Dr. Roohi Jeelani is back to share her operational tips about how she has grown to massive retrieval numbers, without compromising care. What does Dr. Jeelani do, that you could employ in your own practice?
Listen to hear:
Which critical touchpoints absolutely require doctor-patient contact.
How Dr. Jeelani’s workflow operates and how she maintains personal contact with ALL of her patients.
What Dr. Jeelani does differently that is paramount to patient conversion and retention.
How she manages to see, treat, and connect with so many new (and established) patients.
Griffin question whether or not the sheer volume of patients and procedures compromises care, and what Dr. Jeelani has to say about it.
The place for virtual meetings in IVF care.
To listen to the precursor podcast with Roohi, click here: https://www.fertilitybridge.com/inside-reproductive-health/164jeelani
Company: Kindbody
Transcript
Dr. Roohi Jeelani 00:04
Where we're really short sighted is how we schedule our patients and I think navigating your schedule fitting these patients in but also touching on these points at your new patient appointment has been key for me I think patient education's truly the biggest thing that helps one routine, and then rapid follow up
Griffin Jones 00:28
1300 Egg retrievals in a single year while seeing 50 to 60 new patients a month. Oh, that's it. Dr. Roohi Jeelani is an operational mastermind in my view, and you're gonna see why as we walk through this together. She's been on the show three, maybe four times. Now you might be thinking she was just on the show. She was we talked about the changing dynamics in fertility Patient Relations. So Dr. Jeelani is at the forefront of that and how it's been a major new patient recruitment generator for her. And that episode is really important to listen to, in order to be able to fully understand this one. So we did that episode. And I had Miss titled that because I meant to say, the REI that did more retrievals than anyone else in 2022. When we titled it, I left off the year by accident. But even if I hadn't left it off by accident, I also made an assumption that I assume that 1300 is the most we know what happens when we assume there may be another doctor that has done more than that. I don't know if if one provider has done that without other providers under him or her. I don't know if if Dr. Rob kilts or anyone else is either way, it's orders of magnitude more than most folks are doing. And people were very curious as to how she does that. So today we go through the workflow. We go through the virtual consults. We go through the testing, we go through the pre steps that people do with the financial counselor before their first appointment. We go through the scheduling of the follow up appointment before the workup and the tests are done. We go through the role of her scribes. We go through rules for pivotal touchpoints. The doctor Jeelani fields are absolutely necessary for good patient care. And from my experience, what are also very useful in retaining patients and converting them to treatment. We go over rules for your scheduling team so that they can maximize the use in the way that Dr Jeelani has. And I asked Dr. Jeelani, what she views is the biggest bottleneck to stop her from seeing even more patients that if those bottlenecks were removed for you, would you be doing 1300 retrievals. If they were removed for her, would she be doing 3000 4000 5000? I challenge as much as I can about how do you know that the standard of care isn't sacrificed. I'm not a clinician, so I can't totally judge. But that's why I think the first episode with Dr. Jeelani by the first one. I mean, the one that came out in January of 2023, or December of 2022 is necessary to fully understand because this is someone that really wants to provide that attention to her patients. Some of you are going to listen to this episode and say I already knew that shut up. Well, you just listen to the episode and pick out one thing that you didn't know before you listen to it. Dr. Jeelani is very generous with the processes that she shares with you. This is not vague. This is not high level stuff. This is very detailed, and there's almost certainly something that you hadn't considered or hadn't seen applied in that way. So enjoy this episode with one of the rising stars of clinical operations in your field. Dr. Roohi Jeelani, Dr. Jeelani? Really Welcome back to Inside reproductive health again.
Dr. Roohi Jeelani 03:54
Thank you for having me. Glad to be here.
Griffin Jones 03:57
Thank you for coming back on after recording another episode probably a month or so ago, not. Not too long ago, it was a very popular one. I got a lot of text messages. So did you got a lot of emails, and I have to take some culpability for being kind of allows the interviewer because after it was only after we stopped recording, that I was like, Oh, we started talking about how many retrievals that you actually did in last year. And you said 1300. And I said Holy crow. I said, did you not say that in the interview because you didn't want to say it or because I didn't ask him you were like, because he didn't ask me. I thought yeah, like Krav like this. That's this. I did something similar with Amy today where I had to have her back on where I'm asking her a whole bunch of questions during the show. And then afterwards, I'm thinking, Oh, that was the that was the thing that I was circling around and couldn't figure out because I didn't ask bluntly enough for didn't even think to do that. So, you know, but at least got it into the title of the episode and, and people became really interested in and I had said that, I suspect that was the most I said this era who did the most I made an assumption. I don't have I don't have hard data I, I think it could be the most, it could be the case that Dr. kilts, who's been on the show or someone else has done more, but I think that for one person without other providers, it, it very likely could be if not you on an on a very short list. And it is orders of magnitude more than the average person. And so people are fascinated about how it actually gets done. So last time, we were talking about the patient acquisition and Patient Relations funnel that led to it. This time, I want to talk more about the operation side of how this even happened. So can like let's start with maybe just a summary of the growth if 1300 was 2022, what did the lead up to that look like? What were the previous years volumes?
Dr. Roohi Jeelani 06:11
Always a couple 100. So I think the year before it was closer to six to 800, I think around 600. Between six to eight, I'm not quite sure I actually didn't keep tabs on it. This is just more of a personal guards. It's not necessarily a number. It wasn't like, this is what I want to do this what I'm gonna grow to it just became what it became as my presence grew and my social media grew. And then it came to light when I was looking at how many cycles do I do a month, then I started adding it last year, and I was like, Oh, wow, that's gonna equate to over 1000. So it wasn't intentional. I could be, I think close to 1000, the year before closer to a grew every year, proportionately. So I'm hoping it continues to grow as I kind of learn how to manage like you were saying, my staff, my support staff, my patients and kind of figure out things that work for me,
Griffin Jones 07:13
you must be figuring it out to some degree if you nearly doubled from 2021 to 2022. Without it being explicit goal, it was just happening from the things we talked about in the last episode, the new patient acquisition presents that you have from having such a presence in social media and a work ethic that we also talked about in that episode of that you like to work and you like to do it a lot. So you must be figuring some of it out on the operation side. How many new patients is that coming from? Like, if you're, if you're doing that many retrievals? How many new patients are you seeing
Dr. Roohi Jeelani 07:54
I see between 50 to 60 a month.
Griffin Jones 07:58
That's also more than the average. That's also more than the average doctor. So you're, it's very common to see, when you do see somebody seeing a lot of new patients, they very often have a lower IVF conversion rate because they'll see a lot of new patients one month and then they'll have to block off more of their schedule in the next month to do IVF and vice versa. So how can you see that many new patients and do that many retrievals
Dr. Roohi Jeelani 08:27
I think when I was sitting on the patient side, it would be seeing your doctor doing a workup than waiting on the doctor schedule for your next step. I think educating your patients on your next steps understanding what they're once again going back to long term short term goals or and also making sure at their new patient appointment. They have their next steps appointment plugged in instead of do your workup then call for your appointment then you really prolong I think we're we're really short sighted is how we schedule our patients. And I think navigating your schedule fitting these patients in but also touching on these points at your new patient appointment has been key for me, I think patient education truly the biggest thing that helps one routine, and then rapid follow up.
Griffin Jones 09:21
Very often people have the patient go back, do the workup, do the test and then schedule the appointment because they don't want to fill a slot and then have the patient not having done those things. So is how do you have patients in for a follow up and make sure that they have what's necessary for the follow up
Dr. Roohi Jeelani 09:41
at your first appointment right most most patients cycles are very predictable. These patients have been tracking their cycle doing op case. So at that appointment, you say okay, what's your next period do okay, well, this is when you're going to come in. Okay, this is when we do the saline okay tandemly we're going to do a semen analysis. Okay, your neck anticipated periods. Thus, let's regroup before this date to then put a treatment plan in place. So your new patient appointment you're leaving with all of your next steps, as opposed to call with your period or your office and an answer wasn't I was out of town. Oh, that's right, it becomes all frustrations. And then what happens? delayed treatment or you leave the clinic?
Griffin Jones 10:23
Are you doing Hmh and FSH during that time as well? Or is that happening either before at a different time,
Dr. Roohi Jeelani 10:30
at that time at your new patient workup?
Griffin Jones 10:34
How often do you have to reschedule patients because they booked that follow up, but then they haven't done all of those things.
Dr. Roohi Jeelani 10:42
Very rarely, most of the patients are the ones that are mandated like in managed care, where you have to do XY and Z, your Pap smear was a new year, we're not going to approve your diagnostics, but majority of patients now there, you know, these patients want next steps they want to plan they don't that wishy washy approach a feel like leaves them very lost. And then that's when you get why didn't call something got in the way. Now you're concise. This is what you're going to do this is when we're gonna regroup and this is when you get your next steps.
Griffin Jones 11:15
You're saying the majority of cancellations come from those that are mandated because they have something else that they have to qualify for.
Dr. Roohi Jeelani 11:22
Correct? Correct. If if there's cancellations or reasons why the system may not work, are cases of managed care where insurance didn't give authorization for testing or they were missing something before they needed testing. But otherwise, most of these patients will follow through.
Griffin Jones 11:42
When you say very few cancellations ballpark, are we talking less than 5%? Less than 25%? What are we talking for less than less than five to 10%? Wow. So that? So that is that is a small number? At what point do they talk to the financial counselor,
Dr. Roohi Jeelani 12:00
even before they see us so they get a verification of benefits before their new patient appointment. That also helps set the stage for us and them as to what they're walking into. Because a piece of their big pie in decision making is what is this going to cost me? Can I come in for testing? Do I need to do additional testing with my OB GYN before it comes to you?
Griffin Jones 12:23
This is really interesting, because we've approached this in different ways by recommending how people answer the question, how much does IVF cost? And very often, if people ask when people are calling and asking, How much does IVF cost? The answer that they get is not one that they're going to be satisfied with no matter how you answer, even if you give them our base cycle price is $13,000. If they need donor gametes, if they need a gestational carrier, if they're going to have to do multi cycle, it's going to be way more than that. And then you've price anchored them at a place where they are totally unprepared for when they see the actual numbers. Or if they just need timed intercourse, then you've anchored them at a price of something that made them afraid to even come in for the first console. And so we often direct people to to come in for that first console and and then determine the financial course of action. So what's that, like? If they're meeting with a financial counselor before they come in for their first visit?
Dr. Roohi Jeelani 13:34
Most of that appointment is just a rundown of what's covered what's not covered, and I think it helps them, put them at ease, like okay, I'm going to talk to the doctor. And then I'll start with testing and most insurance companies will cover diagnostics. I think it's a treatment where what you're talking about really opens Pandora's box as to what what am I doing? Am I picking and choosing. And I think writing that narrative with your patient or helping them understand that narratives important. So I counsel my patients that fertility and IVF. And time intercourse is not like any other type of medicine. It's not like you have high blood pressure, you do X, Y and Z and no cure, right? Everyone's treatment plan is very different. And it's based on your unique situation and your unique treatment plan. So these calls at the financial navigators who are not medical at all, give you as to give you a ballpark estimate of what it would be if you did X, Y or Z. From that point on, we'll understand and see what add ons you may or may not need. I also counsel them your first cycle is your most basic cycle but it's also your most diagnostic cycle. We understand a lot about what's going on what's causing your infertility what's causing us not to get pregnant or not to stay pregnant. So from that point on, you will typically expect me to do my add ons and recommend further treatment. Most of my patients From the get go, if you look at actually did this post on age and how many cycles most couples need. And I refer and I referenced that post a lot. And I say, depending on you guys and your long term and short term goals, you will see in this that no one is one and done. Could you be one and done, maybe, but that probability is very low. So if you are in a self paced day, if you are looking for a baby now and a baby in the future, most couples will end up doing a multi cycle plan.
Griffin Jones 15:30
The financial counselors are talking about those ballpark options before the first visit,
Dr. Roohi Jeelani 15:36
the financial counselors are giving them a gist of their insurance benefits of what's covered what's not covered. And then when we put a treatment plan in place, then they'll reach out with the specifics.
Griffin Jones 15:47
And then they're reconnected with the financial counselor at that point. When practices are really busy, that can determine where they put different requirements for the patients. In other words, if we have a practice with a 10 week waitlist for the docs, like many people had in early 2022, late 2021, then we can put all we can put everything in the front of the patient journey, meaning that even before someone's able to schedule, we can have them fill out their new patient forms, set up an account in the portal, even do their testing. And if patients, if practices have only a week or two weighed less than there's less that they are usually able to ask the patient to do before that first visit with you doing so much. And you finding that doing the doing the workups before the follow up and scheduled but scheduling the follow up before the workups are actually done. Even though it takes place after why not do the testing even before that first visit. A couple
Dr. Roohi Jeelani 17:01
of reasons. I think insurance won't cover it. But if you have testing done prior to an official consult with a physician, to it's scary to see these results, right. Ultimately, if you practice good medicine, good patient care, the NG bottle says everything else follows. So it's never for me kind of taking it back to why we're here. It was never do 1200 cycles to be the most right it was practice good medicine and everything else kind of rolls in. So as a patient, when you're drawing, you're a mage, and you're getting your partner's semen analysis and you're checking your tubes and you see all these things rolling at you. It's very scary to interpret. It's very scary to understand. So I think not knowing what you're doing or testing. And then getting these results without having a provider following it is intimidating for me as a patient. So getting in that console, understanding what you're testing, why you're testing what they mean briefly, help set the stage for saying okay, this is what I'm going to do. And then I'm going to see my doctor for follow up. We do I mean like most clinics, we do offer our pulse testing to get the pulse of your fertility without seeing Dr. Jelani or anybody where you can come in and check your a major sperm and ultrasound and that's followed up with a 15 minute quick consult to go over your results. But oftentimes, those patients do convert to actual patients saying, okay touched on this, but I want to learn more. I want to know more. So I guess whatever comes first a little bit of mandated by insurance, a little bit of it's mandated by you know, based off of what patient comfort is.
Griffin Jones 18:43
Are you at both you personally are you at both the new visit and the follow up? Yes. Some people use a Advanced Practice provider at one or the other. You are doing so many new patient visits and so many retrievals How are you able to be at both and and why have you not decided to have an EPP do one of those or at least up to this point.
Dr. Roohi Jeelani 19:11
We do have a PPS that help with the overflow and if need be when I go on vacation when I'm out. My patients have my number and I connect with them even before they get to that follow up most of the time. I would say 70 to 80% of the time I connect with the patient even before they get to that follow up appointment. It's I think it's important to have that personal touch. It builds trust and it also no one wants to wait for treatment, right you want it to be yesterday. So as soon as the workups done, I try to touch base with my patients as soon as their retrievals done. I try to touch base with my patients to understand and help them understand what their next steps are from that point.
Griffin Jones 19:57
Do you work with one HPP or are two that are part of your team or do you do you all cycle through the different APs in the group?
Dr. Roohi Jeelani 20:07
It is by region. So all the Chicago APS will see my patients and GS Levin's as they overflow.
Griffin Jones 20:16
How much support do you have there in Chicago from ABB? How many APs are in the Chicago region?
Dr. Roohi Jeelani 20:22
We have Stacey. For for?
Griffin Jones 20:25
How many IVF coordinators do you use?
Dr. Roohi Jeelani 20:29
A lot? Yeah. I think 10 it between eight to 10.
Griffin Jones 20:35
For the group or for yourself. For the group. I once met someone from a group on the West Coast large group did many of the providers did many cycles 678 100. And the person there told me that the providers doing the most at this practice had 15 IVF coordinators each, how many do you have for just you,
Dr. Roohi Jeelani 21:05
we practice as one big entity, so they are familiar with all of our patients? So they're all our IVF. So it's split in IVF coordinators, and then clinical nurses. So the IVF just manages IVF. And then the clinical nurses manage the clinic aspect of it.
Griffin Jones 21:21
What are the pros and cons to doing it each way? What's the Pro to having it for everyone, and everyone's using all of the same IVF coordinators versus a provider having their own specific IVF coordinator or team?
Dr. Roohi Jeelani 21:36
I think it helps break down silos because right, you're in a very busy big center, we're a very busy practice with high volume. And it's harder for your ancillary staff to learn my way and then Angie's way and then loud in this way. So I think when you're unified as a big practice, it really helps them understand one that you're one, one that there's one way and it really breaks down silos, they can cross cover each other, they understand all of us, they're comfortable with all of us. I like it.
Griffin Jones 22:09
Does it unify the practice more like is it more causative of unifying the practice as opposed to being a product of it, because I think of some groups that we worked with not as large as yours. But you wouldn't even know that the partners were in business together. In some cases, it is not the practices nurse it is that doctors, nurse and everybody knows it, and they let you know it and their processes for each provider are very different. Does having every all of the providers use the same staff and use the same advanced practice providers? Does that make you get on the same page with Dr. Loudon and Dr. Bell? So it's more?
Dr. Roohi Jeelani 22:55
Yeah, I think so. Right? Because you want to be one standing friends, like having two parents, you don't want to say opposite things. So it unifies us and helps us have a great relationship, but also then creates less confusion, and then loyalty and commitment they have to all of us equally.
Griffin Jones 23:13
How many of these folks, are you giving your invite folks? I mean, patients, how many patients? Are you giving your cell phone number? Every single one, how often do you get a phone call? Or a text message?
Dr. Roohi Jeelani 23:25
Not that often? And why not? Because I think people really respect it. And I think it's not reactive, right? It's more proactive. When you get insane like Portal messages or upset patients as when you can't get in touch with them. They have a simple question that's not answered, and they're frustrated. But it from the get go. They know this is where you reach me. This is where you reach a nurse. This is what I help with your you're setting expectations. And they don't usually bother you for stuff that they know you don't you can't control.
Griffin Jones 23:56
So you're seeing over the course of the year five by 600 or so. Somewhere between six and 700 new people you're giving every single one of them your cell phone number, how many a month Do you think you get a text message or a phone call from?
Dr. Roohi Jeelani 24:14
Most people don't call text text here and there a lot.
Griffin Jones 24:19
Is it here or there? Is it a lie?
Dr. Roohi Jeelani 24:22
Maybe very different than other people's opinions? Your
Griffin Jones 24:24
addition of a lot is probably way more than my definition a lot. How many? How much texting? Or how many? How many patients text you in a given month? Do you think
Dr. Roohi Jeelani 24:35
I talked to all my patients and
Griffin Jones 24:38
how do you keep that streamlined with with with with what the care team needs to know.
Dr. Roohi Jeelani 24:45
I have a scribe that I think that is my secret tool if anyone wants to know I ascribe all of my text messages into my notes and send them as orders to the nurses. That is like my right hand. How I send her sauce. I'll talk to a patient. So I'll text saying, Hey, are you available, your retrieval was yesterday. This is what the results are. And we want to let's talk about next steps. So I'll we'll hop on a call or FaceTime or zoom zoom, usually, we do a quick call, that is a console converts into a treatment plan in order which my scribe helps me translate to, and sends it to the nurse.
Griffin Jones 25:27
I don't want to put your scribe out of a job, but I'm going to have Dr. Ravi gata on the show later in the season, and we're going to talk about chat GPT. And talking about the different applications for this new open platform artificial intelligence, and how different people are using it now and how they may be able to use it. And one of those is going to have to do with I don't think we're gonna see medical scribes in the future, I don't think we're gonna see medical translators. In the future. I don't know how far off and I'm gonna leave that topic to speculate with Dr. gada. But it makes me think of what we're really talking about is access to care. And you are doing so many more retrievals and cycles than the average person partly because of the operational systems that you have in place. And then it will become well, how much can we really scale that when we take these already efficient operational systems and are able to automate it or reduce steps because of some of the new AI technology that
Dr. Roohi Jeelani 26:39
you're speaking my language? I want to hear that episode, I literally was like, that would be the next step. Because all of this, you can automate it right? That's truly, you want to know, I think that the biggest part about how you get busy and stay busy like this, is patient intervention at the most appropriate time when when does the patient want to hear from their doctor? Right? It's crucial after their new appointment for next steps, post retrieval, post field cycles, miscarriages, so soon as you identify these key pivotal points and automated AI them, I think everyone can do these cycles.
Griffin Jones 27:18
So your scribe is taking these conversations, putting it in the EMR, putting with the patient's records is that but then I imagine that I, when we do interviews, for example, I don't do the screening interviews for candidates, my HR folks do that. But I look at their notes. And even when they leave good notes, I often have questions. How are what gaps are happening when you there's conversations that you're having with patients, and then the care team is reading through the notes afterward,
Dr. Roohi Jeelani 27:54
my scribes on my calls with me. So it's very easy for her to translate it now if I'm training and use crave if they're newer, and they're not as familiar with my terminology and my protocols and my next steps. And you see that little discrepancy. But also then knowing that the nurses can reach out to you if they're confused, I think really helps, right? That fear factor of like, oh, gosh, I don't want to ask a doctor because then they're gonna think I'm stupid, like, just eliminate that. And they know like, it's open door. Text me Call me whenever if you're confused, come up, come ask me, then I'll explain it to you, as opposed to just second guessing or not doing it. And I think that really helps.
Griffin Jones 28:32
How often are the nurses contacting you for things like that?
Dr. Roohi Jeelani 28:37
My nurses talk to me all the time that I talked to them constantly.
Griffin Jones 28:42
So anybody that's listening to this episode, they have to listen to the other episode too, because they go hand in hand, you won't fully understand the context of this conversation. If you don't if you haven't heard the other conversation, your your work ethic, you're constantly communicating. And in order to support an operational system, like the one we're talking about today, has to be based in something like that, at least for for this kind of volume. So when you when you went from maybe six to 800, retrievals in 2021, to about 13 120 22. You weren't sitting on your hands and 2021 You were busy as heck, what got eliminated or automated or delegated that allows you to scale.
Dr. Roohi Jeelani 29:36
I think figuring out what when's crucial. When do you touch base with your patients? What are these pivotal points of decision making? Intervening sooner than later? Right? It's moving up patients like you said, I bet you anyone listening or any fertility clinic has a waitlist of at least a month. So one of the things that I do and I'm really good about is saying okay, well done. bulking out until March. That means these patients also wanted to be pregnant yesterday don't want to wait till March, but they're waiting for March because of me because of my schedule my limitations, right. But if I have an opportunity, like Tuesday finished cases early, hey, I have four hours where I'm not doing anything. Hey, new patient call center, can you pull up these people who are ready to be seen or who want to be seen earlier? Just kind of owning your schedule and really, really thinking about what is that patient feeling? I think I really understood that when our hands were tied, right? Like what happened in 20, from 2019 to 2021, was the world changed. Most of the most of the reason I started understanding this is because a lot of the noise was cut out. You couldn't really go anywhere, do anything. So then I started saying, Okay, well, let's start moving patients up. Let's start understanding what they want. We don't know what the future holds. Let's understand what your future where you want, right? Egg freezing patients who now can't go out on dates, because everyone's masked and distancing. What does that look like for you? So just, I think those three years were really pivotal and understanding how to practice. Practice martyr,
Griffin Jones 31:16
I want to talk to you about touching your schedule like that. But I also want to ask about the pivotal touch points, every patient is different. There's so many different considerations of what might be pivotal to a particular patient. But if I'm putting you on the spot, and having you think of patterns of these, these are the characteristics of a touchpoint that I need to have. And when what are the common patterns,
Dr. Roohi Jeelani 31:41
post retrieval, no one knows their next steps. 100 times as you may have told them, You don't understand them, you forget, you change your mind. I think that's key. positive pregnancy negative pregnancy miscarriage rate, you want to celebrate their wins their losses, their tough times, I wanted someone to celebrate all of those with me. So always reach out to my patients, no matter what that test results shows, they will get a text or a call for me that day. Key PGT I don't understand half of the numbers and letters that come out. I highly doubt any of my patients, they're super confused as what those mean, always reach out to have to wait for your doctor post retrieval, then post PGT 10 For FET is like three to four months of time that no one has. So I'm very intrigued by this system that you're talking about with Ravi but I really think AI eventually for right now I use my notes, my scribe my ancillary support staff to help me as reminders to when to call, who to call and where to call. But I would love to see how AI can interface with this and help us recognize these. Okay, this is where you need to intervene in one.
Griffin Jones 32:57
Do you have a workflow system for yourself other than the EMR? Do you use like a project management system like Asana or or do you use any kind of CRM like Salesforce or HubSpot? What are you using?
Dr. Roohi Jeelani 33:11
I do? Jared Robbins will tell you I'm the most organized disorganized person ever. I make lists every day I have a list. I'm old fashioned, or I'm too old. I write down all my day ones, my day sevens to calls, I have ridiculous amounts of paper and pens right next to me with checkboxes. I call these patients on a daily basis. I've been meaning to try and no, I heard it's fantastic and it's searchable. just haven't gotten around to it.
Griffin Jones 33:41
So you're using old fashioned pen and paper to remember when to I mean, of course you have your scribes that remind you but you're not you don't have like, ping in the EMR for contact this patient at this time after their retrieval of these 1300. Folks, how many of them are you contacting after retrieval? Every single one,
Dr. Roohi Jeelani 34:09
every single one. So one, that's
Griffin Jones 34:11
probably that's partly why you are that you convert so well. Again, you have to listen, the first conversation or else a lot of you'll you won't get all of this one. Because you have to build the lead up in the base and set the expectations to have something this efficient long before you can actually have people go through something so efficient. You've got to be prepared for it. That's what the first conversation is about. But also touch points are the number one thing that get people to make a decision that when they want to make the decision, but they're just afraid they're just they don't know what to do or they don't feel like well, why would I go back there if nobody cared after I talked to them that last time and so we often try To help people automate that, that conversion by giving them a workflow, and it's a ton of work, if it's not, it's a ton of work when you're trying to replicate it with medical assistants when you're trying to replicate it with nurses, when you're trying to make it a workflow in the EMR or the project management system or the CRM, and you're just doing it for every single one of them. Trying to in the most organized, disorganized person, how many virtual consults? Are you still? Are you doing? Some people are doing 100%, almost for new visits? Some people are they're they're straight up back to 2019, no virtual consults. And a lot of people are somewhere in between. What is it for you?
Dr. Roohi Jeelani 35:50
Oh, virtual. So if
Griffin Jones 35:54
that was and then are the in person are they all excuse me is the for the follow up. So they all in person. All virtual, the follow ups are all virtual too. So you're meeting patients for the first time when they come in for the retrieval? Yes, cases? What do you lose with that? If anything?
Dr. Roohi Jeelani 36:17
I don't think anything. I think patients love it. I think everyone's really busy. I think they love the ability to talk when they want at their convenience in the comfort of their home. I think it gives them a lot of flexibility. I don't I've never had a patient say I wanted to see you in person before this retrieval. I always get I'm so glad to meet you. So happy to meet you. But I never had anyone say wish I would have met you sooner.
Griffin Jones 36:46
I think about this a lot that over the course of my career, I have both paid and been paid millions of dollars by from people that I've never met in person before. And I don't think it would be possible if they didn't already know me in some way, if it wasn't from the content that I've created, or maybe they've seen me speak or, and for the folks that I'm hiring that I'm paying, if I didn't know something about them, and at the very least if I wasn't able to see them on video, I don't think it would be the same. If it were if I were interviewing people on the phone. I would say that in person is the best, but video is the second best. So I think a lot of people are going to hear this and they're going to think No way I have to see my patients for that first visit in person or second person or I won't have that rapport with them. And I think they could be right, because they don't have what you have in terms of how many times you've connected with patients on social media, by how many videos they've watched of you how many reels they've watched of you how many pictures they've seen how many long posts they've they've seen from you, could you do this, in your view? All virtual if you didn't have that rapport built up front?
Dr. Roohi Jeelani 38:08
I don't think so I don't think my volume would be my volume without having that
Griffin Jones 38:13
report. Not even not even the volume. But could you could you have the same level of engagement from your patients from just a virtual new visit? And just a virtual follow up if they weren't already really familiar with you?
Dr. Roohi Jeelani 38:29
I think so I think there's practices, let's use CCRM, for example, or another big practice where people would fly in, and they don't know the doctor, they've never met them. That's the Zoom console and they fly and start treatment. I think it's very, or New York has another center that does that. I think I think when it comes to fertility, people just want to go to a place where you're cared for network. So I don't think that, you know, I've had patients say I didn't like the doctor, but I love what they did. So I will stay. I'm gonna go there. So I, I do think it's a piece of the pie, but I don't think you absolutely need an in person when it comes to fertility. Right? It's it goes so fast. It's like tearing off a band aid is 10 days of your life that you don't like I didn't even know when I started or stopped most of my cycles.
Griffin Jones 39:19
Let's talk about testing your schedule a little bit that you figured out during the pandemic, well, how do I move things around to make this more effective? Now, if you're going in every time and say, Well, I just had a Friday afternoon, open up now, call center, go ahead and find people that are on the waitlist that can come in earlier. If you're doing that every time that'll be inefficient. So I assume that you've given some rules to your schedulers to that if this then book vessel, what are those rules? Yeah.
Dr. Roohi Jeelani 39:52
So I started using identified a person that really knows me well and knows my schedule and what I do instead. putting a lot of my personal stuff on there as well. So if there's an open area, there's nothing personal, as well as patients and they know, okay, that's a green light to add stuff on.
Griffin Jones 40:13
Many doctors whenever there is suggested process improvement, or a new technology or an increase in volume, many doctors worry about the sacrifice of the quality of care. And, and so it, I imagine that a doctor that is doing 250 retrievals a year and maybe seeing 500 new patients a year is thing 600 new patients and 1300 retrievals. There's no way that something doesn't get lost in translation, there's no way that someone can give that level of attention to the patient, something's being lost, something's gonna go wrong, some quality is being sacrificed. What quality do you expect they that they expect might be sacrificed? And how do you know it isn't.
Dr. Roohi Jeelani 41:12
So if you, if you expect to, if you try to take a square and fit it in a circle, it's not gonna work, right? If you say, This is my boxed approach, this is how I practice nurses aren't allowed to contact me, patients aren't allowed to contact me, you have to wait for your next appointment to follow up, then you're going to fit that box. But if you want to think outside of the box, and you want to do something revolutionary, then you practice outside of the box medicine. So nurses know it's an open door policy, they their interests align with your interests, which is optimal patient care, your patients know that you understand their goals, their family goals, their short term goals, their long term goals and their timelines. And then they know you're rooting for them. There's not one single patient that delivered pregnant that I still don't touch, but it's not, I'm going to do a retrieval and be done. It's your forever part of my life. Like you're very intimately connected to me. My patients whose babies are five, six year olds, still follow me on Instagram and send me pictures. So it is a relationship. So what I vest in, I think, I don't think quality is being compromised. I think quite the opposite. I think this was way better care than I've received up until I saw Angie. But you know that that's one of the main reasons I switched so many clinics with my son, it was I wasn't getting the answers or the treatment or the follow up that I really felt like I needed. And that's something I promised myself that I would never do to a patient. And I'm this only started because I wanted to hold true to my promise that I don't want someone to feel like me.
Griffin Jones 42:54
And I will let the folks know we've worked with groups of all sizes, we work with 40 dot groups before we work with single practitioner groups. And I have to tell you from doing people's reputation management, it don't matter what size, the practice is, on average, or what kind of volumes they're doing. I've seen small practices get reviews, like it's a baby factory in there, all they care about is money, they just pack the waiting room, it's like man, they're not doing that much volume compared to another place. And I recall seeing a presentation, I wish that I could remember the date, if anyone was at the SRA AI meeting, it was probably 27 tene that I spoke at the Esrei retreat, whoever was there. I remember sitting next to Dr. Liu Exene. So Lou, if you still listen to the show, and you remember where this data came from, please let me know. But it showed the number of complaints or the level of patient satisfaction per volume in there was kind of a J curve. So there was a higher level of satisfaction among smaller boutique practices. And then it bottomed out for a bit for those that were in the middle size, like let's say five to 10 providers, and then it went up as the group got larger. And it's partly because well, if you're if you're real small, there, you can get away with not having a lot of efficient processes, because it's very intimate, just you people often understand. And if you're larger, you should have really established systems like the ones that you're talking about. And it's the people in the middle at the bottom of that J curve that often have lower patient satisfaction because they're not boutique and they don't have the systems. So while we're on the topic of growing pains for those that are growing into that larger group or more efficient or having systems, you're a person that I bet all of the AI can Bernie's and everyone else wants to talk to. Because if you could, if you could see even more patients with the level of care that you're giving them, I know that you would What do you view as the biggest bottlenecks, like, what do you think when you're going through your week is like if I could just automate this or eliminate this or delegate this? What are the biggest bottlenecks that you see?
Dr. Roohi Jeelani 45:24
I'm right now I wish I could, I there was a way to notify when the patient next period is and to make sure that follow up consult was sooner I feel like right now I'm hitting it right where their cycle is, and then getting the meds and starting their cycle is delayed by a week or so. But if I could find out how after because I can do it up until workup. But then from workup to treatment is when they're out of my control and they go to the nurses. So either I work on teaching my nurses and make sure that they see me before their next period. So I can talk treatment to them well in advance. So then they have time to refill their meds, sit on it, think about it do consents, or AI to say, okay, you know, like, based on when they're putting in their LMP, and how often they're getting their cycle. And this is when their treatment, anticipated treatment date should be and they need to follow up well before then. That would be awesome. But that's my bottleneck currently.
Griffin Jones 46:29
I'm gonna let you conclude. And I will preface it with saying this because people usually like that I asked tough questions on the show, I feel like I've been tough enough with you making you prove that nothing's being sacrificed, at least to the extent that I can ask some a clinician, of course, could probably grill you harder. I'm not a clinician guy. Sorry, I can't I can't grill harder. I've asked how do you know nothing's being sacrificed? How do you know that you're actually giving the quality of care? I'm satisfied with the answers. And if anybody watches the British Bake Off Great British baking show, I think it's has to be called in the US now. The judge Paul, Hollywood occasionally gives a handshake to one of the contestants. And it's like, the biggest status because he doesn't usually do it. And he's normally pretty hard. I would rather be if I had to be perceived as one, I would rather be perceived as being more skeptical than somebody that likes to woo. I will say this, though, really, you impress the crap out of me, I have known for a long time that you're really smart. I've known for a long time that you have a new and better dynamic for Patient Relations. I've known for a long time, that you have a crazy work ethic. And it's probably because of those three things that I am satisfied with the explanation that I've gotten today on the fourth, but now I know that you are also an operational mastermind. And and I think it's really useful for those that even if it's like, Man, I don't even want to see 600 new patients or AI or AI will decide how many new patients that you're going to be able to see within a certain timeframe to some degree and all of the technologies that come but people will say, Well, I Yeah, but I don't want to work 80 hours a week or whatever. It's like, okay, that's fine. But think about how much more you can do effectively, even with the volumes that you do want to do and the time that you want to do and be able to give this quality of care, some people are going to say, I knew that stuff already. I doubt it. I doubt you knew every little piece of that you've been so generous today with the level of information out but hope your employers don't get pissed off about it because you were you really gave valuable information they should thank you because of the marketing that it's giving you all and and you've been so generous with it. So I'm gonna let you decide how do you want to conclude about being able to see as many new patients and provide treatment for as many patients as possible without sacrificing patient attention or quality of care?
Dr. Roohi Jeelani 49:25
First, I want to say thank you, that was a lot. I'm very flattered. So honestly, thank you. I think just a practice with my heart and try to do what's best and everything else kind of follows suits. So that's why I can confidently say I'm not compromising any patient care. I have my my nurses teas that you have your patients memorized. I do have my patients memorized because I'm just as vested in them and their family as you know, they trust me with that it's a very intimate process to be true. I started with so I think just genuinely caring really optimizes everything that's, I know it's hard. I know everyone out here cares, right? Everyone did this for a reason no one went to school for 15 years for fun. And I think just remembering why you did this really helps me keep going every day.
Griffin Jones 50:19
Doctor Roohi Jeelani, thank you very much for coming back on the show. Thank you.
Sponsor 50:25
You've been listening to the inside reproductive health podcast with Griffin Jones. If you're ready to take action to make sure that your practice thrives beyond the revolutionary changes that are happening in our field and in society, visit fertility bridge.com To begin the first piece of the fertility marketing system, the goal and competitive diagnostic. Thank you for listening to inside reproductive health
