so they might repeat prior efforts or miss key details in caring for these patients. Per standards set by the American Medical Association, retail clinic providers must establish continuity of care with a patient’s primary care doctor if he has one – this usually takes the form of a faxed note, which can’t compare to real-time communication within an integrated network. Providers at retail clinics are obliged to adhere to rigid protocols for evaluating and treating medical issues, but good chronic care management is customized to a patient’s particular lifestyle and needs. In short, chronic care, more so than one-off medical treatment, is best delivered with consistency by a coordinated team of providers (including NPs and PAs but also primary care doctors and specialists) who have gotten to know the patient over time and have built a relationship of trust.

The idea just might work if established health care systems with specialty providers forge meaningful partnerships with retail clinics – for example, with shared access to electronic health records and staff members who move between settings. If, in other words, the retail clinics are true extensions of the primary care home. It’s hard to say if a retail clinic could or would want to meet these criteria.

While those of us working in more traditional health care settings may have legitimate reservations about how Walgreens-brand chronic care will be delivered, we have to acknowledge that it addresses a need that we are not fulfilling. Walgreens made a savvy business move by targeting a growing population of aging Americans with diabetes and cardiovascular disease and offering services that are truly important and underused. We can and should learn from how their experiment plays out: Who will opt for this care? Will Americans use it as a stopgap between visits with their primary care doctor or only when they don’t have one to begin with (according to the Salt Lake Tribune, nearly half of current Take Care users don’t have access to one)? Will they come back a second time? What will they like about it? Which locations and hours will be most popular? Will the appeal of cheaper care (compared to paying out of pocket) fade as more Americans are folded into insurance plans? If we can better understand how these nontraditional clinics address gaps in the system, we can work with retail clinic providers more effectively and fill those gaps with truly coordinated chronic care.
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12 Of The Biggest Mistakes In Marketing Your Practice

10/14/2010

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For the professional beginning to promote his or her practice, mistakes are a way of life. For some, they’re a costly way. But no one can afford many mistakes in a tough economy, and now it needn’t be so, as I will now share some of the biggest mistakes in practice marketing with you so you can avoid them.

Even though judgments of taste and creativity are often called for in promotion, there are some absolutes — especially absolute mistakes. So to assist you in your learning curve — and to save you time and money — here are a dozen of the biggest mistakes in marketing and advertising your practice. Now you’ll know how to spot them and how to avoid them.

1. Promoting at the wrong time
On a limited budget, start your promotion just prior to your busy season and end it just prior to a seasonal fall-off. Don’t spend your money promoting during dead times unless you’ve spent sufficient money promoting during the up times. It’s always less productive and costs more money.


2a. Choosing the wrong office location
The right one is in an area with an advantageous professional to population (or company) ratio. The wrong one is selected solely on the basis of where you want to live.


2b. Choosing the wrong office location
A freestanding building almost always offers better outdoor signage opportunities than a professional building does. And signage is so crucial in attracting the public that, if done well, it can produce a third of your new patients or clients.


3. Not knowing how to handle objections
If some professionals could hear their staff members handle an objection from a caller, they might well be distraught. Then they’d surely know they’re losing big dollars because their front desk often shoots answers from the hip. Instead: Script out sample answers for each common objection — no money, no time, no interest, no need and I’ll think it over. Results: optimal answers and many more appointments.


4. Not answering price queries correctly
When people call to ask how much, don’t just mention the price. First, explain the unique benefits of receiving the service or product from you. Then quote the price. Without explanation, your services are just like everyone else’s, so price can be the only determinant. With it, you can charge even more.


5. Not preparing a marketing plan
Without analyzing your competition, your objection, your budget and to whom you’re directing your promotion, you’re susceptible to two potential disasters. One — being swayed by salespeople into buying poorly designed and incorrectly targeted promotions. Two — failing to consider all important variables. Both lead you to big losses and dead ends. Instead: Construct a marketing plan first.


6. Sponsoring clubs or sports teams
If it’s not mandatory that the players come in (or are brought in by parents) for a free service so you can meet them, then recognize your sponsorship as altruism, not practice building.


7. Promoting in school yearbooks or church bulletins
These expenditures should come out of your charitable contributions account, not your promotional budget.


8. Putting your name in your ad’s headline
Melvin Belli, Esq. and Michael DeBakey, M.D. can put their names at the top of an ad to get it read. But rarely does a practitioner have enough public recognition to have his/her name entice a browser to read. Instead: Head the ad with strong benefits for coming to you, and keep your name and logo at the bottom.


9. Writing direct mail yourself
Direct mail is the most difficult type of promotion to create. Why? Because it requires that specific techniques be built into a piece to stimulate immediate response. Practitioners rarely have the knowledge — or the talent. Unfortunately, most copywriters aren’t familiar with them. Instead: In direct mail, it almost always pays to hire direct mail specialists. Your response rates can jump 20 times.


10. Cutting prices first
Prices should be the last element in your marketing formula to fiddle with. Before cutting prices, promote other aspects of your practice — experience, new services, selection, hours, convenience, etc. If all else is ineffective, then play the price game.


11. Not knowing your bottom line
If it’s to attract new patients or clients or to retain old ones, that’s the goal. If it’s to please your colleagues (or competitors), that’s a different goal. And each one produces a different kind of promotion. If a promotion is well-done, your competitors will feel threatened, as they should. If they don’t, it’s probably not well-conceived. Knowing which goal is your true bottom line from the beginning saves you money and anguish.


12. Not coding and tracking your advertising
Without effective tracking of which ads are producing how much in what media, you can’t stop the losers and pump up the winners. So to greatly improve ad results, insert keys into your ads — false phone extensions or individual telephone lines for each specific medium. That way, you know the source as soon as they call. Asking them where they heard about you yields 30% to 50% incorrect responses.


And a bonus tip, to make it a baker’s dozen
13. Practice brochures that don’t sell you
Most don’t because they contain extraneous or even negative selling points, like what to do in an emergency, a warning not to miss appointments, a requirement that you pay at once, etc. Instead: Put all the rules in an inexpensive brochure to be given to existing clients or patients. Put only convincing copy in your practice brochure.
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The Four A’s To Attracting And Retaining Patients

10/7/2010

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What are today’s patients looking for? How do they choose a physician? What makes them stay with a healthcare provider?

Once upon a time, healthcare was primarily a physician-driven world. However, the sands have shifted, and now, patients, as consumers, increasingly hold the power. More informed and more inclined to take control of their own healthcare, they have become “pro-sumers” – meaning they are proactive before consuming. These “pro-sumers” read, research, talk, surf and even chat online to gather information before making decisions, including those about their healthcare. They do their “homework” first and want to learn all they can about their health concern, the physicians and treatments available to them, and what others in similar situations have done.

So, practicing medicine today means viewing a patient not just as someone who is ill and needs your help, but as a true consumer making a purchasing decision. That decision just happens to be related to the health and well-being of themselves or a loved one. And as the most successful businesses in other industries already know, the customer should always be your number one priority.

From P’s to A’s

Healthcare today is a business – like it or not.  And any basic business marketing book or course will talk about the “four P’s” – product, price, place and promotion. These elements are still the building blocks of any successful enterprise.

However, what patients believe they want, deserve and expect has really become the driving force in healthcare purchasing decisions. Over the years, service has become an increasingly important part of the “product” physicians provide. Healthcare has become a competitive marketplace. You can have stellar credentials and provide the highest level of care available, but if you can’t keep your patients happy, many will simply leave and find someone who will.

As a result, the true key to any physician’s survival and success in 2010 and beyond is what I call the “four A’s:”
  • Access
  • Availability
  • Accountability
  • Accommodation
Access

Patients want to be able to easily reach the highest level of care available when they need it, where they need it. And they want the freedom to choose and be involved in decisions about their care. Access is the primary reason behind the explosion in “walk-in” clinics that can be found in familiar community locations throughout the country, including inside pharmacies, grocery stores and big-box retailers. These businesses have capitalized on the simple fact that many patients could not get access to their regular physicians in a time they felt was reasonable. And many of these businesses are booming.  While most patients would prefer to see their personal physician, many are willing to give this up in exchange for access to care.

Availability

Closely related to access, patients want availability. They want convenient appointment times, and they don’t want to wait. They also expect their physicians and other healthcare providers to be approachable and readily communicate with them about their condition and treatment options. They want both phone and face-to-face exchanges to be unhurried and compassionate. To address patient demand for availability, many forward-thinking practices now offer non-traditional appointments times, including early in the morning, at lunchtime, evenings and even Saturdays based on the needs of their specific patient population. And others offer express or fast-track walk-in care during certain times of the day.

Accountability

Patients want accountability.  They are looking for someone who will take responsibility and provide accurate answers and explanations. Typically, patients are already anxious and under stress when they turn to you. Often, they are experiencing a health problem. They have questions and concerns, and are looking to you and your staff for answers and solutions. They don’t want to get passed from one person to another. They expect leadership, assistance and guidance in navigating what can be a complex maze.

One example of how many healthcare providers are addressing this need for accountability is the rise in care coordinators or care teams. This approach provides each patient with a single point person in your office who handles all questions related to their care. And it also helps to put patients at ease because they see the same familiar face and hear the same familiar voice each time they interact with your office. By doing this, you are building relationships and loyalty because you are providing a more personal level of care. This can make even large, multi-physician or multi-specialty practices feel “small.”

Accommodation

Finally, today’s patients expect that you will accommodate them.  They want convenience and genuine concern for their well-being – someone who understands their unique, individual challenges and makes it easy to get the care they need. They don’t want cookie-cutter care.  They want customization and personalization. They want to feel engaged and personally recognized during the time they are connected with your practice.

So how can you incorporate the “four A’s” into your practice? Spend some time walking in your patient’s footsteps. Really listen to their needs and learn from their situations. What do they need? What do they want? What do they like and dislike about your practice? Then, examine your current systems, identify potential opportunities and be sure to engage your staff in developing creative solutions to providing exceptional service.
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Medical Kiosk Prototype Holds Promise For The Future

9/16/2010

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Increase in heart disease and diabetes has provoked innovators to think about medical technologies for preventive care that would be easy to use, portable and can allow remote monitoring. Freescale Semiconductor introduced a prototype of a product, which has capability to collect patient health data. This data can be seen by the doctor, either on site, if installed in hospital or could be assessed remotely through cloud computing servers. 

David Niewolny, Medical Segment Marketing Manager, gave me a demonstration of the Freescale Medical Kiosk, which can do the following:
  • take patients weight and height to calculate BMI
  • monitor blood pressure, heart rate and even ECG
  • option of selecting different languages
  • pulse oximetry to know amount of oxygen in blood (by a photodiode sensor, no piercing)
  • glucose level by integrated glucometer (based on needle prick technology)
  • spirometry – blow into a device to gauge lung capacity (critical for asthma patients)
  • information can be uploaded to your computer, cloud (Internet) and downloaded by your doctor
This Medical Kiosk is designed for hospitals to log basic condition of patients, instead of gathering it on forms. At this time Kiosk is somewhat large, about size of your refrigerator, but Freescale wants to develop portable instruments based on the sensors they have developed.

I see utility of this technology very useful in remote areas where healthcare is not assessable in small towns. This way doctors/hospitals can keep a watch on their patients remotely, by either setting up the Medical Kiosk in towns themselves or bringing these systems to towns in a van on regular basis, like every month. 
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Are You Spending Enough (or Too Much) On Marketing?

8/10/2010

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Most medical practices are not strategic about their marketing budget. Their approach to determining how much to spend on marketing is often random – picking a number that feels right or that they can feel comfortable spending. Does your practice fall into this trap? Your marketing budget should be a number that you can back up with results, not just because you think it’s the right amount.

In my experience, there are two methods to determining a marketing budget that gets the best results.

Percentage of Revenue Method

The first method is a percentage of revenue. The exact percentage is determined by the type of medical practice. The range for marketing a medical practice varies from three to fifteen percent (3 to 15%) of annual forecasted revenue. A medical sub-specialty that markets directly to the patient for services not covered by insurance, such as plastic surgery, cosmetic dentistry, or Lasik eye surgery, can expect to be near the top of this range. An audiologist who dispenses hearing aids should find their marketing budget to be in the ten to twelve percent (10 to 12%) range. The high markup on hearing instruments plays an important role in the equation. On the lower end of the range there are medical professionals who acquire their patients mainly through professional referrals. These sub-specialties include urologists, oncologists, and physical therapists. Their marketing budget typically ranges from three to five percent (3 to 5%) of revenues.

Return-on-Investment Method

The second method of determining your marketing budget is the Return-on-Investment (ROI) Method. You have all heard the old adage: You need to spend money to make money. The basic idea of the ROI Method is that for every dollar spent, you will make more than that dollar in return (optimally much more). You can usually forecast your investment from between a ratio of three to one to eight to one (3:1 to 8:1) by analyzing two factors about your practice. The first is the size of your practice. How many locations do you have? Also, the maturity or age of your practice is important. How established are you in your area? A large, well-established practice should expect a much higher return-on-investment than a small practice that is just starting out. Where does your practice fall on this spectrum?

Of course, there are many ways to market your practice for little or no money spent. However, certain methods do require an investment if they’re necessary in order to compete in your market. Having trouble determining the appropriate marketing budget for your practice?

Contact BAC Medical Marketing today for an expert analysis of your practice. 
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Medical Marketing – Guerrilla Style

8/2/2010

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I recently gave in an interview to a medical reporter about ways doctors can use “guerrilla marketing” tactics to improve the profitability of their medical practices, and the reporter posed an interesting question.

The reporter asked “Are traditional marketing methods just no longer working?” We didn’t have the time to fully cover the answer to that question in detail so I wanted to cover it here. But first, let’s define “guerrilla marketing.”

Guerrilla marketing is a term coined and defined by Jay Conrad Levinson is his book Guerilla Marketing. Initially guerrilla marketing was perceived as the use of inexpensive unorthodox promotional activities to attract customers and build small business. Now, the term has become descriptive for most any non-traditional marketing method.

Well, what is “guerrilla marketing” as applied to the health care industry?

Well, as applied to the health care industry guerrilla marketing is simply:

·          Listening to what your prospective patients want

·          Integrating multiple tactics at once to communicate with your patients

·          Finding ways to reach your prospective patients that are cost effective

·          Being flexible and creative in your marketing strategies by acting quickly on opportunities to connect with your prospective patients and outshine your competition

·          Being committed to marketing as a part of your practice management strategy and not just an attempt at advertising to “get your name out there”

So, are traditional healthcare marketing campaigns obsolete?

First of all, the healthcare industry is changing rapidly and physicians must become more aware of how they are perceived in the marketplace. It is becoming more and more evident that healthcare may become consumer-driven. This will require that practice owners find ways to effectively communicate their value to the patients they want to attract to their practices, and one magazine ad or billboard just won’t cut it. Physicians need a healthcare marketing strategy.

Secondly, successful healthcare marketing is relationship based. That is, establishing relationships that provide value to your target market is essential to building your patient base. People are so over advertised to that they are looking for authenticity. They want to spend their money and resources with people and companies that they can trust. This move towards relationship marketing has been on the horizon for some time, but the explosion of social media use has accelerated the demand and effectiveness of building relationships with your target market.

So although traditional advertising and marketing strategies are not obsolete, they are becoming less effective than in the past. Traditional marketing and advertising campaigns are usually about interrupting your prospective patient and saying “hey look at me, choose me, you want me.”  People have learned how to block these kinds of communications out of their mind. Guerrilla marketing or non-traditional marketing says “What do you need? I can meet your need and I can help you because…”

Guerrilla marketing cannot stand alone. You need traditional methods to support a guerrilla strategy. Today, traditional marketing is integrated to support guerrilla marketing strategies.
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    Bruce A. Cadkin, MBA President                          BAC Medical Marketing

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