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Growing Markets by Knowing Referring Physicians Key Concepts and Tools You Can Use

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Page 1: Growing markets by knowing referring physicians

Growing Markets by Knowing

Referring Physicians Key Concepts and Tools You Can Use

Page 2: Growing markets by knowing referring physicians

PAGE 2

Agenda

1. Situation Overview

2. Key Trends

3. The Physician Experience

4. Segmentation and Prioritization Principles

5. Taking Action

6. Additional Resources / Handout Outline

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SITUATION OVERVIEW

1

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Pressure…By the Numbers

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Physicians Today ...

77% are pessimistic about the future of medicine.

82% percent believe they have little ability to change the healthcare

system.

Factors driving widespread feelings of discontent • Liability / defensive medicine pressures

• Medicare / Medicaid / government regulations

• Reimbursement issues

• Uncertainty/ changes of health reform

Source: Physician Foundation Survey, 2012

Size = 13,575 physicians

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Communications Environment

Channel/Message overload

• Anxiety

• Irrelevancy

• Overlooked Audience confusion (physician)

• Economic

• Regulatory

• Cultural

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Good Old Days of Physician Practice

• Physician-based

• Solitary

• Focused

• Controlled

• Work on hook

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New Way: Collaborate to Win

• Care continuum

accountability

• Emphasis on

relationships

• Team dependent

• Constant

communication

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What Credentials Do Doctors Find Most Important in a

Physician Relations Rep?

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What Really Hasn’t Changed

Focus on clinical quality

Customer experience is a differentiator

Brand management matters

Market expansion requires insight

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KEY TRENDS

2

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Internal vs. External Challenges

• Consolidation is hitting many healthcare systems

• Specialists who were competitors are now partnering

• Unresolved political issues

• Divided loyalties in referring clinicians

• Adapting to new governance

• Where does a liaison go with internal barriers to

business development?

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Internal vs. External Challenges

• Moving from “baby-boomer” clinicians to younger groups

• Differing definitions of “great practice”

• Program builders (baby boomers)

• Quality of life with my “job” (gen X-ers)

• Limited training hour challenges (gen X and Y)

• How do you communicate with clinicians in each

group?

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Internal vs. External Challenges

• Clinician turnover in healthcare systems is much

faster than in prior eras

• How well do you know the providers in your

system?

• Are you keeping up with changes in the medical

staff at your organization?

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THE PHYSICIAN EXPERIENCE

3

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Physician Experience Benchmarking

Source: Gelb Consulting Benchmarking survey

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Experience Management Best Practices

Patients Referrers Internal

• Conducting weekly meetings between faculty

and service staff

• Enhancing the role of volunteers, including

recruitment & their role in the patient

experience

• Offering amenities to paramedics

• Sharing best practices across multiple

departments

• Including front-line staff in operational

redesign, particularly for call center and

scheduling

• Implementing real-time organizational

effectiveness feedback system

• Developing uniform customer service

standards across roles

• Providing scripting for organizations,

especially front line staff

• Implementing weekly progress meetings

• Creating non-traditional support groups

• Improving waiting areas by providing laptops for

checkout, pagers for patients and separate areas for

adults and children

• Customizing welcome packets based on geography

and personal preferences

• Offering patient advocates, particularly for destination

and international patients

• Screening interviewees to share their story for

inclusion in marketing materials

• Implementing real-time feedback system for patients

and referring physicians

• Mapping out the experience by setting expectations

for every step and reiterating during steps

• Including referrers on advisory boards

• Sending “thank you” notes and/or calling to

thank them for every referral

• Adding photos and sub-specialty focus to faculty

directory

• Promoting availability of diagnostic center for

undiagnosed patients

• Revamping follow-up notes to include a concise

summary upfront

• Creating opportunities for on-site CME,

backstage tours, and meet and greet with faculty

• Courtesy calls for a personal touch and rapport

with physicians

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Customer Enchantment

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Recognize Needs

Functional Emotional

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Relationships Matter

Source: Cleveland Clinic / Gelb Presentation

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Channels Matter, too

Source: Cleveland Clinic / Gelb Presentation

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Engagement Process

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Video / Audio Recordings

Physical

Environment

Communication

s

From Data…

1.

Interview

Transcripts

2.

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…to Insights

Detailed Findings:

• Key themes

• Verbatim comments

• Strengths and barriers

Day in the Life

Touchpoint Assessment:

• Key Recommendations

• Illustrate with pictures

• Enrich with clips

3.

4.

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Experience Map Awareness

• Perceptions / knowledge of facility

• Choice of hospitals for delivery / practice

• Ideal relationship

Need

• Evaluation and selection of treatment providers

• Discussion with patients (diagnosis, referral options)

• Preparing patients for what to expect

Scheduling

• Initial contact

• Timing and ease of process

• Resources for patients and their families

Treatment

• Coordination of care with specialist

• Progress notes and methods of communication

• Family feedback about their clinical experience

Transition of

Care

• Discharge summary

• Coordination of on-going care

• Ongoing patient care/support

• Call-backs for assistance

Primary Experience Stewards

• Physician Liaisons • Faculty/Staff

• Front Desk Staff • Faculty/Medical Staff

• Faculty/Medical Staff • Support Staff

• Faculty/Medical Staff • Support Staff

• Faculty/Medical Staff

• Support Staff

Key Touchpoints

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What are your key challenges?

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Ways to Engage: Sample Discussion Areas

Patients / Families

• Current Perceptions

• Decision Criteria

• Sources of Frustration

• Areas of Praise

• Usefulness of Touchpoints

• Likelihood to Recommend and

How

Physicians

•Referral Roles / Process

• Ideal Relationship

•Self / Patient Experience

Assessment

•Recommendations

•Likelihood to Refer and

Why

Staff / Executives

• Vision of Ideal

• Current Barriers

• Patient Dissatisfiers

•Opportunities for Improvement

•Model Employee

• Likelihood to Recruit and Why

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Ways to Engage: Advisory Boards

Keys:

Set a Clear Vision

Recruit Thought Leaders

True Collaboration

Recognition, Exchange Value

Right Mixture of Participants

Use for:

Industry Trends

Organizational Strategy

Outreach Planning

Service Line Development

Experience Enhancement / Concept Testing

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Internal Processes

Key Activities

Scheduling First Visit Treatment Follow-up Need

Physician contracts call

center for additional

information

Pain Points

• Calls not returned

• Provided incorrect information

• Need to repeat their “story”

How can CRM support/improve process? Are we improving?

Information Needs

• What is currently collected, needs migrated

• What needs to be collected

• How should that information be organized Assessing, Monitoring and Tracking

• Surveys

• Key Metrics

• Reports and Trends

Liaison Pain Points

• Incomplete records

• Information needs

• High volume of calls

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Service Recovery

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Real-time Insights

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Interested in growing practice Anxious about competitiveness

PCPs and Specialists are different

Concerned about staff

Wants a seamless experience

Uncertain about future

Physician Partners and Personality Traits

Wants to be a partner, know individuals to

whom he refers

Requires respect

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Action Planning

Communication Coordination Care

Awareness Need Scheduling Treatment Transition of

Care

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Incorporating into Lean Work

Page 35: Growing markets by knowing referring physicians

SEGMENTATION AND

PRIORITIZATION PRINCIPLES

4

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FY14 Plan

Can We Grow It?

Where?

Who Controls

Referrals?

Sales-

Verified

Volume

EBITDA

Growth

Opportunity

Mapping Precision

Targeting

Revenue

Sustained

Growth

Building “Right” Volume

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Service Quality &

Outcomes

Value &

Opportunity Context System /

Med Policy

How We Make Your

Practice Life Easier

Why We are Best for

Your Patient

How Misunderstood

Elements Fit In

Benefits of Aligning

with Us

What You Need to

Know to Practice Here

GRAND NARRATIVE STORY

Assets & Attributes

Differentiator Strengths

Programs & Initiatives

Shared Goals

Collaboration & Enrollment

Mutually Beneficial Outcomes

MESSAGE Desired Perception

Source: SVP Strategies LLC

Communications Engagement

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PAGE 38

• Drive “Ease of Practice Life” Strategic Engagement with Physicians

• Adapt Professional Sales Practices to Physician Relations

• Physician Field Team Call Strategies are Aligned to FY14 System Strategies

• Data-driven Field Activity Strategies

• 40 “Quality” Calls to Physicians per Week w/ Incremental Volume Expectations

• Systematic Surfacing of Barriers to Growth (Tickets)

• Field Team Intelligence Puts Pressure on Operations for Timely Responsiveness

• Sales Field Team Seen by Physicians as Relevant Advocate for Physicians

• Hospital CEOs and A-Teams Have Specific Sales Call Expectations

The Culture of Growth: Physicians

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Pre-Call Plan

• Review Field Intelligence

• Purpose for My Call

• Define an Objective / Outcome

• Prepare Message / Questions

• Set Specific Volume Targets

Create Relevance

• Establish Rapport & listen

• Relevant Information Exchange

• Surface Needs / Growth Barriers

• Ask and Answer Questions

Offer Solutions

• Understand Customer Needs

• Address Objections

• Facilitate Issues Management

• Create Connections

Gain Commitment

• Negotiate

• Set Follow Up

• Close on Action

Profile & Strategy Open the Call/Create Relevance

Advocacy for Customer Close

Professional Relationship Model

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Persona: Primary Care Providers

Primary Care Provider

GOALS

• Grow their patient base

• Strengthen reputation through

excellent care for their patients

• Build lasting relationships with their

patients

BEHAVIORS

• Employed or affiliated PCPs refer

to their institution

• Refer locally for less complicated

cases, believing their patients want

convenience

• Refer to The James for many

types of cancer and to other areas

of The OSU

“My patient’s satisfaction with care directly impacts the

success of my practice. When my patients are happy,

they stay with me and refer me to their friends and family.

When I refer a patient, my reputation is at stake.”

NEEDS

• Know what their patients can

expect at The James so they can

prepare them in advance

• Secure timely appointments

• Referral process that does not tax

their resources and staff

• Stay informed about their patient’s

treatment and care

• Have their patients perceive them

as being engaged and involved in

their care

Source: OSUMC / Gelb Presentation

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Persona: Specialists

GOALS

• Grow their patient base

• Strengthen reputation through

excellent care for their patients

• Building lasting relationships with

Primary Care Physicians

BEHAVIORS

• Refers to sub-specialist at The

James for complex cases

• Manages more common cancer-

related issues and screenings

“I am an expert in my specialty. Almost every case I refer is

complex. For rare cases or those that require special

technology, I need a physician at the top of their field with

very specific expertise- distance to travel is less important.”

NEEDS

• Ability to identify oncologists at

The James based on expertise

• Knowledge of

technique/technology available

• Have the patient referred back for

specialist-level care when possible

(such as common surgeries)

Specialist

Source: OSUMC / Gelb Presentation

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TAKING ACTION

5

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Impact of Transformational Leaders

Leaders translate customer

expectations to the organization

and reinforce desired employee

behaviors. They also set strategies

such as value equation, culture

alignment and patient enchantment.

Culture and your brand promise are

linked through the experience

delivered.

This alignment creates an

exceptional experience and a

sustainable competitive advantage.

EXPERIENCE

STRATEGY

Culture Leadership Brand

Ensures

alignment and

sustainment

RTB-CTB

Impacts

Culture

Envisions

Future

Motivates

Individuals

Manages Red

Zones

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PAGE 44

Aligns the culture Creates a shared vision

Builds trust on all levels

Models moral behavior

Advocates for the customer

Motivates the heart

Where It Begins - Transformational Leader

Transformational leadership is the process whereby a person engages others and creates a connection that raises the level of motivation and morality in

both the leader and the follower (Northouse).

Challenges the status quo

Develops and enables others to act

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Establishing a Dual Agenda

The Red Zone

As you progress with dual agenda, conflicts appear

between them. You must look for opportunities in

current operations to make changes.

Use the momentum of

Run the Business to

sustain the Change

agenda.

The Red Zone

Employees Transformational

Leaders

Managers

Future

Business Model

Today’s

Business Model

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Ensuring Commitment

The Red Zone

Your employees will travel up a commitment curve.

While the speed with which this

journey can vary, the steps are

always the same. Our practices

accelerate the timing.

The Red Zone

Acceptance

• Rational

• Emotional

Enable

T I M E

CO

MM

ITM

EN

T

High

Low

Envision

Engage Energize

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Prioritization

Quality

The Kano model shows how tangible customer needs, wants, and suggestions can be segregated into 3 separate requirement categories:

Basic Requirements

Meet these requirements quickly and

with the lowest cost possible

Performance Requirements

Selectively meet these requirements to

achieve highest ROI

Enchantment Requirements

Meet these requirements to achieve

elite status

Competitive

Pressure

Satisfied

Performance

Needs

Enchanted

High

Satisfaction

Dissatisfaction

Enchantment Needs

Unexpected and unspoken,

adds value but not required

Basic Needs

Expected, minimum

requirements

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Action Prioritization Basic

Requirements

Performance

Requirements

Enchantment

Requirements

C o m m u n i c a t i o n

Awareness of

Services Self-Service for Referrals

Creative, Value-Added,

Patient Education for Docs

Accessible,

Responsive

Personnel

Single Point of Contact Engage Physicians in

Developing Services

C o o r d i n a t i o n

Improved

Scheduling

Coordination of Referrals

Outside of Original Intent Real-time Status Updates

Internal

Coordination

Web-Enabled Scheduling

and Lab Results Nurse Navigators

C a r e

Consistent Quality

and Quality

Control Process

Dedicated Physician

Access Concierge Service

Respect for

Referrers

Physician Sat

Measurement

Share Performance

Results

O v e r a l l

E x p e r i e n c e

Presenting a

Clear Brand

Promise

Ownership Culture Engage Physicians

Strategically

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PAGE 49

Run the Business, Change the Business

• Identify the RTB/CTB activities you engage in today:

RTB CTB _________________ __________________ _________________ __________________ _________________ __________________ _________________ __________________ _________________ __________________ _________________ __________________ _________________ __________________

• How would you change this ratio to be a more effective

transformational leader?

• Discussion with table partner

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PAGE 50

RTB/CTB worksheet

Takeaways

1

2

3

How would you change your ratio of RTB/CTB activities?

1

2

3

Call to Action

1

2

3

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Personal Action Plan

What is now clear to you that was not clear to you prior to this workshop?

1

2

3

What has been most valuable for you?

1

2

3

What are the top 3 commitments you will make to improve your effectiveness as a transformational leader?

1

2

3

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Managing the Transition

The Business must be prepared

for each step on the way to the

Future Operating Model

FOM Marketing

Front Office

Planning Trading Moving and

Tracking Settling

Controlling

Trading

Controlling the

Business

Managing the

Business

Mid Office

Back Office

2014 Marketing

Front Office

Planning Trading Moving and

Tracking Settling

Controlling

Trading

Controlling the

Business

Managing the

Business

Mid Office

Back Office

2013 Marketing

Front Office

Planning Trading Moving and

Tracking Settling

Controlling

Trading

Controlling the

Business

Managing the

Business

Mid Office

Back Office

2012 Marketing

Front Office

Planning Trading Moving and

Tracking Settling

Controlling

Trading

Controlling the

Business

Managing the

Business

Mid Office

Back Office

COM Marketing

Front Office

Planning Trading Moving and

Tracking Settling

Controlling

Trading

Controlling the

Business

Managing the

Business

Mid Office

Back Office

COM = Current Operating Model

FOM = Future Operating Model

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PAGE 53

Q&A

Page 54: Growing markets by knowing referring physicians

ADDITIONAL RESOURCES

6

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Session Leader Contact Information

Doug Backous, MD, [email protected]

Shannon Frazier, [email protected]

Jeff Cowart, [email protected]

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Handout

Key Challenges

Discussion Guide

Experience Map

RTB/CTB Activities, Agenda

Personal Action Plan

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Selected Physician Experience Resources

Gelb referring physician experience

management overview

Ohio State University Medical Center

Cleveland Clinic

MD Anderson

Texas Children’s

University of Michigan Health System

Experience Mapping Workshops

Building Enduring Relationships

with Referring Physicians

Healthcare Growth Playbook

Marketing in the Era of Health Reform

Message Mapping – Creating a

Communication Roadmap

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About Gelb Consulting

We understand the nuances of healthcare having worked

with some of the largest and most respected organizations

in the country.

Our healthcare professionals lead stakeholders to make

best use of market information to build and execute sound

strategies.

We uncover attitudes and expectations to form consensus

around which transformational strategy to pursue.

We then provide recommendations, based on our

knowledge of the market segments, as to how to best

achieve real business value.

Selected Clients Barnes-Jewish Hospital Boston Children’s Hospital Cleveland Clinic Cincinnati Children’s Hospital Duke Medicine Froedtert Health Mayo Clinic MD Anderson Cancer Center Memorial Sloan Kettering Menninger Clinic Texas Children’s Hospital The Ohio State University Medical Center University of Chicago Medicine University of Colorado Health University of Michigan Health System

www.endeavormgmt.com/healthcare

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About Barlow/McCarthy

Recognized as one of the nation’s top healthcare consulting firms, Barlow/McCarthy provides

community hospitals, academic medical centers, systems and specialty providers with forward-

thinking physician relationship strategies and solutions:

• Physician relations/sales programs

• Physician recruitment and onboarding

• Engagement communications for physicians

• Practice marketing strategy, design and implementation

• Alignment and leakage; business strategy and model development

• Retention, loyalty and physician leadership development

• Medical staff development and community health needs assessments

Barlow/McCarthy provides insightful and practical advice in physician relationships. We succeed

because we listen and work systematically through hospital/physician challenges. We do the careful

and detailed work it takes to inspire positive change and achieve lasting results.