7 trigger points that infuriate fertility patients and lead to bad reviews for doctors

By Griffin Jones

What should fertility doctors say or not say, do or not do, to avoid angry reactions from patients on the internet?

observation, not advice

This is tricky. I can help practices increase their positive reviews, but I will not tell physicians how they should talk to their patients, because I am not a physician. I write prescriptions only to medicine I’ve swallowed myself. The reason I feel comfortable telling clinics to invest in Facebook ads, is because I have had success reaching new patients through Facebook ads. I’m comfortable telling fertility specialists how to respond to negative reviews online because I have improved doctors’ online reputations from the way I respond to reviewers.

I have never delivered a fertility diagnosis inside a consult room. I’ve never told a couple that their prospective IVF cycle has a 10% chance of success or called someone to tell them that their 3rd IUI was not successful. I have an idea of how I think I would communicate with patients, but I have little tolerance for arm chair quarterbacks. 

navigating the mine field with compassion

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What I can show you, however, are patterns that I’ve observed from upset patients: what I call “landmines” or “trigger points”. These are common themes that, when received a certain way, tend to send patients’ thumbs into a blaze of fury to light up their IVF center on the internet. By being aware of how patients recount certain interactions, you may better prepare for them.

“It’s not what we say, it’s what people hear.”—Frank Luntz, PhD

1). Body Mass Index
When a patient visits an IVF center, her initial testing may reveal that her body mass index (BMI) is too high for a fair probability of IVF success. Patients may first be referred elsewhere to help decrease their BMI. While I cannot tell you how to deliver this news, I can show you how it is sometimes received. Comments like, “he called me fat” or “they refused to even see me because I’m too fat,” are common on social media and review sites. I wouldn’t suppose that the physician used those words, but in a very difficult moment, this is what the patient may hear. 

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2). Age and Diminished Ovarian Reserve
“She told me I was too old to ever get pregnant”. The quality or quantity of a patient’s eggs may be low, and a physician may issue caution about the probability of successful treatment. What could be a very honest move, certainly in patients’ best interest that they not spend money and energy on unwise surgery, can send patients to their keyboards in anger when received the wrong way.

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3). Low probability diagnoses
Patients occasionally feel that their doctor is rooting against them, or shows no compassion for them when going over their diagnosis. Reviews commonly include boasting that the patient got pregnant, even though their doctor said they would not. This article articulates what patients sometimes write about their doctor after they have seen more than one specialist. 

4). Contact availability
“The two week wait” (#2ww) is one of the most notorious chapters of fertility treatment and it is only one of many anxious periods patients have to face. When one doesn't receive a call when she or he was told to expect one, more stress is added to the patient experience.  Failing to call with test results, not responding quickly enough to patient calls or e-mails, and not being available via the media which patients use to communicate are all landmines for patient reaction.

In fact, I would be very curious to know what percentage of negative fertility center reviews come during moments when the patient is waiting for correspondence from the provider. When worries about treatment monopolize a person's mental bandwidth, the wait for answers turns seconds into hours. It is a feeling of helplessness and desperation in which lashing out against the provider online may be an attempt to regain a sense of control.

5). Face time with doctor
Smaller fertility practices frequently claim that individualized care is their edge over larger practice groups. It is an advantage, if in fact, the patient gets to spend more time with the provider. Rarely seeing one’s physician is a very common pain point that leads patients to say things like “baby factory”, “only in it for the money”, and “looked at me as a dollar sign”.

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6). Punctuality and preparation
Doctors are very busy people. So are patients. With high demand from patients, and a nearly infinite number of scenarios that can arise at any moment, the need for providers to maximize their time can make timeliness impractical. Still, patients feel slighted when they are not seen on time because their time is valuable too. The same goes for when they feel the doctor has not read their chart, not taken the time to thoroughly answer their questions, or rushes through their appointment. 

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7). Absolutely anything to do with billing
If these scenarios are landmines for fertility center reviews, the billing department is a minefield in and of itself. Billing issues might account for 1/3 to ½ of your negative reviews. In short, the billing department is arguably the greatest liability to a fertility practice’s online reputation. Patients often feel ambushed by the costs that they incur during the course of treatment. Insurance coverage (or lack thereof), reimbursements, deductible requirements, and variability in medication costs are pain-points unique to healthcare. Patients may lash out against their practice in a public forum because they do not experience these annoyances in most other consumer categories.

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To make matters worse, prospective patients receive very little education about IVF costs prior to treatment. In fact, some practices refuse to detail any cost information on their websites because they are afraid that it will dissuade people in need from seeking a consultation or that it will give a competitive advantage to other IVF centers. Many fertility clinics would rather bury their heads in the sand and hope for the best, than properly use digital media to educate patients about the headaches of insurance and billing.

Setting the stage

As a fertility specialist, you are walking into a minefield of patient anxiety and frustration. I don’t think it would be possible to tip-toe around every possible pressure point. Instead, what may be more prudent, is to disarm the tension as much as possible from the very beginning. Of course, I can’t tell you what to say to patients. From what I observe from their accounts, however, is that many patients do not hear their concerns addressed in this way:

“What you are going through is extremely difficult at times, and that is perfectly normal. You’re not alone because we’re here to help you with everything we can and connect you with resources for those things we can't control. We wish we could wave a magic wand and make everything better right now, but there will likely be parts of this process that are very frustrating.

"Billing, medication costs, and insurance can be a big headache. You may see a charge for a service and think what the heck is this? Just ask, we're here to help you through it.

"There may be times when we don’t call you back as quickly as we want to because our nurses are helping other patients in the same way we want to help you.

"We always try to be on time for our appointments, but every now and again, a patient needs a little extra time with her doctor, and we want to extend that same level of care to you.

"We often have to be the bearers of very delicate news. We balance optimism and our eagerness to help you have a healthy, beautiful baby with our duty to inform you of the implications and realistic outcomes of your different options.

"You don't have it easy and neither do we, but the plus side is that we’re working together. We hope you’ll tell us if we are falling short at all during this process because we need your help to do our best for you".

Satisfaction equals experience minus expectation

By setting expectations abundantly clear ahead of time, you may be able to prevent negative reactions when, not if, issues arise. Some patients develop their own expectations, regardless of what you do to help set them. It’s okay if some people are not satisfied with your practice and staff as long as the dissatisfied number is the lowest it can be. There are certain pressure points that must be approached with empathy during the already tense fertility journey. By setting the stage and disarming the mine field, you can reduce the number of complaints about your practice and doctors, and increase patient satisfaction.

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If it's too late and you need examples on how to respond to negative reviews, read chapter 4 of the Ultimate Guide to Fertility Marketing

A Stern Warning for Fertility Clinics Who Complain About Patient Review Sites

By Griffin Jones

"Change is not painful. resistance to change is painful."

Consider this a gentle "love tap" from a friend. 

A direct warning from me is far milder than what the market has in store. If I don't speak up about this single issue now, then I am neglectful in my duty to help protect the field of reproductive health from cultural and technological shock, because the internet-led market has proven to be unforgiving.

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When I entered the fertility world, I accepted the responsibility of preparing those inside the field from the disruption coming from outside. I built a company to help bridge the gap between the status quo of reproductive health and what's happening in the rest of the tech revolution. So that we're not dealing with contemporary business buzzwords, allow me to give this definition to what entrepreneurs and venture capitalists call "disruption":

  • Major enterprises losing double-digit market share or going out of business within 36 months due to brand new players who come from outside of their field. 

ONline reputation is hardly the tip of the iceberg

This article does not come in reference to any one particular conversation I've had (perhaps even with you) in the last few months...because I've had several. Some have been with clients, some with vendors, some with strategic partners; it's a recurring theme.

When I first started creating content for fertility practices, the topic of "online reputation" is what really piqued the interest of fertility doctors. Many of us are concerned with what people say about us online. We often find the comments to be unfair, untrue, or at the very least, unkind. As we explore, however, you may agree that the root of the issue has less to do with the comments of others and more to do with a strategically flawed grasp for control.

Technological and cultural change are sweeping through nearly every facet of society. We are dissecting online reputation in this instance, simply because it happens to be a very common pain-point. In this deep-dive, we closely examine

  • The cause behind the information shift of the last twenty years
  • Why patients have embraced it
  • The four principal reasons that practices have NOT embraced it
  • Why patients rely on social proof to make decisions
  • The real threat to a fertility center's online reputation
  • What to do once we've stopped resisting 

Many doctors tell me that negative reviews upset them to the point where they can't sleep. You've done everything you could, and if you could wave a magic wand, you would wish for nothing less than for your upset patient to have a healthy baby and a happy family. Before we separate your perspective from the patient's right to have and share a completely different perspective, let's first examine the informational shift that has happened over the last two decades.

the human need to move away from information ASYMMETRY

For any patient to think that she or he is more qualified to review her or his case after a few hours (or even hundreds) of internet research, must be insulting. If you're a fertility doctor, you've gone through four years of undergraduate studies, four years of medical school, four years of residency, and three years of REI fellowship. That's fifteen years of higher education, followed by some of the most demanding board exams in medicine. If you've grown accustomed to this legacy of information control, it's because you've worked extremely hard to do so. 

Information asymmetry, wherein the seller (provider) almost always has an information advantage over the buyer (patient) is wonderful...when you're the seller. Recall other pre-internet situations in which you have been the buyer. Call back to a time when you had to buy a car when only the car dealer knew the manufacturer's suggested retail price (MSRP) or its pre-owned history. Think of buying a house when only the realtor knew the last sale price, its home improvements, and recent sales in the neighborhood.  How did that feel? The best real estate agent in your market has a lot more experience buying and selling homes than you do. She may also be a very authentic and trustworthy professional. Does that mean she should expect you not to use Zillow and Trulia? You don't need me to explain the deep-seated human need to shift from information asymmetry to information parity. As consumers, we do it every day.

For over a century, virtually the only way for someone to obtain in-depth knowledge about any given medical condition was to attend medical school. Like our example of home-buying, patients had a scarcity of information, few provider choices, and no means to talk back. Contrast that with our very different world today.

The drive toward information parity

change coming for ivf centers

When I was a kid in the early 1990s, I wanted a million dollars so I could buy my own video game arcade. Now I have one on my phone (that I have never used). Every one of our patients walks around with a super computer in his or her pocket at all times. Within sixty seconds of being diagnosed with infertility, one can

  • Read various definitions of infertility
  • Study the most common causes
  • Research potential treatments
  • Compare providers
  • Watch video explanations from medical doctors from around the world
  • Find humor and relief from satirical and artistic content
  • Connect with thousands of other patients via social media

Information asymmetry is over. Forever.

patients often need to rely on each other 

Some of us are frustrated that just because our patients have access to virtually limitless information, that does not qualify them to make any diagnoses or prognoses. Correct; they are not medical doctors. They don't have to be. They are human beings with opinions and emotions and they have a right to share their experiences with each other. They frequently have to turn to one another for social proof to help them assess this information.

Also known as informational social influence, social proof is the psychological phenomenon where people rely on the actions and opinions of others to determine the appropriate behavior for a given situation. Talk about ambiguous social situations! What is the appropriate mode of behavior when someone learns that they've been diagnosed with infertility? When they've paid $18,000 of their life savings for two failed IVF cycles?

Social proof may be even more necessary for those dealing with infertility because of the tremendous social pressure to have children. When so few people in one's social network can relate to what they're going through, our patients frequently have to turn to the internet to find those who can empathize with their emotions and relate to their experience. 

information parity meets social proof meets technology

Imagine having to spend thousands of dollars of your own money on fertility treatment, and having no way of knowing which doctor or clinic could be the best fit for you. Along comes a fantastic user experience (UX), with sleek design and fields of search deeply relevant to those struggling with infertility. 

I don't own any equity in or have any commercial partnership with Fertility IQ at this time. Yet when I set myself free from my own desire to have perfect control over my paying clients' online ratings, and put myself in the position of the patient, it's easy to understand why they are using the platform in the hundreds of thousands. Instead of comparing apples to oranges on Google reviews, RateMDs, ZocDoc, Vitals, HealthGrades, or even Yelp, people with infertility read verified experiences from patients by their

  • Age
  • Diagnosis
  • Type of treatment(s)
  • Number of treatments
  • Success or failure of each treatment
  • Income level
  • Number of doctors seen

Complaining about Fertility IQ or any other review site is not as trivial as disliking a website. It's partaking in the exhausting struggle against what patients desperately seek. It is the hubris attempt to fight the human drive to move away from information asymmetry toward information parity. The market, whether through Facebook, Instagram, FIQ, Google, or any other platform will find a way to give it to them. It does not give a damn if we are inconvenienced.

the four main reasons for resisting patient reviews

Tech disruption in infertility field

I won't tell you to let go of control because we can't let go of something we don't have. If Muammar Gaddafi, the despot who antagonized western powers for decades, couldn't suppress social media, how could we? Why would we want to?

Well, after hundreds of conversations with fertility doctors, nurses, and practice managers, I've identified four principal reasons that we yearn to have control over what people say about us online, leading us down the path of most resistance.

  1. What we do is so hard and complicated. People don't have a right to criticize what they don't understand
    Consider the phenomenon of flight. What a magical experience. Distances that would have taken us weeks to travel a century ago, now take us a few hours. Instead of physical exertion, we're served snacks and alcohol while we enjoy unlimited entertainment on our personal supercomputers. The logistics, expertise, and technology required to provide this luxury to us are overwhelming.

    Left to my own devices, I would be lucky to mount a camel for a few miles. I still hate United Airlines, and so do you, and so do millions of our peers. Could we do a better job piloting, procuring maintenance for tens of thousands of aircraft, and maintaining schedules for tens of millions of travelers? Absolutely not. Should we have any right to complain when we're inconvenienced by what is still a tremendous luxury compared to the alternatives? Should is irrelevant; we do have the right, and we frequently exercise it. We are citizens of countries where free speech is (meant to be) protected by our constitutions. 

  2.  These reviews are fake
    Of the four reasons for resistance, this is the most legitimate, if the review is in fact illegitimate. False reviews are a real problem. Up to 15% of online reviews may be fake. If you are certain that a review is not from a patient at all, but from a competitor or an internet troll, flag it for review. I recommend flagging the review from more than one user account. At Fertility Bridge, we see fake reviews rear their ugly heads, and aren't always able to get them taken down. It's unfair and it pisses me off too. Because at least 85% of our reviews are authentic, let's focus on what we can control.

  3. Only unhappy people leave reviews
    A widely held assumption among fertility doctors is that IVF center reviews are overwhelmingly negative. This simply isn't true. In an analysis of 504 fertility clinic reviews, conducted by Fertility Bridge in 2015, 63% of reviews were positive and 37% were negative. Yes, there are reasons that people are motivated to leave negative and positive reviews about their practices. Someone may not have been able to become pregnant and want to take it out on you. Others may sing your praises because they were pregnant. Still, some centers are able to minimize their negative comments and maximize their positive ratings; that is our goal.

  4. Negative reviews use libel and slander
    If you'd like a good laugh with your morning coffee, read RateMDs' FAQs for doctors. In 12 paragraphs, they tell you how you can go pound sand if you think you're going to sue them. Vitals and HealthGrades do too, but RateMDs is the most humorous.
    Sometimes reviews violate the platform's terms of agreement by using hateful or vulgar language, and the site will remove them. Most of the time they do not.

the greatest threat to the accuracy of your reputation

Once we've moved beyond our four cardinal motives for resisting public feedback, we can focus on the real liability to the accuracy of our online reputations.

Last summer, in a summary of fertility doctors' responses to their online reviews, I corrected the old adage, "the customer is always right," to "the patients (plural, meaning the market) are always right". I'll use my own company as an example. Fertility Bridge served eight IVF clinics in 2016. If two of them were dissatisfied, one held a neutral opinion, and five were delighted with the service they received, I might be able to identify a few patterns. But what I would really want to do, is increase the volume of evaluation. Eight sources of feedback? Better than three, I guess. Thirty would be a heck of a lot better. 

The same is true for an IVF center's online reputation. When a fertility doctor has two scathingly negative reviews, one luke-warm review, and one glowing review, the public doesn't have enough information to accurately judge this physician. Very often, fertility doctors have unfavorable online profiles because they simply don't have a high enough volume of reviews on that particular platform. Forget these four motives for distrusting online review platforms; lack of volume is our worst enemy. The higher a clinic's volume, the more likely their reviews are to be positive. Period.

what to do now

Okay, Griffin. We've stopped resisting. We have a high volume of reviews but our ratings are still low. We still hate this. Make it go away.

disrupting the fertility field

If we've truly made it thus far, then we have the best road map for operational/personnel adjustments that we could ever ask for.  We have data to identify the most common problem areas in our practices and fix them. That's right, the same platforms that take control away from us give it right back...if we choose to act on it.

In my opinion, no review site makes it easier to evaluate customer service patterns than Fertility IQ. Clinics are rated by 

  • Operations
  • Scheduling
  • Billing department
  • Nursing Team

Physicians are rated by

  • Whether they treated their patient like a person or a number
  • Communication
  • How often they saw their patients at appointments
  • Response time

When we can measure how patients adore our nursing staff, and their disappointment in when their calls are returned, it's a lot easier to smoke out capacity-related issues that hinder the excellence of our practice experience. Of course we don't have to wait until patients leave our practice to listen to their stories. We can use tools like Press Ganey or Rep Check Up to solicit patient feedback, in-house. Public ratings are the final word, however, and in the eyes of the public, perception is reality.

a new review site is barely a baby serving of disruption

We've hardly seen the tip of the iceberg, my friends. If we cannot adapt to the reality of how patients use the internet to share their experiences, we are not long for what is to come. Regulation has sheltered healthcare from many of the market effects that have impacted other areas, but it won't hold forever. The executives of Zoc Doc, Vitals, and Health Grades are not worried about awkward run-ins at ASRM with physicians who subscribe to their premium offerings. They are interested in being the marketplace where patients find their providers.

FertilityIQ was started in the birthplace of many other innovative tech companies, the San Francisco Bay Area. It was started in the way most disruptive tech companies are, from outside. FertilityIQ doesn't receive funding from IVF clinics. They didn't need our permission to build their company and patients don't need our permission to share their experiences on their platform. This is what disruption looks like. Thousands of entrepreneurs are chomping at the bit to change healthcare in their own way. If we stay in the habit of yearning for control that we don't have, we will wistfully long for the days of unfavorable online profiles being our biggest pain in the neck.

Blockbuster Video chose to be nostalgic about the adventure of going to the video store. Netflix didn't. Marriott could have invented the world's most used lodging app; AirBnb was happy to do it instead. The largest taxi companies balked at the idea of hundreds of millions of passengers choosing to ride in a strangers' car; Uber bet the pot on it and became a multi-billion dollar company.

We are presented with an incredible moment in time to use new market opportunities to build the most successful versions of our practices. I started a company inside of our field, rather than outside, because it is far more agreeable to strategically adapt to technological and cultural change than to be rocked by the market. This is just advice, you certainly don't have to take it. Before you decide anything though, you might ask yourself if what you do now will make you right or wrong in the context of history.

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To learn more about how to improve your fertility practice's online reputation, and to adapt to new patient behavior, download your free copy of the Ultimate Guide to Fertility Marketing

Why did these 9 patients just leave word-of-mouth referrals for their fertility doctors on Instagram?

By Griffin Jones

**Fertility Bridge does not endorse any of the programs or doctors mentioned. They come from responses from our Instagram community**

"The only thing that matters is the lab"

That's what a board-certified reproductive endocrinologist (RE) told me over lunch at the 2016 American Society for Reproductive Medicine (ASRM) annual scientific congress. "The patient experience doesn't matter. The only thing that matters is if they get a baby or not." My efforts to show him all of the evidence to the contrary were fruitless. That was the end of the conversation. Why try to convince the inconvincible?

In some perverse way, it excites me when people are so neglectful of what our patient population demands. Meritocracy might be a lofty ideal, but I love working with fertility clinics who take IVF cycles from people who think like that. A slop-eating grin came over my face as I stared at his plate and thought of the perfect metaphor:

I'm going to eat your lunch.  

Who are they and what did people say?

Who are they and what did people say?

Satisfied don't mean delighted

A 2014 study by Software Advice states that 61% of patients evaluate their new doctor before their first appointment. Over 40% of new patients of Fertility Bridge clients confirm having read online reviews before scheduling their first visit. Nearly 30% say they were referred by a friend.

Bain's Net Promoter System suggests that patients can be divided into three categories across a satisfaction scale from 0 to 10. The single question is, "how likely are you to recommend our practice to a friend or family member?" Those who answer between 0 and 6 are called detractors. They actively discourage others from coming to your practice. Those who respond with a 7 or 8, are labeled passive, because their referral rates are less than 50% of those who respond with a 9 or 10. Finally, those who respond with 9 or 10 are promoters, people who sing the practice's praises to anyone who will listen. You can read more about using your practice culture to turn patients into promoters in Chapter 2 of the free e-book, The Ultimate Guide to Fertility Marketing.

I know many of these promoters very well. They brought me into the field of reproductive health in the first place. After all, people don't get so fired up after they buy a power washer from the Home Depot. So, among thousands of people in the trying-to-conceive (#ttc) community on Instagram, who are actively undergoing or pursuing fertility treatment I asked them the question. Would you recommend your fertility clinic, and why?

1). By Name in New England

Absolutely and I actually have. The first place we went to was terrible and I've shared that with people who have asked for recommendations. I wish I had done some thorough research beforehand but I wasn't aware how common infertility is and how many clinics were out there. The second place was beyond anything I could have hoped for! We saw Dr. Gargiulo at the Center For Reproductive Care (CRC) in Stratham, NH. We are less than an hour away from Boston which is home to some of the top hospitals in the country so we fortunately have a large number of places to choose from. The entire staff at CRC was absolutely fantastic.

I was greeted by name every single time I walked into the office and the nurses were amazing when it came to making the entire process less stressful and knowing when to crack a joke to lighten the mood. The thing that really set CRC apart was the welcome packet. In addition to the typical insurance forms they included an illustrated book that talked about how to talk to all of the different people in your life from co workers to your spouse. Also, they make sure to include that due to the sensitivity of this journey, no one under the age of 18 is allowed into the office for any reason. Reading that one policy was the moment I knew we had finally found the place that truly focuses on their patients and not their numbers.

2). Memorable in Montana

I totally would! I should mention, my RE and her partner are the only ones in the state. Even if she wasn't, I would still recommend her. Her name is Dr. Stacy Shomento with Billings Clinic. Dr. Shomento is in Bozeman, and that is the staff I know and love! She has a pile of patients, but always gives you lots of time and takes a personal interest in you. She also has a stellar, amazing, outgoing staff. Infertility is very personal and invasive. Having a comfortable relationship with the medical staff is a must for me.

She took the time to make personal connections and remembered us, not just our chart. Really, because RE's are so busy, you end up dealing a lot with your nurse, so they really need to be awesome.

3). Compassion in California

I totally would!!!! Coastal Fertility in Irvine, CA is the best! So compassionate. Dr. Werlin rocks!!! He's amazing!!!

4). Knowledge in New Jersey

I would. More specifically, I would recommend my doctor, even though all the doctors are great. Dr. Marcus Jurema from Reproductive Medicine Associates of New Jersey (RMANJ) is what every reproductive endocrinologist should be. I'm thankful I have him in my corner. My doctor is part of RMANJ and was originally with IVFNJ before the merge. I've had several issues with several staff members with both practices.

There's very little communication within the company within different departments (billing, nurses, etc). I'm sure that's because the company is just so big. With that being said, RMA has the best labs in the state, maybe the East Coast. Because of that, I can't leave. Plus, my doctor is amazing.

He teaches as he goes. He knows I need technical info, good or bad. I can't have anything sugar coated. I'm a medical assistant so I research everything. He knows that and will give it to me straight, while also holding my hand through the bad stuff. He's been with me from day one, with every cycle and every loss.

5). Benign in Boston

We switched doctors for our last round of IVF, but we stayed at the same clinic, IVF New England. The nurses are magnificent and since that's who you're interacting with the most, it's invaluable. I never felt like a number there, even though they're a bigger clinic. I always knew I was in good hands, even after 4 failures with my first doctor. It took me a long time to decide to switch. It broke my heart to try someone new, because I trusted him implicitly.

My new RE, Dr. Pauli is amazing. I don't regret not going to him sooner but I'm so glad I did. We were successful on our first round with him and I'm currently 11 weeks pregnant. I love that both doctors called with results of the bigger tests (pgd, era etc) and called to check in on us. Dr. P. called me once with results while he was on vacation.

I have nothing but good things to say about IVFNE. They're not perfect, and some of their methods aren't for everyone. But they are perfect for us. Even if we never got pregnant, I wouldn't feel any differently.

6). Education in the OC

Yep!!!! HRC Fertility in Newport Beach!! I think the best thing about HRC is the coordinator is amazing financing and they can do preimplantation genetic screening (PGS) with a fresh transfer. My doctor was very, very busy all the time, but he did give me pregnant the first time. He never did an ultrasound which I thought was odd but I love the girl who did my ultrasounds.

My doctor was always kind, and answered all my questions but the relationship was definitely not personal. I don't care about that; I want results, and he provides results.

My tech was wonderful because she would walk me through exactly what she was doing. During stims, she would explain what she was counting, what she was looking for, and what she saw. Same after I became pregnant. They followed me for 11 weeks.

7). Making changes in Maryland

Our first one, absolutely not. We were a paycheck at [a very large fertility practice group] and never felt like patients. Our RE told me that our son "must have been a lucky egg and I wanted to go cry in the car, go ahead". It was the worst year of my life. My new doctor, Dr. Mary Ann Sorra with Natural Fertility, actually held my hand when I was put under for a laparoscopy. It feels so nice to finally be cared about.

8). Looked After in Louisiana

Definitely. Arklatex Fertility and Reproductive Health with Dr. Vandermolen. I just felt like they're all so patient. Any time I had questions, I could call the nurse and she would call me right back. They knew me by name. The success rate for the doctor is pretty high, which is always a plus. When I first went to him, he told me what was going on. I felt like I had options instead of having him tell me what I was going to do.

9). Genial in Jersey

Absolutely! RMANJ, because of their lab. I was told I was going to be treated as a number, but on the contrary, I got to talk with my RE personally. He even called me right before my egg retrieval to know how I was doing. The nurse was always on top of things and answered me right away.

The transfer was very detailed oriented. They addressed yeast infections and progesterone levels while my previous clinic always dismissed my concerns.

"A great lab is necessary, but not sufficient"--Jake Anderson-Bialis

While I chose not to include the names of these volunteer promoters, they are perfectly willing to share their experiences with thousands of other people in the infertility community on Instagram. We often believe that people only recommend their IVF center online if they become pregnant or have a baby. We're told that they'll leave negative comments if they have a failed cycle, but research from Fertility Bridge and Fertility IQ show that that's not exactly true.

True for almost every fertility clinic review we read.

True for almost every fertility clinic review we read.

"No question, if a patient has a good result, they're more likely to recommend their fertility doctor/clinic," says Fertility IQ co-founder, Jake Anderson. "With that said, when we look at patients who had failed cycles, it's very clear who is likely to recommend the doctor, and who definitely won't."

It seems that the contrapositive is also valid; when we look at patients who've had successful cycles, it's clear who will be the source of future patients in the form of word-of-mouth referrals. Many people have success at their fertility centers and are "satisfied", but we see in these recommendations that it's compassion and personal connection that turn former IVF patients into zealous promoters of their practices. So the next time a competing fertility doctor tries to convince you that the patient experience is meaningless, and clinical outcomes are all that matter, don't feel disappointed when you can't change his mind. Eat his f'ing lunch.

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For strategy on improving the patient experience, read chapter 2 of my free e-book, The Ultimate Guide to Fertility Marketing, by clicking the button below.

 

 

 

Flipping People's Peanuts at MRSi 2017: Everything is changing, and it's just the beginning

By Griffin Jones
 

This is my third annual recap of the Midwest Reproductive Symposium international (MRSi) , so I'm going to have a little fun with this one. I don't feel like writing another list and I think there's a more valuable point I can convey to you. As of right now, MRSi holds the title for my favorite meeting in the field of reproductive health and I want to use it nudge other meetings to follow suit. I should be a fair judge, I go to almost all of them.

It certainly doesn't hurt that it's on Lake Michigan in Chicago in the summer time, and Dr. Angeline Beltsos knows how to incorporate an interesting theme. Those are pluses, but not enough to make a meeting my favorite. It's big enough to have a diverse range of programming and small enough to be very collaborative and social. People get to know each other and build meaningful relationships. I truly understand how important that is for the field. Louise Brown, the first baby ever born from IVF was a guest at the conference. As Louise put it,

"My parents were willing to advance science and try something that had never been done before because they felt their doctors were truly there for them."

These reasons not withstanding, do you know what I really think MRSi holds over our other meetings in the field? It's the most forward-looking.

Other meetings sometimes do a great job of exploring the latest science and the future prospects for assisted reproductive technologies, but they often stop there. I believe that's a mistake. Compared to some of the technologies that are being developed both inside and outside of our field right now, PGS looks about as complicated as tying a shoe.

A Change Gonna Come. Oh wait. It already did.

Several presentations detailed the incredible growth of technology across multiple facets of society, not just ART. My own talk was titled The Biggest Change Ever in Human Communication: the Tech Revolution and Our Patients. The title isn't hyperbole. I made the case that we are living through a bigger shift than that of the printing press, perhaps even greater than the written word itself. If you would like the slides from my presentation, I will be happy to e-mail them to you. Here's the punchline: the supercomputer in every one's hand, that we call a smartphone, has changed dating, parenting, conversation, and commerce, for us and our patients. We have hardly begun to adapt our operations accordingly. And this is only the beginning.

Bob Huff, Chief Information Officer of RMA of Texas, shared with us technology that is changing the way generalists refer patients, and even the way patients are diagnosed. Scientists have just created functioning mouse embryos through 3D printing

My co-speaker, Hannah Johnson, Operations Director of Vios Fertility, and I, had the pleasure to speak to the mental health professionals group as well as the practice administrators' Business Minds group. We desperately need more of this inter-disciplinary kind of discussion because entire industries are being radically and forcibly changed. You'll forgive me for not using the popular buzzword, "disrupted". I prefer to put it more bluntly. Large institutions and established companies are losing double digit market share or going out of business in periods of 12-36 months. How does that sound?

"We could be looking at widespread clinic closures within the next 5-10 years."--Hannah johnson

I don't want that for this field. I started my career in radio advertising. I watched wealthy and powerful stakeholders go bankrupt because they were comfortable or because they weren't willing to invest time, money, and energy to adapt. As Dr. Francisco Arredondo from RMA of Texas says, "we produce one new fertility specialist per 10 million people per year". A need of such titanic portions is one that is begging for more technological disruption.

how can we learn if every effort is required to produce a particular result?

Broad social and technological change isn't a frame of mind that we usually allow ourselves to explore at most of our regional meetings throughout the year, or even at ASRM. It's a bit more welcome at MRS to question the status quo, and test new platforms and processes, without the scrutiny of the exact result that any particular effort might produce at the given moment. Elizabeth Carr, the first baby born from IVF in the United States, is now a marketing data consultant who also spoke at the conference. "I wouldn't be standing before you today if my parents and their doctors weren't willing to try something that had never been done before."

Virtually every area of medicine and practice management is ready to be disrupted by technology. We can wait for pain, or we can put in the effort and patience required to adapt to these changes. MRSi is the first meeting in our field where we're starting to think and talk in these terms. I hope it serves as an example for the others.

 

Start With Why: Association of Reproductive Managers (ARM) Meeting Recap 2017

By Griffin Jones

We didn't plan it this way...really. Yet still, there was a theme.

The Association for Reproductive Managers (ARM) is the practice managers' professional group within the American Society for Reproductive Medicine (ASRM). As a group, we meet in person twice per year: at ASRM in the fall, and at the ARM Annual Meeting in the spring. We just wrapped up our 2017 meeting on April 28 at the Hotel Chicago (guess which city).

We do have cool graphic art parodies though...

We do have cool graphic art parodies though...

Unlike the ASRM Scientific Congress and Expo, ARM doesn't reach for a semi-relevant motif to title its meeting. There's no "Holding on to Sturdy Practice Management Systems in the Windy City" across the cover page of the ARM program. Yet, in 2017, there was a common theme; I noticed it within the first two talks and it continued for the duration of the meeting.

Start With Why

There is no shortage of tasks to be completed in an REI practice. Managing the system of operations that bring them all together can be daunting. Our speakers helped hone our focus, by prioritizing what needs to be done with the reason(s) why.

  1. What to do with all those frozen embryos?
    Do race, religion, and age predict if patients will abandon their cryopreserved embryos? Apparently not, shows data from Embryo Donation International (EDI). Dr. Craig Sweet, MD, shares data that teaches us not to assume why people abandon their stored embryos, with factors including the number of embryos one has in storage and the number of children one has at home. "People don't donate to your embryo donation program because they don't want to see their child at the mall, and they don't want their children marrying their children," Sweet says of reasons why many patients prefer a geographically broad embryo donation program.
     
  2. The Role of an ART Attorney
    I say it so frequently, it could be my catchphrase. "I'm not an attorney. Talk to an attorney." Heather Ross, JD, is. Ross explains the variances of reproductive health law the clearly demonstrate why we would want to consult someone who specializes at this intersection of ethics, law, and medicine.
     
  3. What Our Patients Expect When They're Not Expecting
    "Satisfaction equals performance minus expectation", says Lisa Duran, CEO of patient experience consulting firm, Reconceived. Duran and Barbara Collura, CEO of RESOLVE, the National Infertility Association, break down patient expectations from across the United States via hundreds of respondents from a custom RESOLVE survey. "Be prepared," Collura says. "The #1 expectation for physician communication is to read the patient's chart before they arrive." Our patients' expectations, not our own assumptions, should determine our operational processes. "We can't keep thinking that high ceilings, and margaritas and yoga equal exceptional customer service" Duran adds.
     
  4. How to Use Your Staff to Attract and Retain Patients
    Sara Mooney, Director of Administration at Seattle Reproductive Medicine (SRM), traced practice values back to the most fundamental principle of patient services. "Patients are the center of our work.  Our role is to support patients in pursuing their dreams". I had the privilege of co-presenting with Mooney, courtesy of professional networking through ARM. Together, we we demonstrated how, in the Digital Age, disengaged staff are a liability to the practice, while engaged staff can be the most powerful source of word-of-mouth referrals. "There is no separating your practice's marketing image from the culture inside the practice," was my $.02.
     
  5. The Embryology Lab and Beyond: Risk Management, Mitigation, and Staff
    Benjamin R. Emery of the University of Utah explained how the lab director and their staff come into play in mitigating risk for the practice.
     
  6. Patient Services Flow: The Financial Counselor/Front Desk Partnership
    Angela McCall and Beth Hume of SRM threw a dangerous axiom to the wind, "because this is the way we've always done it." McCall and Hume talked about barriers to collaboration between front desk staff and financial counselors while implementing new processes at the practice. "We had to get staff buy-in, and really explain why we believed that this was ultimately for the best. And it was."

Why I came back after last year's meeting

Starting with why makes it easy to justify being a member of ARM, attending its meetings, and wanting to see the group grow. Current ARM chairman, Brad Senstra, cordially invited other practice owners and administrators to attend ARM programming in the future. I would take him up on it. The content of the presentations are reason enough to the annual meeting (obviously, I was a speaker). Moreover, the relationships you  build with dozens of other people who have faced similar challenges to those in your practice are invaluable. Being able to make a few phone calls to your trusted friends over the course of the year is the reason why being a member of ARM is so important.

 

 

The 7 Steps of the Fertility Bridge Proven Process for Tracking IVF Marketing Results

How we measure and improve our KPIs (key performance indicators) in the fertility field.

How we measure and improve our KPIs (key performance indicators) in the fertility field.

how do we measure the return on investment (ROI) of an ivf marketing program?

Jackie Sharpe is Regional Marketing Director for HRC Fertility in Southern California. Once, at an Association for Reproductive Managers (ARM) marketing meeting, I asked Jackie, "Is it easier, or harder, to track the effectiveness of marketing today than it was several years ago?"

I could tell she had thought about it before. "It's harder," she replied.

Harder? We have every tool under the sun, from Google Analytics to every kind of Customer Relationship Management (CRM) software and marketing dashboard. We can track every click, page view, Instagram like, Yelp review...everything down to how many minutes the average visitor spends on our website. How is it not easier than ever to track our ROI? Yet, you know what? She's absolutely right.

It's harder to singularly track patient sourcing, not only in spite of these infinite tools, but partly because of them. The  avenues from which today's patient becomes aware of our services are virtually limitless. So too, are the factors that can influence her decision. We need a system, as opposed to a single figure.

indispensable indicators need to be analyzed together

In my last blog post, I wrote about the Six Indispensable Indicators that IVF Marketing is Doomed Without. There are six, because individually, none of them offer us a wholly accurate synopsis of our marketing results. Whether we use the hottest CRM, or an Excel workbook, tools do not replace our overall system for tracking and measuring results. Two examples explain why we report on multiple sources of data.

  1. Human Omission: About 1/3 of patients of Fertility Bridge clients do not fully complete their referral-source questionnaires.  Furthermore, the number of questionnaires entered by the practice is typically only 75% of the total number of new patient visits.  
     
  2. Limits to Digital Tracking: We track internet goals (i.e. appointment requests), but sources are frequently only attributed to the most direct channel. In simpler terms, an IVF clinic on the west coast hosts informational fertility sessions at their offices. When we run ads on social media, registrations increase. On the submission form, registrants overwhelmingly check Facebook or Instagram as the sources of how they came to hear about the event. Still, when we look at our goals in Google Analytics or Hubspot, a much smaller percentage are credited for coming directly from any one channel. 

Instead of relying on numbers that provide incomplete information, we use a proven system that includes our Indispensable Indicators. Functioning as a whole, the system allows us to measure and understand the effectiveness of our efforts, and subsequently, the money we're spending. These are the seven steps of the Fertility Bridge Proven Process for Tracking Marketing Results that we implement with each new client.

1). Put the right person in the right seat

Someone inside the clinic must own your Indispensable Indicators. If these data are not readily available and accounted for, then the marketing strategy operates aimlessly. This person is often the practice administrator. He or she may be the clinic liaison, marketing director, or billing manager. Ideally, this is someone who is fascinated with being a student of your practice's key performance indicators. If the person has neither the authority nor the capacity to implement all of the steps involved in the Proven Process for Tracking Results, the point is moot. Whoever is chosen, he or she is responsible for reporting on the Indispensable Indicators every single month.

2). Collect existing data

Because of clinical reporting, you likely know your clinic's IVF volume, year-to-year, but that doesn't tell us anything about our monthly progress. We still don't know what impact individual marketing efforts have had on profit and patient volume.  In this phase of the Proven Process for Tracking Results, we gather all of the information we have for our Six Indispensable Indicators and enter them into one file. It's likely that you don't have complete figures for all six indicators, but partial information is a start. If you use a practice software like eIVF, you may be able to readily pull some of these fields.

3). create uniformity

Even when clinics do record some of their necessary KPIs, we at Fertility Bridge often find that we're not comparing apples to apples. The way you define your Indispensable Indicators can be customized to your practice, but they must be defined to ensure continuity. 

Monthly recorded table of Indispensable Indicators

Monthly recorded table of Indispensable Indicators

1). Lead

Is a phone inquiry, a website appointment request, and an RSVP to a fertility seminar all worth the same?

2). New Patient Visit

Does this include patients who had a successful IVF cycle with your practice but come back for babies two and three? Only someone who comes to the practice for the first time? Phone consults? Couples (including same-sex couples)? Individual female patients? Male and female patients separately?

Define new patient visits so that there are no duplicate or missing appointment numbers.

3). New Patient Sources

One clinic on the east coast had "the internet" listed as one of four questionnaire options for more than six years. So of course, from 2010 to 2016 the number of people that came from the internet increased by nearly 70%. But the internet has changed a lot in six years. What does "the internet" mean? Online reviews? Referrals from friends through social media? Searching for reproductive health services?

Offer different referral sourcing options to which respondents check "yes" or "no" to reduce ambiguity.

4). IVF cycles: For business purposes, how do we define an IVF cycle? Starts? Frozen transfers? Once the cycle bills? Does our number include restarts? Cancellations?

Again, the objective is to avoid duplication. An IVF cycle, as it is billed, should be unique to a particular month.

5). IVF Conversion Rates

If New Patient Visits and IVF Cycles aren't uniform, this number will start to look really funky.

6). Gross Revenue

4). Set benchmarks

Once we have our figures, month-to-month, we have clear benchmarks from which to measure our progress. The more months of data, the more reliable the benchmarks. It typically takes Fertility Bridge clients at least three months to collect this data; it's not readily available.

5). Set Internet Goals

Marketing dashboard customized for fertility clinics

Marketing dashboard customized for fertility clinics

Many IVF clinics have appointment request forms on their websites, but most do not have goals set for these forms in Google Analytics. Using a thank-you page for these forms, we track how many appointment requests and contact forms we receive on a weekly and monthly basis. Depending on your practice's size, you may have anywhere from fifty to several hundred of these forms completed in a given month. The person in charge of your Indispensable Indicators  checks how many inquiries went on to schedule new patient visits. Once we know how many new patient visits lead to an IVF cycle, we can even assign dollar values to these goals. 

6). Link the appropriate online properties

All vessels must row in the same direction. When we run a pay-per-click campaign on Google, Bing, or Yahoo, for example, we sync with your website's Google Analytics account so that we can measure the effectiveness of your campaigns in one place. When we run Facebook and Instagram ads, we install a pixel on your practice's website to show us how our ads convert. It's another way of seeing how many people fill out a form submission when coming from these channels.

Tracking how many request appointment forms came from a Facebook campaign

Tracking how many request appointment forms came from a Facebook campaign

7). Collect Weekly. Report Monthly

Tracking these numbers at the end of each month would be a bear. It's much easier to record them as they come in. Weekly recording also provides greater accountability; we don't wait until the end of the month to realize that we are missing our Indispensable Indicators

the whole is greater than the sum of its parts

We have a year of data on IVF cycles, patient volume, and referral sourcing. At month 12, we feel comfortable making a shift in our marketing strategy. We decide to take half of the budget that we had spent on print advertising, and spend it on paid social media advertising. How do we track the return on investment of our new advertising campaign?

If we've only recorded one number, we likely won't be able to.  If between months 12 and 15, however, we have the necessary data to see

  • A 30% increase in new patient appointments.
  • An 18% increase in new appointment requests submitted from visitors coming from social media, and
  • A 50% increase in the number of patients who report coming to our practice after having seen us on social media

then we can reasonably conclude that that marketing campaign was successful.

In a vacuum, none of these figures give us enough information to gauge the effectiveness of our marketing efforts. Because there are so many factors for which to account, we implement one system to measure and understand them. Individually, they are incomplete, and can therefore be misleading. When we organize and rely on our Six Indispensable Indicators, however, our IVF marketing's return on investment becomes greater than ever.

For more tools and tactics on measuring your fertility marketing efforts, read chapter 2 of my free e-book, The Ultimate Guide to Fertility Marketing.

 

 

6 Indispensable Numbers Your IVF Marketing is Doomed Without

By Griffin Jones

so...What can you do for me?

When a fertility doctor (or any business owner for that matter) hires a marketer, they very often want to know, to the dollar, what the results will be.

Imagine if I bragged, "My company will increase your new patient visits by 40%!" Would they know, even remotely to the number, what a 40% increase looks like? Would they know to what they could attribute the increase? I've found that the answer is almost always no, because in the fertility field, we rarely have the data we need to gauge the effectiveness of our marketing. Even less often is that data readily accessible. I called this The Biggest Marketing Challenge Facing Fertility Centers, back in 2016. Unfortunately, not much has changed.

We need to know certain Key Performance Indicators (KPI) to measure fertility practice growth

We need to know certain Key Performance Indicators (KPI) to measure fertility practice growth

Extreme Ownership

To be completely fair, incomplete or non-existent tracking of key performance indicators (KPI) is not  a phenomenon that is unique to fertility clinics, or even small healthcare practices. I've written about it at length in The Ultimate Guide to Fertility Marketing; many marketers complain that their clients don't track the volume and sourcing of their customers and revenue. How can one be held to a measure of success if we don't have enough (or any) measurements? Years ago, I decided to hone the focus of my marketing company to the field of fertility, because I needed to take extreme ownership of certain Indispensable Indicators. Collecting, reporting on, storing, and making decisions from these Indispensable Indicators are part of the Fertility Bridge Proven Process for Tracking Results.

6 Indispensable Indicators Every Fertility Center Needs To Know

  1. Leads
    1. The total number of phone inquiries, contact submissions, new appointment requests, new patient e-mails, webinar registrants, and seminar attendees who give their contact information to the IVF center.
  2. New Patient Visits
    1. The total number of appointments scheduled by new patients or returning patients starting new treatment.
  3. New Patient Sources
    1. All of the ways that new patients learned about the practice before scheduling their first appointment.
  4.  IVF cycles
    1. The total number of unique IVF cycles started or billed to a particular month.
  5. Conversion Rates
    1. The percentage of leads that become new patient visits and the percentage of new patient visits that go on to start IVF cycles.
  6. Gross Monthly Revenue

Indispensable Indicators in action

In the following example, watch how effective these figures make our decisions on patient recruitment. We have a year of data on IVF cycles, patient volume, and referral sourcing. At month 12, we feel comfortable making a shift in our marketing strategy. We decide to take half of the budget that we had spent on print advertising, and spend it on paid social media advertising. Why?

Instead of gambling on a hunch, we operate with data from our Indispensable Indicators.  Between months 12 and 15, we see a

  • 30% increase in new patient appointments.
  • 18% increase in new appointment requests submitted from visitors coming from social media
  • 50% increase in the number of patients who report coming to our practice after having seen us on social media

We had enough data to reasonably make this first marketing decision, and now we have even more data to make the next one.

is branding dead?

Instead of thinking in terms of practice development, we frequently view marketing as tit-for-tat; purchase x advertising, receive y result. There are plenty of lead-generation sites, agencies, and pay-per-click platforms from which we can buy leads. Sometimes it's prudent to buy appointments in these ways, it's just not business development.

One REI from a small U.S. market, who participated in a fertility marketing network asked me, "how do I know whether or not the patients they send would have come to me anyway?" 

We don't.

patient relations in fertility marketing

Until we have access to some kind of Orwellian brain-mapping technology, we'll never know all of the reasons that someone came to our practice. To think that we can account for every one of our team's achievements with six key performance indicators would be very short-sighted. In fact, it would be very limiting to the brand and long-term vision of the practice.

Rather than accomplish top-line marketing goals, our Indispensable Indicators measure the bottom-line of our marketing efforts. Without them, we spend time, money, and energy aimlessly. With them, we have real, specific, and measurable objectives to which we are accountable. At last, we can focus on the progress of our long-term strategy.

Not sure where to start with your Indispensable Indicators? In my next blog post, I outline the steps of the Fertility Bridge Proven Process for Tracking Results! In the meantime, click below to read Chapter 1 (Defining Marketing Strategy) of my absolutely free e-book, The Ultimate Guide to Fertility Marketing.

Should I fire my fertility center's marketing manager?

By Griffin Jones

Fertility doctors frequently ask me, “Is it better to have an in-house marketing person or contract an outside marketing firm?” You might expect me to favor the choice of hiring the firm. I don’t. The two are not mutually exclusive; each role is critically important to the other. In fact, across the board, your staff are paramount to your fertility practice's efforts to recruit new patients. There are assignments that your in-practice marketer should and should NOT be tasked with to maximize effectiveness and cost-efficiency. The same is true of your agency. Depending on the size of your practice, it may seem redundant to have both an internal marketing person and an agency on retainer. When used correctly, they will each pay for themselves and then some. 

marketing manager or clinic liaison?

If the practice has only one dedicated marketing person, his or her greatest productivity may very well come from the assignment of practice liaison. This is a function that is extremely difficult to outsource. As a marketer, my focus on digital media is owed only to its powerful results in attracting new patients. Digital’s proven ability to grow fertility practices doesn’t make physician referrals any less meaningful. Even in 2017, OB/GYN referrals still count for a tremendous share of new patients. Having someone who can regularly schedule physician-to-physician lunches, deliver semen analysis kits and information about infertility support, and educate OB/GYN staff in your area is tremendously valuable to the practice. Markets differ widely on the return on investment (ROI) of MD referrals, but in some cases, it may be a fertility center’s fastest path to growth.

physician referral case study

I asked an expert on the topic to share her experience on nurturing relationships with referring doctors. Shirley Sinclair is the practice manager of the Fertility Center of Chattanooga.

"For over 10 years, we’ve tried to find the magic source of how to bring in more patients and one of the top ways is still through referring physicians.  This process has taken us some time to fine-tune, but it has proven to be very successful.  We know our physicians are very busy, especially OB/GYN’s, so it is critical to remember that every minute of their day is valuable.  With that in mind, we developed a few different ways for doctors to easily consume our message.
•    Distribute referral packets in a beautiful folder filled with
o    information about our clinics
o     fact-sheets about infertility and testing
o    semen analysis kit.  
•    Provide a referral sheet for the referring physician, in which they can
o    add the patient name,
o    check off the type of appointment they are requesting (such as semen analysis, consult, etc.)
o     Fax back to our office

"We contact the patient to set up the appointment, thereby freeing up the referral’s time.  We take these packets to each office about every 6 weeks, along with some type of goodie for the staff.  This is not the time to ask to speak with anyone!  They will remember you more if you do not become a nuisance.  Also, do not leave too many packets; the idea is to show consistency and for you to become familiar with the staff.   

"Another great tip is to set up lunches with referring practices.  While this can be time consuming, this is a wonderful tool to use, especially when you have a new program or new protocol that you would like to share with the doctors.  Always take one of your physicians and, in addition, it is helpful to take someone from your staff that is familiar with the clinical side, as well as financial.  Physicians are always curious about what insurance will pay for as it is one of the first questions patients ask their doctor when they are encouraged to see a fertility specialist.  

"Use this time to assure the physicians that you would like to set up a partnership in providing the best care for their patient.  In other words, remind them that your goal is to help the patient become pregnant and send them right back!  Also, educate the physician that referring a patient sooner, rather than later, will save the patient precious time, money, and especially undue emotional stress.  Hanging on to a patient 6 months longer could be the deciding factor of what type of treatment the patient will end up having, therefore, adding additional hardship to the patient.  

"While these tips are vital, they are worthless unless you track them.  We use an EMR that is designed for fertility clinics, called eIVF, to track our referral sources.  Keep track of which physicians’ offices refer to you! In addition, make sure your physicians follow a protocol to send letters to the referring physician after the patient’s visit. Then send a follow up letter when you send the patient, hopefully pregnant, back to her OB/GYN.  Keeping your referring physician in the loop about their patients will solidify a long, successful relationship that will not only be beneficial to each of you, but, most importantly, to the patients for whom you both care!"

WAYS YOUR MARKETING MANAGER CAN HELP YOUR AGENCY

If you have more than one practice marketing person, or you live in a market where physician relations is not a full time job, your marketing manager is irreplaceable for a number of tasks that need to be accomplished within the practice. 

hiring a fertility marketing agency

Content sourcing. I don’t fly a member of my team to Honolulu every time we want to post a picture of the Fertility Institute of Hawaii’s staff to Instagram. Homemade and frequent content is vital to any practice’s content marketing strategy. In-practice marketers can serve as “brand journalists”, collecting the necessary images, stories, and videos to be sent to the agency for editing and distribution.

Operational changes.  You may find that your online reputation is not as great as it should be, simply because of one or two common patterns. Patients might love your staff, but report your response time to be abysmal. The practice manager super-serves the practice when he or she is able to implement systemic changes that are needed to improve the marketing imprint of the practice.

Tracking. Your marketing agency will be able to tell you how many people RSVPed to your practice’s IVF informational session. Your in-practice marketer will tell you how many actually showed up. If using a CRM or not, the in-practice marketer is critical in measuring and reporting the volume and sourcing of new patients.

WAYS YOUR AGENCY CAN SERVE YOUR MARKETING MANAGER

Not the first time I've included a Jerry Maguire meme on my blog 

Not the first time I've included a Jerry Maguire meme on my blog 

One stop shopping. Your practice manager has enough to do without searching for a website developer, a photographer, a graphic designer, a writer, or a cinematographer every time your practice needs something. Your agency can provide that to you under one roof. 

Social Media and Online Community Management. It’s not a good use of your practice manager’s time to respond to every comment on social media or online review sources, or to have to scour for content to post every day. Your agency can handle online interaction and take the lead from your practice manager when specific questions arise. 

Content Development. Your agency can turn the raw text, photo, and video your practice sends into polished infographics, edited e-books, and maximize their distribution on social media and the web. The creative content and design that your agency helps you create doesn’t have to stay on your online properties, either. Digital materials like infographics and guides make for valuable resources that turn your clinic liaison’s visits into less of a sales call, and into more of a service to the referring doctor. 

Advertising. It’s possible to waste a lot of money on bad advertising. Does your team know how to target same-sex couples, who married within the last year, who recently visited your website and live within 25 miles of your practice? Mine does.

Tracking. Your business manager doesn’t have to be an expert in Google Analytics or using a customer relationship management (CRM) software. Your agency can be in charge of mastering your conversion system. 

THERE IS NO "I" IN aggregate TEAM MARKETING EFFORTS

A clinic liaison or marketing manager can be very effective for your practice. So can a hired agency. When they work in tandem, they return their investment exponentially. Studies find that marketing leads convert seven times more frequently when employees are fully involved in the process.  Patients often mention their favorite staff when they leave positive reviews about their fertility center, and the compassion of team members can be invaluable in the fertility journey. Some personnel may want to be the star of a video, and others may prefer a “behind the scenes” role. From contributing to blog posts, to planning events like the baby reunion to promoting support networks, there are plenty of ways to engage staff in the practice’s marketing strategy.

The 7 Worst Responses to Fertility Doctor Reviews on the Internet

By Griffin Jones

"The customer is always right"

Who knew this hyperbole, coined by Harry Selfridge in 1909, declaring his department store's commitment to customer service, would go on to become a thorn in the side of employees everywhere? It's a terrific internal mantra to aspire toward, but it can be very harmful when interpreted as a universal rule. Customers, or in our case, patients, may sometimes project their frustrations on to you or your staff and no one has the right to be abusive to your team members. Maintaining the notion that a single patient's point of view is infallible can put unfair stress on our employees. Gordon Bethune, former CEO of Continental Airlines, says that when companies don't support their employees when a customer is out of line, resentment results and service deteriorates. If we don't care for and support our staff members, how can they in turn care for and support our patients? 

I can't say I agree with the first part of this sentiment, but certainly the latter

I can't say I agree with the first part of this sentiment, but certainly the latter

In the case of public reviews of our practices, feedback isn't necessarily valuable when it comes from a focus group of one, but rather when we observe recurring themes from multiple people. The patient (singular) might not always be right, but the patients (plural, collective) are ALWAYS right. We should err in favor of the patient's perspective because it defines for us a higher standard of performance. But how do we respond to a negative comment when it's just plain unfair or untrue?  If you know in your heart of hearts that a particular reviewer is in the wrong, and you've truly done everything you can to make things right, you don't have to respond at all. If you're uncertain, or you want to publicly affirm your practice's genuine concern for every single patient, I have a better axiom for you:

"the patient might as well be right"

Remember, we're dealing with the court of public opinion. Miranda rights apply; anything you say can and will be used against you. For that reason, I'm concerned with the way many practices (cough, physicians) react to defend their case. Prospective patients reading our reviews have no way of knowing what really happened within the walls of your office. They can only judge us by how we respond in kind. Instead of winning the benefit of the doubt, we may say something to fall out of favor.  What's worse, physicians frequently disclose protected health information (PHI) when they attempt to argue their side of the story. To show you just how much our words can produce a completely undesired effect, I pulled seven real-life examples of how fertility specialists and practice administrators have answered negative public criticism. Warning: they go from bad to worse.

7 worst responses to fertility doctor reviews on the internet

7). Less is more

This response starts and ends just fine, but the physician gives into the temptation to make a correction. Responses to negative reviews are not the venue to discuss treatment protocol, or success rates, for that matter. The first two and last two sentences would have been fine for this response. Keep it short and take the conversation offline.

6). some battles aren't worth fighting

I didn't include the review here because it was very long. It was indeed an attack on the doctor himself. For that reason, it's better not to respond. We should respond to all negative reviews where we can at least offer a resolution, and none of those to which we cannot. When the commentary is a direct attack, nothing can be gained from turning the monologue into a dialogue, especially when it is the only response on the page.

5). Let your positive reviews speak for you...not the other way around

We don't get to determine if a reviewer's post is "excessively negative", our readers do. People browsing the page will notice when most people have a very high opinion of us. Pointing it out to them makes us look defensive. Besides, referring to this patients' initial consult and following correspondence discloses PHI.

4). Let it go, just let it go

As you can see at the top of this review, this doctor has a stellar online reputation. This is one of his only negative reviews. He doesn't need to defend his honor, his most delighted patients have already done that for them. Still, the response goes on to drag out the argument and include PHI. Very dangerous. 

3). No one can tell patients how to feel

"Just relax" or "stop worrying and it will happen" are two phrases that our patients unequivocally detest. Though likely not intended this way, insisting that a patient's bad news was delivered appropriately, when he or she feels the opposite, follows a similar vein. The practice's rapport is undermined and once again, more PHI.

2). No, seriously. let it go

Another REI, whose patients overwhelmingly love him otherwise. Responding to this single negative review in this way leaves a poor impression that is probably not representative of who he is as a physician. I don't see any of the 18 identifiers of PHI in this exchange, but it strikes me as an unnecessary risk.

1). I know it hurts, it's just not the place

I didn't include this review because the response is plenty long as it is. Besides, the doctor painstakingly recaps everything. I won't mince words, this is the worst response to a fertility center review that I have ever seen. I don't necessarily fault the physician for feeling this way. These comments seem to have really hurt him. He may have really cared about this patient and put forth his best effort to provide her with exceptional care. It sounds like he wanted to be completely transparent about the potential outcome. The patient didn't receive it that way, and that must be terribly disappointing. It's simply not the appropriate place to express one's disappointment. This response is one of the only accounts that prospective patients have to judge this physician's personality. Without knowing anything else about this doctor, fertility patients are left with a very poor impression.

hold your fire

You have three options when someone leaves negative criticism about you or your practice. You can

  1. Not reply at all
  2. Have a trained, neutral representative answer on your behalf
  3. Wait until your head is clear enough to leave a brief, solution-oriented response

I don't share these seven examples with you in jest. The way in which our words can betray us is a very serious concern. It's a threat to your brand and often, a legal liability. What may feel vindicating for a moment could be disastrous to your public image for a much longer time. Your time and energy are better spent on constantly adapting to collective patient feedback and delivering the best possible experience to the people you serve. You have my permission to give yourself permission to not be perfect. While it's necessary to devoutly heed collective patient opinion, there are times when you just aren't able to please certain individuals. Our goal in responding to negative reviews is not to defend our case in a particular incident but rather to show that we deeply care about how our patients perceive their interaction with us.

You can read my six critical rules for responding to negative reviews right here. If you want to reply to a negative remark that someone made about you online, and you don't want to make matters worse, just send me an e-mail or give me a call. We'll write a much better response that could make the patient feel better, will hopefully make you feel better, and will certainly make prospective patients feel better about you.