internet 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!"


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.


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. 


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.

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!

What Canadian Fertility Centres Need to Know About the Law and Digital Media

By Griffin Jones

A patient’s health information is sacred and a fertility practice’s community of adoring supporters is invaluable. In a world where social media and communication technology develop years ahead of the law, how do we safeguard both privacy and engagement without sacrifice to one or the other? I have interviewed several attorneys regarding the Health Information Portability and Accountability Act (HIPAA) and other regulatory schemes in the United States, but I’ve yet to investigate the law relevant to you, the leaders in reproductive health across Canada.

Dr. Alan West

Dr. Alan West

That is, until now. Dr. Alan West is a physician and a partner at the law firm of Gowling WLG in Toronto. He specializes in healthcare advertising law. Mr. Evan Atwood is a senior associate at the same office who specializes in consumer and healthcare privacy law. You should always consult an attorney for specific legal advice, which Dr. West and Mr. Atwood do not give here, but they offer us some education about how the law can pertain to a Canadian fertility clinic’s internet presence.

Federal and provincial regulations

“We don’t have HIPAA. My head spins when I have to deal with HIPAA.” West clarifies. “We have a mix of federal and provincial laws”. Canada’s PIPEDA (Personal Information Protection and Electronic Documents Act), applies to health information as well as consumer information and applies only in provinces that haven’t passed their own statutes with privacy protections equivalent to those contained in the federal statute. .

Several provinces, including British Columbia and Ontario, have their own health privacy laws. In Ontario, the law is called PHIPA (the Personal Health Information Protection Act).  Atwood explains, “Both fortunately and unfortunately, the law does not explicitly state what information is prohibited from being released without authorization.” Unlike HIPAA in the United States, which has a data set of 18 identifying factors (name, date of birth, license plate number, etc.) for Protected Health Information (PHI), there is no concept of a data set in Canadian privacy law. The principles are much more general.

HIPAA’s 2013 Omnibus rule, adds liability to “business associates”, those who receive and send PHI to “covered entities” (healthcare providers). The obligations of a business associate are explicit. Again, in Canada, the law is not as specific, but the health records custodian (you, the fertility centre) is obliged to see that its vendors only store that data on behalf of the health records custodian, with the same protections in place.  

“The law is always behind the actual practice of medicine.”

Mr. Evan Atwood

Mr. Evan Atwood

In some provinces, medical practices are prohibited from mentioning the brand names of pharmaceuticals and devices in their advertisements. The regulation of marketing falls more on the practices than on the drug companies. “Doctors are allowed to advertise their own services, but they are not supposed to identify or associate themselves with specific products or drugs. Although many do so.” West finds. West and Atwood point to the example of “physician locators”, search engines within pharmaceutical or manufacturer websites, that list nearby physician offices who administer their products. These websites may be impermissibly marketing directly to the consumer, but “I know of no prosecution for using brand names in advertising,” West says.

West offers some insight as to why there is a lack of enforcement of some laws in healthcare advertising. Provincial boards of medical examiners have limited resources, and they spend their attention on investigating serious cases of fraud and malpractice, not on the use of brand names in advertising, which in some instances, have found their way into the public vernacular. In some provinces, there is no obligation to investigate every complaint that is reported to the provincial board. In others, such as Ontario, the board is obliged to investigate every written complaint. They might not take an enforcement action, but the risk is higher because they have to at least open the file.

This is important to know, because what is permissible in one province, may be prohibited by another province’s advertising law. In Ontario for instance, under the Medicine Act, patient testimonials are not permissible. Nonetheless, some medical practices may include testimonials on their websites, including some fertility centres. Whether you use testimonials on your website or not, what about the content posted by a patient to your Facebook or Google Places profile? In that case, it might be advisable not to solicit reviews. “It might not be the intent of the law, but I would rather be the prosecuting attorney than the defendant in such a scenario,” West opines. “As the law is written, I think the doctor has an obligation to police the postings on his or her social media channel”.

“The law has not caught up to reality, to put it mildly”, Atwood adds. “Still, there’s never been a prosecution for what a patient has put on a provider’s social media channel”.

Digital Media and Privacy Law

This wisdom comes with regard to provinces with regulations prohibiting patient testimonials, not with regard to health privacy. Consent is implied when a patient posts his or her own information on a clinic’s blog or social media channel. The doctor can leave it on their site. “Doctors and practices are allowed to respond to reviews and comments because the patient waives his or her right to privacy when they post their own information” West says.

“Implied consent has limits,” Atwood cautions. “You can’t take that content and use it somewhere else”. Failing to obtain the proper consent is a mistake that Atwood and West commonly see. Though Canadian law does not specify six core elements for what is required in an authorization (as in HIPAA), expressed, written consent should be obtained whenever you use patient information outside of what is specified in the law.

West leaves us with a bit of caution. While provincial boards have not yet enforced certain regulations, such as those against the use of brand names in physician advertising, he believes punitive measures could be likely in the future. “Be forewarned of enforcement action. That may be something we see quite a bit more.”

Get specific legal advice

In every country, the technologies and media that people use to communicate develop much more rapidly than the laws that regulate them. We have to engage our online communities in a way that respects patient privacy and also complies with the law. In my opinion, Canada’s laws seem to follow common sense more so than the ambiguity of other regulatory schemes, but I’m not an attorney. I recommend you always consult an attorney about the federal, provincial, and local regulations specific to your area.

Dr. Alan West is a partner in Gowling WLG's Toronto office, practicing primarily in areas of law related to pharmaceuticals and health care.

Mr. Evan Atwood is a senior associate at Gowling WLG’s Toronto office, with experience in guiding clients with advertising compliance issues with Health Canada.

A Look Into Practice-Wide HIPAA Education with Ashley Trotto

By Griffin Jones

This is the fifth interview in a series exploring the implications of the Health Insurance Portability and Accountability Act (HIPAA) as it relates to digital media.

Ashley N. Trotto

Ashley N. Trotto

Ms. Ashley Trotto practices health care law in Knoxville, Tennessee. Ms. Trotto’s comments do not contain legal advice, but they do educate us about some of the risks that face fertility centers with respect to HIPAA and social media. The reason I’ve reached out to Ms. Trotto and other experts in healthcare law is because there is surprisingly little guidance online about HIPAA and social media. Much of the information available is vague or may even be incorrect. I asked Ms. Trotto why there is so little information on the subject.

Trotto: The information that is online is often gray, which is understandable because the Department of Health and Human Services (HHS) and the Office of Civil Rights (OCR) have not issued guidelines regarding social media and HIPAA. But it’s coming. We don’t know when, but the agencies will have to issue guidelines eventually.

The greatest unknown for healthcare providers in social media may be when a patient posts their own information. I think we all know to never post protected health information (PHI) on our websites or social media without express written consent.

You would think it’s common knowledge not to post patient information without authorization, but apparently it’s not as common as we might think. If you read some of the briefs of these breaches, most of them are inadvertent. There are 18 different identifiers that are addressed in HIPAA’s privacy rule. A staff member may believe that they are not publishing patient information, but many factors can be used to identify a patient. There have been breaches where the practice or staff members have shared information without the patient’s explicit consent. While any consent would be better than none, HHS has specific regulations regarding what is needed for a HIPAA authorization.

For this reason, I recommend against publishing any patient information whatsoever unless accompanied by a HIPAA authorization for the explicit use of marketing and social media. What happens when patients post their own information to a fertility practice’s blog, place page, or social media channel?

Physicians can’t stop patients from posting their own information. A big concern would be if patients posted content that included information about other patients. The practice would want to take that down, but a patient is free to talk about their own information wherever they like.

Is acknowledging a patient comment or review with a simple “Thank you”, or “We take your concern very seriously, please call us at…” disclosure of the patient-physician relationship?

 Generally, no. I wouldn’t be concerned about responding where the patient has already disclosed that information. However, that the doctor or practice must be very careful not to offer medical advice or include any additional information that the patient did not.

What should healthcare providers be doing right now to ensure HIPAA compliance?

The greatest action a practice can take to prevent a breach of HIPAA is to implement team-wide education. We need everyone in the practice to know what HIPAA is, what PHI is, and what a breach is. Practice-wide education is key, and policy drafting is second. Practices need to have a privacy officer who is in charge of HIPAA compliance so it may make sense to bring in outside firms who can help explain the complex law and implement training procedures.

Generally, I think the biggest thing is just being aware. The smallest mistake could be a breach. There is a recent example of a HIPAA breach where a medical practice used an online scheduling calendar in which users could see the names of other people who had scheduled appointments, and their appointment times. The breach wasn’t intentional, but the calendar was not secure, and the practice was found in violation.

To name just one HIPAA risk to look out for would be extremely difficult. But to name one thing that you can do to protect your practice—that would absolutely be education and training for the entire team.

Ashley Trotto focuses her practice on Affordable Care Act (ACA) compliance. She practices with the firm, Kennerly Montgomery, in Knoxville, Tennessee. If you would like to learn more from Ashley’s expertise, you can contact her here.

10 Infertility Support Ideas from a Conversation That Never Would Have Happened 10 Years Ago

By Griffin Jones

"We're all working together. That's the secret." --Sam Walton

On one hand, I absolutely hate millennial business buzzwords, and on the other, I deliberately use them often. I choose to say "silo busting" because of how important it is for different "departments" to be familiar with each other's goals and challenges. "Silos" aren't just separate departments within companies, they can be any sub-category of any group.  According to social scientist, Tom Wolff, PhD, of the University of Kansas, all community stakeholders have to be engaged in order to solve common problems facing the community. In the infertility community, our many roles account for many different stakeholders.  We have embryologists (scientists), reproductive endocrinologists (doctors), nurses, business managers, patients, support groups, mental health professionals, and advocates (among others). 

Bringing ideas together

Bringing ideas together

Physicians need to focus on the clinical treatment of hundreds of patients. Embryologists have to worry about the conditions of the lab and of the gametes. Patients are managing their personal aspirations, medical concerns, relationships, and financial status at once.  Business managers have goals for new patient consults and IVF cycles. With such demanding tasks, it's easy for all members of the team to lose sight of the complete patient experience, and it's easy for patients not to understand why. 

According to the Harvard Business Review, "customer-centric companies live by a set of values that put the customer front and center, and they reinforce those values through cultural elements, power structures, metrics, and incentives that reward customer-focused, solutions-oriented behavior".  In other words, we need feedback from every stakeholder in the community to collectively agree upon mutual goals. How the heck do we that? We can start by talking to one the same time.

New technology=new opportunities

Just two decades ago, we  had very few opportunities to bring together people from different ends of the fertility space for public conversation. Today, new media allows us to bring together experts and advocates from nearly every part of the world.  Blab is a relatively new social media platform that is still in Beta (product and market testing). Who knows if it will skyrocket in growth like Snapchat or fizzle away like Foursquare, but the forum gives us something we are all hungry for: the ability to openly meet around a topic with public dialogue. Think Twitter meets Google Hangouts. Blab is a way, for up to four people with webcams, to have a conversation that is open to the public to comment on and ask questions in real time. Last year, when I first learned about Blab, I immediately thought about its potential benefit the infertility space. We don't have too many opportunities to bring together doctors, patients, and support advocates in a public setting. I wanted to do exactly that.


We know from psychological research that infertility causes as much stress and anxiety as a cancer diagnosis. Yet we frequently hear from patients that they found out above their infertility support group on their own.  We  also observe from fertility clinic reviews, that patients are three times more likely to leave a negative review if their fertility treatment did not result in a pregnancy. So if the practice is only concerned with the clinical outcome of treatment, the public reputation of the clinic will suffer accordingly. Informing patients of support resources has an emotional benefit to the patient, a professional benefit to the physician, and a business benefit to the practice. According to a 2013 survey by Dimensional Research, 90% of customers report that their buying decisions are influenced by online reviews. If we want patients to be as satisfied with their experience as possible, we need to know what support resources exist, and how to direct the patient to them, if they so choose. In order to do that, we need representation from everyone involved.

Who's responsible for what?

In January 2016, I hosted a Blab with

  • Dr. Matt Retzloff, Reproductive Endocrinology and Infertility (REI) physician at Fertility Center of San Antonio
  • Rebecca Flick, Vice President, Communications, at RESOLVE, the National Infertility Association
  • Melissa Campbell, Infertility blogger and support advocate from the website, Triumphs and Trials

From four different perspectives and one half-hour conversation, we were able to extract at least ten different observations that are important for practices, patients, and support groups to know:

  1. People are often reluctant to see an REI because they are afraid that IVF will be pushed on them. REI practices may want to inform local OBGYN offices of infertility support groups in their area, because some patients seek peer opinion before they seek professional opinion. Equipping OBGYN practices with support contact deepens the relationship with the referring office and provides another step in which patients may become comfortable to seeing an REI. 
  2. "Writing a prescription for RESOLVE" is one way for patients to leave their first consult with information on support. It also ensures that talking about support resources becomes part of the standard of care.
  3. RESOLVE flyers on local support group information belong in folders that go home with all new patients. When a new support group forms in your area, RESOLVE will e-mail you a flyer with the group meeting details and contact information. This info may also be found through RESOLVE's zip code search
  4. Go through RESOLVE training: For areas where support groups don't exist, interested patients can go through RESOLVE training online.
  5. Instagram is home to one of the most vibrant online infertility support communities. People dealing with infertility sometimes send each other care packages and cards to the communities they form online. This free resource, for you to give to patients about infertility blogs and podcasts, came largely from suggestions on Instagram. 
  6. Social media can be great for peer support, but professional input is limited because of HIPAA regulations. For medical advice, patients should always contact a physician.
  7. Staff may need training on responding to and distributing information on requests for support. Unfortunately this is not the first time I've heard of someone wanting to leave support information with their doctor's office and not receive a response.
  8. Remove the perception that REI=IVF. All options are only available when the patient comes to see the REI. More content on when IVF may not be necessary, could help patients make their decision to schedule an initial consultation sooner than later.
  9. Patients should do additional research on support resources: The practice can give the patient an excellent start on infertility support information, and they will be able to find out what is best for their individual needs with some investigation.
  10. Training/education on support may be beneficial for REI fellows. At issue, too many people are not receiving emotional and social support for their infertility despite receiving clinical treatment for their condition. By setting a training standard for REI fellows, we could incorporate support into the standard of care. 

we're just getting started

One conversation won't cover all of the issues we have in the infertility space. Still, twenty years ago, we didn't have the opportunity to bring people together to consider various perspectives on a common issue. With emerging digital media, we have the opportunity to remove barriers that don't need to exist anymore. We have a chance to learn from each other so that we can all benefit from the improved patient-practice relationship. Using new media like Blab can be the first step in building more and stronger relationships across different disciplines within the field of infertility.


Top 7 Ways to Market Your Fertility Practice in 2016

By Griffin Jones

2015 was an interesting year for fertility centers. We saw big mergers in both the United States and Canada to watch large practices become extremely large practices. Meanwhile, other practices sold equity to team up with larger management firms while some reproductive endocrinologists (RE) opened their own clinics. That's no surprise; infertility treatment remains a high-growth category. The Society for Advanced Reproductive Technology (SART) numbers show an increase in ART cycles every year from 2003 to 2013 and we expect the 2014 and 2015 reports to follow the trend. I see a few possible scenarios in this increasingly competitive market for IVF patients:

SART reported a 6% increase in ART cycles from 2013 to 2012

SART reported a 6% increase in ART cycles from 2013 to 2012

  • You want to grow as an independent practice
  • You are an independent practice who has to defend market share from growing competitors
  • You can grow to have a higher valuation to sell equity to a management company
  • You are an equity firm who needs to increase fertility patients to return your investment in a practice group
  • You are a large practice group who would like to merge and acquire other fertility clinics

Whichever scenario best describes you, I generally believe that increasing market share is the best way to sustain your practice. The focus doesn't belong on converting consultations to IVF cycles, does it? From my research, patients are more likely to negatively review their practice when they feel rushed into a particular treatment option. Isn't it better if we can increase the number of consultations and let the number of IVF cycles increase by proxy? That way, according to patient feedback, you can properly manage patient expectations to provide the best possible care experience. That appears to be a virtuous cycle from which you will increase market share.

Additionally, increasing market share is a hedge against a recession. Personally, I like to be prepared for a recession, even when the economy is strong. I don't know if the next economic downturn will come in twenty weeks or twenty years, but if we're in business for long enough, we will experience one.  Increasing market share from competitors helps blunt the sting of the decline in the economy. Whatever your own reasons for growing your fertility center, these are the top 7 ways to market your fertility clinic in 2016.

  1. Invest in patient experience. Nothing exposes a faulty patient experience better than good fertility marketing. When patient delight is at its best, marketing is far more effective (and often cheaper). You may choose to hire someone like Reconceived to help you install a patient-centered culture or you might create your own system. Research shows us that patients increasingly choose their medical practices from online reviews. We can't delete online reviews from sites like Google, Yelp, Facebook, Ratemds, or Healthgrades, so minimizing negative experiences and getting the most from positive ones is paramount to growth.
  2. Respond to online reviews. The patient experience extends to the online world. Patient delight is part of the conversion cycle and delight requires interaction after treatment has ended. Sometimes people are displeased with their experience with your practice. That's okay. It's important to acknowledge these patients online because your audience consists of every prospective patient who factors that review into their decision-making process. This should be done very delicately, Read the six critical rules for responding to negative fertility reviews. You can also nurture your "word-of-mouth" referral network by responding to positive reviews. These are the patients that have taken time out of their day to promote your practice and increase your social proof. Thanking them rewards and encourages a culture around your practice.
  3. Post original content to Facebook This is a way for you to dabble in the world of content creation. You don't need to invest much at first. You can start with your iPhone. Selfies with the embryologists, a family-style photo with the nurses, and an RE with his birthday cake will almost always garner more engagement than rhetorical questions or links to studies. Above all, it will help to instill the habits of content creation in which everyone on your team can participate.
  4. Start using Instagram. Instagram is an absurdly powerful connection tool in the infertility community. We have to be even more cautious with how we use it because of HIPAA regulations, but I've identified seven powerful ways for fertility centers to attract new patients with this fiercely popular medium.
  5. Use online video. Don't skimp on your selection of a cinematographer. Good ones don't come cheap. I would hire someone at the caliber of John Paget in your market. In my experience, the most effective use of online video is for social proof. Rather than a scripted commercial, online video can capture the feelings, emotions, and concerns of your former patients. You will need HIPAA release authorizations, but through your social media channels, you can find several delighted former patients who will be willing to share their experiences. For someone who is considering your practice, the heartfelt validation of one of their peers may be enough for them to make their decision at that moment.
  6. Invest in inbound marketing software. I advise this with a word of caution. It's only worth spending the money on inbound marketing software if you are also ready to invest the resources and time into creating the content that the software is intended to manage. Integramed uses a system offered by SalesForce. I personally like the inbound marketing platform offered by Hubspot. Inbound marketing provides you with a system to follow to create content to meet your goals. For example, let's say your practice does 500 IVF cycles per year and you would like to increase that by 10% in 2016. You use the content management system to track where your leads are coming from, how to increase them, and how to improve conversions. Inbound marketing is the most proven form of marketing there has ever been. But you need to be able to first quantify your goals, and be willing to invest the resources to meet them.
  7. Optimize for mobile. Really, this item belongs on the 2010 list, but I still see many fertility centers whose websites are non-responsive to mobile. The problem is two-fold. First, new updates to Google's algorithm tend to lower the search ranking of those websites that aren't mobile friendly. The second is that you can look at your bounce rate in your Google Analytics account. Your bounce rate may be 30 to 50% higher than normal. This means the patient is leaving your site without interacting with it because the site doesn't look good on their iPhone. The data from Google (below) demonstrates that the majority of your web traffic likely comes from mobile and tablets as well.
A breakout of Google searches for IVF by device as of December, 2015. Only 35% of IVF searches come from desktop.

A breakout of Google searches for IVF by device as of December, 2015. Only 35% of IVF searches come from desktop.

By all indications, 2016 will follow the trend of increased competition among fertility clinics. Some practices will merge to become larger, some will sell equity to large management firms, and some REs will go off on there own to begin new practices. Whether you are looking to defend you own market share, or to grow across multiple markets, these are the top seven ways to market your fertility clinic in 2016. 

Take IVF cycles from your competitors this year. Read my absolutely free e-book, Digital Marketing for Fertility Centers: How to Use Digital Media to Acquire New IVF Patients in 2016.

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. 

The 7 Most Powerful Ways for Fertility Centers to Use Instagram

By Griffin Jones

What is the most frustrating thing about managing social media for your fertility center? If I ask this question to enough people, sure enough, this answer will be fairly common: there are too many platforms. How do we participate in all of them? 

Ready for the good news? You don't. I'll make this much simpler for you. All we need to do is reverse-engineer the attention of the patient. What media do IVF patients spend the most time with, and how does it relate to their struggle with infertility?

When we frame the question in this way, we easily see that Instagram is one of the most important social media platforms for fertility centers to participate in. 

  1. IVF patients are on Instagram. 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. 

Because of the structure of Instagram, it can be trickier than Facebook to interact with your community due to HIPAA regulations. I recommend against following patients back on Twitter, Instagram, and Snapchat. There's no law against it, but it could be argued as disclosure of a patient-physician relationship

So how do you engage your community on Instagram if HIPAA prevents you from participating in a more fluid and natural interaction? Here are some things you can do.

marketing for fertility centers
  1. Include it in your social media policy. Every healthcare practice needs a social media policy. You can e-mail me if you would like me to send you a free template, but you should always have your practice attorney customize it to your needs. Simply explain in plain English, that your practice will not follow back people that follow you on your Instagram account. While you would love to, your first priority is patient privacy and adhering to HIPAA regulations.
  2. Post the link to your fertility clinic's social media policy here in your Instagram profile (image above). 
  3. Let people find you. Post photos of your team: the practice picnic, a group hug of the nurses, an RE's birthday, are all appropriate for Instagram. Once you start posting original content, that offers something for people to comment on.
  4. Link your Instagram account to your Facecbook page and website. Give people a reason to follow. "See how we bond as a team".
  5. Use hashtags. There are so many hashtags relevant to infertility that it merits its own post. Start with #ttc and #infertility and you will find their derivatives.
  6. Respond to comments. Once people comment on your photo, you can respond. I suggest referring to them by their Instagram username, rather than their name. Also, just be careful not to add any new information to the conversation. A heartfelt thank you will do.
  7. Post video responses. In my opinion, I see this as the greatest opportunity for fertility centers on Instagram. When people give you love through comments on your posts (the Instagram equivalent to reviews), you can post a fifteen second video thanking them, telling them how wonderful it made you feel. Don't tag their username in the post, rather reply to one of their comments on your posts to notify them that you posted a video reply for them.

Do you use Instagram for your practice? What have you found?

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.

28 Scathing Words for REs Across Fertility Center Reviews

By Griffin Jones

If you are a reproductive endocrinologist (RE), you don't have an easy job. I don't mention this to state the obvious, nor flatter you, nor am I referring to surgical talent, study, or training.

It's heir-apparent that one of the most difficult aspects of the role of an RE is serving a population under enormous emotional and mental stress, who are often financially burdened, subject to unfair social pressure, all within great deal of outcome-uncertainty.

I chose to make the wordcloud from the 28 most common negative adjectives used, those that were each used in five or more reviews.

I chose to make the wordcloud from the 28 most common negative adjectives used, those that were each used in five or more reviews.

When the fragility of this accord is overwhelmed, the RE's public image often suffers in the form of negative online reviews. I'm not referring to recurring themes across several reviews that really help us understand the personality of a doctor before meeting him or her. If twelve different reviewers use the word "arrogant" to describe you, then you're arrogant. If it's common enough, then it's true that perception is reality.

I'm concerned when an RE's message is interpreted in a completely different way than it was intended. It's bad for the practice, and above all, so many of you have told me how it really upsets you. I have begun a project to comprehensively analyze RE and fertility clinic reviews, to establish a resource of actions that lead to the highest possible level of patient satisfaction.

This second phase of this project is an in-depth analysis I did of 130 RE reviews on I formed several key anecdotal observations, but I was most interested in aggregating a set of data for you.  So I focused only on the negative adjectives used to describe REs and their staff. I skipped over those reviews where no adjectives were used. Each adjective counted only once per review, regardless of how many times it was used. The final tally included:

  • 130 REs 
  • 349 reviews
  • 119 different adjectives

As you can see from the word cloud above, the word "rude" was the most common adjective used. In fact, it appeared in 91 different reviews. The data is important because it frames how certain experiences are later recounted to a much broader audience on the web. Understanding the language of dissatisfied patients provides insight to the interactions that lead to their expression of frustration.

Equally, analyzing the language of positive reviews is just as important. Will those words be the exact opposites of the most common negative adjectives, or will others be used? More importantly, the feedback of delighted patients is the compass for the growth of the practice. Comparing the languages of delighted patients and of aggrieved patients will help us form a support-guide for maximizing patient delight and improving staff and physician morale. I expect to have the positive review word cloud done for you by Thanksgiving (2015).

If you would like the raw data from this report, I will be happy to send you the spreadsheet. Just e-mail me at or leave a comment below.

If you'd like a little further explanation of the data, you can watch my video post here: