IVF marketing

A New Vision and Different Strategy for IVF Centers to Thrive Beyond 2018

By Griffin Jones

Part 2 of a four part series on the main business challenges facing fertility centers because of the shift from "small clinic" to "entrepreneurial endeavor"

We might criticize REI fellows for not wanting to take over existing IVF practices, but they are making the same decision that current practice owners have made for decades. They are deciding to be doctors and not CEOs. At the time, starting an independent practice didn’t mean launching a commercial enterprise. The difference is that new doctors know they can’t get away with that today.

Organizational leadership is an issue at many fertility practices

Organizational leadership is an issue at many fertility practices

In Part 1 of our series on the contemporary fertility practice’s shift from “small, independent healthcare practice”, to “entrepreneurial venture”, we discussed the traditional model’s outdated business structure. Now, in Part 2, let’s talk about how the leadership atop that structure dramatically affects a fertility center’s ability to do business today, leave alone tomorrow. We’ll discuss eight critical elements of vision and strategy, and we’ll deeply explore those with which IVF centers tend to have the most trouble.

A new vision and different strategy needed for fertility centers

We mentioned that the Practice Director is in charge of an IVF clinic, where the CEO is tasked with the overall responsibility of creating, planning, implementing and integrating the strategic direction of an organization. But what happens when infertility clinics don’t have a clear vision in place? Here are some real life examples:

  • One partner wants to sell his share of the practice to a private equity firm but his partner wants to remain independent.
  • The practice principal wants to increase fertility preservation, bur the rest of her team knows very little about this initiative.
  • Practices jump from one marketing venture to the next, wasting time and money because they aren’t making their advertising work toward their vision.
  • Business development projects are started and abandoned because practices have few benchmarks in place and consequently don’t accurately measure if they’re moving toward their goal.

“Hope is not a strategy,”—Rick Page

Do any of these problems resonate with your practice? We’ve accepted that the head of our company, Principal, Founder, CEO, President, or whatever we choose to call it, has responsibilities that extend far beyond the role of physician and even that of Medical Director and Practice Director. Now visionaries can lead their practices in ways that allow us to super-serve their patients and grow. The leader of a company identifies, articulates, and plans its

  • Core Values
  • Core Focus
  • 10-year target
  • High Level marketing strategy
  • 3-year picture
  • 1-year plan
  • Quarterly Priorities
  • Issues

All of these tenets are essential, with the priority starting at the top of the list. Some we will link to external sources for further reading, because we need to spend more time with the most common principals with which fertility clinics struggle.

1). Core Values

I’ll wager that your values are far more compelling than those of the average business. After all, you’ve devoted a career to helping loving parents create life. But how do you articulate your values to your team, to patients, and to the public? We work in a field that is both being changed by society, and changing society…rapidly. How do we stay true to who we are and what we believe while being able to adapt? When core values are true and defined, leaders make hiring decisions that allow them to unload responsibilities and feel comfortable that their practice is in good hands.

2). Core Focus

Your Why and Your What. Purpose, passion, and cause combined with your niche. The more closely aligned employees are with Core Focus and Core Values, the more prepared they are to make decisions in the best interest of the practice, and the less practice owners need to micromanage.

3). 10 Year Target

Where one wants to be in ten years is the destination from which the rest of the roadmap is drawn. This is where fertility centers frequently fall off track. Do you want to open more offices or labs? Do you want to attract patients from overseas? Do you want to pilot a technological solution? You may notice that we can’t move to the next core tenet of Vision and Planning, the High Level Marketing Strategy, until we have solid long term goals.

Original fertility marketing consultant, Yogi Berra, on strategic growth

Original fertility marketing consultant, Yogi Berra, on strategic growth

In the same week, I received two calls from two different fertility doctors who had the same question, “how much money should I spend on marketing?”

A million dollars. A couple thousand dollars. My answers to each of them were starkly different.

The first doctor was in his early sixties. He works for a larger practice group and does a little bit of marketing for himself. He’d like to perform seven or eight more egg retrievals per month. He plans to retire in the next two years.

The second physician just completed his REI board certification in the United States. He’s in his early thirties. He wants to move back to Latin America to start a large IVF center that draws patients from the United States, Canada, and Europe.

These are two vastly different long-term targets that dramatically impact who they will hire, how they will build from patient feedback, and how they will market. The 10 Year Target could be the most measurable differentiator between visionary entrepreneurs and independent physicians. Fertility practice groups without a defined long-term target are finding themselves directed by the demands of the day instead of concentrating their resources on becoming who they want to be. Entrepreneurial Operating System (EOS) founder, Gino Wickman, says that the 10 Year Target is not the time to be conservative. Dream big for the best version of yourself and your practice.

4). High Level Marketing Strategy

Do we know who we want to serve and what we mean to them? Is our 10 Year Target defined? Great. Our High Level Marketing Strategy involves doing whatever it takes to get there, within our core values and core focus. It details our

  • Goals (obtained from 10 Year Target, 3 Year Picture, and 1 Year Plan)
  • Benchmarks
  • Unique Marketing Position (obtained from Core Values and Core Focus)
  • Practice Brand
  • Content Strategy
  • Distribution Strategy (advertising)

Benchmarks

Many practices want to jump right into marketing without having reliable benchmarks or key performance indicators (KPI) to plan their strategy. Without them, money and effort may be wasted.  If you’ve ever spent money on advertising and aren’t sure of the results, revisit your KPIs. Do you have access to all or any of these Indispensable Indicators?

  • New Patient to IVF Conversion
  • Phone Call to New Patient Conversion
  • Online Contact Forms to New Patient
  •  Cost Per New Patient
  •  Patient Life Time Value
  • Cost Per Lead

We are data-driven marketers. Results must be measured as accurately as they can be. If you need help calculating your Indispensable Indicators, read Chapter 2 of The Ultimate Guide to Fertility Marketing.

Brand

If you feel like you can’t trust your employees or marketing partners with your message, you may need to document your practice's brand. At the Midwest Reproductive Symposium international (MRSi) in June 2018, I will be giving a branding workshop for fertility centers with branding expert, Mara Lucato. Here’s a glimpse of my thesis.

Brand is being known to the people we serve: how and why we help them with their problems. Logos, color schemes, and slogans, are relevant, or not, in so far as they help us achieve that end.

In our case, we have a community of people that desperately needs our help. In many cases, they don’t know who we are or how we can help them. Our brand and our high level marketing strategy involve providing them with as much value as we can, and then making it as easy as possible for them to do business with us. It includes

  • Connecting them with peer and professional support
  • Educating them
  • Encouraging them
  • Standing up for them

We are charged with making sure that everyone in our region knows that infertility is a common medical issue. That people struggling with infertility are human and their problem is human.
They need to know that we are the ones who will help them. That is a fertility center’s brand.

Content and Advertising Strategy

A fertility practice’s High Level Marketing Strategy activates its brand by delivering its message across the platforms on which patients spend their time and attention. The platforms, and consequently the methods, change. 15 years ago, creating an infertility support blog was a game-changer. 10 years ago, having a Facebook page was a tremendous way to reach new people. Three years ago, Instagram stories and Facebook Live didn’t exist. Today, they are among the best ways to connect with prospective patients. Four years from now, there will be new tactics, and some of our current marketing efforts will be less relevant. A High Level Marketing Strategy allows us to adapt our marketing efforts to the tactics that are relevant to the attention of the people we serve.

5). 3 Year Picture

The 3 year picture and the 1 Year Plan zoom in on the 10 year target. Where are we going to be in three years? What is our revenue? How many IVF cycles are we doing? How many physicians are on staff? In the same way that practices often lack a 10 year target, the three year picture serves the same importance, just getting closer to bridging Vision and Traction.

6). 1 Year Plan

Long term planning for fertility centers

Often fertility centers have annual volume goals, but are they committed before the start of the year? Are they realistic?

7). Quarterly Priorities

Again, fertility practices frequently fall off track here. Do we have three to seven quarterly priorities that must be accomplished this quarter? Are we accomplishing priorities that move our business toward its one year plan, its three year picture, and its ten year target? Or are we drowning in the issues of the day-to-day?

8). Issues

Just another REI practice manager

Just another REI practice manager

The image of Sisyphus pushing the rock up the hill for all of eternity resonates with many practice managers. Fertility centers’ staffs frequently burn out because they are working on the same issues with no resolution. Care teams spend so much time working on issues that are urgent, they may have precious little time to focus on important, big picture issues. Take a look at the Eisenhower Decision Matrix. 

The Eisenhower Decision Matrix applied to fertility clinics

The Eisenhower Decision Matrix applied to fertility clinics

As a fertility specialist, or a practice manager, you never have to deal with matters in Quadrant 1, do you? Yeah right. Fertility centers live in Quadrant 1. Employers that make their employees and managers work in quadrant 4 ought to go to jail, (joking…or am I?). Work of little importance and urgency robs human beings of their energy and happiness. Most of the responsibilities in Quadrant 4, by definition, can be eliminated. Let software do the rest.

Now we’re left with Quadrants 2 and 3. As the owner or manager of your practice, with your very limited time remaining from Quadrant 1, which do you prioritize between “urgent and non-important” and “important and not urgent”? It’s Quadrant 3, isn’t it? We often worry about issues that are not important but they have to be attended to right away. This isn’t to say that issues in Quadrant 3 don’t need to be addressed, but that’s exactly what we do, address them. By prioritizing issues in Quadrant 2, we solve them. Visionaries that focus their companies in Quadrant 2 make Quadrant 3 less relevant, and Quadrant 1 less overwhelming.

Paint the picture, chart the course

With a clear vision and strategy, fertility centers know exactly what their goals are and how to achieve them. Without them, practices frustrate their team members, exhaust resources, and find themselves losing market share to competitive IVF centers. Whether one wants to be the largest fertility preservation company in the world, or happily perform 150 egg retrievals per year and super-serve their patients, there’s no right or wrong answer. Their Core Values, Core Focus, and 10 year target inform their High Level Marketing Strategy, 3 Year Picture, 1 Year Plan, Quarterly Priorities, and resolution of Issues. When practices follow a strategy to a committed vision, they are prepared for the powerful competitors and challenges that pursue them. And just in the nick of time, because there are plenty. We’ll talk more about them in Part 3 of our series on the tectonic shift from medical clinic to entrepreneurial enterprise.

If you would like help building your practice’s High level Marketing Strategy, learn more about the Fertility Marketing Blueprint below.

Set Up to Fail: Fertility Clinics Not Structured for 2018

By Griffin Jones

Part 1 of a four part series on the main business challenges facing fertility centers because of the shift from "small clinic" to "entrepreneurial endeavor"

“Young doctors aren’t willing to work long hours,”

“Fellows today don’t have entrepreneurial chops,”

“New REIs don’t want to pay their dues.”

Millennial fertility doctors may sometimes be perceived this way

Millennial fertility doctors may sometimes be perceived this way

Have you ever made any of these comments or heard them said about your peers? It’s common to razz new subspecialists coming out of their Reproductive Endocrinology and Infertility (REI) fellowship. I often hear from recruiting physicians, that new REIs are not entrepreneurial. That they have no desire to take over a retiring doctor’s fertility center and run their own practice. It is said that fellows and new specialists want to work for someone else, clock their hours, and go home.

There may be valid points in this general perspective, but I see a much more comprehensive picture. Would you like to see what I observe from my semi-outsider’s vantage point? The radical statement to follow is the thesis behind the core business challenges with which so many fertility centers battle today.

The Tectonic Shift from "SMALL CLINIC" to "ENTREPRENEURIAL ENDEAVOR"

I don’t believe that many practice owners wanted to be entrepreneurs either. I suppose many physicians wanted to run their own fertility center and practice medicine the way they prefer. Is that unfair? Twenty to twenty five years ago, that may have been a tenable position. At that time, fertility specialists opened and operated small medical practices. Today, whether they like it or not, independent practices are entrepreneurial enterprises. We have sailed away from our calm cottage lakes, and onto the ocean of commercial venture. Here, our competitive threats come not only from other fertility centers, but from Wall Street, Silicon Valley, and a dynamically changing society. Canadian and European friends, this includes you too.

In this series, we’ll identify the main threats and challenges that fertility doctors, now accidental entrepreneurs, face in this new, unforgiving landscape.

  • Practice Business Structure
  • Vision and Strategy
  • Fierce Competition
  • Rapidly Changing Technology and Society

And we will force ourselves to answer the question we can no longer afford to avoid:

What is the plan?

Part 1: PRACTICE BUSINESS STRUCTURE

Independent fertility centers’ competitive challenges begin long before we even begin to think about marketing. Typically, they are inherent to the structure of the practice. If you own an IVF center run by fourteen employees, it may be tempting to ignore corporate structure. On the contrary, it is lack of structure that frequently keeps small practices from competing with large firms. Here we see the first differences between an REI practice, and a commercial endeavor.

A fertility clinic is run by a

  • Medical Director
  • Practice Director
  • Lab Director
  • Practice Administrator

Who runs the large corporations that are buying and operating fertility clinics across North America? Did you know that your new competitors are led by a C-Suite? They have a

  • Chief Executive Officer (CEO)
  • Chief Operating Officer (COO)
  • Chief Marketing Officer (CMO)
  • Chief Technology Officer (CTO)
  • Chief Financial Officer (CFO)
  • Chief Information Officer (CIO)
  • Chief Human Resources Officer (CHRO)
Entrepreneurial Operating System (EOS) Accountability Chart applied to fertility clinics

Entrepreneurial Operating System (EOS) Accountability Chart applied to fertility clinics

This isn’t to suggest that a four physician, twenty five employee IVF clinic needs to have the same corporate structure as their large competitors. They don’t. They need to run their company on a business operating system (BOS) if they want to articulate a vision, agree upon a strategy, and enable their entire team to achieve their collective goals. Fertility Bridge is run on an operating system called the Entrepreneurial Operating System (EOS). To clarify, I am not an EOS consultant, nor do I sell their services at this time. You can find another BOS or you can build your own, though I have no idea why anyone would want to start from scratch.

One of the strongest arguments of EOS is that there are three core functions in any business. In our field, we might split Operations into Medical and Lab, or even Compliance, but the three core functions are

  • Operations
  • Finance
  • Sales and Marketing

In most independent IVF centers, instead of planning for the three core business functions for which someone must execute, they are often bundled into “other” and dropped in the lap of the practice administrator. Is she or he expected to run the operations of the practice, account for the finances, recruit and manage team members and write and execute a complete marketing plan? Is she or he an expert on digital media, law, technology, workforce development, and corporate strategy? Is that fair? Is that realistic?

How many seats are you in?

Rather than hire someone for each of these roles right away, which most fertility centers cannot do, EOS helps with the concept of “one person, one seat”. One person can hold more than one seat, but one seat cannot be occupied by more than one person. This helps small practices flush out capacity related issues and step out of roles as they grow.

Take a look at an example accountability chart below. How many seats are you in? How many seats are unclear as to who is accountable for them?

Example Accountability Chart for fertility clinics.png

As an REI physician, in just one very busy seat, you probably have to perform

  • 150+ egg retrievals,
  • Several dozen intrauterine inseminations (IUI),
  • All other surgeries

Oh, and you still have to spend time with and respond to your patients.

While infertility doctors at corporate-run clinics can devote all of their working time to their "REI seat", you’re the Medical Director or Practice Director of your IVF center and you have many other roles. As the head of an entrepreneurial venture, you now have additional responsibilities to properly delegate or do yourself.

  • Implement the vision of your company
  • Hire and interview every employee
  • Execute the marketing strategy
  • Account for the finances
  • Run the operations of the office
  • Manage every member of every team

Simply delegating each of these responsibilities can be a full time job, let alone sitting in each individual seat. Again, independent practices don’t necessarily need dozens of employees to run the business side. If they want to maintain or grow their practice, they need to eliminate, automate, and delegate. [A wink to those practice principals that are still signing paper checks].

Is "control" hindering your practice's growth?

Something stops fertility centers’ teams from taking ownership of each of these responsibilities and taking them off of the practice owner’s lap. As one writer says, “Want to drive your employees absolutely crazy? Give them responsibility without authority”.

If we hire a Human Resources Manager, but she doesn’t have the authority to choose the payroll company, negotiate salaries, or make the final decision on hires, then the responsibility of Human Resources continues to consume our time and energy.

If we hire a finance officer, but this person isn’t able to choose the bookkeeping software, set pay dates, and decide the terms of Accounts Payable and Accounts Receivable, then we haven’t delegated finance.

If a practice hires a marketing director, but the marketing director doesn’t have creative control and isn’t given a budget and goals for which they are responsible, then the load of marketing remains in our lap.

How does it impact the growth of your practice if you and your partners deal in every facet of the business without clearly defined roles in an operating system? How does it affect the way you practice medicine? How does it weigh on your relationships with your patients, your team members, and your loved ones?

SHIFTING from "practice owner" to "visionary"

If this describes you or your partners, is it because you're reluctant to pass on control? When practice owners feel that that they need to manage every movement in the practice, it may be because there is not a cohesive culture behind a clear vision. By acknowledging the tectonic shift that has happened in the field of reproductive health, that independent fertility practices are in fact commercial enterprises, practice principals can step into the role of visionary. In the next part of our series on the difference between fertility practices and entrepreneurial ventures, we’ll see when a company follows an operating system, practice principals are able to chart a vision and plan that allows them to pass responsibility to their team and adapt their practices to our changing world.

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

By Griffin Jones

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

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

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

easy part.jpg

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

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

ONline reputation is hardly the tip of the iceberg

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

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

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

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

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

the human need to move away from information ASYMMETRY

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

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

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

The drive toward information parity

change coming for ivf centers

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

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

Information asymmetry is over. Forever.

patients often need to rely on each other 

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

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

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

information parity meets social proof meets technology

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

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

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

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

the four main reasons for resisting patient reviews

Tech disruption in infertility field

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

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

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

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

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

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

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

the greatest threat to the accuracy of your reputation

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

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

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

what to do now

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

disrupting the fertility field

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

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

  • Operations
  • Scheduling
  • Billing department
  • Nursing Team

Physicians are rated by

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

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

a new review site is barely a baby serving of disruption

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

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

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

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

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

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. 

 

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!