On this episode of Inside Reproductive Health, Griffin talks to Dr. John Crochet of the Center of Reproductive Medicine. CoRM is an independently-owned clinic based in Houston, Texas, one of the largest markets in the field. In recent years, PE-owned and PE-backed clinics have started to take over the city, making the independent clinic almost obsolete… or have they?
Together, we discuss how the Center of Reproductive Medicine continues to thrive despite the money being funneled into their competitors in the market. From how they hire new docs to their philosophy on patient experience, we hear it all.
Dr. John Crochet trained in Reproductive Endocrinology and Infertility at Duke University and Obstetrics and Gynecology at the University of Texas. Originally from Texas, Dr. Crochet went back to his roots, joining the Center of Reproductive Medicine in 2012. As an REI, Dr. Crochet has a goal of providing personalized care and an evidence-based approach to each family hoping to expand.
Learn more about Dr. John Crochet and the Center of Reproductive Medicine by visiting www.infertilitytexas.com
Mentioned in this episode:
38 - Dr. Candace Perfetto
58 - Dr. Lowell Ku
To get started on a marketing plan for your company, complete the Goal and Competitive Diagnostic at FertilityBridge.com.
***
Welcome to Inside Reproductive Health, the shoptalk of the fertility field. Here, you'll hear authentic and unscripted conversations about practice management, patient relations, and business development from the most forward-thinking experts in our field.
Wall Street and Silicon Valley both want your patients, but there is a plan if you're willing to take action. Visit fertilitybridge.com to learn about the first piece of building a Fertility Marketing System--The Goal and Competitive Diagnostic. Now, here's the founder of Fertility Bridge and the host of Inside Reproductive Health, Griffin Jones.
JONES 2:02
Dr. Crochet, John, welcome to Inside Reproductive Health.
CROCHET 2:06
Thank you. Appreciate the invite to join it.
JONES 2:09
I'm interested in exploring the independent practice scenario juxtaposed against the network landscape. And you're in Houston, which makes this really interesting of a case study to me. Let's start maybe with your entering into the field after fellowship, you came to your current practice in 2012. Is that right?
CROCHET 2:33
Yeah, 2012. So I finished residency, senior fellowship in 2012. Took a month to kind of make a move, and then got right after it on August 1, 2012.
JONES 2:44
That was, so that was right out of fellowship, the first gig--
CROCHET 2:48
Right out of fellowship.
JONES 2:50
Did you know at that time that you wanted to become a partner at a practice? Were you just concerned with getting a job? Were you looking ahead to building something with partners and building something of your own? What was your outlook like, at that point?
CROCHET 3:09
Yeah, so, you know, I think that mainly just getting a job, really, you know, I wanted a job where I could grow professionally. I didn't know that I would be as interested in the business side of things as I ultimately have become. But it really was just looking for a practice where I felt like there was an alignment of our approach to patients and how we, you know, how I practice and how the physicians that were in practice, how they practice. And so I wanted to continue to grow and continue to learn. And so I really looked for that kind of opportunity and not so much focusing on what was the right business opportunity? What would provide the best opportunity from the standpoint of building value and equity in something that would ultimately result in an opportunity to monetize later down the road? You know, those weren't initial concerns that I--or considerations that I had.
JONES
Why did it work?
CROCHET
Ultimately, there were a couple of physicians that were in the practice that I joined. Dr. Schnell and Dr. Sims, both had been at Center of Reproductive Medicine for a while. We had a couple of locations, or they had a couple of locations. From a geographic standpoint, it's where I wanted to be--I'm in Houston, the Houston area, Southeast Texas, is my hometown. It's where I grew up. So there was a draw from a geographic standpoint. From the standpoint of an approach to patients, what I liked, or what I heard from the physicians was a patient-centered, patient-focused, let's put the patients first, let's take care of the patients in a way that really makes them feel supported. And, ultimately, it was that kind of feeling that I got about how the practice currently took care of patients, that it really aligned with how I envisioned how I would be as an independent practicing physician.
JONES 5:08
So you were the third doc into a two doc operation at that time.
CROCHET 5:12
Correct.
JONES 5:13
And we've had your colleague, Dr. Perfetto, on the show before, I think, sometime last year, and so now you have--Dr. Sims has since retired, is that right? And now you there's four docs?
CROCHET 5:20
There's four. So we also--so Dr. Perfetto, joined us in about 2015. Dr. Kathiresan joined us in about 2017/2018. And then Dr. Sims retired, really just a couple of months ago.
JONES 5:39
So you're the third person in and then you bring on two more docs. What's that like? We've had Dr. Lowell Ku from Dallas on the show, and he talked about he was number two, and I think they're up to six or seven up there at their group. So what was it like?
CROCHET 5:55
I mean, it's a good experience. I think that it's been a learning process. There was--each time we've brought in a new physician, there's been a specific need that the practice had. So when I joined, they really were just so busy that it really, they needed someone to come in and provide some relief, so I didn't have to necessarily build new referral patterns. I didn't have to go out and gain new business. I just had to keep the business, the referral, the referring doctors that we had just, you know, interested in our practice and provide maybe a little bit of an alternative, somebody that was a local guy. And so it worked really well, right? When Dr. Perfetto joined, and then ultimately, when Dr. Kathiresan joined, they were tasked with much bigger, much bigger goals--they had to develop new offices. So when we brought in these these new physicians, we also added locations. And so when you add in locations, you have a new geographic footprint. So they were tasked with going out and creating new relationships. They weren't from Houston, they weren't from Texas originally, and so they had to go out and really develop new referral sources and new relationships, and they both have done an excellent job of that.
JONES 7:06
With regard to referring providers is being from the particular area, generally as much of an advantage as one might think it is?
CROCHET 7:16
Well, I don't think it's an advantage at all. When it comes down to it, I think that it does give an opportunity for discussion. So one thing that, you know, I trained at UT Southwestern at Parkland Hospital in Dallas--there's tons of graduates from that particular residency, there are a bunch in the Houston area, and so you have that immediate connection oftentimes. So if it's not somebody that you overlap training with--you've overlapped in some way, you guys have had the same mentors, you know the same people. So when you go into an OB/GYN office that you hope will refer you patients, there can be an immediate connection. So it helps in that initial interaction, it helps in that initial encounter. But once they start referring patients to you, you better take good care of those patients, because that is what's going to keep them referring to you.
JONES 8:12
That's what--we'll link Dr. Perfetto's episode in the show notes because her perspective is in that episode of building up her practice. So you come in and join Dr. Sims and Dr. Schnell, you have two doctors join later. Perception or reality? It's easier to recruit younger docs if you have a younger doc.
CROCHET 8:35
Yeah, I think that's reality. I do believe that what it does do is it gives, especially if a young doc has been successful--so what I believe--and I'm, you know, I'm you know, eight, nine years removed from it now or even closer to 10--but one of the things that I did like about other practices that I interviewed with, is that there was a track record, there were footsteps that I could just walk in, right? There were fellows that had joined a practice and had ultimately become productive, and ultimately partners. And that's what I wanted to do for a lot of different reasons. And so I think that when you have a younger doctor who's done that, and you can look at it say, hey, we've got the playbook, you know, we just have to follow it. That's tangible, that when you're trying to recruit somebody, that's tangible, that they can look at and say, Okay, this particular practice has a track record of doing that. And that is, that's exciting to me.
JONES 9:34
I think it's an advantage for the recruited physician, I think it's definitely advantage for that bridge physician in your case. And I don't know if you leveraged it this way, John, but I would say to anyone who is thinking about joining an existing group, if they do not have docs that are let's say, you know, further out than 10 years from retirement, but especially if they don't have any docs that are further out than five years from retirement, I believe that the younger doc has a disproportionate amount of leverage, that's what it seems to me. And then by that person being in and being successful, they have the ability to recruit other docs and build more equity in their thing. I've seen it happen a couple of times. And I think this is where some of the debate in private equity comes in. I had a meeting earlier this year and it was for independent practices. And one person thought that we're just going to be talking about exits for retiring docs and said, "I don't want to be a part of that." And it wasn't about that at all. But I think what the perception is and possibly the reality is that it benefits most people who are going to retire within five years and less so the younger partners. I heard one person make a really good counter argument and I'd still love to have them on the show about it. But how do you see that dynamic of younger docs having the opportunity to build equity versus maybe retiring docs cashing out?
CROCHET 11:07
Yeah, so, you know, I think that there's a lot of trepidation and from what I've heard in people in private equity is there is this concern, that it may not be the best scenario for them to identify a practice, there's a lot of successful practices out there. You know, one of the things that is truly remarkable to me, just in the field of reproductive endocrinology is how entrepreneurial physicians in this subspecialty are. I think, that in general, most people think of as physicians as being poor business people. And my experience with my colleagues in this field has been contrary to that. I think there's a lot of really, really excellent business people that merge being good doctors with good business, and that's the scenario that you want, right? When you practice medicine based on it being a business, then ultimately, that's going to be a problem for patients. But when you practice good medicine and build a good business model around that, then that's when really everybody benefits: patients benefit, the physicians and the practices benefit. And so, you know, I think that it would be a problem. If I were someone in private equity, I would have real concerns about, you know, a scenario where somebody is looking to cash out, so to speak, and it probably is more inviting, to have a scenario where there are younger physicians who are--and young is relative, I guess, I mean, I think it probably really does get at when that particular physician plans to retire, I guess that's the better way to say it, as opposed to making it an age thing, because I don't think it's that at all. I think, there are people who plan to work, you know, for 10 to 15 more years--And so, at any age, right? So younger people may do that. Older people may do that. But, you know, I think that as far as leverage goes, or as far as the equity goes, I think that both sides win from a private equity standpoint, and from physicians who are looking to monetize their lifelong investment that they've put into something, that those sides tend to come together and both do well when that relationship is made. When you know, it's looking like there's 10 to 15 years more work to be done, so to speak.
JONES 13:28
I think that's a good way of putting it. The time to exit is what really changes things because one, what happens to the equity after, and two, the control, I can listen to someone telling me what to do for two or three years, but not 10 or 12. And I can probably do it if I'm getting a big paycheck right before retirement, but 35-year-old Griff Jones have no desire in selling equity in my company because I love the control and I see the upside. You all are, in Houston. You're now the largest independent group in that market. Whereas five years ago, you would have been number four. And so you've got four doc, you've got an advanced provider, those optics look really good. What's Houston, fourth, or fifth largest market in the country? And so you must all be getting calls every week?
CROCHET 14:24
We do get a lot of calls. And you're right, it does look good and to be quite honest, it feels good. It feels good to have a successful practice, right? And so there's a lot of things that I think define success. One of the things that I'm big about is secondary gains. So I think as physicians, you know, obviously, none of us-I don't think any of us--hate making a good living. But I really want people, I want to work with people, I want to work with employees. So we hire to this. I mean, we have core values that we hire to. And we hire to people that want to accomplish some secondary gain, right. And so I have nurses that come to me daily and have great pride in the fact that they've been able to help those individuals in the way that they have. I have research personnel who feel accomplished when they start a study or when they close a study. You know, my billing people have a sense of accomplishment when they solve a particular issue where, you know, we've had to previously fight for this or fight for that. And it's just fight for the benefits that the patients are owed. But they figure out what's the right way to submit the paperwork or what's the right way to code it so that everybody gets what, you know, is, owed or due. And so, you know, I hope that people look for that secondary gain, right? So yeah, it feels good and it looks good to be in a position where we have a successful practice. And we have that ability to be able to monetize. And virtually every type of acquisition, merger, consolidation, we've had private equity, we've had people that want to make the Center of Reproductive Medicine their platform, we have people that are in our geographic area that want to merge. So we've kicked the tires on all of those types of scenarios. I'm a big believer in--although we're not shopping, it's not something that's in my, you know, six-month plan, or my two-year plan, or even my five-year plan--but I do think it's quite smart to listen when those opportunities arise. And that's what we do. We sit down, I have an open-door policy, I meet with anybody that wants to meet, and I listen to what they have in mind. And there are some scenarios that sound enticing, quite frankly, but at the end of the day, what's more enticing is to have a practice that is independent, and have a practice that's physician-owned and physician-run. And that can adapt quickly, especially in a scenario like what we just dealt with. With COVID, we were able, Dr. Schnell and I and the other physicians were able to sit down in our management team regularly--daily, weekly--and make pretty broad and specific changes in some instances, that dramatically impacted how we practice medicine for the good of our patients, and also how we applied our business plan so that we could continue to thrive in such a stressful scenario.
JONES 17:32
So what is it about either that dynamic response that you just described during COVID or the one I'm paraphrasing, but you were saying secondary benefits that personnel are motivated toward--what is it about the offers that you've looked at thus far, that you've dealt with, or the conversations that you've had, that you felt we wouldn't be able to have this if we went in that direction?
CROCHET 17:58
Yeah, I mean, it's a combination of things. It's a combination of--so I talk about secondary gain. One of the secondary gains is that as much as I love taking care of patients--and as much as that's who I am, that's, you know, what I trained to do for so long--is that I do enjoy the running-- the business aspect of it, too. So, I do get a lot of secondary gains and having accomplishments on the business side of things. So when we come up with a marketing plan that works, or when we do a promotion of some sort, or, you know, any number of things that involves growth and development, that is something that, you know, lights a fire in me, right? And I think it makes me a better physician, just like, you know, somebody who has hobbies--and I have a couple too, you know, music and sports and things like that--well, you know, I'm a better person, I'm a better physician when I'm actively doing those things. I believe that I'm a better physician because I'm connected in what's going on from a business standpoint. And again, I think that the key is to practice good medicine and design a business model around good medicine. I believe it's a problem when you figure out or when there are instances where people figure out you know, what reimburses the most and just sort of hits that easy button over and over again. And yeah, maybe they do well from a financial standpoint, but that is probably not taking the best care of patients.
**COMMERCIAL BREAK**
I would be a bad fertility doctor, because I only want to take on the cases that I know are going to be successful. I only want people to say these sorts of things about me and my company, like Greg in Chicago: "Our resources are not endless. And I think that with Fertility Bridge, there's a much deeper dive." Or Dr. Young in Iowa, "I've gotten more positive feedback from patients from anything in the last 30 years of practice." Or Brad in Seattle, "You have multiple experts on your team and for, you know, a very small price to get that level of consulting for just a couple hours would be really valuable." Okay, you get the idea.
So this is how we set you up so you are 100% guaranteed to be successful in your goal over time. It's not a magical wand. Until you do this do not pass go, do not collect $200, and definitely do not get in any long-term commitments or launching issues.
You sign up for the Goal and Competitive Diagnostic at FertilityBridge.com. You fill out your Business Needs Profile, we establish your benchmarks and desired outcomes. Then we meet for our 90-minute consult. We provide you with business Intel revenue estimates and a competitive overview of the field to facilitate the prioritization of your goals between your partners and leadership team. Then we have a 30-minute follow-up, we tell you exactly what you need to audit and strategize to build your plan. I'll also give you one big marketing idea that will make you say, "Damn, that's good!" If we fail to do any of these things, we give you your money back because it's only $597.
And because I need you to be successful, because I need you to say all those really sweet things about me and my company, maybe even a gem like this one from Holly and Dr. Hutchison from Arizona, "If we didn't have Fertility Bridge, honestly, I think we would be getting closer to retiring."
There's no long-term commitment whatsoever and there's a 100% money-back guarantee. Send your manager to FertilityBridge.com, have them sign up for the Goal and Competitive Diagnostic. And I will see you and your partners on Zoom.
JONES
Part of the reason why I wanted you on the show is because of your position in the practice having come in within the last decade, having become a partner and you know, not being too far out from that and that being a little less common among younger docs now. But also because you're in Houston. And I think when people look at Houston, I think they see that as the possible future. When I hear people talk about consolidation, I often hear people wonder, Are there going to be two or three groups that own 80% of the centers in this country in the next decade or so? And so, if somebody looks at 2016 data, you probably all had 10 or 15% of the market four years ago, and I looked at some other names and say, Well, that's not called that anymore. That's not called that anymore. And probably two thirds of your marketplace, the volumes there are now within groups that are PE-owned or PE-backed. What have been the implications of that in your market in the last four years?
CROCHET 22:58
Yeah. So I mean, I agree. I think Houston is a market that people have been focused on and probably should be focused on. I think when when people look at areas of need, Houston continues to be one of those areas where we feel like there probably could be more accessibility from the standpoint of more physicians and more locations. And, you know, one of the--and I agree with that, you know, and that's part of why we are currently as active as we've ever been in looking for a physician, or more, to join us, right? I mean, this is something that--our approach, you know, much like we have an open-door policy from a business standpoint, I have an open-door policy with graduating fellows or people that are having geographic life changes. And so we want to talk with any and everybody that has any plans to go anywhere, and especially to Houston. And what we want to do, what we've wanted to do, is we've wanted to create a situation where we identify the right kind of people, people that have an alignment in goals and philosophies, hire those kinds of people, hire those kinds of physicians. And then that allows us to kind of continue to take care of patients the way that we would want to do that, right? But with that, we're as growth-focused and is growth-oriented as we've ever been. We understand that it has become more crucial for us to recruit and hire a physician that, you know, checks all those boxes for us. And we feel like it's a great opportunity. So it's, you know, but with that, right, we've continued to evaluate those opportunities that come up from a private equity standpoint, or a, you know, a merger standpoint. And at this point where we are in the maturation of our career, or of our practice, we feel like what gives the Center of Reproductive Medicine the best opportunity to continue on that path of growth is to stay physician-owned and physician-managed. I still believe that those are going to be the most successful reproductive endocrine practices and fertility practices and just medical practices, in general.
JONES 25:15
That physician-owned will be the most successful?
CROCHET 25:17
I do. Yeah.
JONES 25:19
Why?
CROCHET 25:20
Well, I think that ultimately, it offers an alternative--and this kind of gets to the question that you asked--which is that it offers an alternative to a feeling that, you know, people like to feel connected to a community and medicine is very much a community and patients want to feel like their physician is a you know, is part of their local community. And so, you know, I think that--now, I believe that there are networks that do a very good job at taking care of patients, they have great success, they have great reviews, they meet all the metrics that you would want to meet. But I do believe that patients know the difference. And that it offers an alternative to what has become the norm or the-- I've wondered if 80% of the market is going to be owned by two or three entities at some point. Patients are savvy. Patients that--fertility patients are extremely savvy, they know that, they talk, they talk on message boards, and there is always going to be an opportunity for independent practices always. In fact, when you look--our field in general is a relatively young field. And when you look at businesses across the board, you know, one of the major businesses in Houston and in Texas is oil and gas, right? And when you look at oil and gas as a model of business in general, that business goes through phases of--it's sort of a balance between networks and privately-owned entities, and you have periods of time where things move towards consolidation, and you have periods of time, where it moves towards more independent, right? And I think that we're at one of those times in our evolution--I'm talking about the field, not our practice--where we're evolving towards a more consolidated-type industry. And I think after that, you know, after some time of that, then we'll move back more towards independence. And that could be people that are breaking off from the networks they've joined, it could be new physicians that want to pursue something different. But I think ultimately, that'll happen.
JONES 27:21
So I describe it as the same phenomenon as craft beer. And as regional banks. You have a local bank that merges up with the other local bank becomes regional bank, merges with the other guys, get purchased by Citi, or HSBC, or a national conglomerate, and it starts all over again. And we've seen that with beers where it used to have a brewery in every city, and then it became Miller, Coors and Bud. And then international conglomerates bought each of those--you had SAB MillerCoors and InBev Anheuser-Busch. But now once again, you have multiple breweries in every city, and they're growing, and then the middle guys are growing. And the cycle just continues: it's consolidate, fracture, rebuild, and it's happening everywhere. It's already happening in our field. I think you're spot on with that. Where I'm a little less bought into your point--I think your point is very true about the market being savvy and about people wanting to have a connection with physicians and providers. I just don't see that always being--I don't see that being a given. Meaning if it's an advantage that the group leverages, I think there really is an advantage to be had. I see a lot of practices that are saying, Nah, we're good. And then they just sort of assume that, well, you know, we've got a local connection, or we have a good reputation. And then I sometimes see that erode. And it's like, well, you still need to invest in these other areas. And so talk about maybe what's really important to invest in because I think groups like yours that are doing it are reaping the rewards. And I think that there are others that are just one solid competitor away from really having a different year.
CROCHET 29:22
Yeah, no, I agree with that. The last part of your comment I completely agree with and I think there's a difference in staying independent for the sake of independent, for the sake of it being independent and saying that ultimately what you want is control over what you do day in and day out. I do agree with you that consolidation is coming. And these entities, you know, they're about business. And they're very savvy, savvy marketers, and they are great at building relationships with referring providers and patients directly. And so it can be a real problem for a practice who is not growth-focused. And I think that's--if you want to remain independent, I think there would be a concern in staying independent, but also not investing in growth. I think that it's got to be a mainstay of what you do day in and day out. And that's whether you're independent, or you know, plan to join a private equity scenario, or join a network. I think that ultimately, you're going to be a successful practice if you invest in growth, and eventually you're going to have problems if you're not.
JONES 30:42
Why is that? Because I think growth can mean different things, which is probably why we agree on this, but why is that the case that being growth focused is maybe requisite for remaining successfully independent?
CROCHET 30:57
So I mean, it's a combination of things. So it's really based on history, right? When you look at any business or you look at any medical practice, when people kind of get comfortable with where they are, and sort of take a moment to sit back and relax and say, Look what we've accomplished, then that's when you probably start to slip a little bit. So it's mainly based on just the history of businesses in general, and businesses that have constantly concentrated on growth and how we grow. And I think you're right, I think growth is a lot of different things. And so it's more about what history shows us in business, and less about a specific thing that we can point to and say, Alright, we have to do growth, because if you don't, this is going to happen.
JONES 31:42
I think the adage of growing or dying is very relevant, I think it can be different things in different cases. You know, I don't want to grow my client list of 40 clients, I want to have no more than 12 clients. And I want to have average four-year engagements, and I want to replace--so with 12 clients, average four-year engagements, you're replacing two to three clients a year with ones that follow the process more easily and are more profitable. So that's growth, but it's not my foot off the pedal, it's still we want to--we want this to be our growth, but our growth isn't just growing and growing. But I think viewing it in the frame that you've said is really important, because I look at some people and I just think you're not paranoid enough for me, man, you're not paranoid! To be a successful business person, I feel like you should always be waiting for Google to come out with something that puts you out of business, or for the market to just go a completely different way or for COVID to happen or a number of different things. And I feel that growth is partly what can help with that if you're leveraged properly.
CROCHET 33:05
Yeah
JONES 33:06
And so what are some of the things that you think are really important for independent groups to invest in that might sometimes be overlooked?
CROCHET 33:17
Yeah. So, you know, I don't know that the formula is incredibly different for an independent practice as it is for a network. You know, I think obviously, the main thing is invest in good patient care, right? So one of the things that I have seen, that I have witnessed in practices that are independent and are not exhibiting that growth that we talked about--so we talked about growth and a number of different things. It's growing with how the field changes, right? So our field has changed rapidly in the 15 years that I've been doing it right. There's a lot of things that we do differently than we did 15 years ago. There's a lot of things that we did differently in the last two years than we did two years ago. That requires capital investment in your own practice, that requires equipment, that requires people. Today, we have more people employed by our company than we've ever had, we have more clinical people than we've ever had, right?And so I think the number one thing is to invest in your practice, and invest in technology. Learn, learn what's new, and what's current state, cutting edge. And so I think that's probably the single most important thing, right? That's one A I guess one B is taking good care of patients. So there is no substitute for that. So patients talk. Patients tell their friends and their neighbors and their family, how fabulous or how not fabulous any particular physician is. They tell their referring doctors. There's nothing better than those kinds of referral sources because what we've demonstrated is those kinds of referrals turn into--it's not just feet through the door--it's these are people who stay engaged all the way through the process. Exactly, they stay engaged. So they come in, they get evaluated, if they need surgery, they have surgery. If they need IUIs, they do IUIs, if they need IVF they do IVF. So those are the most valuable kinds of patients from the standpoint of generating revenue. But you know, the recipe beyond that is having a really solid marketing plan. And I think not just having the plan, but working the plan. And so this is, you know, we've had our ups and downs from a marketing standpoint, and there have been times where I felt like we've done a great--we've had a great plan and we just not have--we've not done our best at following through for any number of different reasons. There have been times where, you know, I feel like our effort is there, but that our plan isn't as cohesive as it could be. Right? And so it requires a lot of communication across a lot of individuals focusing on those things. And then from a marketing standpoint, I mean, you know, I don't think there's anything I can teach you about marketing. But you know, it's having a good plan, having, you know, having your ducks in a row from the standpoint of SEO and social media and things of that sort. All of that comes together, you know, these are the things that the networks are doing, these are the things that independent practices should be doing.
JONES 36:08
What you just talked about referrals is something that--with regard to teaching others about marketing, I think that is possible, that's what got me into the field so quickly. I had to figure everything else out after that. But I knew with that one bullet of getting patients to talk to their friends and family, you can solve for a lot, because to your point, it's not just people in the door, they're going all the way through because they see the results that their friends have. And I was speaking with someone in a very large market, who has a very large, like, really good practice, very well known, and they just don't have any engagement on their social media. They said, Yeah, but we're doing this content, we're doing the paid ads, it's not about the content, necessarily, if it's not yielding engagement, and the paid ads are only as effective when they're spreading the fire of word of mouth. So I sometimes hear people say, internet referrals don't convert as well as MD referrals, or friend referrals. But friend referrals convert the best. And those are two--those can be two separate things because today where I talk to my friend is on the internet. It might be a review site, but it's most likely Facebook, TikTok, Instagram, one of the social platforms. And so I think that point alone is something that most independent practices are not leveraging nearly as well. If you really invest in your word-of-mouth referral network, you will have the leverage going into the negotiation. So I think that's a really good point. I want to allow you to give a little bit of a plug because you said you're recruiting for docs. I would say, there's 140-150 REI fellows, probably a third of them, listen to the show at one point or another. So maybe there's a few listening to this episode, maybe some of them want to come to Houston, Texas! Talk a little bit about what that ideal fit was, because you said, you know, we're looking for people that fit a value set. And so talk about someone that would be a really good value fit for them.
CROCHET 38:19
Yeah, so, you know, what I would say is probably the overriding approach amongst our physicians, and I don't think this is terribly different, you know, I would like to believe that--what I'm saying is, I don't think this is the secret sauce, but it's, you know, an evidence-based approach to medicine. Right? And I think that it's physicians who are comfortable having conversations with their colleagues about both easy and difficult scenarios, right? So I think there's a commitment to growth professionally. There's a lot to learn. You know, I've learned a lot from the docs that were in the practice, when I joined. And I've learned a lot from the physicians that have joined. A lot about patient care, a lot about life. You know, we're family-focused. We are very prideful in our work and the way that we take care of patients, but we're also prideful in the way that we take care of each other, and we take care of our employees. And we want it to be a fun and rewarding place to do what we do, right? So, you know, I do want to encourage people to search for that secondary gain. And I want to know what makes, for example, a new fellow tick. I mean, you know, I do believe that there is a focus that you should have in your first several years and it really is growing that practice. That is the primary goal. Really all day long every day, if we're not seeing patients in those first two years, it should be doing some effort that results in the developing a relationship or some activity that could result in the referral of a patient. It just takes time and effort and you have to invest in practice growth. We happen to be a practice that has a philosophy that cannot be done on your own. There's, there's--we have all been in this market now--the Houston market--for, you know, at a minimum of five years. So we have a lot of established relationships. And there's always an opportunity to shore up a relationship or create a new one. And when somebody new comes in, you know, that's a good opportunity that--so for a fellow, right, we want somebody who's really not afraid to go out and do what they've learned to do. All of these fellows have been trained well, they all can take good care of patients. And now it's time to really go out and in and work to create a practice. And then over time, you know, I hope that they find what their secondary gain is. And it might be that it's being involved in research, or perhaps they do have an acumen for business and enjoy an element that comes from it. They want to be involved on that side of it. So we want to encourage growth throughout a physician's career.
JONES 41:09
John, is there anything I didn't ask you that you would want to share with the audience who is mostly practice owners, your colleagues, some fellows, some executives and managers? Is there anything that I didn't ask you'd want to wrap up with?
CROCHET 41:22
I don't think so, Griff, I think we really hit on a lot of the topics that are I think, would be important for, you know, a fellow that's wanting to decide what type of practice they want to join an independent practice or a network. Although, you know, I didn't think about those kinds of things and I think it worked out well, I think maybe I did to some degree--but, you know, I think we touched on a lot of those topics. You know, maybe there are physicians that are trying to decide whether or not they stay independent, or they join a network, you know, I really believe that there are benefits to all of those scenarios. And I don't know that one is better than the other. And so I want to be clear on that. You know, I think that it's really about what's finding what's right for that particular practice, that particular physician. So for some that might be being an independent practice. For us, that's been the path that has made the most sense for us and for others, being involved in a network is, you know, having that consolidation of thought and consolidation of resources is something that is, you know, there's real tangible benefit to that. So, I think the most important thing is that any physician that is, you know, has the same kind of opportunities that we've had and is thinking about how they want their practice to continue to go is ultimately to do what fits for both their short-term and long-term goals.
JONES
Dr. John Crochet, thank you very much for coming on Inside Reproductive Health.
***
You’ve been listening to the Inside Reproductive Health Podcast with Griffin Jones. If you're ready to take action to make sure that your practice drives beyond the revolutionary changes that are happening in our field and in society, visit fertiltybridge.com to begin the first piece of the Fertility Marketing System, the Goal and Competitive Diagnostic. Thank you for listening to Inside Reproductive Health.