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
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Soul Search
In reference to your June 30 blog, “What Makes a Great Physician Group Practice?” I want to get even more basic in the idea of a great versus so-so practice. Having been on both sides of the healthcare market, as an employee and as a patient, I find that patient centered operations work best when staff works respectfully, as a team. Team leadership starts at the top and filters all the way down. A valued employee will quite naturally pass a sense of wellbeing to the patient through subtle communication - a lifeline in the otherwise formal business of marketing.
Most of us have entered medical offices where from the first visit we sense an “ill wind” ruffling through the forms at the reception area. We look through the glass barrier at employees who pass one another without so much as a glance; the doctors, somewhere in the back, don’t seem to know the very people hired to help their practice and who can make them look good.
Recently I visited a retinal specialist. While he and his office assistant worked to adjust ocular equipment to my needs, I listened to their communication: “What do you think, Doc? Is this the way we should turn the lens for her?” the assistant asked. Later the receptionist told me how happy she felt to be working for a smart and caring doctor.
In another medical office a physician, not looking at me, said “I’ll have to double charge you now.” I had mentioned my sore shoulder right after he removed a skin cancer from my leg. But consider the case of my friend who went to a physician for a black growth on the bottom of her foot. “We’ll schedule surgery for that,” the physician monotoned while whisking down the hall. My friend just wanted out of there. Too bad no one could point her toward the exit and she had to navigate the maze on her own.
But what good news for my friend! The black growth on her foot turned out to be a piece of lining from her shoe. In the end she never had to “bare her soul” to the surgeon. For years she has told the story though, and while the doctor has likely departed our world by now, the negative marketing of his office gets resuscitated at countless social gatherings.
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