Social Media

All In This Together: 4 Ways Practices and Patients Are Uniting Around Infertility Awareness Week

By Griffin Jones

If I asked you to name what comes between September and November, you might answer Breast Cancer Awareness Month (BCAM) before you say October. Is there any oncology center in America that doesn't participate in breast cancer awareness month? Is there anyone who doesn't recognize those pink ribbons? Over 1.5 million people participate in the Susan G. Komen races alone. With major partners like the NFL and Proctor and Gamble, the month is almost too popular; to the point where criticism is made that brands exploit the cause for their own profitability. Meanwhile, all the infertility community wants is recognition of their disease and the resources to treat it.  Yet of course BCAM is so much more widely known than National Infertility Awareness Week (NIAW). After all, statistics show that 12% of all U.S. women will develop breast cancer in their lifetime. That's dramatically higher than the 11.9% of women who receive infertility services within their lifetime. 


Infertility lacks a giant brand champion, like the National Football League

Infertility lacks a giant brand champion, like the National Football League

Breast cancer is a serious disease that causes horrible hardship on millions of families. It deserves every bit of attention that it receives. I hope 2016 is the year when the infertility community acts in solidarity for the same.

NIAW 2016 is quickly approaching, April 24-30 (May 12-20 in Canada), and clinics and patients have a vested interest in spreading awareness about infertility. The lack of infertility awareness is one big problem that compounds many others. Practices have time and priority constraints that sometimes keep them from being fully active in their promotion of the cause. Those struggling with infertility have priorities of their own, and for some, infertility may be too personal of an issue to discuss with others. I understand; no one can tell you that you should talk about infertility in an open setting. It's a personal decision and one only you can make. It's worth examining, however, how obscuring infertility from the public eye compounds the other issues that come with it.

1). Social PRESSURE

"When are you going to have a baby?"
"Don't you want kids?"
"You can have my kids."
"You can always adopt."
"Just relax and it will happen."

People ask these questions because they know very little about the infertility journey. Comments like these are what spurred Tyra Banks and Chrissy Teigen to inspire the #stopasking hashtag in the fall of 2015. I know how much this bothers you because I see the companionship that forms around the #ttc (trying to conceive) community every time this pain point comes up. Some of the most popular themes that I post to social media are the articles that talk about what not to say to someone with infertility.

One of the most popular infertility e-cards on Pinterest

One of the most popular infertility e-cards on Pinterest

Discussing your plans for children makes for easy conversation...for someone else. Most of your friends and acquaintances have no idea how common infertility is or how painful such otherwise ordinary questions can be. I would have had no idea if I didn't work in the infertility space. I'm sure I would have made many of the same stupid comments, all with the best of intentions. If these conversations bring you great pain, it may be less painful to participate in the conversations that help educate people.

Social pressure may also be projected onto fertility clinics and their staff. When someone spends thousands of dollars on IVF, they are essentially paying you to solve their problem of infertility...problem...singular. Of course infertility actually becomes an amalgam of many problems. Because you are the one being paid to "solve the problem", by default, you can be assigned responsibility for all of them. By participating in the greater cause to address the social pressure that your patients face, you may be able to allay some of the pressure that you feel as well.

2). Financial BURDEN

At issue: far too many people think of infertility treatment as elective. Only 15 states mandate that insurances cover any kind of infertility treatment and of those, RESOLVE grades only five with an A.  Legislators and employers don't feel hurried to extend coverage because they don't perceive it as a great enough priority to their constituents or employees. If infertility was more widely talked about, and greater societal emphasis was given to its treatment, less cost would fall on you as a patient. It's a big deal when an insurance company tries to avoid paying for treatment of other diseases. If everyone you knew understood the severity of infertility, far more companies and states would mandate coverage for IVF and other services. Having to pay for IVF out of pocket is owed in no small part to a lack of knowledge about the disease.

States ranked by RESOLVE

States ranked by RESOLVE

Clinics, too, face financial limits when public understanding of infertility is poor. There are three reasons.

  1. Your "word-of-mouth" referral network is dramatically smaller than its full potential if your patients don't feel comfortable speaking about infertility. A patient cannot recommend you to someone who would really benefit from hearing about her experience if the conversation isn't welcome to take place. 
  2. People are sometimes terrified to see an infertility specialist, because they have insufficient information and a lack of assurance from confidants. Fear reduces the total number of people who should be coming to your office.
  3. Cost is the single greatest factor that prevents patients from proceeding with treatment for infertility. Dr. Tarun Jain of Chicago IVF finds that "in states where IVF coverage is mandated, about thee times as many people use IVF than in non-mandated states. It's about the same multiple seen in European countries which cover IVF." If infertility was enough of a public concern, your center could be doing three times the number of cycles that you  do now, and many of your patients wouldn't be overwhelmed with the stress of the cost.

3). Emotional STRESS

Many people going through infertility say they feel much better when they are able talk to others who can validate their feelings and experiences. "I am so happy to have found all of you" is a very common sentiment among the #ttccommunity on Instagram. Many more would love to connect with people who share their experience: they just don't know they exist. Not all support groups are equal and some types of support may be better fit for you than others. You may feel more comfortable face to face, or you might like an online setting with anonymity. Some may prefer not to connect with anyone at all, and that's perfectly fine, but everyone should be informed of their options. Most people struggling with infertility say that they found their support resources on their own. Neither peer support nor mental health professionals (MHP) can eliminate the burden of stress that accompanies infertility, but a lack of general attention to infertility lays an unnecessary barrier to emotional relief.

Photo from Good Housekeeping

Photo from Good Housekeeping

Emotional stress has even broader implications for practitioners than only their patients' mental health . According to a study by Courtney Lynch, PhD, MHP, of The Ohio State University School of Medicine, women with high stress levels had decreased odds of pregnancy of 29% compared to women with low levels. While there's no data to prove that greater emotional support will increase the likelihood of pregnancy, research from the University of Michigan Health System concludes that peer support helps reduce stress, isolation, and depression.

Equally, my research shows that only 2% of negative fertility center reviews mention a successful pregnancy or the birth of a baby. The contrapositive is true for positive fertility center reviews. What's interesting is that several dozen fertility doctors in the United States and Canada have very few negative reviews. We know that their success rates are not above 80%. For reasons not yet defined, patients feel they have other venues for venting their stress. Neither the clinic, nor the doctor, nor the nursing staff should be the focus of an individual's emotional stress, so it is in the practice's interest to empower patients to access other avenues of support if they so choose.

4). Medical Impact

A very common concern shared by reproductive endocrinology and infertility (REI) specialists is when a woman waits too long to be seen by a fertility doctor. Time can be a crucial factor in the process of fertility treatment and if a woman is reluctant to schedule an initial consultation, she may be equipped with less options later on. Melissa Campbell of the infertility awareness blog, Triumphs and Trials, shares that women dealing with infertility are often hesitant to see an REI because they are nervous that the doctor will pressure them into IVF.

"To me, it felt like a death wish," Campbell says. "I'm going to go [to a fertility clinic] and they're going to push me into IVF. I feel like I have to do everything possible before I even go see an RE"  

"We need to remove the perception that REI equals IVF," says Dr. Matt Retzloff of Fertility Center of San Antonio. "One of the trade-offs is, the longer we wait, the less tools we have in the tool chest to help out. We want to see you sooner. It gives us more options."

Is it a reach to say that clinics' success rates would improve if couples and individuals coping with infertility scheduled their first appointments earlier in life? Very generally, patients would have increased probabilities of having a baby if they were able to take advantage of more options and benefit from earlier detection. As a society, we can both receive and deliver better medical services if the public is more alert to the challenges of infertility.

Take action: #Startasking

It's time to team up. Practices, advocates, couples and individuals dealing with infertility, and their collective communities can act together to turn the tide to bolster understanding of infertility. This year, RESOLVE has laid the groundwork for a very powerful social media campaign. Instead of a theme that demands that people stop asking, the #startasking initiative addresses social stigma head-on, by encouraging people to learn more about infertility, its implications, and options for treatment. Working together, and taking advantage of the tremendous power of digital media, here are four ways to make National Infertility Awareness Week 2016 the most successful yet.

1). Snap those selfies
 People love to see their fertility doctors and nurses through social media. People love seeing IVF babies. People still struggling with infertility love to see their supporters from the #ttccommunity. Download the official NIAW selfie sign which includes a #startasking bubble to write in your #startasking topic. Here's the easiest way to approach the topics you'll pick for your #startasking questions. 

  • For clinics: What are the five most common misconceptions that your new patients have about infertility and treatment? These usually tie into patients' greatest fears. For example, if you find that your patients are reluctant to schedule an initial consultation because they are afraid that they will be pressured into using IVF, your post might be, "#startasking us about options other than IVF".
  • For people with infertility: This is your chance. You get to control the conversation for once. Instead of holding back tears because someone else took your conversation in the direction of when you will have kids, this is your opportunity to decide what you want people to know about your journey. 

2). Ask with video
Instagram video allows for fifteen seconds and there's no such limit on Facebook. For no cost, use your smartphone to record your video questions and post them on your own channels and those of others. Practices can both pose and answer general questions to and from their communities. People dealing with infertility can record their questions and answers and share them with both the #infertilitycommunity and their clinics.

3). Share each other's content
I normally don't recommend that clinics spend too much time on Twitter, but if you have a Twitter account, this is the time when it makes sense to post and share other groups' content using the #startasking and #niaw hasthtags. Share RESOLVE's posts on Facebook and Twitter. The #ttccommunity is very good at sharing content, even on Instagram where there is no native reposting function. Sharing one another's posts about #NIAW is a tremendous way to increase the visibility of the community.

4). Tag each other
I know I needn't say more, #ttccommunity. You are the best at tagging one another and bringing each other into the conversation. I hope that #startasking and #niaw make for a very meaningful dialogue for all of you. While fertility centers can't tag patients without the proper authorization, we can tag @resolveorg and other support resources, and even tag other clinics. Yes, competing fertility centers can collaborate on content distribution. Competitors joining forces for a specific cause is often very well-received, like when the three major news networks came together for the fight against cancer.  Patients find it reassuring and media outlets pay greater attention.

Push for The Turning Point

Nearly every problem we face in the infertility space is compounded when awareness about infertility is low. You face unfair social pressure and financial stress because not enough people are conscious about the devastation caused by infertility. Medical treatment is denied to hundreds of thousands of people every year. Other medical conditions have found tremendous recognition through their awareness efforts and the infertility world has an opportunity to unite in a way that benefits everyone and gains the acknowledgment it deserves. RESOLVE President and CEO, Barbara Collura, encourages "the entire infertility community to call attention to this disease. By asking the tough questions about infertility, we not only have an opportunity to raise awareness about this disease, but also to motivate all who are touched by infertility to commit to the cause.”

At the very least, National Infertility Awareness Week 2016 is an opportunity to gain more exposure for your practice and more understanding for your fight as a patient. As a specific time-frame with a specific goal, it is easy for the media and public to understand and support. More ambitiously, it could be a turning point in this long, exhausting struggle of an issue that people know so little about, or worse, doubt its seriousness. You don't have to hope that a major network reporter will pick up your press release and decide to cover infertility awareness week. We have the power to call attention to the cause with the content that we create. Our own social media efforts give us the distribution to reach beyond our immediate communities. Our creativity will determine how far it will go. Patients, practices, and advocates are coming together to benefit the entire field. 


3 Common Things Fertility Practices Do On the Internet that Make HIPAA Lawyers Cringe

By Griffin Jones

"We must all obey the great law of change. It is the most powerful law of nature."--Edmund Burke

In the summer of 2015, I asked my e-mail list of fertility doctors if if they had any questions about the Health Insurance Portability and Accountability Act (HIPAA) as it relates to internet marketing. Except I didn't write HIPAA. I wrote HIPPA. Thankfully, someone who read the e-mail, corrected me. I was a little embarrassed. I knew what the acronym stood for, but I still wrote it incorrectly. Why would I spell it that way? 

What happens when patients want to engage with you?

What happens when patients want to engage with you?

It wasn't until several weeks later that I realized why I would misspell such a commonly known acronym. It's because nearly everyone spells it that way. You may have made this mistake, I see it from physicians frequently, even on their websites (sometimes even from lawyers). Heck, even the Substance Abuse and Mental Health Services Administration misspells HIPAA. My observation isn't that we're all phonetic spellers, it's that we don't have a great deal of familiarity with such a broad legal statute.

Technology, culture, and the law

I don't envy your position of having to handle protected health information (PHI). So why, as a marketer, am I so interested in learning more about privacy regulations? Because technology moves faster than the law can possibly hope to keep pace with. I'll take this one step further; the way human beings annex technology into their daily lives moves faster than they can properly regulate it. We see legislation failing to keep up with assisted reproductive technology (ART) across the field. We see antiquated laws or delays in new regulations for driverless cars, music sharing, and even new currencies like Bitcoin. Why wouldn't we expect a similar legal lag in privacy and communication?

Unlike many disciplines in medicine, and contrary to what some people in our own space still seem to believe, fertility is an extremely social category. The #infertility hasthtag has been posted on Instagram 142,335 times--up 30% from when I reported on the rise of Instagram among the infertility community, three months ago. Patients post medical records with their practice and doctor's name. Sometimes they just say hello. When do we engage? When do we not?

The phrase "social media" does not appear anywhere in HIPAA, so we are left to turn to lawyers to interpret the law. That's why I interviewed seven of them. Their insight spans beyond my scope of internet marketing, and I suggest you educate your team on HIPAA because all of the attorneys agreed that training is the best way to prevent a breach. I recommend you consult your own attorney often and that is not me. I'm just someone who knows how infertility patients communicate and what they use to connect, which leads me to observe some scenarios in which fertility centers may be at risk of privacy law violations.

Be human, be careful

We have to imagine that future laws and statutes will have to be more explicit with rules of engagement between patients and providers in digital media and communication technology. I hope that legislators involve physicians, patient advocacy groups, and tech developers in their consideration of new regulations, because I worry that a lack of understanding in how communication technology is actually used could lead to limits on patients' free speech, and ultimately hinder the standard of care. Reservedly, I'm optimistic because millennials are only beginning to change healthcare and we are a demographic that demands online engagement. In the meantime, I am paying very close attention to how policies and technologies develop, so that we can continually adjust and evolve when called for. I'll say it one last time--I'm not an attorney. Talk to an attorney. Maybe I'm too conservative, but this is how I see the intersection of law, culture, and technology at this moment. From what I observe as someone who monitors the fertility marketing landscape, these are common mistakes:

1). Posting pictures of baby collages

In 2014, the New York Times published an article about fertility centers having to take down baby photos in their office because it is a violation of HIPAA to display any of the 18 identifiers of PHI without explicit authorization. 

18 identifiers of Protected Health Information; from  UCSF

18 identifiers of Protected Health Information; from UCSF

It seems that most of the fertility centers took down the baby photos, though they didn't necessarily have to. It is possible for you to post baby photos to your website or social media accounts and keep them in the office for public view. If you have a signed HIPAA authorization on record for every image in the collage or baby wall, for the purposes of external marketing and social media, you are allowed to post those pictures. If I were a betting man, however, my hunch would be that you have not done that.

2). Sharing pictures from the fertility center baby reunion. 

Trust me, I know how this hurts. The picture of everyone--team members, physicians, former patients, spouses, and adorable children--makes for the best fertility center cover photo of all time. Many of you have this very picture on your websites, place pages, and social media accounts. Again, unless you have a signed authorization from every single patient in the picture, this isn't legal. Would it be likely that the Office of Civil Rights (OCR) would take action against you? I doubt it, but I always play it cautious in this space. Just last month, a physical therapy provider agreed to pay $25,000 in fines for posting pictures of patients to their website without the proper authorization. This doesn't mean you can't post the incredible pictures of your wonderful baby reunion, it means you should have HIPAA authorization forms on-hand at the event. 

HIPAA Authorizations have six core elements:

  1.  A specific and meaningful description of the information to be used or disclosed.
  2. The name or other specific identification of the person(s), or class of persons, authorized to make the requested use or disclosure.
  3. The name or other specific identification of the persons(s), or class of persons, to whom the fertility practice may make the requested use or disclosure (i.e., the intended recipients).
  4. Description of each purpose of the requested use or disclosure. 
  5. Must contain an expiration date or an expiration event.
  6. The signature of the individual and the date.

And they must include these three statements:

  1. Individual’s right to revoke the Authorization.
  2. Clarification that the covered entity is not permitted to condition the provision of treatment on the execution of a valid Authorization. 
  3. Explanation that there is a potential that the information may be re-disclosed by the recipient of the information and that the recipient may not be required to comply with the Privacy Rule.

You can borrow an example of a simple authorization form from Tulane University Medical Group. Most of the people at your baby reunions really want you to use their picture. A socially appropriate way of asking their permission might be

  • "Hi everyone, we would hate to leave you out of our event photos, but we can only share them publicly if we have your authorization. Please come over to our table to sign the form if you'd like to be in the pictures." If you have a photographer on site, you may even consider having a team member accompany them with a clipboard of the appropriate forms. Don't worry, in an environment like your baby reunion, most people would be disappointed if you didn't ask.

3). Publicly responding with too much information

Often when I see this, it is in response to a negative review. Physicians sometimes refute complaints by using details to support their argument. This makes for poor marketing, atrocious customer service, and worse yet, it may be illegal. If any of the 18 patient identifiers can be traced to that person's review account (a full face photo in Yelp, a name on Facebook, and e-mail address on a Google account, etc.), that would be a breach of PHI. Please, please, please, resist the temptation to respond to a reviewer with any of their information.

This is an example of a potentially illegal, and otherwise awful way of responding to a fertility patient review

This is an example of a potentially illegal, and otherwise awful way of responding to a fertility patient review

To be fair, it is isn't only the negative reviews in which I see doctors and nurses respond with too much information. Sometimes, with the very best of intentions, doctors and nurses comment on a patient photo to the effect of "I'm so glad we could help you through this. That was such a hard time for you." We suppose this is of much lower risk than responding with too much information to a negative review; after all, do you think a person who was very upset with you wouldn't take the first chance they could get to file a complaint? But once more, I would rather play it safe. If you look at the way I respond to patients, I really don't even acknowledge that they were a patient at the practice. We want to be human, authentic, and emotionally sensitive in our engagements, but we also want to make sure we don't add any patient information. We can tell them their photo is lovely, thank them for their kind words, and wish them a great week. If it is a complaint, we can tell them we are sorry to hear that and we would like to hear more from them offline. That's it. Keep it very simple.

Pay attention and adjust accordingly

There is a lot of fear mongering on the web about privacy and patient engagement, and I'm concerned that practices will be afraid to engage their patients online, which is a critical part of patient relations in our connected world. Equally, extreme caution is necessary to protect the trust and privacy of our communities. Because we want to engage our patients effectively, authentically, and respect privacy laws, we have to be smart. You should consult with your attorney often because this is just one of the many areas of our field and our world that is changing faster than laws can keep pace with. I am guardedly optimistic that as new generations impact healthcare, more widely-adopted practices for patient engagement will establish themselves. In the meantime, we can pay attention to legal, technological, and social developments and continually evolve our policies and habits. 

We don't "like" it anymore: 7 reactions from the infertility community to Facebook's new options

By Griffin Jones

Now here's a social media update that has already begun to change the way fertility practices and their patients interact with each other. We have been waiting for this new function for some time. On February 24, Facebook introduced a change to how its users can react to content on the platform. In the past, you posted a status update and people either liked it or they commented on it (if they reacted at all). And that was it. So if I posted a picture of my breakfast, an announcement about starting my new job, or the passing of my Grandmother, you as my Facebook "friend" would have to comment on the photo in order to distinguish your reaction from a general like. The like function would feel very inappropriate if the post mentioned bad news, or very underwhelming if it dealt with something outstanding.

Now, the infertility community has more ways to react to each other's content

Now, the infertility community has more ways to react to each other's content

For some, this change won't be especially pronounced. Few life chapters are as emotionally diverse as what we see. For the infertility space on the other hand,  there is no emotion that doesn't appear across the range of news that we receive and deliver. From the ecstatic triumph of a beautiful baby after a long journey, to the torment of the loss of a pregnancy, to the needed levity of inside jokes, every possible emotional expression can be seen among the online #ttc (trying to conceive) community. Now, Facebook is offering more ways of being able to react to the content we see. Last fall, Facebook tested its new reactions in Ireland and Spain. This week, the new options were made available to the rest of the world, and the infertility community is already using them. 

More ways for the infertility community to express their emotions

More ways for the infertility community to express their emotions

It's distinctly possible that it will take some time for social norms to establish themselves with regard to how people dealing with infertility choose to use their new reactions. In the same way that e-mail open rates were astoundingly high in the 1990's, or that you followed back everyone who followed you in the early days of Twitter, we may see the love reaction take over for the like function for a while. Nonetheless, we are already starting to see distinct responses to infertility content. For example, of the 100 people that reacted to an e-card that posted by Buffalo IVF, we can see that nine people "loved it", six people "laughed" at it, and the rest liked it. .Let's break down the new Facebook reactions, and how we see them developing into new social norms in the infertility family.

  1. "Like": Traditionally, we've seen the like button used for everything, because it was our only option. Now that the like function's monopoly is over; the only certain prediction is that it will be used less frequently. I think we will continue to see the like button used for different kinds of practice news, such as soliciting feedback about a baby reunion, and in other demonstrations of community support. For example, a post about your team at your local RESOLVE Walk of Hope is content that will probably continue to be "liked".
  2. "Yay": I imagine this will be  a common response to pregnancy announcements and other accomplishments like weight loss and embryo status. Yay can be used in place of like and love in most cases.
  3. "Love": We can expect to see a lot of love in the fertility space. We're seeing a lot if it already. New baby pictures are already getting lots of love, and it's only just begun. A like simply doesn't cut it when it comes to responding to a beautiful baby picture or an emotional pregnancy announcement. For those fertility clinics whose doctors and nurses are absolute sweethearts, I predict we will see a lot of hearts under their photos as well.
  4. "Haha": There is an exceptional sense of humor to the infertility community and a growing body of research indicates that laughter has therapeutic value. This would explain why we see so many e-cards, memes, and inside jokes in the #ttc community. The @infertility_hopeandhumor account has more than 2,800 followers on Instagram. From my experience, I've noticed that the funny content often grabs the most interaction. I think humorous posts will be even more appropriate for practices to share now that there is a reaction that fits its purpose.
  5. "Wow" is definitely the most ambiguous of the new reactions. I see this function being used in parallel with  all of the other reactions except for sad. It will be interesting to see what meaning the infertility family decides to give to wow.
  6. "Angry" Other extremely popular posts are those that capture the feelings of the social pressure faced by couples and individuals struggling with infertility. The most shared link posted by Fertility Institute of Hawaii, for instance, discussed the social protocol of asking someone when they are going to have a child. At risk of generalization, the infertility community hates this. They hate being told they can just adopt. They hate being offered their friends' children in jest. They hate being told to "just relax and it will happen." These topics are almost always the most popular among the Huffington Post's beat of articles on infertility. I wonder if we will see a lot of angry emojis under these links. 
  7. "Sad" The word doesn't even begin to describe the heartbreak and loss that so many people coping with infertility feel every day. The #infertility and #ttc tags are heavily populated with status updates about loneliness, depression, and loss. In our community, early pregnancy loss is far too common, and frequently, this is a subject where people turn to blogging to express their feelings of hurt. Often, the infertility-related posts on Instagram with the most comments, are those of outpouring support for someone mourning the child that they were unable to carry to term. This is a frequent, delicate, and compelling issue for our community. The sad reaction will be one we use more than we would like, as it offers a gentle, quiet way of expressing our sympathy.
More people "loved" this photo than liked it

More people "loved" this photo than liked it

Getting closer

The new Facebook reactions represent an interesting baby step; one toward a more fluid blending of human and technological communication . There have been times where I have chosen not to respond to a particular comment, because it wasn't appropriate to offer words, and the gesture of a like would not have been suitable. I would have appreciated some of the options that are now at our disposal. The ability to react with more emojis doesn't meet the emotional diversity of the infertility journey, but it does allow us to virtually "put our hand on a shoulder" or beam a smile when words aren't pertinent. We can express ourselves more acutely, as fertility practices and patients further develop the language of the infertility community.


The Sacred Scroll of Infertility: 8 reasons fertility clinics can't afford to ignore Instagram in 2016

By Griffin Jones

This is worth saying again. Instagram is an insanely powerful social media channel for fertility marketing. I don't say this because data proves that Instagram is the second largest social network in the world. Twitter and Linkedin are large social networks too, but I typically don't recommend that fertility clinics spend too much time with them. They just aren't places where people usually talk about children or the journey of infertility. Instagram is different. 

The #infertilitycommunity on Instagram is an extremely supportive peer-network. The content ranges from endearment to levity to humor to heartbreak.

The #infertilitycommunity on Instagram is an extremely supportive peer-network. The content ranges from endearment to levity to humor to heartbreak.

I talked about the 7 most powerful ways clinics can use Instagram for fertility marketing, but I think I understated what makes Instagram so important to individuals and couples coping with infertility. Fertility clinics can't afford to ignore Instagram because

  1. IVF patients are on Instagram. Research shows that 55% of women ages 18 to 29 and 28% of women ages 30 to 49 are active on Instagram.
  2. Instagram is a place for people to connect with others about their struggle with infertility. The #infertility and #ttc (trying to conceive) hashtags account for over 110,000 and 329,000 posts, respectively. 
  3. Infertility bloggers and podcasters use Instagram as one of their primary avenues to promote their content and engage their audiences.
  4. People create Instagram accounts for the singular reason of infertility. I wish I had a way of quantifying this for you, but if you browse through the #ttccommunity, you will find that most of the accounts include keywords like journey, ttc, waiting, baby, PCOS, etc. 
  5. Instagram is a scroll of the infertility language. Do you know what DH, AF, BFP, and BFN mean? They do. If you don't (I didn't), RESOLVE has a great dictionary of the infertility language
  6. Instagram is the second largest social media channel in the world. Ok, that does count for something.
  7. Parents post baby pictures on Instagram. Do they ever.
  8. Instagram is a referral source. There is no re-posting in Instagram, instead people tag their friends in the comment of a photo if they want their friend to see it. Example: If you post a picture of your amazing nurses on Instagram, this may offer the opportunity for a delighted former patient to tag a friend of hers to see the photo of her amazing care team. 

Instagram is such a critical tool for IVF marketing because it draws so much attention from the infertility community. It is a support network that offers humor, encouragement, counsel, and companionship. Fertility centers can use this social media platform to attract new IVF patients if they can provide the value that people struggling with infertility are looking for on Instagram.

If you want to use Instagram and other social media to attract more infertility patients, read Chapter 3 of my free e-book, Digital Marketing for Fertility Centers: How to Use Digital Media to Acquire New IVF Patients in 2016. 

A Self-Education in Social Media for REs, with Dr. Brian Levine

By Griffin Jones

Brian Levine, MD, is a reproductive endocrinologist (RE) with CCRM New York. Dr. Levine sits on the American Society for Reproductive Medicine's (ASRM) tech committee and speaks on social media to the American College of Obstetrics and Gynecology (ACOG). I thought he would be a great resource to keep us abreast of the rapidly changing landscape in communication technology. 

There are other REs who participate in and talk about social media as it relates to reproductive health, like Dr. Serena Chen and Dr. Kenan Omurtag, but there aren't many. I asked Dr. Levine why that is.

Levine: Many REs are scared to participate in social media. We're not educated about it, we're only warned about the bad things that can happen. No one teaches you how to engage. We need to build discussion so that we can self-educate. 

Dr. Brian Levine, courtesy of his Twitter profile

Dr. Brian Levine, courtesy of his Twitter profile

Griffin: What are some of the bad things that can happen?

L: Protecting patient privacy is obviously the first priority. But it's also important to protect your own (physician) privacy. Once you post something, it may be permanently accessible.  

G: So what are the benefits?

L: Social media is part and parcel of understanding new technology in general. It allows for practices, providers, and patients to have an equal voice. Anyone can be involved in social media. It's also a great way to educate patients in a casual manner. It defines the culture of the practice. 

G: What makes for good content?

L: Good content is material that's there, that's accessible, and easy to digest. Original content can be great too, but if people don't retweet or repost it, it's a lot of work for nothing. Also, original content can be tricky because people will view that as your actual viewpoint. 

G: How does an RE even get started on social media?

L: You need a policy in place that addresses how you will respond to comments, add content, etc. Policies have to be very careful.  Also, focus on one or two channels before moving on to others. You can spread yourself too thin and have no social media coverage. Society in general should be supporting the doctors, but ultimately it falls on the physician to take the initiative. 

G: Online media is great most of the time, when patients leave glowing reviews and supportive commentary, but what about when reviews are negative?

L: It's often better to just take it on the chin. Responding to reviews is delicate, and it's more important to show your commitment to providing a solution. Reviews are also a tool to respond to feedback. You need to find out what the problem is. You need to fix that for your future patients.

If you would like to follow Dr. Levine, his twitter account is @DrBrianLevine and he is the technology editor at Contemporary OBGYN.

The Top 10 Tweets from ASRM 2015

By Griffin Jones 

We've just wrapped up an excellent time at the 2015 meeting of the American Society for Reproductive Medicine (ASRM) in Baltimore. It was my very first ASRM meeting, and the only thing I like more than meeting new friends is getting to see old ones. 

With so many tracks and sessions over the five day meeting, you couldn't be everywhere at once. But thanks to #ASRM2015's live tweeters, we had people keeping us abreast of what went on. Here are 10 of the most informative tweets from the meeting.

10). "IVF cycles w/older egg donors outcomes not much different from younger donors say McGill Univ docs"--ASRM

9). "The latest IVI study by our Dr. @DrGalliano_IVI at #ASRM2015 confirms: Freezing embryos does not affect prematurity or weight in newborns "-IVI Fertility

8). "New research says a high-fat diet, not just being obese, could impact #fertility in both men and women"--CCRM OC

7). "A new test for women undergoing IVF could help increase rates of conception by up to 75%."--Eleanor Stevenson, PhD

6). "Infertility can predispose women to ovarian cancer, but IVF does not add to this risk."--Dr. Richard Paulson

5). "Women with #PCOS could have an advantage concerning risk of osteoporosis. Post menopausal women are protected from bone loss".--Amy Medling, PCOS Diva

4). "Sperm shortage: Lots of demand, not enough supply."--Alanna Petroff, CNN Money

3). "Choosing the right words can reduce barriers to care."--Joseph Davis, DO

2). "There is still a lot of work to do in terms of access to ART Assisted Reproductive Technology"--Serena H Chen, MD

1). "#IVF & ART in the digital age- Resources like @resolveorg & @pre_conceive mean more help than ever before".--Dr. Shara M. Brofman

And of course I had to award honorable mention to Dr. Jason Franasiak and Dr. Juancho G. Velasco for best photo tweet from a lecture...

There were hundreds of tweets and I only chose ten of them. What did you hear at the conference that deserves to be on this list?



Forget Twitter: The 2 Most Important Social Networks for Fertility Centers

By Griffin Jones

It's annoying, isn't it? So many social networks come and go, how can a Reproductive Endocrinologist and her practice manager be expected to be fully engaged in a dozen social media platforms?  The task becomes much less daunting when we reverse engineer our patients' attention. We don't have to be experts of every social network, we just need to know on which our prospective patients spend the most time.

 In 2017, I may well have new recommendations regarding into which platforms you should invest your time and resources. Through 2016, however, the two social media networks on which every fertility center should be present are Facebook and Instagram.

Facebook can be the best review site for fertility centers as well as a referral source.

Facebook can be the best review site for fertility centers as well as a referral source.

1.    Facebook. 
Facebook is by far the largest, and most widely used social network in the world. 70% of Facebook users check their accounts daily, with 43% of users checking every day .
There are 49 million women between the ages of 25 and 45 on Facebook in the United States and Canada. The ad targeting capability on Facebook is unparalleled to any other medium, period.

Yet, on their own, none of these are reasons for your fertility center to be on Facebook. The reason fertility centers need to be active on Facebook is because content of babies and children is central to the DNA of the platform. 97% of US mothers who use Facebook every day, post pictures of their children . If your practice is active on Facebook, you know that former patients will post pictures of their children from every occasion to your Facebook timeline, sometimes on the day of delivery.

Facebook is also a meeting point for peer support. The Infertility Inspirations community has over 13,000 members for example. Dozens of other closed groups account for thousands of members each.

2.    Instagram. 
Instagram has surpassed Twitter to become the second largest social media network in the world . It took Instagram only eight months to reach 100 million photo uploads. The growth rate of Instagram is astonishing. But again, it’s not Instagram’s massive numbers that make it a necessity for fertility centers. Like Facebook, baby pictures and inspirational content are inherent to the platform. The popular #ttc (trying to conceive) hashtag on Instagram counts for more than 300,000 posts. Related hashtags, #ttccommunity and #ttcsisters account for more than 25,000 and 67,000 respectively. 

The number of emerging social networks can appear overwhelming for an already swamped RE and practice administrator. But your practice does not have to be, nor should be, involved in more than a few. Social networks require a commitment of time, energy, and resources. One should be reliably served before beginning an additional. Priority is determined by the social nature of the network and the attention of the patient.  In 2016, Facebook and Instagram are the two most important platforms for fertility clinics to utilize. 

In taking my own advice, I have admittedly neglected Pinterest. Is your fertility center active on Pinterest? Please tell me about it, I would love to hear what you've found.

Turn Your Social Media Channels into an IVF Referral Network

By Griffin Jones

A fertility center’s Return on Investment in social media can be traced back to the activism of its community.The value of social media is not that we have a free broadcast mechanism to reach people with any time we like. None of that is true—it’s neither free, nor a broadcast mechanism, nor will people see our message whenever we please.

The value of social media is your community.  Fertility centers acquire new patients through social media when they have a passionate, connected, community of people that zealously advocates for them.  This is "word of mouth". Communities will gladly rise up for their fertility centers—providing better advertising than we could ever hope to buy—but only if they are engaged. To engage your community:

•    Respond to all direct messages as quickly as possible
•    Reply to all comments and posts
•    Thank those who leave reviews and compliments
•    Crowdsource: Ask for input on various practice initiatives

Responding to comments and reviews is a critical part of community management for infertility clinics. 

Responding to comments and reviews is a critical part of community management for infertility clinics. 

The most direct way to use social media to attract new IVF patients is to empower current and former patients with a "word of mouth" referral network. When you interact with your community of supporters, the number of people who are they are able to refer to your practice increases dramatically.  If you look at the Facebook pages of the vast majority of fertility centers in North America  you will find that patient communities are largely ignored. If you are unable to dedicate the time it takes to respond to, thank, and inspire your community, your ROI on social will be very limited.


The Harsh and Scary Truth About Social Media for Fertility Centers

By Griffin Jones

If you’re spending money on internet marketing, you should know this axiomatic truth:
Posting something on social media does not mean that anyone sees it. 

Many fertility clinics spend money on growing their Facebook fan base or their number of twitter followers. Often, the number of a practice's "followers" or "likes" are too large while their message remains unseen. Equally, an infertility clinic's message won't be seen if its community size isn't big enough.

 Because they think that their message is being seen, many fertility centers pay their web firms to grow irrelevant metrics. Irrelevant metrics are any numbers that don’t lead to reaching new patients or delighting former and existing ones. They include your number of

  • Instagram, Twitter, and SnapChat followers 
  • Facebook fans
  • Times per week you post to social media 

You may have 15,000 fans on Facebook, but if no one likes, comments on, or shares your content, virtually no one will see your post. Reach is dependent on interaction. Comments, shares, replies, reviews, and posts from users are the ways that existing and former patients attract new patients to your fertility center. Facebook, for example, has an algorithm that they use to determine which content you as a user will see. This algorithm is impacted by one’s online behavior, including how often one likes, comments on, clicks, or shares the content of someone else. Facebook will show you more of what you interact with and less to none of that which you do not. 

It doesn't matter how many Facebook fans this fertility clinic has, almost no one will see this post because no one has shared, liked, or commented on it. 

It doesn't matter how many Facebook fans this fertility clinic has, almost no one will see this post because no one has shared, liked, or commented on it. 

Equally, 10 followers on Instagram or 100 Facebook fans won’t make an impact on your practice either. This is the appropriate time to purchase advertising on the select social media platform. If you are not extremely targeted with your ads however, you will make the first mistake of having a disengaged community size that is too large. You will waste money on the wrong people who will stop seeing your message anyway. 

The number of your fertility center's fans and followers does not guarantee that even anyone will see your message. Some clinics spend too much money to grow community sizes that are bigger than relevant. Other practices lack enough people in their social media communities to be able to share their message. Grow your social media community to the size where interaction is at is peak, and then focus on serving that community.

4 Tested and True Types of Social Media Content for Fertility Clinics

By Griffin Jones

Infertility clinics are possibly the single greatest social media anomaly in healthcare.

 Why? Most disciplines within healthcare are not social. Reproductive endocrinology, because of parental aspirations and deep community need, is extremely social. Therefore, the content that generates "word of mouth" referrals for fertility clinics is radically different.

 People don’t go on Instagram or Twitter to talk about foot pain, skin rashes, or stomach aches. Fertility clinics don't have anything to learn from podiatrists, dermatologists, and gastroenterologists except for what not to post. People are not on Facebook or Instagram to read medical studies. 

On the other hand, people want to see, share, and talk about pictures of babies on Facebook and Instagram. People want to see pictures of their friends’ children. People want to boast about their own children. Patients also use these platforms for peer support. If the fertility center uses their social media channels correctly, people will use the center as a medium to connect with the practice, each other, and bring their friends, family, and acquaintances into the circle.

The content that generates leads to more new patients is that which aligns with the reasons people are on each platform.  Four types of social media content proven to work for fertility centers are:

  1. Photos of nurses and doctors
  2. Patient Generated Content: The pictures that patients post to your timeline (with permission)
  3. Inspirational Quotes/Images
  4. Infertility related e-cards and memes

Reproductive Endocrinology and Infertility is unique as a social category of healthcare. Other disciplines do not enjoy "word of mouth" referral networks built on social media because their content does not align with the reasons people use various platforms. Social media serves as an infrastructure for generating new IVF patients because the content of fertility clinics matches the nature of many social media platforms.