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.

_________________

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. 

 

Why Would Anyone Else Care About Infertility? How I Became an Ally to a Community I Had Nothing to Do With

By Griffin Jones

"Don't worry, you can always adopt"

I don't know if I ever had a conversation with anyone struggling with infertility (about the topic) before a few years ago. If I had, I probably would have said something silly like the above. I would have said it with the best of intentions, and hopefully, I would have kept an open mind. I knew nothing about infertility.  I had barely heard of IVF. I had no idea what a reproductive endocrinologist (RE) was. I am a young male with zero medical background and no personal connection to infertility. On paper, I was the least likely person to become an ally of the infertility community. And that's the very reason it seemed so important to become one.

caring about infertility

expanding the community

Whatever the issue at hand, progress will be limited if the consequences only apply to the people directly affected. This is true if we're talking about small issues at the local school board or large ones like repealing laws that ban same-sex marriage. Every community needs allies who are not "native" to their background for credibility and traction. I found infertility awareness to be an important concern that needed attention from more people than only couples struggling to conceive. It looked like they needed reinforcements, might be one way to put it. Still, there are infinite communities that I don't belong to that need support from the broader public. Why this one?

acknowledging the right to feel

There is a particular nuance in the way the infertility community is treated that piqued my curiosity. I still can't totally articulate it, but it has to do with we, as a society, not letting people feel what they need to feel. Responses like "at least you have one child already", or "stop worrying about it and it will happen" are pretty consistent with how we react to a lot of feelings that we don't totally understand. We jump to the "solution" because we want the feelings of hurt to end immediately. Sometimes out of compassion, sometimes out of laziness, and probably anywhere in between.

"You'll find someone else."
"You'll land a new job."  
"It's not so bad."

I wanted to shut up for a minute and allow people their right to feel.

ThAT blurry area between Sympathy and Empathy

Judging how other people should feel seems to stem from trying to equate someone's reality to our own. We often compare experiences as though they could possibly be the same, instead of drawing from them to imagine how someone feels. Dictionary.com describes sympathy as "feeling compassion, sorrow, or pity for the hardships that another person encounters, while empathy is putting yourself in the shoes of another".  The only way to know the pain of infertility (or cancer, or the loss of a spouse, or absolutely anything you could imagine) is to experience it personally.

Relating to imagine what people feel, not knowing exactly what they feel.

Relating to imagine what people feel, not knowing exactly what they feel.

We might not be able to fully understand someone's experience that we don't share, but we can usually empathize when we try.  I've never had to go through the "two week wait", but I know how anxious and frustrated I become when someone tells me to "just relax". People might not pester you about when you're going to have kids when that's what you want more than anything in the world. You may, however, know the soul-wrenching feeling you get when people ask you about a life goal that you're trying your best to achieve, and you have no idea when it will happen. Interacting with people with infertility has made me more aware of imagining what people might feel, in all kinds of scenarios, instead of judging what they should feel.

Playing for the team that drafted me

I noticed the community that emerges from this longing to be understood when I first started doing social media for fertility centers in 2014. Some people who had children because of assisted reproductive technology (ART) were so overjoyed that they wanted to tell the world about it. The emotional attachments they had to their doctors and care team was palpable. They exuded a sense of triumph that comes only from a prolonged period of hard times. I had worked with several other business categories in the past and never seen anything like it. Then I wondered about the people that haven't had success or are still on their journey. What do they need help with? So I took it upon myself to e-mail the group leader of every RESOLVE support group in America. You'll be able to read more about that in my memoir, The Unlikely Tale of How I Became Besties with the National Infertility Association. Turns out, you're not supposed to do that. Before the nice people at RESOLVE could contact me to say "hey knock that off, guy", I had already talked with dozens of people dealing with infertility over the phone and via e-mail conversations. Their reception of me sealed the deal that these were people I could get behind.

If you don't get this analogy, you're going to have to re-watch Jerry Maguire

If you don't get this analogy, you're going to have to re-watch Jerry Maguire

I was completely upfront about who I was. "Hi, I'm a marketer and I'm thinking about starting a business for fertility practices. I would love to know what information you really wanted from your clinic(s) that you just couldn't get". I'll translate this for you:

"Hey, I'm some dude that knows nothing about you, nothing about your problem, nothing about medicine, and I would maybe like to possibly make some money some day".

"Go f yourself" would have been a perfectly reasonable response. But I didn't get that at all (maybe once). Instead, people were generally very eager to talk to me. They told me a lot. They told me about a whole bunch of stuff I had never heard of before...stuff that most people would consider very private that I didn't even ask about. They even thanked me for doing my research. Thank me? A marketer? Didn't they know that marketer is just one or two rungs better on the scum ladder than investment banker? I had never been acknowledged like this before--why them? I realized right away it was because they were yearning to be listened to. I learned first hand how little they felt understood, even by their clinics. I felt armed.

I jumped on Instagram to engage with the #ttc (trying to conceive) community there. Same thing. "Hey everyone. I'm a marketer. I don't know your journey, but I promise I will out-listen anyone who tries to compete with me in the business I'm building". Once again, I've been totally humbled by the welcome I've received, both online and in person. I get occasional shout-outs, words of encouragement, and people keeping tabs on me. I've been a marketer for ten years now and I've never received that from any other segment I've worked with. That is a very rewarding thing about working with a population with whom the stakes are so high. Shit matters. People don't feel that way when they buy a Hyundai Sonata. Even though I work with clinics, and not directly with patients, it's the patients that get me excited about what I do.

Stay classy, #infertilitycommunity

My guardedly optimistic prediction for the future is that public awareness around infertility will grow significantly. When it does, I hope the discipline of listening to and trying to imagine the feelings of others wins over the comparison of struggles. Affording people their right to feel and the humility of using experiences to empathize instead of drawing contrast are amazing lessons in humanity. I realize that I am totally idealizing the values of a very diverse and massive population of people. But that's what they are--ideals. And those are what made me want to be an ally to a community I originally had nothing to do with. 

 

What 22 Infertility Bloggers Hated About Choosing Their Fertility Clinic

By Griffin Jones

"a prudent question is one half of wisdom"--francis bacon

Recently, someone who is very involved in the field of infertility reinforced what hundreds of patients have told me for two years; there's an astounding gap between the way many fertility practices deliver their services and what patients want and expect. That's exactly why our company has the word "Bridge" in its name. According to a study conducted in 2012 by Forrester, 80% of companies say they deliver superior service to their customers. Meanwhile, only 8% of those companies received a superior customer rating. If you're seeking treatment for infertility, the delivery of the services you receive should be nothing less than superior. No clinic is entitled to your selection. Even in states and countries where some rounds of IVF are covered, there are still many circumstances in which you could pay tens of thousands of dollars of your own money. If you live in a large enough area, or are able to travel, you have a choice. Your choice isn't an easy one to make, given how much is at stake. I don't own any fertility centers (...yet), but because we direct their marketing based on what you tell us, I'll speak about them in the first person voice.

Getting out of our own way

infertility blogger round up

As fertility practice groups, we sometimes spend a lot of money in an attempt to help you make that decision. Or at least we think we do. Sometimes we try to grow our practices without any strong understanding of what you need to feel comfortable (and eventually very satisfied) to move forward with treatment at our center or someone else's. We frequently forget that there is a simpler way of earning your choice. We could remove the unnecessary challenges, annoyances, uncertainties, and causes for anxiety that you face when you are searching for a fertility specialist. How do we build not just a proven marketing system, but an entire practice culture, around what goes through your mind when you debate coming to our clinic, another practice group, or seeking no treatment at all? This is a laborious and continuing process, but I had a crazy idea of where to start when I entered this field, and I decided to do it again.

I asked you.

In early 2015, I wrote a report from interviews with several infertility peer support group leaders. This time, I decided to ask over twenty prominent infertility bloggers to candidly answer the same short question. One question isn't enough to understand everything involved in how you decide which practice will play this instrumental role in your life, and what we need to do to make you feel very good about that decision. We need as much feedback as we can possibly get. We need to ask follow up questions, issue patient satisfaction surveys, read what you say anonymously about us online, take action on your collective input and repeat that process forever. Still, in their own right, the candid answers of several different people to the same question is very insightful. I chose bloggers because they have not only a wealth of personal experience, but also because they are each in contact with hundreds of other people who deal with infertility. They are on the pulse of the infertility community. As you'll read, there are several reasons why people choose clinics, and they're not mutually exclusive. 

20 infertility bloggers all answered one question

20 infertility bloggers all answered one question

What was the most annoying part about choosing your fertility clinic?"

OVERWHELMING OPTIONS

In Due Time , @caroline_induetime 
"There are too many clinics to choose from. It's so hard to choose one".

No Bun in the Oven @nobunintheoven 
"Choosing a fertility clinic is an overwhelming experience because it's an expensive process! The most annoying part of finding my clinic was finding reliable experiences about the doctors. Where is the Rate My Fertility Doctor website? Where can a couple go to find real life experiences on these professionals who are getting paid tens of thousands of dollars for treatment? It was hard to find and we were ultimately left shopping at several clinics before finding the 'right one' for us".

Hoping for a Best@hopingforbabybest
"Wondering if you made the right choice".

Anonymous 

"Just scared of making the wrong choice".

UNCLEAR COSTS/BILLING

Smart Fertility Choices, @SmartFertilityChoices
"It was difficult to understand the entire cost involved in doing a cycle".

Rad Kitten@RadKitten
"Cost first and foremost. Second is beside manner. I'm not just a paycheck, I'm a person".

TTC a Taxson Baby@ttcataxsonbaby
"The most annoying part about choosing my fertility clinic was finding out that they don't take either of our insurances! Annoying and frustrating"!

Happiness Glass@happinessglass_
"That insurance dictates where you can or cannot go. Also I chose based on location/convenience to me rather than quality of service".

Amateur Nester, @amateurnester
"I found it frustrating that most clinics didn't have their costs listed on their websites. It would have made planning much easier if we'd had this information up front".

Its Positive Living, @its_positive
"Insurance (not having many options to chose from in my network/being tied to my network ... I have an HMO)".

THE RIGHT FIT WITH THE RIGHT PERSONNEL

The 2 Week Wait, @the2weekwait
"It was finding both a doctor and suggested protocol I truly felt enthusiastic about. To me, success rates can be manipulated, other patient opinions can vary and ultimately - nothing is more reliable than your own gut. If a doctor clicks with you, if the treatment suggested makes sense and you feel good about, that's all you need".

PCOS Diva, @PCOSDiva
It is disappointing when doctors do not have a solid understanding of how to treat PCOS using lifestyle modification as first line therapy.

Expecting Anything, @expectinganything
The most annoying part for me was the "marketing" behind this process by doctors/clinics. I mean, I get that it's a business for them, but some doctors forget that we are human, and this is real life shit for us! They all have different "sell tactics". They either beat you down and make you feel really bad or depressed about your situation, or they try to be overly sincere and emotional. We just want some facts and compassion people! Is it that hard!? I don't need to see all of the trophies "ie, baby pictures" plastered on the walls or some premeditated sob story. Show me your success rates and that you give a shit. It's that easy!

Our Misconception@ourmisconception
"The gatekeepers. You know the receptionists. These are the first faces you will see and the first you speak to when scheduling a consult or an appointment. They will be the ones that set the tone for the rest of the patient/user experience. Having navigated a cacophony of medical offices, this is an area/industry where empathy, education of the patient and social etiquette need to be greatly invested in as it lacks in most cases. My husband once had to spell out craniotomy to the appointment scheduler of his brain surgeons office. True story".

Triumphs and Trials@triumphsandtrials
"The most annoying part was going in to it blindly. Not knowing what the doctors were like and if they would be a good fit".

Anonymous 
"I needed an individualized approach on my treatment and a specialist who is willing to spare time to answer my questions and stay on top of all the details about my case. Not every clinic can do that due to patient volume. I was glad I was able to find the clinic I dreamed for after trying a big center in bay area, CA".

A LACK OF ALTERNATIVES

Infertile Soil, @infertilesoil
"In Canada you need to be referred to a fertility clinic (sometimes clinics will charge you if you don't have a referral) and many times doctors will refer you to just one particular clinic.

SIFTING THROUGH COMPLICATED INFORMATION

Trials Bring Joy@chels819
"Navigating outdated SART data".

AN EASY CHOICE FROM A TRUSTED SOURCE

Secret Infertility@FranMeadows
"I had a transition with ease since my OB/GYN referred me over to a fertility doctor that they personally used. This helped me feel more confident from the moment I walked through their doors. There was nothing annoying about me choosing a doctor".

 Life Abundant@lifeabundant_jw
"Nothing. My OB is able to do everything except IVF and is very knowledgeable in infertility treatment practice after doing her residency in a fertility clinic, so I have gotten lucky and have the best of both worlds. If we need IVF, I'll have to go elsewhere, and I will connect with her residency clinic and the doctor she trained under".

LET'S NOT MAKE THIS ANY HARDER THAN IT HAS TO BE

Hilariously Infertile, @hilariously_infertile
Uhhh. Being freakin' infertile is the most annoying part about choosing a fertility clinic.

Waiting In Hope, @waiting_in_hope
Honestly the most annoying part about choosing a fertility clinic is having to choose one AT ALL. Having to acknowledge the need for a fertility clinic/reproductive endocrinologist is heart breaking. It’s an acceptance that something is wrong. You have to grieve the loss of having a baby the “normal OB/GYN” route. And that it just might not be "easy".

Give the people what they want

As much as it's a service to you to equip you with clear information to make your decision, really, it's in our own best interest. The most effective way to grow our practices is through the detailed execution of a very simple premise: give you what you want. You can't decide on a clinic because you have no idea how SART success rates are being presented? Guess we need to make a video explaining SART data in plain English. You can't compare IVF costs between our competitors because no one will give you a straight answer? Sounds like we need to make an IVF cost checklist that you can download to compare potential additional costs. You felt isolated during your time at our practice because we never told you about support groups in our area? Apparently we need to make sure all of our patients go home knowing about the online, professional, and peer support resources that are available to them. In the age of ubiquitous communication, there is no shortage of ways to be able to collect and validate your input. Some clinics will ignore you and tell themselves they do a great job of getting you the information you want. Others will heed your suggestions and grow because of it. These are the clinics that deserve your choice, because you deserve nothing less.

Do you have something you want to say about your experience with your practice? Good, bad, or neutral? Please leave a comment or send me an e-mail! I would love to hear what you have to say.

MRS 2016 Meeting Recap: How To Use the Patient Experience as a Business Strategy

By Griffin Jones

You could put summer-time Chicago against just about any city in the world, so we're all glad that Dr. Angeline Beltsos, MD doesn't hold the Midwest Reproductive Symposium international (MRSi) in February. From June 15-18, without a cloud in the sky and an oceanic view of Lake Michigan, we met at MRSi 2016 at the historic Drake Hotel in Gold Coast. The event boasted a Business Minds Meeting, a Nurses' Practicum, and a Scientific Program. I went back to Chicago this year for my second MRSi because it's just the right size. It's a great place to connect with colleagues who share your practice role and also for physicians, nurses, and practice managers to share programming and meaningful conversation with one another. If you haven't been, add MRSi to the list for next year. You'll be able to talk to people and listen to topics that you won't always be able to get to at ASRM.

Panel discussion at MRSi Business Minds Meeting

Panel discussion at MRSi Business Minds Meeting

While I did attend some of Friday's Scientific Program, I'll use this post to run down Thursday's Business Minds Meeting for some of the things that you really need to know about utilizing different aspects of your clinic operations to grow your practice.

The ART of Incorporating the PATIENT EXPERIENCE as the Center of the Business Strategy

Janet Fraser, Board President of Fertility Matters and the COO of Atlantic Assisted Reproductive Therapies (AART), co-chaired the meeting with Derek Larkin, CEO of Boston IVF. 

“Improving our patients’ experience makes our patients happier and it’s better for our business”, Fraser mentioned of the day's theme. The thought was reinforced by all of the speakers; fine-tuning our operations so that our patients are more satisfied is measurably beneficial to the top line of the practice. Larkin emphasized the importance of continually adjusting to patient needs. "Patient expectations are continually evolving, and so must the experience that we provide to them. It's an unending process."

Incorporating Emotional Support to Decrease Patient Burden During Infertility Treatment

Dr. Alice Domar, PhD of the Domar Center for Mind/Body Health at Boston IVF talked about the importance of focusing not only on patient recruitment, but also on patient retention. “It’s human nature to pay attention to the patients in front of you, and not the ones who you don’t see (those who have dropped out of care). Studies have shown that people who were depressed were far more likely to drop out of their IVF cycle." Domar points to a 2004 Boston IVF study: Of 112 respondents, 40% displayed psychiatric disorders while going through infertility treatment. A separate 2011 study shows that care was significantly higher of a priority for patients, as opposed to physicians, for whom the greatest priority was success rates. "67% of people declined to fill out a survey on self-reporting depression because they didn’t want their physician to know how depressed they were," Domar adds. To date, four different studies show that infertility patients have the same levels of anxiety as cancer patients. 

Boston IVF tested retention techniques in a 2015 study that was published in Fertility and Sterility. Drop out rates reduced 67% in the intervention group."If you have effective communication with your patients, they perceive that you spent more time with them". Domar brings to attention the dollar amounts that practices spend on marketing to new patients, and how little is spent on retaining them by responding to trends in drop outs. 
 

Getting Staff Buy-In On The Importance of The Patient Experience

Hannah Johnson speaking on patient retention, courtesy of Vios Facebook page

Hannah Johnson speaking on patient retention, courtesy of Vios Facebook page

“Intrinsic motivation tends to be lost when we only focus on the extrinsic motivators, so we have to focus on activities where the reward is inherent in what we’re doing". Hannah Johnson, Director of Operations at Vios Global dives deep into how we motivate and empower our team members to take personal interest in each of their patient interactions. We need to allow our team to step back to appreciate the positive difference they make, including making sure they are aware when they are named in positive patient comments. We also need to empower them to correct errors. "It’s okay for your staff to make mistakes. Let’s talk about how we can make the patient feel really good about what happened.”

 

The Magic of Using the Patient Experience as a Focal Point of Your Employees' Day

“People don’t do what the mission of the organization states, they do what their managers pay attention to.” Lisa Duran is the CEO of Reconceived and has trained dozens of fertility centers in North America on how to build a patient-focused culture. Duran says that when many practices don't feel like they're fulfilling their mission statements, it's often because of a breakdown in the details of execution. We broke out into separate teams to identify challenges that different members of our team face in their day-to-day duties, and how we might be able to support them. Departments and staff need reinforcement and understanding from one another. “I want to know that my opinion matters,” Duran says of the most common desire that staff report before going into training.

In their own words

We had the privilege of hearing the first hand account of a couple who has gone through infertility treatment for many years. When asked what would have most benefited them to know when they first began their treatment, they each replied
"Don't be complacent if you're not getting the answers you need. Keep asking". 
"I wish that I wouldn't have waited so long. I wish I would have sought out treatment much earlier".
Hearing from patients in panel-form was a first for me at MRSi, and should be common practice at our conferences...imho.

Strategic Planning: Folding the Patient Experience into Your Business Plans

"Perception is reality. What patients feel is what they share." Rick Dietz, Chief Business Officer of Boston IVF, spoke in detail about the constant feedback loop of implementing and adjusting to patient input. Dietz says that practice strategy should be informed by a number of different metrics, and that self-reporting from patients is only one method at our disposal. "We can use patient surveys to give us clues and direction. But they don't tell the whole story."

Never Underestimate the Role of the Nurse in Patient Retention

"Nurses need proper training of how to talk with patients or you're going to get a lot more questions." Lori Whalen, RN, of HRC Fertility spoke about the importance of nurses as agents of patient retention. Whalen reminds us that nurses frequently have the most contact with patients and can be excellent sources of what patients want or what about our operations might be frustrating them. They can even find other solutions to patient problems, such as helping them find ways to save money. "Shared donors can cut costs in half for patients who wouldn't be able to afford it otherwise," Whalen says.

The Vital Role of Digital Media in Recruiting New Patients 

It was my first time speaking in the field and I was very pleased to have a great audience that asked meaningful questions. What can I say in this single post that isn't better summarized in greater detail throughout the blog? Suffice it to say that I reaffirmed what matters above all else in fertility marketing: the attention of people dealing with infertility. When we know what people with infertility are paying attention to, then we can measure how we will increase IVF cycles, increase patient-to-patient referrals, and improve our conversions of prospective patients to scheduled patients. You can view the first half of my talk here:

It takes a village

The strongest recurring theme of the Business Minds meeting was the critical involvement of everyone at the practice. I frequently see public feedback when patients are happy with their physicians, but not their staff, and vice-versa. Patients form their opinions about their experience based on every interaction they have with us; from the receptionist who greets them, to the medical team that cares for them, to exceptional customer service both online and offline. When we support all of the role players on our team, and learn about best practices from clinic groups across North America, we can dramatically improve both our delivery of care and patient satisfaction. Now that's an excellent foundation for growth. I recommend that at least once a year, you accompany a few of your team members to an inter-role meeting like MRSi to identify how you can improve your practice operations. You might be pleasantly surprised by what you learn from your own team, and what they learn from you.

See you next year at MRSi 2017!