What Makes A Great Physician Group Practice?

By Patrick T. Buckley, as published in HealthLeaders Media Physicians' E-zine.

In his 2001 book, Good To Great, author Jim Collins talked about research he and his associates had conducted on why some companies thrived during economic downturns and others in the same field floundered. Although the companies that Collins and his team studied didn’t include medical group practices, there are a number of principles that are relevant to physicians trying to run a successful business.

So what makes a group practice great? In many cases, marketing makes the difference between a mediocre group practice and an exceptional one.

CEOs will tell you that the “moments of truth” for a business occur in daily operations. All the publicity, promotion, and advertising in the world won’t matter one bit if the word on the street is that it is difficult to make an appointment or get in to see your physician. Those who would separate marketing from operations fail to see that the two are integrally wound together. Timely appointment-setting, friendly reception, respect for the patient’s opinion, and protecting patients’ rights are all things that happen through customer interaction—which is operations and marketing.

In a recent focus group I arranged and witnessed, the facilitator asked participants what they felt truly equated to a great experience when seeing a physician. “I was concerned that there may have been wrong information in my medical record and asked if I could review it,” one participant said. “Not only did they let me review it, but they apologized after I pointed out mistakes in the record and promised to correct them. They also asked that I double-check with them later to make sure the corrections were made.”

Another participant boasted that the nurse arranged for a pick up when she wasn’t able to drive. Others lauded simple things like being able to make appointments online or in the evening and being informed of the doctor’s progress every ten minutes when waiting for an appointment.

These are the things that Jim Collins would say are the mark of a great, not just a good, medical group practice. They are the result of truly listening to the patient, putting the customer (patient) first, and doing something as opposed to just talking about it. At first, employees and their managers are worried that implementing patient-driven enhancements will take too much time and cost too much. However, practices that operate with a focus on the patient have actually seen employee morale improve while costs have not skyrocketed. In fact, in some cases, they have gone down because of spin-off efficiencies as a result of process improvements.

A number of progressive medical groups have learned the secret to building and sustaining patient volume. They have integrated market research into their efforts to improve operations, and they have fine-tuned their operations to incorporate marketing concepts. But even the best-run practices struggle with the on-going throughput/efficiency vs. customer satisfaction challenge. There is an opportunity cost to an unused MRI machine or an empty exam room. Machines and buildings have sunk costs that must be covered by paying customers. To the degree that a practice can accommodate throughput without sacrificing clinical quality, it will achieve coverage of the fixed and variable costs that exist with all operations. But will it achieve customer satisfaction?

A recent study that was reported in the Denver Business Journal suggests that efforts at increasing efficiency can be compatible with customer service. The article claims that overbooking patients (similar to how airlines overbook flights) may be better for large practices where there can be a significant number of patient no-shows. Which leads one to ask: Wouldn’t it make sense to find out why there are so many no-shows and devise a strategy that would cut down on them? This is where market research and strategy can be instrumental in not only improving operational efficiency but in increasing patient loyalty and satisfaction.
Together, operations and marketing help bring in patients and keep them coming back to a physician’s practice (if medically necessary).

There are many factors involved in attaining patient loyalty, including competent clinical management of chronic disease from specialists and pharmacologic management of cholesterol levels and blood pressure by primary care physicians. However, what makes a patient refer other potential patients to the practice (the “multiplier effect” of marketing), is primarily the skills and understanding of the physician in meeting the patient’s specific health care needs. And what makes you’re a great group practice is making your interaction with patients more than just a “get ‘em in, get ‘em out” experience.

'Til next time.
--TMW

Customer Service Expectations Are Universal

Last week I received an email from someone named “Pablo”. No last name, just Pablo. At first I figured it was spam and moved it to my junk mail folder. But something told me I should open the message, so I did. Turns out Pablo is the director of marketing at the Hospital of the University of Navarra, Spain. He had bought a copy of my book—The Complete Guide To Hospital Marketing—via the internet, and wanted to tell me how grateful he was to have read it. He also said it was comforting to see that hospital marketing is taken seriously here in the U.S.

Folks, I’m not making this up! Here are Pablo’s own words (there are a few grammatical and language roughspots, but the meaning comes through loud and clear):

“Sincerely, the best thing of the book is the approach of the hospital marketing. In Spain…people who work in hospital in marketing matters are not respected. For you, hospital marketing is really a branch of marketing, and you speak about with authority, so, it’s very good to read people who think that marketing in the hospital is not for the crazy people, but for the people who understand the hospital context and who know the importance of hospital role in the society.”

Pablo goes on to write: “In Spain, the hospital marketing is technology, technology and technology. We have forgotten the role of human experiences, the essence of healthcare brands.”

The funny thing about this email from a hospital marketer in Spain is that it could have been written by someone right here in the good old U S of A. Unfortunately, many of our hospitals focus their marketing on technology just as Pablo says his hospital does. About six years ago I made a trip to Germany, a few months after the horror of 911. While there, I visited the University of Heidelberg and its teaching hospital. I was impressed that they had technology even more advanced than that in some of our university hospitals. But more impressive was the friendliness I detected in the staff, the cleanliness in the halls, the ease I had in communicating with the physicians and nurses.

Somehow it's comforting to know that hospital marketers across the world are concerned that "we have forgotten the role of human experiences." Wouldn’t it be great if there were international standards for customer service in health care?

'Til next time.
--TMW

Multi-tasking And Rising Attention Deficits: Just Coincidence?

It’s in practically every job description: “Fast-paced environment; must be able to multi-task”. Employers once prized those employees who could put their entire attention to a task to be sure it was done right. Now, if you can’t prepare your powerpoint presentation while you carry out an important phone conversation , eat your yogurt lunch, and respond to the latest email from your boss, you may be headed for the glue factory.

Whatever happened to focusing on the task at hand, and to doing a thorough job? Is speed that much more important than accuracy? Is it really more productive to do so many things at once?

Has efficiency trumped effectiveness?

Ever since the early 20th-century time and motion studies of Frederick Taylor, workplaces have looked for ways to get employees to do more in an eight hour day (now a ten to twelve-hour day/night). Typing 75 words a minute was better than 60. Speeding up the testing of more water heater cylinders on the production line, even though the error rate for detecting defects increased, was valued in that industry.

The multi-tasking craze has taken the “doing more is better” thinking to the point where it even is affecting the quality of information we receive in our electoral process. Politicians are forced to sound-bite their way onto CNN, MSNBC, and Fox News. Does our collective intelligence as an electorate increase proportionally with the more talking heads we listen to? (Remember the headline in the London Daily Mirror after the 2004 presidential election: “How can 59 million Americans be so dumb?).

I would love to see a research study to determine if there is a correlation between poorer decision-making and multi-tasking. And I would love to hear what you all think on this subject. Oops—gotta go, my cell phone is ringing, my cordless is ringing, I'm balancing a salad on my lap, and I’m trying to follow the stock market gadget on my desktop as I type this.
--TMW