What's a patient worth to your practice?

Most businesses exist to make money.  We've all heard the phrase "maximize profits and keep costs low." Among many factors, one of the major ways to build a successful and profitable medical practice is to reduce patient acquisition costs through a variety of patient retention techniques.

With that said, keep the following in mind: for an average company, it costs five times as much to obtain a new customer than to retain a current one. It can reach up to sixteen times as much to turn a new customer into one as profitable as a lost customer.   And that can be directly applied to most medical practices, especially ones that focuses on cosmetic services or charge fee for service.  Gone are the days when physicians could expect people to patiently sit for over an hour in the dull, dark waiting room with old boring magazines to read and then expect them to be grateful to even be seen.  Most of our patients are frustrated if they can't be seen within a day or two and will not tolerate waiting beyond 10 minutes in the waiting room.  And I don't blame them.  They are paying a lot of money for their treatments and are busy themselves.  Plus if we can't accomidate them, then usually there are at least 5 other physicians in the area who can do their Botox that same week.

What's a practice to do?  Treat the patient more like a customer and understand your practice through their eyes.   According to Marc Mertz  with The Horizon Group, a national health care consulting company, most patients base their level of satisfaction on two things: the front office staff and the office itself.  Can that be true?  You mean they don't seek out the best physician through hell and high water?  Actually patients tend to judge your clinic by the things that you likely take for granted.  And no matter how skilled you are as the doctor or where you went to medical school, they key in on a rude receptionist or the paint chipping from an exam room wall.  In fact, according to a survey of family practice patients, the front-office staff, ambiance of the practice facility, clinical support staff, and then physicians were ranked in order of importance as factors influencing patient satisfaction.

This is very important information and if you were suprised by it, then it was even more important for you!  Physicians tend to focus on their clinical expertise and think that staying abreast in their field is enough to guarentee a happy patient population.  And while that may be true in some fields, that is not the case in the field of elective cosmetic procedures.  So how do we adapt to this information?  One sure way to fail is to ignore it.  But offices who succeed tend to take it in, learn from it, and actually implement the changes necessary to keep their patients happy and, in turn, keep them coming back to them over and over again.

To read more about steps that you can use to improve your office, click here

Resources: Physician info sites from a psychiatrist

From Corpus Callosum: Yeah he's a psychiatrist, but what the hell...


img_mm_logo.jpgMerck Medicus is a great site.  I had to provide some medical license information, so I don't think it is available to everyone.  That is annoying, but I understand why they do that. The site provides free access to resources such as Harrison's Online, Mosby's Drug Consult, etc.  I assume the pay for that access, and I also assume that they would have to pay a lot more if they opened it up to everyone.

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Biomed Central is a publisher of open-access biomedical journals.  Some seem rather obscure to me, such as  Cerebrospinal Fluid Research, but others have a wider appeal.  I occasionally browse these journals just to keep myself updated, or to find things to blog about.


channel_MB.gifThe Doctor's Guide to the Internet is a news aggregator that pulls in articles from a variety of sources, plus some CME programs.  You can register, then customize you own page with the feeds that are of greatest interest to you.  Sometimes the robots pick incorrectly, such as when it included Unexpected hemodynamic depression after induction of anaesthesia - (Anasthesiol Intensivmed Notfallmed Schmerzther) in the channel for Depression.  The robots pick up a lot of case reports, which are a good way to refresh your knowledge base and exercise your clinical thinking skills.  

phrma-logo.gifPhRMA Medicines in Development is on online database of pharmaceuticals currently in some stage of development.  I like to browse through it from time to time, in order to keep up on what is in the pipeline. 

Medspa Patient Analytics: Who's looking at you?

surfacemap.jpgWhere are your potential clients coming from?

This image shows where visitors to Surface Medical Spas web site originated over the last 24 hours.

(It's interesting to not that Cape Town, South Africa and Ha Noi, Viet Nam are among them.)

Our Park City location receives the most out of state visits. I'd tentatively place that number at around 5-8% of our total patient volume. Many of these patients have second homes in Park City or are regular visitors. 

If your site is static I can guarantee that it's difficult to find and will only grow harder to find as the market grows and 'real' businesses enter the market. 

Anonymous posts lack credibility: Please enter your medical spas web site.

balloon_about.gifIn most settings and especially on the web, anonymity is safety. But, anonymous posts lack any real credibility because there's no accountability.

There are comments on this site from MD, AestheticRN and others that are anonymous.

54px-Speech_balloon.svg.pngMD recently touted Cutera as being 'the best'. Is MD a Cutera rep planting info? Does he train for Cutera? We'll never know. (Unless he comments again here.)

Please comment on anything you wish. We love comments. We encourage comments. Just link to your site so that we can weight the credibility of your thoughts. 

Note: Posts that 'flame' anyone commenting on this site or indulge in personal attacks or harsh criticism of a point of view will be removed almost immediately. This site is for sharing information. Put some weight behind your comments.

Customer Service Obsession: Love your patients the Amazon way.

 Is obsessive customer service part of your medical practice?

Amazon is taking a page from Nordstrom's 'heroic customer service' book. Why? Because it's good business. I posted on the oft-induldged stupidity of price wars. One of the differentiators that drives business is customer service. Notice I did not say 'patient care'. Customer service is outside of the medical care you're providing. Customer service is the touchy-feely warm and cozy perceptions that your patients have or don't have.

From my friend Shmula's blog on Amazon's customer obsession:
blockquote.gifpushing 300,000 - 600,000 units of product per day through a fulfillment center is no easy task. gratefully, Amazon’s home-grown software and efficient processes help to deal with the immense volume. sometimes, if there are inventory gliches or poor product flow, an activity known in warehousing as “product chasing” occurs. “chasing” is when a product is ordered, but it is nowhere to be found in the (1MMft^2) facility. in reality, it is somewhere, but according to the inventory software the product is supposed to be in its assigned bin, but it has been moved somehow, drifted to another bin, or stolen. this defect is called Inventory Record Defect Rate and is one of the most important metrics at Amazon, and is highly scrutinized and reviewed by Bezos and his senior team.

customer_lifecycle_experience.gifWhy is it important? because when the front-end Amazon store allows you to order something, the precondition is that the product and the quantity desired is currently in an Amazon facility: the software follows a very complicated algorithm based on network optimization, shortest path techniques, and traveling salesman routing; a check is made against the inventory database — in real time — how many are available, which facility, and how many have been committed already. when the order drops into the assigned facility, the picker goes to the bin where the product is supposed to be, but because IRDR is poor, the item is not there. this situation leads to two following options: (1) go to a local store and buy the item and ship it to the customer or (2) do a “network flip”, where the assigned facility “flips” the order to another facility that has that product. option (2) is ideal, but during the holiday season, it is very difficult to do. during the holidays, option (1) is common.

doing option (1) is heroic and is a true example of customer obsession at work: it’s not about serving all customers as an aggregate, but it’s about serving one really well, several million times. at Amazon, they really believe this and live this.

This kind of take-no-prisoners approach to customer service is absent in most clinics I see. You're asking your patients to spend their money inside of your business. Great customer service is your obligation.

Physician, wash thy hands.

24freak.190.jpgNY Times story on physicians spreading bacteria.

There also seem to be psychological reasons for noncompliance. The first is what might be called a perception deficit. In one Australian medical study, doctors self-reported their hand-washing rate at 73 percent, whereas when these same doctors were observed, their actual rate was a paltry 9 percent. The second psychological reason, according to one Cedars-Sinai doctor, is arrogance. “The ego can kick in after you have been in practice a while,” explains Paul Silka, an emergency-department physician who is also the hospital’s chief of staff. “You say: ‘Hey, I couldn’t be carrying the bad bugs. It’s the other hospital personnel.”’ Furthermore, most of the doctors at Cedars-Sinai are free agents who work for themselves, not for the hospital, and many of them saw the looming Joint Commission review as a nuisance. Their incentives, in other words, were not quite aligned with the hospital’s.

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Does Thermage work? Let's take a poll.

Termage is making strides in improving their Thermacool TC treatment.

  • Thermage treatments offer skin tightening with non-invasive radiofrequency energy
  • Thermage claims to tone and tighten sagging facial and neck skin
  • There is no downtime after Thermage, but maintenance treatments may be necessary

As a medical treatment, do you think Thermage works?

Medical Spa Investment Scams: What's that medspa scams link?

Medical Spa Investment Scams: What's the link at the top of the page?

Warning%20SCAM%20200(1).jpgI've received an email asking about those links so I thought I'd explain the sponsored links on the main blog page.  (The four green links near the top of the page are the main ones.) The businesses there are paying to be there in order to gain visibility and drive traffic to their sites. This blog takes in a little money from Yahoo when someone visits those sites from this one. It's not much.

We do this for two reasons. First, I want to pay my hosting bills. Second and more importantly, readers of this site are looking for information and the links offer examples of med spa sites or other information useful to our readers. The Medspa Investment Scams link is one of those.

Is the Medical Spa Investment Scams e-book worth paying for? To be honest I don't know. However I did just buy it. As soon as I read it I'll post a review and see if it's worth the $60 or so. 

Medspa Consultants writing business & marketing plans.

The infamous Medical Spa Business Consulting Plan: The emperor has no clothes.


chart.gifI've received a few emails lately castigating a number of medspa consultants by name. (Since I have no other information those names will not be mentioned.) You might first read my view of most medspa consulting and/or franchises here.

The physicians/owners feel that they were over-promised and under-delivered. One doc referred numerous times to the 'medspa business plan' that his medical spa consultant wrote for him. I thought I'd weigh in on this business and marketing plan issue.

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UnitedHealth: Dr. McGuyire got caught with his thumb on the scale.

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"UnitedHealth, one of the nation’s two largest health insurers, also dismissed its general counsel and a member of its board in what amounted to a sweeping overhaul of its governance practices and leadership ranks. The options that Dr. McGuire had been granted over the years have led to criminal and civil investigations and public disapproval.

In a sweeping report released yesterday that was highly critical of management, a law firm hired by UnitedHealth to investigate the timing of stock options concluded that the company was riddled with poor controls and conflicts of interest. The report, which the company posted on its Web site, found that UnitedHealth had backdated options to maximize employees’ compensation."

Read the entire NY Times article here

(via Kevin MD)


Update -
The Health Care Blog: "Whether or not it was illegal, his actions suggest staggering greed."

 

Group visits for cosmetic patients?

Via Kevin, M.D.

The Doctor will see you,alll, now: Group Appointments Give Patients More Time To Talk

blockquote.gifChang's office began offering such group visits only for patients with diabetes, and then for people with asthma. Instead of spending 10 or 15 minutes each with 10 patients — many of whom need to hear the same thing — she might spend 90 minutes with 18 patients. Each patient learns from others' questions and symptoms, and the doctor covers much more.

Group visits

Studies have found that patients attending group visits had fewer emergency room and specialist visits (and thus lower monthly costs), stayed healthier and were more satisfied with their care. Three models exist.
Cooperative health care clinic, created by Dr. John Scott in Wheat Ridge, Colo., in 1991, is an alternative to individual doctor visits. The same group of patients usually sees the doctor together monthly.
Specialty group visits, which Scott developed in 1995, are similar, but patients have the same diagnosis, such as pregnancy, diabetes, hypertension, arthritis or fibromyalgia.
Drop-in group medical appointments, developed in 1996 by clinical psychologist Edward Noffsinger in San Jose, Calif., typically have different patients at each session.

I wonder if you could do this in a cosmetic setting. Has anyone tried something like this? 

DoctorsDirect.com: Book your appointment online?

 Sent by DocBiz from Alarm Clock:

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A columnist at the Washington Post wrote an article today commenting that there is no Orbitz for health care. Doctors Direct would like to get there and has raised $2.5M in Series A funding led by Spark Capital . Tommy McGloin is the President and CEO of DoctorsDirect.com. Before joining DoctorsDirect.com, he headed MapQuest for 4 years and before that McGloin headed AOL Moviefone. This one doesn't compute. Users search for docs using a variety of paremeters and can than book an appointment. That's nice but DoctorsDirect takes a booking fee and it won't touch insurance. So if you are uninsured or too rich to care about insurance, Doctor'sDirect is a swell service. It doesn't add up why a seasoned lead like McGloin sees an opportunity here.

And from the Washington Post.

Dentists & medspas?

MD posted this in the Physician to Physician Q&A discussion area:

blockquote.gifDoes anybody know if it is legal for a dentist to purchase and run an IPL/Nd:YAG? A local dentist just informed me he was getting into the med spa business to "generate lots of revenue" Humm- good luck with that....

MD makes a point. Dentists, docs, nurses, hair stylists and others who don't have a good business sense and feel that everyone's just making money hand over fist are in for a rude awakening. As I've posted before, one of my friends makes his living (a very, very good one) buying tecnology from doctors going out of business and selling it to doctors rushing into business. I would bet my left kidney against a bag of hammers that there will be a used IPL going cheap in a dentists office.

Biggest medspa challenge? No suprise: Getting patients.

AestheticRN posts these medspa statistics in a discussion thread here:

 

31% of income is generated by hair removal
42% of the medspas polled generate 0-$99k gross per year.
35% of the medspas polled see between 1-19 people per week.
52% of the medspas reported the biggest challenge was getting and keeping clients.

 

Med Spa Legal: How to legally open a medical spa.


gavil.jpgIntroduction

There are so many factors that go into the formation of a business, let alone a medical one, that each case must be examined individually. State laws and regulations, state medical boards, and your own preferences and goals will need to be addressed. While basic principals remain consistent in most states, topics and examples discussed here are generalized by necessity. Hence, if you just fire from the hip and get yourself in trouble, I'm not to blame. Step one will be to consult a lawyer and accountant. 

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