How to sell your ObGyn practice

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How to sell your ObGyn practice
Your retirement may be a long way off, but the planning pointers presented here can help smooth the transition of your practice when you decide to sell

For ObGyns, 2 intensely stressful career milestones are the day you start your practice and the day you decide to put it up for sale.

One of us, Dr. Baum, started a practice in 1976. At that time, many clinicians seemed to work right up until the day they died—in mid-examination or with scalpel in hand! Today, clinicians seriously contemplate leaving an active practice at age 55, 60, or, more traditionally, 65.

ObGyns in group practice, even those with only 1 or 2 partners, presumably have in place a well-thought-out and properly drafted contract with buyout and phase-down provisions. For members of a group practice, it is imperative to critically review and discuss contractual arrangements periodically and decide if they make sense as much now as they did at the start. ObGyns who continually revisit their contracts probably have an exit strategy that is fairly self-executing and effective and that will provide the seller with a seamless transition to retirement.

A solo ObGyn who is selling a practice has 3 basic options: find a successor physician, sell to a hospital or to a larger group, or close the practice.


Related article:
ObGyns’ choice of practice environment is a big deal

Preparing your practice for sale

Regardless of who will take over your practice, you need to prepare for its transition.

The most important aspect of selling your practice is knowing its finances and ensuring that they are in order. Any serious buyer will ask to examine your books, see how you are running the business, and assess its vitality and potential growth. Simply, a buyer will want to know where your revenue comes from and where it goes.

Your practice will be attractive to a buyer if it shows a stable or growing revenue base, an attractive payer mix, reasonable overhead, and personal income that is steady if not increasing. If your earning capacity is low or declining, you will need to explain why.

Timing is key

We strongly recommend beginning the process 3 to 5 years before your intended exit.

By starting early, up to 5 years in advance, you can maximize the likelihood that your practice will retain all or most of its value. Moreover, you can use the long lead time to thoroughly explore all available options and find a committed buyer.

Selling a practice can be a complicated affair, and many ObGyns do not have the requisite skills. So much of the success in selling depends on the specifics of the practice, the physician, and the market (the hospital and physician environment).

Identifying potential buyers

Other ObGyns. Recruiting an ObGyn to take over your practice seems to be the best option but can prove very difficult in today’s environment. Many younger clinicians are either joining large groups or becoming hospital employees.

Other physician groups. While working your way down your list of potential buyers, you should also be quietly, subtly, and tactfully assessing other practices, even your competitors, to see if any are candidates for merging with and/or acquiring yours and all your charts, records, and referring physicians.

Hospitals. In today’s health care environment, in which more than half of clinicians are becoming hospital employees, selling to your associated hospital may be a viable option.

Your practice is probably contributing millions of dollars in income to that hospital each year, and of course the hospital would like to maintain this revenue stream. You should consider talking to the hospital’s CEO or medical director.

Hospitals also know that, if you leave and the market cannot absorb the resulting increase in demand for care, patients may go elsewhere, to a competing hospital or outside the community. Rather than lose your market share, a hospital may consider the obvious solution: recruit a replacement ObGyn for your practice.

Your goal here is to negotiate an agreement in which your hospital will recruit a replacement ObGyn, provide financial support, and transition your practice to that ObGyn over a specified period.

The hospital could acquire your practice and either employ you during the transition or provide recruiting support and an income guarantee to help your practice pay the new physician’s salary. Whether to sell or remain independent is often driven by the needs and desires of the recruit. As the vast majority of clinicians coming out of training are seeking employment, in most cases the agreement will require a sale.

Selling to a hospital a few years before your retirement can be a plus. You might find employment a welcome respite from the daunting responsibility of managing your own practice. Life can become much less stressful as you introduce and transition your patients to the new ObGyn. You will be working less, taking fewer calls, and maintaining or even increasing your income, all without the burden of managing the practice.

Read about determining your practice’s value

 

 

Putting a monetary value on your practice

After deciding to sell your practice, you need to determine its value. Buying a practice may be the largest financial transaction a young ObGyn will ever make. For a retiring physician, valuation of a practice may reflect a career’s worth of “sweat equity.”

What is your practice worth?

All ObGyns believe their practice is worth far more than any young ObGyn or hospital is willing to pay for it. After all, you have spent a medical lifetime creating, building, and nurturing your practice. You have cared for several thousand patients, who have been loyal and may want to stay with the practice under its new ObGyn. So, how does a retiring physician put a value on his or her practice and then “cast the net” to the marketplace? How do you find a buyer who will pay the asking price and then help the practice make the transition from seller to buyer and continue to serve their patients?

The buyer’s perspective on value. In a pure sense, the value of any asset is what a potential buyer is willing to pay. From a value standpoint, the price that potential buyers are willing to pay varies by the specifics of the situation, regardless of what a valuation or practice appraisal might indicate.

For example, once your plan to retire becomes known, why would a young ObGyn agree to pay X dollars for all your medical records? After all, the potential buyer knows that your existing patients and your referral base will need to seek care from another ObGyn after you leave, and they will likely stay with the practice if they feel they will be treated well by the new clinician.

A hospital may take a similar tack but more often will be willing to pay fair market value for your practice. Hospitals, however, cannot legally pay more than fair market value as determined by an independent appraiser.


Related article:
Four pillars of a successful practice: 1. Keep your current patients happy

Valuation methods

The valuation of any business generally is approached in terms of market, assets, and income.

The market approach usually is taken only with regard to office real estate. Given the lack of reliable and comparable sales information, this approach is seldom used in the valuation of medical practices. If you own your office real estate, a real estate appraiser will establish its fair market value.

In the assets approach, the individual assets of a medical practice are valued on the basis of their current market values. These assets are either tangible or intangible.

Tangible assets can be seen and touched. Furniture, equipment, and office real estate are examples.

The fair market value of used furniture and equipment is most often determined by replacement cost. The value of these items is limited. Usually it starts at 50% of the cost of buying new furniture or equipment of the same utility. From there, the value is lowered on the basis of the age and condition of the items.

Often, the market value of major ObGyn office equipment, such as a DXA (dual-energy x-ray absorptiometry) scanner, is based on similar items for sale or recently sold in the used secondary equipment market.

Tangible assets may include accounts receivable (A/R). A/R represents uncollected payment for work performed. Most buyers want to avoid paying for A/R and assuming the risk of collections. Generally, you should expect to retain your A/R and pay a small or nominal fee to have the buyer handle the collections after you have retired.

Intangible assets are not physical. Examples include the physician’s name, phone number, reputation, referral base, trained staff, and medical records—in other words, what gets patients to keep coming back. Most physicians value these goodwill or “blue-sky” assets highly. Today, unfortunately, most sellers are unable to reap any financial benefit from their intangible assets.

The income approach is based on the premise that the value of any business is in the income it generates for its owner. In simple terms, value in the income approach is a multiple of the cash the business generates after expenses.

Read important keys to transitioning the practice

 

 

Transitioning the practice: Role of the seller and the buyer

First and very important is the contract agreement regarding the overlap period, when both the exiting ObGyn and the new ObGyn are at the practice. We suggest making the overlap a minimum of 6 months and a maximum of 1 year. During this period, the exiting physician can introduce the incoming physician to the patients. A face-to-face introduction can amount to an endorsement, which can ease a patient’s mind and help her decide to take on the new ObGyn and philosophy rather than search elsewhere for obstetric and gynecologic care. The new ObGyn also can use the overlap period to become familiar and comfortable with the staff and learn the process for physician and staff management of case flow, from scheduling and examination to insurance and patient follow-up.

We suggest that the exiting ObGyn send a farewell/welcome letter to patients and referring physicians. The letter should state the exiting ObGyn’s intention to leave (or retire from) the practice and should introduce the ObGyn who will be taking over.

The exiting ObGyn should also take the new ObGyn to meet the physicians who have been providing referrals over the years. We suggest visiting each referring physician’s office to make the introduction. Another good way to introduce a new ObGyn to referring physicians and other professionals—endocrinologists, cardiologists, nurses, pharmaceutical representatives—is to host an open house at your practice. Invite the staff members of the referring physicians as well, since they can be invaluable in making referrals.

We recommend that the exiting ObGyn spend the money to update all the practice’s stationery, brochures, and print materials and ensure they look professional. Note that it is not acceptable to place the new ObGyn’s name under the exiting ObGyn’s name. If the practice has a website, introduce the new physician there and make any necessary updates regarding office hours and accepted insurance plans.

If the exiting ObGyn’s practice lacks a robust Internet and social media presence, the new ObGyn should establish one. We recommend setting up an interactive website that patients can use to make appointments and pay bills. The website should have an email component that can be used to ask questions, raise concerns, and get answers. We also recommend opening Facebook, YouTube, and Twitter accounts for the practice and being active on these social media.

In our experience, smoothly transitioning practices can achieve patient retention rates as high as 90% to 95%. For practices without a plan, however, these rates may be as low as 50%, or worse. Therefore, work out a plan in advance, and include the steps described here, so that on arrival the new ObGyn can hit the ground running.

Acquiring a successful medical practice is doable and offers many advantages, such as autonomy and the ability to make business decisions affecting the practice. Despite all the changes happening in health care, we still think this is the best way to go.


Related article:
Four pillars of a successful practice: 4. Motivate your staff

Bottom line

Selling an ObGyn practice can be a daunting process. However, deciding to sell your practice, performing the valuation, and ensuring a smooth transition are part and parcel of making the transfer a success, equitable for both the buyer and the seller.

 

Share your thoughts! Send your Letter to the Editor to [email protected]. Please include your name and the city and state in which you practice.

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Mr. Bauman is a practice management consultant and CEO of Delta Health Care, Brentwood, Tennessee.

Dr. Baum is a Professor of Clinical Urology at Tulane Medical School, New Orleans, Louisiana, and is the author of The Complete Business Guide for a Successful Medical Practice (Springer, 2016). He is an OBG Management Contributing Editor.

The authors report no financial relationships relevant to this article.

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Mr. Bauman is a practice management consultant and CEO of Delta Health Care, Brentwood, Tennessee.

Dr. Baum is a Professor of Clinical Urology at Tulane Medical School, New Orleans, Louisiana, and is the author of The Complete Business Guide for a Successful Medical Practice (Springer, 2016). He is an OBG Management Contributing Editor.

The authors report no financial relationships relevant to this article.

Author and Disclosure Information

Mr. Bauman is a practice management consultant and CEO of Delta Health Care, Brentwood, Tennessee.

Dr. Baum is a Professor of Clinical Urology at Tulane Medical School, New Orleans, Louisiana, and is the author of The Complete Business Guide for a Successful Medical Practice (Springer, 2016). He is an OBG Management Contributing Editor.

The authors report no financial relationships relevant to this article.

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Your retirement may be a long way off, but the planning pointers presented here can help smooth the transition of your practice when you decide to sell
Your retirement may be a long way off, but the planning pointers presented here can help smooth the transition of your practice when you decide to sell

For ObGyns, 2 intensely stressful career milestones are the day you start your practice and the day you decide to put it up for sale.

One of us, Dr. Baum, started a practice in 1976. At that time, many clinicians seemed to work right up until the day they died—in mid-examination or with scalpel in hand! Today, clinicians seriously contemplate leaving an active practice at age 55, 60, or, more traditionally, 65.

ObGyns in group practice, even those with only 1 or 2 partners, presumably have in place a well-thought-out and properly drafted contract with buyout and phase-down provisions. For members of a group practice, it is imperative to critically review and discuss contractual arrangements periodically and decide if they make sense as much now as they did at the start. ObGyns who continually revisit their contracts probably have an exit strategy that is fairly self-executing and effective and that will provide the seller with a seamless transition to retirement.

A solo ObGyn who is selling a practice has 3 basic options: find a successor physician, sell to a hospital or to a larger group, or close the practice.


Related article:
ObGyns’ choice of practice environment is a big deal

Preparing your practice for sale

Regardless of who will take over your practice, you need to prepare for its transition.

The most important aspect of selling your practice is knowing its finances and ensuring that they are in order. Any serious buyer will ask to examine your books, see how you are running the business, and assess its vitality and potential growth. Simply, a buyer will want to know where your revenue comes from and where it goes.

Your practice will be attractive to a buyer if it shows a stable or growing revenue base, an attractive payer mix, reasonable overhead, and personal income that is steady if not increasing. If your earning capacity is low or declining, you will need to explain why.

Timing is key

We strongly recommend beginning the process 3 to 5 years before your intended exit.

By starting early, up to 5 years in advance, you can maximize the likelihood that your practice will retain all or most of its value. Moreover, you can use the long lead time to thoroughly explore all available options and find a committed buyer.

Selling a practice can be a complicated affair, and many ObGyns do not have the requisite skills. So much of the success in selling depends on the specifics of the practice, the physician, and the market (the hospital and physician environment).

Identifying potential buyers

Other ObGyns. Recruiting an ObGyn to take over your practice seems to be the best option but can prove very difficult in today’s environment. Many younger clinicians are either joining large groups or becoming hospital employees.

Other physician groups. While working your way down your list of potential buyers, you should also be quietly, subtly, and tactfully assessing other practices, even your competitors, to see if any are candidates for merging with and/or acquiring yours and all your charts, records, and referring physicians.

Hospitals. In today’s health care environment, in which more than half of clinicians are becoming hospital employees, selling to your associated hospital may be a viable option.

Your practice is probably contributing millions of dollars in income to that hospital each year, and of course the hospital would like to maintain this revenue stream. You should consider talking to the hospital’s CEO or medical director.

Hospitals also know that, if you leave and the market cannot absorb the resulting increase in demand for care, patients may go elsewhere, to a competing hospital or outside the community. Rather than lose your market share, a hospital may consider the obvious solution: recruit a replacement ObGyn for your practice.

Your goal here is to negotiate an agreement in which your hospital will recruit a replacement ObGyn, provide financial support, and transition your practice to that ObGyn over a specified period.

The hospital could acquire your practice and either employ you during the transition or provide recruiting support and an income guarantee to help your practice pay the new physician’s salary. Whether to sell or remain independent is often driven by the needs and desires of the recruit. As the vast majority of clinicians coming out of training are seeking employment, in most cases the agreement will require a sale.

Selling to a hospital a few years before your retirement can be a plus. You might find employment a welcome respite from the daunting responsibility of managing your own practice. Life can become much less stressful as you introduce and transition your patients to the new ObGyn. You will be working less, taking fewer calls, and maintaining or even increasing your income, all without the burden of managing the practice.

Read about determining your practice’s value

 

 

Putting a monetary value on your practice

After deciding to sell your practice, you need to determine its value. Buying a practice may be the largest financial transaction a young ObGyn will ever make. For a retiring physician, valuation of a practice may reflect a career’s worth of “sweat equity.”

What is your practice worth?

All ObGyns believe their practice is worth far more than any young ObGyn or hospital is willing to pay for it. After all, you have spent a medical lifetime creating, building, and nurturing your practice. You have cared for several thousand patients, who have been loyal and may want to stay with the practice under its new ObGyn. So, how does a retiring physician put a value on his or her practice and then “cast the net” to the marketplace? How do you find a buyer who will pay the asking price and then help the practice make the transition from seller to buyer and continue to serve their patients?

The buyer’s perspective on value. In a pure sense, the value of any asset is what a potential buyer is willing to pay. From a value standpoint, the price that potential buyers are willing to pay varies by the specifics of the situation, regardless of what a valuation or practice appraisal might indicate.

For example, once your plan to retire becomes known, why would a young ObGyn agree to pay X dollars for all your medical records? After all, the potential buyer knows that your existing patients and your referral base will need to seek care from another ObGyn after you leave, and they will likely stay with the practice if they feel they will be treated well by the new clinician.

A hospital may take a similar tack but more often will be willing to pay fair market value for your practice. Hospitals, however, cannot legally pay more than fair market value as determined by an independent appraiser.


Related article:
Four pillars of a successful practice: 1. Keep your current patients happy

Valuation methods

The valuation of any business generally is approached in terms of market, assets, and income.

The market approach usually is taken only with regard to office real estate. Given the lack of reliable and comparable sales information, this approach is seldom used in the valuation of medical practices. If you own your office real estate, a real estate appraiser will establish its fair market value.

In the assets approach, the individual assets of a medical practice are valued on the basis of their current market values. These assets are either tangible or intangible.

Tangible assets can be seen and touched. Furniture, equipment, and office real estate are examples.

The fair market value of used furniture and equipment is most often determined by replacement cost. The value of these items is limited. Usually it starts at 50% of the cost of buying new furniture or equipment of the same utility. From there, the value is lowered on the basis of the age and condition of the items.

Often, the market value of major ObGyn office equipment, such as a DXA (dual-energy x-ray absorptiometry) scanner, is based on similar items for sale or recently sold in the used secondary equipment market.

Tangible assets may include accounts receivable (A/R). A/R represents uncollected payment for work performed. Most buyers want to avoid paying for A/R and assuming the risk of collections. Generally, you should expect to retain your A/R and pay a small or nominal fee to have the buyer handle the collections after you have retired.

Intangible assets are not physical. Examples include the physician’s name, phone number, reputation, referral base, trained staff, and medical records—in other words, what gets patients to keep coming back. Most physicians value these goodwill or “blue-sky” assets highly. Today, unfortunately, most sellers are unable to reap any financial benefit from their intangible assets.

The income approach is based on the premise that the value of any business is in the income it generates for its owner. In simple terms, value in the income approach is a multiple of the cash the business generates after expenses.

Read important keys to transitioning the practice

 

 

Transitioning the practice: Role of the seller and the buyer

First and very important is the contract agreement regarding the overlap period, when both the exiting ObGyn and the new ObGyn are at the practice. We suggest making the overlap a minimum of 6 months and a maximum of 1 year. During this period, the exiting physician can introduce the incoming physician to the patients. A face-to-face introduction can amount to an endorsement, which can ease a patient’s mind and help her decide to take on the new ObGyn and philosophy rather than search elsewhere for obstetric and gynecologic care. The new ObGyn also can use the overlap period to become familiar and comfortable with the staff and learn the process for physician and staff management of case flow, from scheduling and examination to insurance and patient follow-up.

We suggest that the exiting ObGyn send a farewell/welcome letter to patients and referring physicians. The letter should state the exiting ObGyn’s intention to leave (or retire from) the practice and should introduce the ObGyn who will be taking over.

The exiting ObGyn should also take the new ObGyn to meet the physicians who have been providing referrals over the years. We suggest visiting each referring physician’s office to make the introduction. Another good way to introduce a new ObGyn to referring physicians and other professionals—endocrinologists, cardiologists, nurses, pharmaceutical representatives—is to host an open house at your practice. Invite the staff members of the referring physicians as well, since they can be invaluable in making referrals.

We recommend that the exiting ObGyn spend the money to update all the practice’s stationery, brochures, and print materials and ensure they look professional. Note that it is not acceptable to place the new ObGyn’s name under the exiting ObGyn’s name. If the practice has a website, introduce the new physician there and make any necessary updates regarding office hours and accepted insurance plans.

If the exiting ObGyn’s practice lacks a robust Internet and social media presence, the new ObGyn should establish one. We recommend setting up an interactive website that patients can use to make appointments and pay bills. The website should have an email component that can be used to ask questions, raise concerns, and get answers. We also recommend opening Facebook, YouTube, and Twitter accounts for the practice and being active on these social media.

In our experience, smoothly transitioning practices can achieve patient retention rates as high as 90% to 95%. For practices without a plan, however, these rates may be as low as 50%, or worse. Therefore, work out a plan in advance, and include the steps described here, so that on arrival the new ObGyn can hit the ground running.

Acquiring a successful medical practice is doable and offers many advantages, such as autonomy and the ability to make business decisions affecting the practice. Despite all the changes happening in health care, we still think this is the best way to go.


Related article:
Four pillars of a successful practice: 4. Motivate your staff

Bottom line

Selling an ObGyn practice can be a daunting process. However, deciding to sell your practice, performing the valuation, and ensuring a smooth transition are part and parcel of making the transfer a success, equitable for both the buyer and the seller.

 

Share your thoughts! Send your Letter to the Editor to [email protected]. Please include your name and the city and state in which you practice.

For ObGyns, 2 intensely stressful career milestones are the day you start your practice and the day you decide to put it up for sale.

One of us, Dr. Baum, started a practice in 1976. At that time, many clinicians seemed to work right up until the day they died—in mid-examination or with scalpel in hand! Today, clinicians seriously contemplate leaving an active practice at age 55, 60, or, more traditionally, 65.

ObGyns in group practice, even those with only 1 or 2 partners, presumably have in place a well-thought-out and properly drafted contract with buyout and phase-down provisions. For members of a group practice, it is imperative to critically review and discuss contractual arrangements periodically and decide if they make sense as much now as they did at the start. ObGyns who continually revisit their contracts probably have an exit strategy that is fairly self-executing and effective and that will provide the seller with a seamless transition to retirement.

A solo ObGyn who is selling a practice has 3 basic options: find a successor physician, sell to a hospital or to a larger group, or close the practice.


Related article:
ObGyns’ choice of practice environment is a big deal

Preparing your practice for sale

Regardless of who will take over your practice, you need to prepare for its transition.

The most important aspect of selling your practice is knowing its finances and ensuring that they are in order. Any serious buyer will ask to examine your books, see how you are running the business, and assess its vitality and potential growth. Simply, a buyer will want to know where your revenue comes from and where it goes.

Your practice will be attractive to a buyer if it shows a stable or growing revenue base, an attractive payer mix, reasonable overhead, and personal income that is steady if not increasing. If your earning capacity is low or declining, you will need to explain why.

Timing is key

We strongly recommend beginning the process 3 to 5 years before your intended exit.

By starting early, up to 5 years in advance, you can maximize the likelihood that your practice will retain all or most of its value. Moreover, you can use the long lead time to thoroughly explore all available options and find a committed buyer.

Selling a practice can be a complicated affair, and many ObGyns do not have the requisite skills. So much of the success in selling depends on the specifics of the practice, the physician, and the market (the hospital and physician environment).

Identifying potential buyers

Other ObGyns. Recruiting an ObGyn to take over your practice seems to be the best option but can prove very difficult in today’s environment. Many younger clinicians are either joining large groups or becoming hospital employees.

Other physician groups. While working your way down your list of potential buyers, you should also be quietly, subtly, and tactfully assessing other practices, even your competitors, to see if any are candidates for merging with and/or acquiring yours and all your charts, records, and referring physicians.

Hospitals. In today’s health care environment, in which more than half of clinicians are becoming hospital employees, selling to your associated hospital may be a viable option.

Your practice is probably contributing millions of dollars in income to that hospital each year, and of course the hospital would like to maintain this revenue stream. You should consider talking to the hospital’s CEO or medical director.

Hospitals also know that, if you leave and the market cannot absorb the resulting increase in demand for care, patients may go elsewhere, to a competing hospital or outside the community. Rather than lose your market share, a hospital may consider the obvious solution: recruit a replacement ObGyn for your practice.

Your goal here is to negotiate an agreement in which your hospital will recruit a replacement ObGyn, provide financial support, and transition your practice to that ObGyn over a specified period.

The hospital could acquire your practice and either employ you during the transition or provide recruiting support and an income guarantee to help your practice pay the new physician’s salary. Whether to sell or remain independent is often driven by the needs and desires of the recruit. As the vast majority of clinicians coming out of training are seeking employment, in most cases the agreement will require a sale.

Selling to a hospital a few years before your retirement can be a plus. You might find employment a welcome respite from the daunting responsibility of managing your own practice. Life can become much less stressful as you introduce and transition your patients to the new ObGyn. You will be working less, taking fewer calls, and maintaining or even increasing your income, all without the burden of managing the practice.

Read about determining your practice’s value

 

 

Putting a monetary value on your practice

After deciding to sell your practice, you need to determine its value. Buying a practice may be the largest financial transaction a young ObGyn will ever make. For a retiring physician, valuation of a practice may reflect a career’s worth of “sweat equity.”

What is your practice worth?

All ObGyns believe their practice is worth far more than any young ObGyn or hospital is willing to pay for it. After all, you have spent a medical lifetime creating, building, and nurturing your practice. You have cared for several thousand patients, who have been loyal and may want to stay with the practice under its new ObGyn. So, how does a retiring physician put a value on his or her practice and then “cast the net” to the marketplace? How do you find a buyer who will pay the asking price and then help the practice make the transition from seller to buyer and continue to serve their patients?

The buyer’s perspective on value. In a pure sense, the value of any asset is what a potential buyer is willing to pay. From a value standpoint, the price that potential buyers are willing to pay varies by the specifics of the situation, regardless of what a valuation or practice appraisal might indicate.

For example, once your plan to retire becomes known, why would a young ObGyn agree to pay X dollars for all your medical records? After all, the potential buyer knows that your existing patients and your referral base will need to seek care from another ObGyn after you leave, and they will likely stay with the practice if they feel they will be treated well by the new clinician.

A hospital may take a similar tack but more often will be willing to pay fair market value for your practice. Hospitals, however, cannot legally pay more than fair market value as determined by an independent appraiser.


Related article:
Four pillars of a successful practice: 1. Keep your current patients happy

Valuation methods

The valuation of any business generally is approached in terms of market, assets, and income.

The market approach usually is taken only with regard to office real estate. Given the lack of reliable and comparable sales information, this approach is seldom used in the valuation of medical practices. If you own your office real estate, a real estate appraiser will establish its fair market value.

In the assets approach, the individual assets of a medical practice are valued on the basis of their current market values. These assets are either tangible or intangible.

Tangible assets can be seen and touched. Furniture, equipment, and office real estate are examples.

The fair market value of used furniture and equipment is most often determined by replacement cost. The value of these items is limited. Usually it starts at 50% of the cost of buying new furniture or equipment of the same utility. From there, the value is lowered on the basis of the age and condition of the items.

Often, the market value of major ObGyn office equipment, such as a DXA (dual-energy x-ray absorptiometry) scanner, is based on similar items for sale or recently sold in the used secondary equipment market.

Tangible assets may include accounts receivable (A/R). A/R represents uncollected payment for work performed. Most buyers want to avoid paying for A/R and assuming the risk of collections. Generally, you should expect to retain your A/R and pay a small or nominal fee to have the buyer handle the collections after you have retired.

Intangible assets are not physical. Examples include the physician’s name, phone number, reputation, referral base, trained staff, and medical records—in other words, what gets patients to keep coming back. Most physicians value these goodwill or “blue-sky” assets highly. Today, unfortunately, most sellers are unable to reap any financial benefit from their intangible assets.

The income approach is based on the premise that the value of any business is in the income it generates for its owner. In simple terms, value in the income approach is a multiple of the cash the business generates after expenses.

Read important keys to transitioning the practice

 

 

Transitioning the practice: Role of the seller and the buyer

First and very important is the contract agreement regarding the overlap period, when both the exiting ObGyn and the new ObGyn are at the practice. We suggest making the overlap a minimum of 6 months and a maximum of 1 year. During this period, the exiting physician can introduce the incoming physician to the patients. A face-to-face introduction can amount to an endorsement, which can ease a patient’s mind and help her decide to take on the new ObGyn and philosophy rather than search elsewhere for obstetric and gynecologic care. The new ObGyn also can use the overlap period to become familiar and comfortable with the staff and learn the process for physician and staff management of case flow, from scheduling and examination to insurance and patient follow-up.

We suggest that the exiting ObGyn send a farewell/welcome letter to patients and referring physicians. The letter should state the exiting ObGyn’s intention to leave (or retire from) the practice and should introduce the ObGyn who will be taking over.

The exiting ObGyn should also take the new ObGyn to meet the physicians who have been providing referrals over the years. We suggest visiting each referring physician’s office to make the introduction. Another good way to introduce a new ObGyn to referring physicians and other professionals—endocrinologists, cardiologists, nurses, pharmaceutical representatives—is to host an open house at your practice. Invite the staff members of the referring physicians as well, since they can be invaluable in making referrals.

We recommend that the exiting ObGyn spend the money to update all the practice’s stationery, brochures, and print materials and ensure they look professional. Note that it is not acceptable to place the new ObGyn’s name under the exiting ObGyn’s name. If the practice has a website, introduce the new physician there and make any necessary updates regarding office hours and accepted insurance plans.

If the exiting ObGyn’s practice lacks a robust Internet and social media presence, the new ObGyn should establish one. We recommend setting up an interactive website that patients can use to make appointments and pay bills. The website should have an email component that can be used to ask questions, raise concerns, and get answers. We also recommend opening Facebook, YouTube, and Twitter accounts for the practice and being active on these social media.

In our experience, smoothly transitioning practices can achieve patient retention rates as high as 90% to 95%. For practices without a plan, however, these rates may be as low as 50%, or worse. Therefore, work out a plan in advance, and include the steps described here, so that on arrival the new ObGyn can hit the ground running.

Acquiring a successful medical practice is doable and offers many advantages, such as autonomy and the ability to make business decisions affecting the practice. Despite all the changes happening in health care, we still think this is the best way to go.


Related article:
Four pillars of a successful practice: 4. Motivate your staff

Bottom line

Selling an ObGyn practice can be a daunting process. However, deciding to sell your practice, performing the valuation, and ensuring a smooth transition are part and parcel of making the transfer a success, equitable for both the buyer and the seller.

 

Share your thoughts! Send your Letter to the Editor to [email protected]. Please include your name and the city and state in which you practice.

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Your patients are talking: Isn’t it time you take responsibility for your online reputation?

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Your patients are talking: Isn’t it time you take responsibility for your online reputation?
Most physician reviews are positive, but negative criticism may be posted by a disgruntled patient. Here, why and how you should manage your online reputation.

In a web-focused world, it should not take much convincing that monitoring your online reputation is time well spent. For some of us, it may be hard to believe that online reviews have evolved beyond restaurants and plumbers, but today your patients are flocking to the Internet to read and leave reviews about you, your staff, and your services. What can you do to protect your online reputation?

We first addressed this topic in December 2014 (“Using the Internet in your practice. Part 4: Reputation management—how to gather kudos and combat negative online reviews1). Have you implemented any of the tactics we offered then? We hope that you do take proactive steps to protect your online image.

What is a physician’s most precious asset?

You might answer this question with, “my patients” or “the training and education that I have obtained to practice my craft.” But the real answer is that your most precious asset is your reputation.

Physicians live and die by their reputations. We spend our entire medical careers polishing and protecting this status. The Internet dramatically has altered the way people gather information. It is sad but true that a single comment that only takes a few seconds and a single mouse-click to post can be seen by thousands and ruin that life-long effort.

How are physicians rated on the web?

Online physician reviews are positive 70% to 90% of the time.2 Most physicians have 5 or fewer reviews on any one site.3 Of the approximately 30 sites that monitor physicians and hospitals online, one of the most popular is AngiesList.com. This site requires registration and a fee; a member can review a physician every 6 months. On free websites such as Yelp.com and doctorsscorecard.com the reviewer can comment once. Other sites such as vitals.com or DrScore.com limit the reviews from 1 source, which prevents an angry patient from stuffing the ballot box.2

Pay attention

At a minimum, physicians should be monitoring their reputation by conducting periodic searches—“Googling” their name and practice name—to identify what information is already online. You may find that 3, 4, or even 10 reviews appear on various sites. If you are lucky, these reviews will be positive. Don’t be surprised, however, if 1 or 2 are not. Let’s face it: even the most accredited and experienced physician cannot possibly satisfy every patient who walks through the door.

How do you manage your online reputation?
Neil Baum, MD, and Ron Romano have offered tips on ways to manage online reputations in the past,1 and they urge Ob-Gyns to take an active role in this process in order to increase positive exposure to patients and maintain an active practice. Is active reputation management something that ObGyns are spending their valuable time on? To find out, OBG Management reached out to its Virtual Editorial Board. We found that many readers are paying attention to patient satisfaction. Some are soliciting online reviews and maintaining active upkeep on their online reputation. Here are a few responses we received from practicing ObGyns across the United States.

William E. McGrath Jr, MD, of Fernandina Beach, Florida, says that his office provides patients with a list of 5 popular review websites during their visits, and that approximately 1 in 10 will follow up with a review. Patient reviews are also prominently posted on his practice’s website. The large, private, single-specialty group to which his practice belongs requires patient satisfaction surveys for quality assurance review and insurance contract negotiations. “It is all about physician-patient communication,” he says.

Keith S. Merlin, MD, of Brockton, Massachusetts, says that he has checked online reviews to ensure their accuracy. His practice uses surveys, a suggestion box, and a mystery shopper to measure patient satisfaction, a worthwhile effort he says to understand where the practice is doing well and what needs to be done better.

Wesley Hambright, MD, of Jacksonville, North Carolina, reports that he has established a Google Alert to monitor for new content relating to his practice.

Patrick Pevoto, MD, MBA, of Austin, Texas, informs us that he has just started to think about ways to manage his online reputation. He has created a website and is writing a monthly blog, which he posts on his site. He acknowledges the importance of assessing patient satisfaction in his practice but is not applying large-scale measurement techniques yet. To keep his patients happy, he handles concerns that arise on a personal, case-by-case basis.

John Armstrong, MD, MS, of Napa, California, also reports that management of his online reputation is in the beginning stages. He uses focus groups and feels that listening to his patients when they do comment on their experience is important to his overall practice. Listening helps to “identify areas to improve and reaffirms when we are doing well,” he says. To keep his patients happy, he strives to “give extraordinary care and simply be nice to people.” When issues arise, making it right and being polite are important elements, he asserts.

Delos J. Clow, DO, MS, of Chillicothe, Missouri, does measure patient satisfaction, and feels this is very important to his practice in order to identify and correct any negative trends. He does not actively monitor his practice reputation online.

Robert del Rosario, MD, of Camp Hill, Pennsylvania, similarly does not actively manage an online reputation, but does focus on patient satisfaction. To enhance satisfaction, he tries to de-emphasize the electronic medical record to “make visits more personal and less interrogative.” Additionally, his practice objectively gauges aspects of care that might be able to be improved upon.

Reference
  1. Romano R, Baum NH. Using the Internet in your practice. Part 4: Reputation management—how to gather kudos and combat negative online reviews. OBG Manag. 2014;26(12):23,24,26,28.

Tell your own story

As physicians, you may not have control over what others say about you, but you can take ownership of your online presence by establishing a website, blog, and social media platforms, ensuring your story is being properly communicated. Without an online presence, you are entirely at the mercy of directory and review sites.

Optimize your website

A site that successfully uses search engine optimization (SEO) will have the upper hand when patients hunt for a physician in your area because the information will be posted at the top of the search page, well above the reviews and listings left by patients and other third-party sources. This is a critical step for your online brand because it will be difficult for other sites to mask your credibility. This should motivate you to develop an online presence, regularly update information, and participate in Internet dialog with other sites.

Generate quality, natural reviews

If your site is in good standing in search results, the next step is to implement a patient reviews strategy to start acquiring positive online reviews. A third-party provider can work with you to launch a local search engine optimization strategy and a natural reviews management program tailored for your practice’s needs. For the most part, however, we do not recommend using an online reputation management company. It is far better and more economical to ask satisfied patients to provide reviews.

At first, you may be tempted to actively petition or solicit reviews through survey software, but this method is manipulative and can lead to reputation problems for your practice. Google actively tracks where reviews originate and uses advanced algorithms to determine the review’s integrity. A petitioned review is classified as less valid, and therefore Google will assume it was not written under the same pretense as a natural, unsolicited review.

Quality customer service and outstanding patient care are often what achieve the organic reviews you are striving for. To encourage a steady flow, administer a process that encourages your most satisfied, loyal patients to review your practice.

Keep the process simple. Capture positive compliments at the point of service. Before a patient leaves your office, hand her a card (FIGURE) with easy steps for posting an online review, or offer her a tablet that links directly to your website review section. If your patient is not computer savvy, ask her to complete a 4- to 5-question survey and give her a clipboard and a pen. Then have a staff member post it on your website.

Before a patient leaves your office, hand her a card that offers easy steps for posting an online review.

In Dr. Baum’s practice, there is a poster in every exam room and in the reception area where patients can scan the quick response (QR) code and immediately submit a testimonial. Using this system, the practice is able to collect 3 to 5 positive reviews every day.

A patient pleased with your staff’s service will happily take 5 minutes to submit a review. Acquire 5 to 10 reviews monthly and within a year’s time you will have generated enough positive reviews to negate any damaging comments that inevitably will emerge from time to time.

Should you respond to a negative online review?
CASE  Patient criticizes physician in a review forum

A physician with a robust Internet presence will have his or her name and the practice appear at the top of search engine results pages (as is the case with Dr. Neil Baum when “urologist” plus “New Orleans” is typed into the Google search engine window). By far most of Dr. Baum’s reviews are positive. In one instance, however, a patient on a physician review website referred to Dr. Baum as “technologically advanced but more motivated to increase his income by performing too many diagnostic tests.”

If you find a negative comment in an online directory or review website, what should you do?


The Office for Civil Rights (OCR) within the US Department of Health and Human Services (HHS) is responsible for handling Health Insurance Portability and Accountability Act of 1996 (HIPAA)1 complaints. Deven McGraw, OCR’s deputy director of health information privacy, states that “just because patients have rated their health provider publicly doesn’t give their health provider permission to rate them in return.”2,3 In fact, some health care providers who responded to poor online reviews ran into trouble with privacy rules established by HIPAA.2,3

Mr. McGraw notes that, when responding to online reviews, health professionals should speak generally about the way they treat patients while complying with HIPAA regulations. He suggests, “If the complaint is about poor patient care … say, ‘I provide all of my patients with good patient care’ and ‘I’ve been reviewed in other contexts and have good reviews.’”2,3

According to Yelp’s senior director of litigation, Aaron Schur, most patient complaints center on practice-based concerns such as wait times, office staff, and billing, not about the medical service delivered. Although most physicians do not respond, says Mr. Schur, those who do, tend to ask patients to discuss the matter in private or to apologize.2,3

What are the consequences of a HIPAA violation?

OCR Director Jocelyn Samuels says that the office’s primary role is to help health providers follow HIPAA regulations.2,5 The OCR can resolve HIPPA violations privately and informally, impose fines of up to $50,000 per violation, or it can file criminal charges against violators.2,4

The majority of the office’s investigation and enforcement of HIPAA has been against large medical data breaches.2,5 Small privacy breaches by large health care providers (eg, CVS, Walmart, Lab Corp, Quest Diagnostics, and others) generally do not result in legal consequences; the providers are privately warned. According to ProPublica, even repeated HIPAA violations tend not to be fined.2,4

Small-scale infractions can be more damaging on a personal level to both patients and physicians. However, the OCR does not typically become involved in privacy breaches that include only a few individuals. Health care providers are rarely punished for small HIPPA breaches; instead, the OCR typically settles for pledges to fix any problems and issues reminders of HIPPA requirements.2,5

Although the OCR is often the only place patients can go to seek vindication, HIPAA does not support the right to sue for violation of personal privacy. People who seek a legal remedy must find another means, which is easier in some states than in others.2,5

Health care providers have tried myriad ways to attempt to combat negative reviews. Some have sued patients, attracting a flood of attention but achieving little legal success. Others have asked patients to remove their complaints.2,3

Best practices
Create and circulate a policy. Medical privacy breaches involving sensitive health details can occur when office or hospital staff share patient information due to personal hostility or lack of understanding of HIPPA policy.2,5 Have a practice policy for responding to online reviews by patients, and make sure the staff members who have access to the practice’s online accounts understand your policy and the possible repercussions of not following it. Teach and continue to remind your staff about HIPPA regulations and hold them to a high ethical level of privacy.

Solicit reviews on an ongoing basis. Jeffrey Segal, a review site critic, says that all reviews are valuable. Physicians should respond carefully to negative comments and encourage satisfied patients to post positive reviews. “’For doctors who get bent out of shape to get rid of negative reviews, it’s a denominator problem,’ he said. ‘If they only have three reviews and two are negative, the denominator is the problem. … If you can figure out a way to cultivate reviews from hundreds of patients rather than a few patients, the problem is solved.’”2,3

CASE  Resolved
Dr. Baum never responded directly to the negative patient review, and others he has received. He balances the rare negative response with numerous and plentiful positive responses by making it a practice to encourage reviews from all of his patients.


References

  1. HIPAA for Professionals. US Department of Health & Human Services. http://www.hhs.gov/hipaa/for-professionals/index.html. Accessed October 11, 2016.
  2. Hall SD. Providers responding to Yelp reviews must be mindful of HIPAA. FierceHealthcare. http://www.fiercehealthcare.com/it/providers-responding-to-yelp-reviews-must-be-mindful-hipaa. Published May 31, 2016. Accessed October 7, 2016.
  3. Ornstein C. Stung by Yelp reviews, health providers spill patient secrets. ProPublica. https://www.propublica.org/article/stung-by-yelp-reviews-health -providers-spill-patient-secrets. Published May 27, 2016. Accessed October 11, 2016.
  4. Ornstein C, Waldman A. Few consequences for health privacy law’s repeat offenders. ProPublica. https://www.propublica.org/article/few-consequences-for-health-privacy-law-repeat-offenders. Published December 29, 2015. Accessed October 11, 2016.
  5. Ornstein C. Small-scale violations of medical privacy often cause the most harm. ProPublica. https://www.propublica.org/article/small-scale-violations-of-medical-privacy-often-cause-the-most-harm. Published December 10, 2015. Accessed October 11, 2016.

The bottom line

Patients are seeking and leaving reviews about you and your practice online and you need to actively manage your online reputation. Do not let one disgruntled patient ruin your reputation. Our advice: Do not wait for a negative review to begin your reputation management. Take an active role and generate positive reviews to drown out negative remarks made by an occasional patient. This is an inexpensive process that does work.

 

Share your thoughts! Send your Letter to the Editor to [email protected]. Please include your name and the city and state in which you practice.

References
  1. Romano R, Baum NH. Using the Internet in your practice. Part 4: Reputation management-how to gather kudos and combat negative online reviews. OBG Manag. 2014;26(12):23,24,26,28.
  2. Lagu T, Hannon NS, Rothberg MB, Lindenauer PK. Patients' evaluations of health care providers in the era of social networking: an analysis of physician rating websites. J Gen Intern Med. 2010;25(9):942-946.
  3. Gunter J. For better or maybe, worse, patients are judging your care online. OBG Manag. 2011;23(3):47-51.
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Author and Disclosure Information

Mr. Romano is President of www.YourInternetDoctor.com and CEO of Instant Marketing Systems. He co-authored The Internet Survival Guide for Doctors (2014, Instant Marketing Systems) and No B.S. Direct Marketing (2006, Entrepreneur Press) and contributed to the Walking with the Wise series (2004, Mentors Publishing). He is an Internet marketing consultant, speaker, and creator of “The Implementation Blueprint System.”

Dr. Baum practices urology in New Orleans, Louisiana, and is Professor of Clinical Urology, at Tulane Medical School in New Orleans. He is an OBG Management Contributing Editor.

The authors report no financial relationships relevant to this article.

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Author and Disclosure Information

Mr. Romano is President of www.YourInternetDoctor.com and CEO of Instant Marketing Systems. He co-authored The Internet Survival Guide for Doctors (2014, Instant Marketing Systems) and No B.S. Direct Marketing (2006, Entrepreneur Press) and contributed to the Walking with the Wise series (2004, Mentors Publishing). He is an Internet marketing consultant, speaker, and creator of “The Implementation Blueprint System.”

Dr. Baum practices urology in New Orleans, Louisiana, and is Professor of Clinical Urology, at Tulane Medical School in New Orleans. He is an OBG Management Contributing Editor.

The authors report no financial relationships relevant to this article.

Author and Disclosure Information

Mr. Romano is President of www.YourInternetDoctor.com and CEO of Instant Marketing Systems. He co-authored The Internet Survival Guide for Doctors (2014, Instant Marketing Systems) and No B.S. Direct Marketing (2006, Entrepreneur Press) and contributed to the Walking with the Wise series (2004, Mentors Publishing). He is an Internet marketing consultant, speaker, and creator of “The Implementation Blueprint System.”

Dr. Baum practices urology in New Orleans, Louisiana, and is Professor of Clinical Urology, at Tulane Medical School in New Orleans. He is an OBG Management Contributing Editor.

The authors report no financial relationships relevant to this article.

Article PDF
Article PDF
Most physician reviews are positive, but negative criticism may be posted by a disgruntled patient. Here, why and how you should manage your online reputation.
Most physician reviews are positive, but negative criticism may be posted by a disgruntled patient. Here, why and how you should manage your online reputation.

In a web-focused world, it should not take much convincing that monitoring your online reputation is time well spent. For some of us, it may be hard to believe that online reviews have evolved beyond restaurants and plumbers, but today your patients are flocking to the Internet to read and leave reviews about you, your staff, and your services. What can you do to protect your online reputation?

We first addressed this topic in December 2014 (“Using the Internet in your practice. Part 4: Reputation management—how to gather kudos and combat negative online reviews1). Have you implemented any of the tactics we offered then? We hope that you do take proactive steps to protect your online image.

What is a physician’s most precious asset?

You might answer this question with, “my patients” or “the training and education that I have obtained to practice my craft.” But the real answer is that your most precious asset is your reputation.

Physicians live and die by their reputations. We spend our entire medical careers polishing and protecting this status. The Internet dramatically has altered the way people gather information. It is sad but true that a single comment that only takes a few seconds and a single mouse-click to post can be seen by thousands and ruin that life-long effort.

How are physicians rated on the web?

Online physician reviews are positive 70% to 90% of the time.2 Most physicians have 5 or fewer reviews on any one site.3 Of the approximately 30 sites that monitor physicians and hospitals online, one of the most popular is AngiesList.com. This site requires registration and a fee; a member can review a physician every 6 months. On free websites such as Yelp.com and doctorsscorecard.com the reviewer can comment once. Other sites such as vitals.com or DrScore.com limit the reviews from 1 source, which prevents an angry patient from stuffing the ballot box.2

Pay attention

At a minimum, physicians should be monitoring their reputation by conducting periodic searches—“Googling” their name and practice name—to identify what information is already online. You may find that 3, 4, or even 10 reviews appear on various sites. If you are lucky, these reviews will be positive. Don’t be surprised, however, if 1 or 2 are not. Let’s face it: even the most accredited and experienced physician cannot possibly satisfy every patient who walks through the door.

How do you manage your online reputation?
Neil Baum, MD, and Ron Romano have offered tips on ways to manage online reputations in the past,1 and they urge Ob-Gyns to take an active role in this process in order to increase positive exposure to patients and maintain an active practice. Is active reputation management something that ObGyns are spending their valuable time on? To find out, OBG Management reached out to its Virtual Editorial Board. We found that many readers are paying attention to patient satisfaction. Some are soliciting online reviews and maintaining active upkeep on their online reputation. Here are a few responses we received from practicing ObGyns across the United States.

William E. McGrath Jr, MD, of Fernandina Beach, Florida, says that his office provides patients with a list of 5 popular review websites during their visits, and that approximately 1 in 10 will follow up with a review. Patient reviews are also prominently posted on his practice’s website. The large, private, single-specialty group to which his practice belongs requires patient satisfaction surveys for quality assurance review and insurance contract negotiations. “It is all about physician-patient communication,” he says.

Keith S. Merlin, MD, of Brockton, Massachusetts, says that he has checked online reviews to ensure their accuracy. His practice uses surveys, a suggestion box, and a mystery shopper to measure patient satisfaction, a worthwhile effort he says to understand where the practice is doing well and what needs to be done better.

Wesley Hambright, MD, of Jacksonville, North Carolina, reports that he has established a Google Alert to monitor for new content relating to his practice.

Patrick Pevoto, MD, MBA, of Austin, Texas, informs us that he has just started to think about ways to manage his online reputation. He has created a website and is writing a monthly blog, which he posts on his site. He acknowledges the importance of assessing patient satisfaction in his practice but is not applying large-scale measurement techniques yet. To keep his patients happy, he handles concerns that arise on a personal, case-by-case basis.

John Armstrong, MD, MS, of Napa, California, also reports that management of his online reputation is in the beginning stages. He uses focus groups and feels that listening to his patients when they do comment on their experience is important to his overall practice. Listening helps to “identify areas to improve and reaffirms when we are doing well,” he says. To keep his patients happy, he strives to “give extraordinary care and simply be nice to people.” When issues arise, making it right and being polite are important elements, he asserts.

Delos J. Clow, DO, MS, of Chillicothe, Missouri, does measure patient satisfaction, and feels this is very important to his practice in order to identify and correct any negative trends. He does not actively monitor his practice reputation online.

Robert del Rosario, MD, of Camp Hill, Pennsylvania, similarly does not actively manage an online reputation, but does focus on patient satisfaction. To enhance satisfaction, he tries to de-emphasize the electronic medical record to “make visits more personal and less interrogative.” Additionally, his practice objectively gauges aspects of care that might be able to be improved upon.

Reference
  1. Romano R, Baum NH. Using the Internet in your practice. Part 4: Reputation management—how to gather kudos and combat negative online reviews. OBG Manag. 2014;26(12):23,24,26,28.

Tell your own story

As physicians, you may not have control over what others say about you, but you can take ownership of your online presence by establishing a website, blog, and social media platforms, ensuring your story is being properly communicated. Without an online presence, you are entirely at the mercy of directory and review sites.

Optimize your website

A site that successfully uses search engine optimization (SEO) will have the upper hand when patients hunt for a physician in your area because the information will be posted at the top of the search page, well above the reviews and listings left by patients and other third-party sources. This is a critical step for your online brand because it will be difficult for other sites to mask your credibility. This should motivate you to develop an online presence, regularly update information, and participate in Internet dialog with other sites.

Generate quality, natural reviews

If your site is in good standing in search results, the next step is to implement a patient reviews strategy to start acquiring positive online reviews. A third-party provider can work with you to launch a local search engine optimization strategy and a natural reviews management program tailored for your practice’s needs. For the most part, however, we do not recommend using an online reputation management company. It is far better and more economical to ask satisfied patients to provide reviews.

At first, you may be tempted to actively petition or solicit reviews through survey software, but this method is manipulative and can lead to reputation problems for your practice. Google actively tracks where reviews originate and uses advanced algorithms to determine the review’s integrity. A petitioned review is classified as less valid, and therefore Google will assume it was not written under the same pretense as a natural, unsolicited review.

Quality customer service and outstanding patient care are often what achieve the organic reviews you are striving for. To encourage a steady flow, administer a process that encourages your most satisfied, loyal patients to review your practice.

Keep the process simple. Capture positive compliments at the point of service. Before a patient leaves your office, hand her a card (FIGURE) with easy steps for posting an online review, or offer her a tablet that links directly to your website review section. If your patient is not computer savvy, ask her to complete a 4- to 5-question survey and give her a clipboard and a pen. Then have a staff member post it on your website.

Before a patient leaves your office, hand her a card that offers easy steps for posting an online review.

In Dr. Baum’s practice, there is a poster in every exam room and in the reception area where patients can scan the quick response (QR) code and immediately submit a testimonial. Using this system, the practice is able to collect 3 to 5 positive reviews every day.

A patient pleased with your staff’s service will happily take 5 minutes to submit a review. Acquire 5 to 10 reviews monthly and within a year’s time you will have generated enough positive reviews to negate any damaging comments that inevitably will emerge from time to time.

Should you respond to a negative online review?
CASE  Patient criticizes physician in a review forum

A physician with a robust Internet presence will have his or her name and the practice appear at the top of search engine results pages (as is the case with Dr. Neil Baum when “urologist” plus “New Orleans” is typed into the Google search engine window). By far most of Dr. Baum’s reviews are positive. In one instance, however, a patient on a physician review website referred to Dr. Baum as “technologically advanced but more motivated to increase his income by performing too many diagnostic tests.”

If you find a negative comment in an online directory or review website, what should you do?


The Office for Civil Rights (OCR) within the US Department of Health and Human Services (HHS) is responsible for handling Health Insurance Portability and Accountability Act of 1996 (HIPAA)1 complaints. Deven McGraw, OCR’s deputy director of health information privacy, states that “just because patients have rated their health provider publicly doesn’t give their health provider permission to rate them in return.”2,3 In fact, some health care providers who responded to poor online reviews ran into trouble with privacy rules established by HIPAA.2,3

Mr. McGraw notes that, when responding to online reviews, health professionals should speak generally about the way they treat patients while complying with HIPAA regulations. He suggests, “If the complaint is about poor patient care … say, ‘I provide all of my patients with good patient care’ and ‘I’ve been reviewed in other contexts and have good reviews.’”2,3

According to Yelp’s senior director of litigation, Aaron Schur, most patient complaints center on practice-based concerns such as wait times, office staff, and billing, not about the medical service delivered. Although most physicians do not respond, says Mr. Schur, those who do, tend to ask patients to discuss the matter in private or to apologize.2,3

What are the consequences of a HIPAA violation?

OCR Director Jocelyn Samuels says that the office’s primary role is to help health providers follow HIPAA regulations.2,5 The OCR can resolve HIPPA violations privately and informally, impose fines of up to $50,000 per violation, or it can file criminal charges against violators.2,4

The majority of the office’s investigation and enforcement of HIPAA has been against large medical data breaches.2,5 Small privacy breaches by large health care providers (eg, CVS, Walmart, Lab Corp, Quest Diagnostics, and others) generally do not result in legal consequences; the providers are privately warned. According to ProPublica, even repeated HIPAA violations tend not to be fined.2,4

Small-scale infractions can be more damaging on a personal level to both patients and physicians. However, the OCR does not typically become involved in privacy breaches that include only a few individuals. Health care providers are rarely punished for small HIPPA breaches; instead, the OCR typically settles for pledges to fix any problems and issues reminders of HIPPA requirements.2,5

Although the OCR is often the only place patients can go to seek vindication, HIPAA does not support the right to sue for violation of personal privacy. People who seek a legal remedy must find another means, which is easier in some states than in others.2,5

Health care providers have tried myriad ways to attempt to combat negative reviews. Some have sued patients, attracting a flood of attention but achieving little legal success. Others have asked patients to remove their complaints.2,3

Best practices
Create and circulate a policy. Medical privacy breaches involving sensitive health details can occur when office or hospital staff share patient information due to personal hostility or lack of understanding of HIPPA policy.2,5 Have a practice policy for responding to online reviews by patients, and make sure the staff members who have access to the practice’s online accounts understand your policy and the possible repercussions of not following it. Teach and continue to remind your staff about HIPPA regulations and hold them to a high ethical level of privacy.

Solicit reviews on an ongoing basis. Jeffrey Segal, a review site critic, says that all reviews are valuable. Physicians should respond carefully to negative comments and encourage satisfied patients to post positive reviews. “’For doctors who get bent out of shape to get rid of negative reviews, it’s a denominator problem,’ he said. ‘If they only have three reviews and two are negative, the denominator is the problem. … If you can figure out a way to cultivate reviews from hundreds of patients rather than a few patients, the problem is solved.’”2,3

CASE  Resolved
Dr. Baum never responded directly to the negative patient review, and others he has received. He balances the rare negative response with numerous and plentiful positive responses by making it a practice to encourage reviews from all of his patients.


References

  1. HIPAA for Professionals. US Department of Health & Human Services. http://www.hhs.gov/hipaa/for-professionals/index.html. Accessed October 11, 2016.
  2. Hall SD. Providers responding to Yelp reviews must be mindful of HIPAA. FierceHealthcare. http://www.fiercehealthcare.com/it/providers-responding-to-yelp-reviews-must-be-mindful-hipaa. Published May 31, 2016. Accessed October 7, 2016.
  3. Ornstein C. Stung by Yelp reviews, health providers spill patient secrets. ProPublica. https://www.propublica.org/article/stung-by-yelp-reviews-health -providers-spill-patient-secrets. Published May 27, 2016. Accessed October 11, 2016.
  4. Ornstein C, Waldman A. Few consequences for health privacy law’s repeat offenders. ProPublica. https://www.propublica.org/article/few-consequences-for-health-privacy-law-repeat-offenders. Published December 29, 2015. Accessed October 11, 2016.
  5. Ornstein C. Small-scale violations of medical privacy often cause the most harm. ProPublica. https://www.propublica.org/article/small-scale-violations-of-medical-privacy-often-cause-the-most-harm. Published December 10, 2015. Accessed October 11, 2016.

The bottom line

Patients are seeking and leaving reviews about you and your practice online and you need to actively manage your online reputation. Do not let one disgruntled patient ruin your reputation. Our advice: Do not wait for a negative review to begin your reputation management. Take an active role and generate positive reviews to drown out negative remarks made by an occasional patient. This is an inexpensive process that does work.

 

Share your thoughts! Send your Letter to the Editor to [email protected]. Please include your name and the city and state in which you practice.

In a web-focused world, it should not take much convincing that monitoring your online reputation is time well spent. For some of us, it may be hard to believe that online reviews have evolved beyond restaurants and plumbers, but today your patients are flocking to the Internet to read and leave reviews about you, your staff, and your services. What can you do to protect your online reputation?

We first addressed this topic in December 2014 (“Using the Internet in your practice. Part 4: Reputation management—how to gather kudos and combat negative online reviews1). Have you implemented any of the tactics we offered then? We hope that you do take proactive steps to protect your online image.

What is a physician’s most precious asset?

You might answer this question with, “my patients” or “the training and education that I have obtained to practice my craft.” But the real answer is that your most precious asset is your reputation.

Physicians live and die by their reputations. We spend our entire medical careers polishing and protecting this status. The Internet dramatically has altered the way people gather information. It is sad but true that a single comment that only takes a few seconds and a single mouse-click to post can be seen by thousands and ruin that life-long effort.

How are physicians rated on the web?

Online physician reviews are positive 70% to 90% of the time.2 Most physicians have 5 or fewer reviews on any one site.3 Of the approximately 30 sites that monitor physicians and hospitals online, one of the most popular is AngiesList.com. This site requires registration and a fee; a member can review a physician every 6 months. On free websites such as Yelp.com and doctorsscorecard.com the reviewer can comment once. Other sites such as vitals.com or DrScore.com limit the reviews from 1 source, which prevents an angry patient from stuffing the ballot box.2

Pay attention

At a minimum, physicians should be monitoring their reputation by conducting periodic searches—“Googling” their name and practice name—to identify what information is already online. You may find that 3, 4, or even 10 reviews appear on various sites. If you are lucky, these reviews will be positive. Don’t be surprised, however, if 1 or 2 are not. Let’s face it: even the most accredited and experienced physician cannot possibly satisfy every patient who walks through the door.

How do you manage your online reputation?
Neil Baum, MD, and Ron Romano have offered tips on ways to manage online reputations in the past,1 and they urge Ob-Gyns to take an active role in this process in order to increase positive exposure to patients and maintain an active practice. Is active reputation management something that ObGyns are spending their valuable time on? To find out, OBG Management reached out to its Virtual Editorial Board. We found that many readers are paying attention to patient satisfaction. Some are soliciting online reviews and maintaining active upkeep on their online reputation. Here are a few responses we received from practicing ObGyns across the United States.

William E. McGrath Jr, MD, of Fernandina Beach, Florida, says that his office provides patients with a list of 5 popular review websites during their visits, and that approximately 1 in 10 will follow up with a review. Patient reviews are also prominently posted on his practice’s website. The large, private, single-specialty group to which his practice belongs requires patient satisfaction surveys for quality assurance review and insurance contract negotiations. “It is all about physician-patient communication,” he says.

Keith S. Merlin, MD, of Brockton, Massachusetts, says that he has checked online reviews to ensure their accuracy. His practice uses surveys, a suggestion box, and a mystery shopper to measure patient satisfaction, a worthwhile effort he says to understand where the practice is doing well and what needs to be done better.

Wesley Hambright, MD, of Jacksonville, North Carolina, reports that he has established a Google Alert to monitor for new content relating to his practice.

Patrick Pevoto, MD, MBA, of Austin, Texas, informs us that he has just started to think about ways to manage his online reputation. He has created a website and is writing a monthly blog, which he posts on his site. He acknowledges the importance of assessing patient satisfaction in his practice but is not applying large-scale measurement techniques yet. To keep his patients happy, he handles concerns that arise on a personal, case-by-case basis.

John Armstrong, MD, MS, of Napa, California, also reports that management of his online reputation is in the beginning stages. He uses focus groups and feels that listening to his patients when they do comment on their experience is important to his overall practice. Listening helps to “identify areas to improve and reaffirms when we are doing well,” he says. To keep his patients happy, he strives to “give extraordinary care and simply be nice to people.” When issues arise, making it right and being polite are important elements, he asserts.

Delos J. Clow, DO, MS, of Chillicothe, Missouri, does measure patient satisfaction, and feels this is very important to his practice in order to identify and correct any negative trends. He does not actively monitor his practice reputation online.

Robert del Rosario, MD, of Camp Hill, Pennsylvania, similarly does not actively manage an online reputation, but does focus on patient satisfaction. To enhance satisfaction, he tries to de-emphasize the electronic medical record to “make visits more personal and less interrogative.” Additionally, his practice objectively gauges aspects of care that might be able to be improved upon.

Reference
  1. Romano R, Baum NH. Using the Internet in your practice. Part 4: Reputation management—how to gather kudos and combat negative online reviews. OBG Manag. 2014;26(12):23,24,26,28.

Tell your own story

As physicians, you may not have control over what others say about you, but you can take ownership of your online presence by establishing a website, blog, and social media platforms, ensuring your story is being properly communicated. Without an online presence, you are entirely at the mercy of directory and review sites.

Optimize your website

A site that successfully uses search engine optimization (SEO) will have the upper hand when patients hunt for a physician in your area because the information will be posted at the top of the search page, well above the reviews and listings left by patients and other third-party sources. This is a critical step for your online brand because it will be difficult for other sites to mask your credibility. This should motivate you to develop an online presence, regularly update information, and participate in Internet dialog with other sites.

Generate quality, natural reviews

If your site is in good standing in search results, the next step is to implement a patient reviews strategy to start acquiring positive online reviews. A third-party provider can work with you to launch a local search engine optimization strategy and a natural reviews management program tailored for your practice’s needs. For the most part, however, we do not recommend using an online reputation management company. It is far better and more economical to ask satisfied patients to provide reviews.

At first, you may be tempted to actively petition or solicit reviews through survey software, but this method is manipulative and can lead to reputation problems for your practice. Google actively tracks where reviews originate and uses advanced algorithms to determine the review’s integrity. A petitioned review is classified as less valid, and therefore Google will assume it was not written under the same pretense as a natural, unsolicited review.

Quality customer service and outstanding patient care are often what achieve the organic reviews you are striving for. To encourage a steady flow, administer a process that encourages your most satisfied, loyal patients to review your practice.

Keep the process simple. Capture positive compliments at the point of service. Before a patient leaves your office, hand her a card (FIGURE) with easy steps for posting an online review, or offer her a tablet that links directly to your website review section. If your patient is not computer savvy, ask her to complete a 4- to 5-question survey and give her a clipboard and a pen. Then have a staff member post it on your website.

Before a patient leaves your office, hand her a card that offers easy steps for posting an online review.

In Dr. Baum’s practice, there is a poster in every exam room and in the reception area where patients can scan the quick response (QR) code and immediately submit a testimonial. Using this system, the practice is able to collect 3 to 5 positive reviews every day.

A patient pleased with your staff’s service will happily take 5 minutes to submit a review. Acquire 5 to 10 reviews monthly and within a year’s time you will have generated enough positive reviews to negate any damaging comments that inevitably will emerge from time to time.

Should you respond to a negative online review?
CASE  Patient criticizes physician in a review forum

A physician with a robust Internet presence will have his or her name and the practice appear at the top of search engine results pages (as is the case with Dr. Neil Baum when “urologist” plus “New Orleans” is typed into the Google search engine window). By far most of Dr. Baum’s reviews are positive. In one instance, however, a patient on a physician review website referred to Dr. Baum as “technologically advanced but more motivated to increase his income by performing too many diagnostic tests.”

If you find a negative comment in an online directory or review website, what should you do?


The Office for Civil Rights (OCR) within the US Department of Health and Human Services (HHS) is responsible for handling Health Insurance Portability and Accountability Act of 1996 (HIPAA)1 complaints. Deven McGraw, OCR’s deputy director of health information privacy, states that “just because patients have rated their health provider publicly doesn’t give their health provider permission to rate them in return.”2,3 In fact, some health care providers who responded to poor online reviews ran into trouble with privacy rules established by HIPAA.2,3

Mr. McGraw notes that, when responding to online reviews, health professionals should speak generally about the way they treat patients while complying with HIPAA regulations. He suggests, “If the complaint is about poor patient care … say, ‘I provide all of my patients with good patient care’ and ‘I’ve been reviewed in other contexts and have good reviews.’”2,3

According to Yelp’s senior director of litigation, Aaron Schur, most patient complaints center on practice-based concerns such as wait times, office staff, and billing, not about the medical service delivered. Although most physicians do not respond, says Mr. Schur, those who do, tend to ask patients to discuss the matter in private or to apologize.2,3

What are the consequences of a HIPAA violation?

OCR Director Jocelyn Samuels says that the office’s primary role is to help health providers follow HIPAA regulations.2,5 The OCR can resolve HIPPA violations privately and informally, impose fines of up to $50,000 per violation, or it can file criminal charges against violators.2,4

The majority of the office’s investigation and enforcement of HIPAA has been against large medical data breaches.2,5 Small privacy breaches by large health care providers (eg, CVS, Walmart, Lab Corp, Quest Diagnostics, and others) generally do not result in legal consequences; the providers are privately warned. According to ProPublica, even repeated HIPAA violations tend not to be fined.2,4

Small-scale infractions can be more damaging on a personal level to both patients and physicians. However, the OCR does not typically become involved in privacy breaches that include only a few individuals. Health care providers are rarely punished for small HIPPA breaches; instead, the OCR typically settles for pledges to fix any problems and issues reminders of HIPPA requirements.2,5

Although the OCR is often the only place patients can go to seek vindication, HIPAA does not support the right to sue for violation of personal privacy. People who seek a legal remedy must find another means, which is easier in some states than in others.2,5

Health care providers have tried myriad ways to attempt to combat negative reviews. Some have sued patients, attracting a flood of attention but achieving little legal success. Others have asked patients to remove their complaints.2,3

Best practices
Create and circulate a policy. Medical privacy breaches involving sensitive health details can occur when office or hospital staff share patient information due to personal hostility or lack of understanding of HIPPA policy.2,5 Have a practice policy for responding to online reviews by patients, and make sure the staff members who have access to the practice’s online accounts understand your policy and the possible repercussions of not following it. Teach and continue to remind your staff about HIPPA regulations and hold them to a high ethical level of privacy.

Solicit reviews on an ongoing basis. Jeffrey Segal, a review site critic, says that all reviews are valuable. Physicians should respond carefully to negative comments and encourage satisfied patients to post positive reviews. “’For doctors who get bent out of shape to get rid of negative reviews, it’s a denominator problem,’ he said. ‘If they only have three reviews and two are negative, the denominator is the problem. … If you can figure out a way to cultivate reviews from hundreds of patients rather than a few patients, the problem is solved.’”2,3

CASE  Resolved
Dr. Baum never responded directly to the negative patient review, and others he has received. He balances the rare negative response with numerous and plentiful positive responses by making it a practice to encourage reviews from all of his patients.


References

  1. HIPAA for Professionals. US Department of Health & Human Services. http://www.hhs.gov/hipaa/for-professionals/index.html. Accessed October 11, 2016.
  2. Hall SD. Providers responding to Yelp reviews must be mindful of HIPAA. FierceHealthcare. http://www.fiercehealthcare.com/it/providers-responding-to-yelp-reviews-must-be-mindful-hipaa. Published May 31, 2016. Accessed October 7, 2016.
  3. Ornstein C. Stung by Yelp reviews, health providers spill patient secrets. ProPublica. https://www.propublica.org/article/stung-by-yelp-reviews-health -providers-spill-patient-secrets. Published May 27, 2016. Accessed October 11, 2016.
  4. Ornstein C, Waldman A. Few consequences for health privacy law’s repeat offenders. ProPublica. https://www.propublica.org/article/few-consequences-for-health-privacy-law-repeat-offenders. Published December 29, 2015. Accessed October 11, 2016.
  5. Ornstein C. Small-scale violations of medical privacy often cause the most harm. ProPublica. https://www.propublica.org/article/small-scale-violations-of-medical-privacy-often-cause-the-most-harm. Published December 10, 2015. Accessed October 11, 2016.

The bottom line

Patients are seeking and leaving reviews about you and your practice online and you need to actively manage your online reputation. Do not let one disgruntled patient ruin your reputation. Our advice: Do not wait for a negative review to begin your reputation management. Take an active role and generate positive reviews to drown out negative remarks made by an occasional patient. This is an inexpensive process that does work.

 

Share your thoughts! Send your Letter to the Editor to [email protected]. Please include your name and the city and state in which you practice.

References
  1. Romano R, Baum NH. Using the Internet in your practice. Part 4: Reputation management-how to gather kudos and combat negative online reviews. OBG Manag. 2014;26(12):23,24,26,28.
  2. Lagu T, Hannon NS, Rothberg MB, Lindenauer PK. Patients' evaluations of health care providers in the era of social networking: an analysis of physician rating websites. J Gen Intern Med. 2010;25(9):942-946.
  3. Gunter J. For better or maybe, worse, patients are judging your care online. OBG Manag. 2011;23(3):47-51.
References
  1. Romano R, Baum NH. Using the Internet in your practice. Part 4: Reputation management-how to gather kudos and combat negative online reviews. OBG Manag. 2014;26(12):23,24,26,28.
  2. Lagu T, Hannon NS, Rothberg MB, Lindenauer PK. Patients' evaluations of health care providers in the era of social networking: an analysis of physician rating websites. J Gen Intern Med. 2010;25(9):942-946.
  3. Gunter J. For better or maybe, worse, patients are judging your care online. OBG Manag. 2011;23(3):47-51.
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  • How your peers manage online reputation
  • Should you respond to a negative review?
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Public speaking fundamentals. Presentation follow-up: What to do after the last slide is shown

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Public speaking fundamentals. Presentation follow-up: What to do after the last slide is shown
One-on-one follow-up with program attendees in various ways can help to solidify your talk in their minds. You may also want to explore other means of disseminating your message.

Paul Zwolak for OBG Management

This third article in a series on public speaking describes steps you can take immediately following the program to strengthen the impact of your diligent preparation (“Preparation: Tips that lead to a solid, engaging presentation.” OBG Manag. 2016;28[7]:31–36) and honed presentation (“The program: Key elements in capturing and holding audience attention.” OBG Manag. 2016;28[9]:46–50). Don’t overlook these details.

Find ways to stay in touch

You have concluded your talk. The audience response was enthusiastic and the brief Q&A session productive. But it is not over yet. Postpone putting away your computer and disconnecting the audiovisual equipment. Instead, mingle with the attendees—as you also did, we hope, before the program began. There is always more you can learn about your listeners. And, importantly, a few of them would undoubtedly like to ask you one-on-one about a case related to the topic you covered or about another problem in your area of expertise.

We suggest that, as part of your follow-up, you take the names of attendees you speak with. Make a note relevant to each one and plan to send a personal letter that perhaps includes an article you wrote or one published by a credible source. For example, if one of us (MK) gives a talk for a physician audience on a clinical topic, I will send the inquiring physician a note and an article on the topic, with the key sentences related to his or her question highlighted. A sticky note on the article’s front page directs the physician’s attention to the page containing the answer to his or her question (FIGURE). Using this simple technique can make you a value-added resource long after your presentation.

Figure Follow up with program attendees who made specific inquiries about your talk by sending personalized notes with helpful documents.

Alternatively, you could e-mail the article to a representative for the organization that you were speaking for. This makes you an asset to the representative, who will likely tell colleagues about your assistance, which could earn you a return speaking engagement.

Make sure, too, that you have an ample supply of business cards—the quickest and easiest way to give out your contact information.

You may also want to distribute a handout of your presentation. This could of course be a printout of your slide show presentation (assuming there are no copyright concerns). But we think it is better to distribute a single page with salient points you would like the audience to take away from your program. However you prepare your handout, be certain each page displays your name, address, phone numbers, and e-mail and website addresses.

Another suggestion: An unobtrusive way to obtain the names of those who attend your program is to collect their business cards in a container before the presentation and hold a drawing for a prize at the end of the program. We often give away a copy of one of our books, but any small gift would work.

Ask for feedback

If you are speaking on behalf of an organization or another sponsoring entity, it is helpful to ask the meeting planner what they thought of the program. Ask for constructive criticism and input on how you might improve the program. Also ask if you were able to get across your most important points.

Finally, send a note to the meeting planner or representative expressing your thanks for the invitation and offering to provide any additional information they might need or want.

Extend the reach of your message

If your talk would be appropriate for a broader audience, you could consider adapting it for publication. Be sure to understand the audience of the publication and review the selected journal’s guidance for authors.

If you do write an article, share it with your colleagues and perhaps your patients. You might also consider posting the article on your website. Yet another option would be to videotape your presentation, keeping it under 10 minutes, and upload it to the video-sharing website YouTube.

Bottom line. The payoff for your research and preparation need not end with the speaking engagement.

Share your thoughts! Send your Letter to the Editor to [email protected]. Please include your name and the city and state in which you practice.

Article PDF
Author and Disclosure Information

Dr. Karram is Professor of Obstetrics and Gynecology and Urology, University of Cincinnati School of Medicine, and Director, Urogynecology, The Christ Hospital, Cincinnati, Ohio.

Dr. Baum practices urology in New Orleans, Louisiana, and is Associate Clinical Professor of Urology, Tulane Medical School and Louisiana State University School of Medicine, New Orleans. Dr. Baum is an OBG Management Contributing Editor. 

The authors report no financial relationships relevant to this article.

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Dr. Karram is Professor of Obstetrics and Gynecology and Urology, University of Cincinnati School of Medicine, and Director, Urogynecology, The Christ Hospital, Cincinnati, Ohio.

Dr. Baum practices urology in New Orleans, Louisiana, and is Associate Clinical Professor of Urology, Tulane Medical School and Louisiana State University School of Medicine, New Orleans. Dr. Baum is an OBG Management Contributing Editor. 

The authors report no financial relationships relevant to this article.

Author and Disclosure Information

Dr. Karram is Professor of Obstetrics and Gynecology and Urology, University of Cincinnati School of Medicine, and Director, Urogynecology, The Christ Hospital, Cincinnati, Ohio.

Dr. Baum practices urology in New Orleans, Louisiana, and is Associate Clinical Professor of Urology, Tulane Medical School and Louisiana State University School of Medicine, New Orleans. Dr. Baum is an OBG Management Contributing Editor. 

The authors report no financial relationships relevant to this article.

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One-on-one follow-up with program attendees in various ways can help to solidify your talk in their minds. You may also want to explore other means of disseminating your message.
One-on-one follow-up with program attendees in various ways can help to solidify your talk in their minds. You may also want to explore other means of disseminating your message.

Paul Zwolak for OBG Management

This third article in a series on public speaking describes steps you can take immediately following the program to strengthen the impact of your diligent preparation (“Preparation: Tips that lead to a solid, engaging presentation.” OBG Manag. 2016;28[7]:31–36) and honed presentation (“The program: Key elements in capturing and holding audience attention.” OBG Manag. 2016;28[9]:46–50). Don’t overlook these details.

Find ways to stay in touch

You have concluded your talk. The audience response was enthusiastic and the brief Q&A session productive. But it is not over yet. Postpone putting away your computer and disconnecting the audiovisual equipment. Instead, mingle with the attendees—as you also did, we hope, before the program began. There is always more you can learn about your listeners. And, importantly, a few of them would undoubtedly like to ask you one-on-one about a case related to the topic you covered or about another problem in your area of expertise.

We suggest that, as part of your follow-up, you take the names of attendees you speak with. Make a note relevant to each one and plan to send a personal letter that perhaps includes an article you wrote or one published by a credible source. For example, if one of us (MK) gives a talk for a physician audience on a clinical topic, I will send the inquiring physician a note and an article on the topic, with the key sentences related to his or her question highlighted. A sticky note on the article’s front page directs the physician’s attention to the page containing the answer to his or her question (FIGURE). Using this simple technique can make you a value-added resource long after your presentation.

Figure Follow up with program attendees who made specific inquiries about your talk by sending personalized notes with helpful documents.

Alternatively, you could e-mail the article to a representative for the organization that you were speaking for. This makes you an asset to the representative, who will likely tell colleagues about your assistance, which could earn you a return speaking engagement.

Make sure, too, that you have an ample supply of business cards—the quickest and easiest way to give out your contact information.

You may also want to distribute a handout of your presentation. This could of course be a printout of your slide show presentation (assuming there are no copyright concerns). But we think it is better to distribute a single page with salient points you would like the audience to take away from your program. However you prepare your handout, be certain each page displays your name, address, phone numbers, and e-mail and website addresses.

Another suggestion: An unobtrusive way to obtain the names of those who attend your program is to collect their business cards in a container before the presentation and hold a drawing for a prize at the end of the program. We often give away a copy of one of our books, but any small gift would work.

Ask for feedback

If you are speaking on behalf of an organization or another sponsoring entity, it is helpful to ask the meeting planner what they thought of the program. Ask for constructive criticism and input on how you might improve the program. Also ask if you were able to get across your most important points.

Finally, send a note to the meeting planner or representative expressing your thanks for the invitation and offering to provide any additional information they might need or want.

Extend the reach of your message

If your talk would be appropriate for a broader audience, you could consider adapting it for publication. Be sure to understand the audience of the publication and review the selected journal’s guidance for authors.

If you do write an article, share it with your colleagues and perhaps your patients. You might also consider posting the article on your website. Yet another option would be to videotape your presentation, keeping it under 10 minutes, and upload it to the video-sharing website YouTube.

Bottom line. The payoff for your research and preparation need not end with the speaking engagement.

Share your thoughts! Send your Letter to the Editor to [email protected]. Please include your name and the city and state in which you practice.

Paul Zwolak for OBG Management

This third article in a series on public speaking describes steps you can take immediately following the program to strengthen the impact of your diligent preparation (“Preparation: Tips that lead to a solid, engaging presentation.” OBG Manag. 2016;28[7]:31–36) and honed presentation (“The program: Key elements in capturing and holding audience attention.” OBG Manag. 2016;28[9]:46–50). Don’t overlook these details.

Find ways to stay in touch

You have concluded your talk. The audience response was enthusiastic and the brief Q&A session productive. But it is not over yet. Postpone putting away your computer and disconnecting the audiovisual equipment. Instead, mingle with the attendees—as you also did, we hope, before the program began. There is always more you can learn about your listeners. And, importantly, a few of them would undoubtedly like to ask you one-on-one about a case related to the topic you covered or about another problem in your area of expertise.

We suggest that, as part of your follow-up, you take the names of attendees you speak with. Make a note relevant to each one and plan to send a personal letter that perhaps includes an article you wrote or one published by a credible source. For example, if one of us (MK) gives a talk for a physician audience on a clinical topic, I will send the inquiring physician a note and an article on the topic, with the key sentences related to his or her question highlighted. A sticky note on the article’s front page directs the physician’s attention to the page containing the answer to his or her question (FIGURE). Using this simple technique can make you a value-added resource long after your presentation.

Figure Follow up with program attendees who made specific inquiries about your talk by sending personalized notes with helpful documents.

Alternatively, you could e-mail the article to a representative for the organization that you were speaking for. This makes you an asset to the representative, who will likely tell colleagues about your assistance, which could earn you a return speaking engagement.

Make sure, too, that you have an ample supply of business cards—the quickest and easiest way to give out your contact information.

You may also want to distribute a handout of your presentation. This could of course be a printout of your slide show presentation (assuming there are no copyright concerns). But we think it is better to distribute a single page with salient points you would like the audience to take away from your program. However you prepare your handout, be certain each page displays your name, address, phone numbers, and e-mail and website addresses.

Another suggestion: An unobtrusive way to obtain the names of those who attend your program is to collect their business cards in a container before the presentation and hold a drawing for a prize at the end of the program. We often give away a copy of one of our books, but any small gift would work.

Ask for feedback

If you are speaking on behalf of an organization or another sponsoring entity, it is helpful to ask the meeting planner what they thought of the program. Ask for constructive criticism and input on how you might improve the program. Also ask if you were able to get across your most important points.

Finally, send a note to the meeting planner or representative expressing your thanks for the invitation and offering to provide any additional information they might need or want.

Extend the reach of your message

If your talk would be appropriate for a broader audience, you could consider adapting it for publication. Be sure to understand the audience of the publication and review the selected journal’s guidance for authors.

If you do write an article, share it with your colleagues and perhaps your patients. You might also consider posting the article on your website. Yet another option would be to videotape your presentation, keeping it under 10 minutes, and upload it to the video-sharing website YouTube.

Bottom line. The payoff for your research and preparation need not end with the speaking engagement.

Share your thoughts! Send your Letter to the Editor to [email protected]. Please include your name and the city and state in which you practice.

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Public speaking fundamentals. The program: Key elements in capturing and holding audience attention

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In the first part of this article series (“Preparation: Tips that lead to a solid, engaging presentation,” OBG Manag. 2016;28[7]:31–36.), we offered tips on preparing for a group presentation. In this article, part 2, we discuss the presentation itself and what you can do to capture and hold your audience’s attention.

Paul Zwolak for OBG Management

How to connect with the audience

Let’s assume the meeting host has just introduced you to the audience using, as we suggested in the previous article, an autobiographical profile you provided. You now have the audience’s undivided attention. What you do and say in the next 30 to 60 seconds will set the stage for your program. Following the requisite “thank you” to the host and meeting sponsor, use this time to establish your expertise as a spokesperson on the chosen topic. Or, if the introductory remarks made your expertise plain, you may choose to connect with the audience on an informal, personal level. If you are from out of town, for instance, you could remark on an interesting aspect of the city or region you are visiting that you learned on the Internet before arriving.

Underscore the topic’s importance. On the other hand, you might want to begin with an insightful statistic germane to your talk. For example, a talk on breast cancer might begin with, “According to the American Cancer Society, there are nearly 250,000 new cases of breast cancer each year, and breast cancer accounts for more than 40,000 deaths per year. That means more women die from breast cancer than die in auto accidents each year. So this emphasizes the importance of appropriately screening women for breast cancer annually after age 40.”

An opening story about a patient can be powerful. Better yet, a personal experience reflecting your topic is a great way to connect with your audience members and get their attention. For example, one of us (NHB) gives talks on practice management and practice efficiency. I might talk about when I was called from an exam room 3 times to answer “emergency” phone calls from a patient who wanted only to request her medical records. To ensure that this embarrassment would never happen again, I put in place a system that I then describe for the audience.

Alternatively, an opening that addresses the audience’s unspoken question, “What’s in this for me?” is sure to grab their attention. For instance, a talk on office productivity might begin by promising to share a way to increase annual collections by $250,000 per physician through scheduling adjustments that can increase the number of examined patients by one per hour.

Steer clear of these openings. In general, avoid “I’m delighted to be here” and other clichés. One exception would be if you can make that cliché humorous. For example, if a speaker from the deep South is visiting the northern part of the country in summer, she might say, “Most speakers say they’re delighted to be here, and you may well question their sincerity. However, I’m from New Orleans where the temperature is approaching 105 degrees with 95% humidity. You know I’m really delighted to be here!”

Importantly, avoid starting with an apology. Do not mention problems with the audiovisual equipment or why you arrived late. The audience does not care, and you will immediately lose their attention. They want to be educated and entertained. There is no better way to do this than by offering a compelling and captivating opening that begins the moment after you are introduced.

Finally, avoid use of the “royal I,” as in “I am here to talk about XYZ.” It places you in a position superior to the audience, and that is a turnoff. Instead, you could say to the audience, “The reason you are here is to learn about XYZ.” This places the audience on an equal level with you, and they know there will be something in the presentation for them.

Housekeeping notes

The audience will appreciate knowing how long you plan to speak and whether you will take questions during or after the presentation. Based on our experience, if there are fewer than 20 attendees, we often encourage questions during the program instead of waiting until the end. This makes the program more conversational and usually generates more questions. With a dinner presentation, we prefer to speak while the audience is eating. We usually start after the waiters have taken the orders and the attendees have had their appetizers. We might say we will finish the program by the time they are ready for dessert. We also mention that we will distribute a handout after the presentation so they do not have to worry about following the handout, taking notes, and watching the speaker while trying to eat.

 

 

The main body of the program

As for structuring your talk, we suggest you follow this time-honored advice often attributed to Aristotle: Tell the audience what you are going to say, say it, and tell them what you said.

So we begin a presentation by stating the objectives of our program, usually limited to 3 and no more than 4. For example, a talk on hormone therapy (HT) for treating vasomotor symptoms of menopause might mention 1) the history of HT use, 2) which women are appropriate candidates for HT, and 3) how to monitor women who receive HT.

Enhance the talk’s relevance. We like to begin a clinical program with a case scenario wherein we describe how one of our patients had the specific problem and how we used a particular drug, treatment, or device to manage the case. We try to select a patient similar to ones who would be seen by members of the audience.

Simplify as much as possible. We then present the slides exactly as they have been provided by the pharmaceutical company. Most company slides contain too many words as well as diagrams that are too complex for the audience to grasp easily. We try to find one salient point on each slide and focus attention on that single word, phrase, or sentence. We can do this in a small audience by walking over to the screen and pointing it out, or we can use the laser pointer from a distance.

Change things up to keep the message fresh. Let’s be honest, most medical talks are dry and boring. Try to inject some energy and enthusiasm in the middle of the presentation. Every few minutes we tell a story or ask the audience a question. For example, during a program on practice management, one of us (NHB) will relate a story about an unhappy patient and then ask a physician in the audience how he or she might handle the disgruntled patient. This is a nice break from the main content of the presentation, re-engaging the audience in an interactive exchange.

Should you use humor?

Although many physicians attempt to use humor during a presentation, few are talented at stand-up comedy. However, used judiciously humor, like seasoning in fine cuisine, can do great things for a presentation. It can break the ice, drive home a point, and enhance your likeability. It can, though, also backfire. One of us (NHB) once gave a talk to a large audience of pharmaceutical representatives. As part of my wrap-up I displayed a slide from the cover of Economics that showed 2 camels in the mating position. My closing line was that reps need to “hump to it” and get involved with their physicians and be value-added in their product detailing. Afterward, the meeting planner told me that he would never hire me again. He said I had a great program, great material, and a good connection with the audience. But my closing was over the top. I learned my lesson. Never use material that has the potential to offend. If you want to use humor, the self-deprecatingkind is always safest.

Try using visual aids

Our observation is that few physician speakers use visual aids other than their slides. We have learned that audience attention will stay focused on you if you make use of visual aids. For example, if we are speaking to a lay audience about urinary incontinence, we might use a balloon to demonstrate the bladder and the urethra.

Studies have shown that there are more nerve endings from the eye to the brain than from the ear to the brain. Humans purportedly receive 25 times as much stimulus from visual cues than from auditory ones. To paraphrase an old proverb, “One seeing is better than 100 times hearing about”!

A few suggestions regarding the use of visual aids:

  1. Keep the visual aid out of sight until you are ready to use it. You do not want the audience staring at it when they should be focusing on you or your slide material. We usually keep our visual aids under the table that supports the computer and projector.
  2. Make certain the visual aid is large enough to be seen by everyone in the audience.
  3. Do not hand out the aid to the audience during your program. Doing so will divert their attention from you and your material.
  4. When you have finished using the aid, put it away.
 

 

Closing out the program

After we have covered the program’s 3 objectives, we let the audience know we are approaching the end of the presentation. For a dinner program, we try to time the ending just as plates are being cleared and before dessert is served. We then restate the 3 objectives as they might pertain to the attendees’ patients and practices. At this time, we take questions from the audience, even if some were asked during the presentation. We repeat each question when it is asked so that everyone can hear it. (This also gives us a few seconds to think about it and frame our answer.) If it appears that many questions will be asked, we assure everyone that we plan to finish on time and will remain after the program is over to answer additional questions.

Tips on fielding questions. When responding to a question, direct your attention initially to the person who asked it. After that, spend about 20% of the time focused on that person and 80% of the time on the rest of the audience. If you focus only on the questioner, it becomes a one-on-one conversation. You want to end your response with your eyes on the group and not on the questioner. Looking at the group will also act as a bridge to the next question. Although we used to reply to an inquiry with, “That’s a great question,” we now suggest avoiding this comment. Why? Because it is unlikely that you’ll keep using that line, and the next questioner who does not receive the same compliment might feel slighted.

Wrap up. When you announce, “I would like to conclude my program with…,” this is the magical time when you hold the complete attention of the audience. Often, the speaker’s last words are the ones the audience remembers the longest. So this is the time to offer your take-home message. For example, a talk on how to motivate your staff might conclude, “Remember, your staff members are the people that patients encounter first and the ones they see last as they leave the office. Every patient can have a positive experience with you and your practice if you ensure that your personnel are highly motivated. This happens in part by your effort to recognize their accomplishments.” Then hold up your hands and spread out your arms as you end with “Thank you.” The audience likely will applaud and, if your speech is truly exceptional, you might receive a gratifying standing ovation!

Be seated

Renowned for his speeches, Franklin Delano Roosevelt summarized the art of effective speaking when he said, “Be sincere. Be brief. Be seated.” When your time is up, turn the program back over to the meeting host and take a seat.

In the final article in this public speaking series, we will discuss the follow-up steps to take once the program is over, including the call to action or what you want the audience to do after you have left the podium or the speaking venue.

Share your thoughts! Send your Letter to the Editor to [email protected]. Please include your name and the city and state in which you practice.

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Dr. Karram is Professor of Obstetrics and Gynecology and Urology, University of Cincinnati School of Medicine, and Director, Urogynecology, The Christ Hospital, Cincinnati, Ohio.

Dr. Baum practices urology in New Orleans, Louisiana, and is Associate Clinical Professor of Urology, Tulane Medical School and Louisiana State University School of Medicine, New Orleans. Dr. Baum is an OBG Managment Contributing Editor

The authors report no financial relationships relevant to this article.

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Dr. Karram is Professor of Obstetrics and Gynecology and Urology, University of Cincinnati School of Medicine, and Director, Urogynecology, The Christ Hospital, Cincinnati, Ohio.

Dr. Baum practices urology in New Orleans, Louisiana, and is Associate Clinical Professor of Urology, Tulane Medical School and Louisiana State University School of Medicine, New Orleans. Dr. Baum is an OBG Managment Contributing Editor

The authors report no financial relationships relevant to this article.

Author and Disclosure Information

Dr. Karram is Professor of Obstetrics and Gynecology and Urology, University of Cincinnati School of Medicine, and Director, Urogynecology, The Christ Hospital, Cincinnati, Ohio.

Dr. Baum practices urology in New Orleans, Louisiana, and is Associate Clinical Professor of Urology, Tulane Medical School and Louisiana State University School of Medicine, New Orleans. Dr. Baum is an OBG Managment Contributing Editor

The authors report no financial relationships relevant to this article.

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In the first part of this article series (“Preparation: Tips that lead to a solid, engaging presentation,” OBG Manag. 2016;28[7]:31–36.), we offered tips on preparing for a group presentation. In this article, part 2, we discuss the presentation itself and what you can do to capture and hold your audience’s attention.

Paul Zwolak for OBG Management

How to connect with the audience

Let’s assume the meeting host has just introduced you to the audience using, as we suggested in the previous article, an autobiographical profile you provided. You now have the audience’s undivided attention. What you do and say in the next 30 to 60 seconds will set the stage for your program. Following the requisite “thank you” to the host and meeting sponsor, use this time to establish your expertise as a spokesperson on the chosen topic. Or, if the introductory remarks made your expertise plain, you may choose to connect with the audience on an informal, personal level. If you are from out of town, for instance, you could remark on an interesting aspect of the city or region you are visiting that you learned on the Internet before arriving.

Underscore the topic’s importance. On the other hand, you might want to begin with an insightful statistic germane to your talk. For example, a talk on breast cancer might begin with, “According to the American Cancer Society, there are nearly 250,000 new cases of breast cancer each year, and breast cancer accounts for more than 40,000 deaths per year. That means more women die from breast cancer than die in auto accidents each year. So this emphasizes the importance of appropriately screening women for breast cancer annually after age 40.”

An opening story about a patient can be powerful. Better yet, a personal experience reflecting your topic is a great way to connect with your audience members and get their attention. For example, one of us (NHB) gives talks on practice management and practice efficiency. I might talk about when I was called from an exam room 3 times to answer “emergency” phone calls from a patient who wanted only to request her medical records. To ensure that this embarrassment would never happen again, I put in place a system that I then describe for the audience.

Alternatively, an opening that addresses the audience’s unspoken question, “What’s in this for me?” is sure to grab their attention. For instance, a talk on office productivity might begin by promising to share a way to increase annual collections by $250,000 per physician through scheduling adjustments that can increase the number of examined patients by one per hour.

Steer clear of these openings. In general, avoid “I’m delighted to be here” and other clichés. One exception would be if you can make that cliché humorous. For example, if a speaker from the deep South is visiting the northern part of the country in summer, she might say, “Most speakers say they’re delighted to be here, and you may well question their sincerity. However, I’m from New Orleans where the temperature is approaching 105 degrees with 95% humidity. You know I’m really delighted to be here!”

Importantly, avoid starting with an apology. Do not mention problems with the audiovisual equipment or why you arrived late. The audience does not care, and you will immediately lose their attention. They want to be educated and entertained. There is no better way to do this than by offering a compelling and captivating opening that begins the moment after you are introduced.

Finally, avoid use of the “royal I,” as in “I am here to talk about XYZ.” It places you in a position superior to the audience, and that is a turnoff. Instead, you could say to the audience, “The reason you are here is to learn about XYZ.” This places the audience on an equal level with you, and they know there will be something in the presentation for them.

Housekeeping notes

The audience will appreciate knowing how long you plan to speak and whether you will take questions during or after the presentation. Based on our experience, if there are fewer than 20 attendees, we often encourage questions during the program instead of waiting until the end. This makes the program more conversational and usually generates more questions. With a dinner presentation, we prefer to speak while the audience is eating. We usually start after the waiters have taken the orders and the attendees have had their appetizers. We might say we will finish the program by the time they are ready for dessert. We also mention that we will distribute a handout after the presentation so they do not have to worry about following the handout, taking notes, and watching the speaker while trying to eat.

 

 

The main body of the program

As for structuring your talk, we suggest you follow this time-honored advice often attributed to Aristotle: Tell the audience what you are going to say, say it, and tell them what you said.

So we begin a presentation by stating the objectives of our program, usually limited to 3 and no more than 4. For example, a talk on hormone therapy (HT) for treating vasomotor symptoms of menopause might mention 1) the history of HT use, 2) which women are appropriate candidates for HT, and 3) how to monitor women who receive HT.

Enhance the talk’s relevance. We like to begin a clinical program with a case scenario wherein we describe how one of our patients had the specific problem and how we used a particular drug, treatment, or device to manage the case. We try to select a patient similar to ones who would be seen by members of the audience.

Simplify as much as possible. We then present the slides exactly as they have been provided by the pharmaceutical company. Most company slides contain too many words as well as diagrams that are too complex for the audience to grasp easily. We try to find one salient point on each slide and focus attention on that single word, phrase, or sentence. We can do this in a small audience by walking over to the screen and pointing it out, or we can use the laser pointer from a distance.

Change things up to keep the message fresh. Let’s be honest, most medical talks are dry and boring. Try to inject some energy and enthusiasm in the middle of the presentation. Every few minutes we tell a story or ask the audience a question. For example, during a program on practice management, one of us (NHB) will relate a story about an unhappy patient and then ask a physician in the audience how he or she might handle the disgruntled patient. This is a nice break from the main content of the presentation, re-engaging the audience in an interactive exchange.

Should you use humor?

Although many physicians attempt to use humor during a presentation, few are talented at stand-up comedy. However, used judiciously humor, like seasoning in fine cuisine, can do great things for a presentation. It can break the ice, drive home a point, and enhance your likeability. It can, though, also backfire. One of us (NHB) once gave a talk to a large audience of pharmaceutical representatives. As part of my wrap-up I displayed a slide from the cover of Economics that showed 2 camels in the mating position. My closing line was that reps need to “hump to it” and get involved with their physicians and be value-added in their product detailing. Afterward, the meeting planner told me that he would never hire me again. He said I had a great program, great material, and a good connection with the audience. But my closing was over the top. I learned my lesson. Never use material that has the potential to offend. If you want to use humor, the self-deprecatingkind is always safest.

Try using visual aids

Our observation is that few physician speakers use visual aids other than their slides. We have learned that audience attention will stay focused on you if you make use of visual aids. For example, if we are speaking to a lay audience about urinary incontinence, we might use a balloon to demonstrate the bladder and the urethra.

Studies have shown that there are more nerve endings from the eye to the brain than from the ear to the brain. Humans purportedly receive 25 times as much stimulus from visual cues than from auditory ones. To paraphrase an old proverb, “One seeing is better than 100 times hearing about”!

A few suggestions regarding the use of visual aids:

  1. Keep the visual aid out of sight until you are ready to use it. You do not want the audience staring at it when they should be focusing on you or your slide material. We usually keep our visual aids under the table that supports the computer and projector.
  2. Make certain the visual aid is large enough to be seen by everyone in the audience.
  3. Do not hand out the aid to the audience during your program. Doing so will divert their attention from you and your material.
  4. When you have finished using the aid, put it away.
 

 

Closing out the program

After we have covered the program’s 3 objectives, we let the audience know we are approaching the end of the presentation. For a dinner program, we try to time the ending just as plates are being cleared and before dessert is served. We then restate the 3 objectives as they might pertain to the attendees’ patients and practices. At this time, we take questions from the audience, even if some were asked during the presentation. We repeat each question when it is asked so that everyone can hear it. (This also gives us a few seconds to think about it and frame our answer.) If it appears that many questions will be asked, we assure everyone that we plan to finish on time and will remain after the program is over to answer additional questions.

Tips on fielding questions. When responding to a question, direct your attention initially to the person who asked it. After that, spend about 20% of the time focused on that person and 80% of the time on the rest of the audience. If you focus only on the questioner, it becomes a one-on-one conversation. You want to end your response with your eyes on the group and not on the questioner. Looking at the group will also act as a bridge to the next question. Although we used to reply to an inquiry with, “That’s a great question,” we now suggest avoiding this comment. Why? Because it is unlikely that you’ll keep using that line, and the next questioner who does not receive the same compliment might feel slighted.

Wrap up. When you announce, “I would like to conclude my program with…,” this is the magical time when you hold the complete attention of the audience. Often, the speaker’s last words are the ones the audience remembers the longest. So this is the time to offer your take-home message. For example, a talk on how to motivate your staff might conclude, “Remember, your staff members are the people that patients encounter first and the ones they see last as they leave the office. Every patient can have a positive experience with you and your practice if you ensure that your personnel are highly motivated. This happens in part by your effort to recognize their accomplishments.” Then hold up your hands and spread out your arms as you end with “Thank you.” The audience likely will applaud and, if your speech is truly exceptional, you might receive a gratifying standing ovation!

Be seated

Renowned for his speeches, Franklin Delano Roosevelt summarized the art of effective speaking when he said, “Be sincere. Be brief. Be seated.” When your time is up, turn the program back over to the meeting host and take a seat.

In the final article in this public speaking series, we will discuss the follow-up steps to take once the program is over, including the call to action or what you want the audience to do after you have left the podium or the speaking venue.

Share your thoughts! Send your Letter to the Editor to [email protected]. Please include your name and the city and state in which you practice.

In the first part of this article series (“Preparation: Tips that lead to a solid, engaging presentation,” OBG Manag. 2016;28[7]:31–36.), we offered tips on preparing for a group presentation. In this article, part 2, we discuss the presentation itself and what you can do to capture and hold your audience’s attention.

Paul Zwolak for OBG Management

How to connect with the audience

Let’s assume the meeting host has just introduced you to the audience using, as we suggested in the previous article, an autobiographical profile you provided. You now have the audience’s undivided attention. What you do and say in the next 30 to 60 seconds will set the stage for your program. Following the requisite “thank you” to the host and meeting sponsor, use this time to establish your expertise as a spokesperson on the chosen topic. Or, if the introductory remarks made your expertise plain, you may choose to connect with the audience on an informal, personal level. If you are from out of town, for instance, you could remark on an interesting aspect of the city or region you are visiting that you learned on the Internet before arriving.

Underscore the topic’s importance. On the other hand, you might want to begin with an insightful statistic germane to your talk. For example, a talk on breast cancer might begin with, “According to the American Cancer Society, there are nearly 250,000 new cases of breast cancer each year, and breast cancer accounts for more than 40,000 deaths per year. That means more women die from breast cancer than die in auto accidents each year. So this emphasizes the importance of appropriately screening women for breast cancer annually after age 40.”

An opening story about a patient can be powerful. Better yet, a personal experience reflecting your topic is a great way to connect with your audience members and get their attention. For example, one of us (NHB) gives talks on practice management and practice efficiency. I might talk about when I was called from an exam room 3 times to answer “emergency” phone calls from a patient who wanted only to request her medical records. To ensure that this embarrassment would never happen again, I put in place a system that I then describe for the audience.

Alternatively, an opening that addresses the audience’s unspoken question, “What’s in this for me?” is sure to grab their attention. For instance, a talk on office productivity might begin by promising to share a way to increase annual collections by $250,000 per physician through scheduling adjustments that can increase the number of examined patients by one per hour.

Steer clear of these openings. In general, avoid “I’m delighted to be here” and other clichés. One exception would be if you can make that cliché humorous. For example, if a speaker from the deep South is visiting the northern part of the country in summer, she might say, “Most speakers say they’re delighted to be here, and you may well question their sincerity. However, I’m from New Orleans where the temperature is approaching 105 degrees with 95% humidity. You know I’m really delighted to be here!”

Importantly, avoid starting with an apology. Do not mention problems with the audiovisual equipment or why you arrived late. The audience does not care, and you will immediately lose their attention. They want to be educated and entertained. There is no better way to do this than by offering a compelling and captivating opening that begins the moment after you are introduced.

Finally, avoid use of the “royal I,” as in “I am here to talk about XYZ.” It places you in a position superior to the audience, and that is a turnoff. Instead, you could say to the audience, “The reason you are here is to learn about XYZ.” This places the audience on an equal level with you, and they know there will be something in the presentation for them.

Housekeeping notes

The audience will appreciate knowing how long you plan to speak and whether you will take questions during or after the presentation. Based on our experience, if there are fewer than 20 attendees, we often encourage questions during the program instead of waiting until the end. This makes the program more conversational and usually generates more questions. With a dinner presentation, we prefer to speak while the audience is eating. We usually start after the waiters have taken the orders and the attendees have had their appetizers. We might say we will finish the program by the time they are ready for dessert. We also mention that we will distribute a handout after the presentation so they do not have to worry about following the handout, taking notes, and watching the speaker while trying to eat.

 

 

The main body of the program

As for structuring your talk, we suggest you follow this time-honored advice often attributed to Aristotle: Tell the audience what you are going to say, say it, and tell them what you said.

So we begin a presentation by stating the objectives of our program, usually limited to 3 and no more than 4. For example, a talk on hormone therapy (HT) for treating vasomotor symptoms of menopause might mention 1) the history of HT use, 2) which women are appropriate candidates for HT, and 3) how to monitor women who receive HT.

Enhance the talk’s relevance. We like to begin a clinical program with a case scenario wherein we describe how one of our patients had the specific problem and how we used a particular drug, treatment, or device to manage the case. We try to select a patient similar to ones who would be seen by members of the audience.

Simplify as much as possible. We then present the slides exactly as they have been provided by the pharmaceutical company. Most company slides contain too many words as well as diagrams that are too complex for the audience to grasp easily. We try to find one salient point on each slide and focus attention on that single word, phrase, or sentence. We can do this in a small audience by walking over to the screen and pointing it out, or we can use the laser pointer from a distance.

Change things up to keep the message fresh. Let’s be honest, most medical talks are dry and boring. Try to inject some energy and enthusiasm in the middle of the presentation. Every few minutes we tell a story or ask the audience a question. For example, during a program on practice management, one of us (NHB) will relate a story about an unhappy patient and then ask a physician in the audience how he or she might handle the disgruntled patient. This is a nice break from the main content of the presentation, re-engaging the audience in an interactive exchange.

Should you use humor?

Although many physicians attempt to use humor during a presentation, few are talented at stand-up comedy. However, used judiciously humor, like seasoning in fine cuisine, can do great things for a presentation. It can break the ice, drive home a point, and enhance your likeability. It can, though, also backfire. One of us (NHB) once gave a talk to a large audience of pharmaceutical representatives. As part of my wrap-up I displayed a slide from the cover of Economics that showed 2 camels in the mating position. My closing line was that reps need to “hump to it” and get involved with their physicians and be value-added in their product detailing. Afterward, the meeting planner told me that he would never hire me again. He said I had a great program, great material, and a good connection with the audience. But my closing was over the top. I learned my lesson. Never use material that has the potential to offend. If you want to use humor, the self-deprecatingkind is always safest.

Try using visual aids

Our observation is that few physician speakers use visual aids other than their slides. We have learned that audience attention will stay focused on you if you make use of visual aids. For example, if we are speaking to a lay audience about urinary incontinence, we might use a balloon to demonstrate the bladder and the urethra.

Studies have shown that there are more nerve endings from the eye to the brain than from the ear to the brain. Humans purportedly receive 25 times as much stimulus from visual cues than from auditory ones. To paraphrase an old proverb, “One seeing is better than 100 times hearing about”!

A few suggestions regarding the use of visual aids:

  1. Keep the visual aid out of sight until you are ready to use it. You do not want the audience staring at it when they should be focusing on you or your slide material. We usually keep our visual aids under the table that supports the computer and projector.
  2. Make certain the visual aid is large enough to be seen by everyone in the audience.
  3. Do not hand out the aid to the audience during your program. Doing so will divert their attention from you and your material.
  4. When you have finished using the aid, put it away.
 

 

Closing out the program

After we have covered the program’s 3 objectives, we let the audience know we are approaching the end of the presentation. For a dinner program, we try to time the ending just as plates are being cleared and before dessert is served. We then restate the 3 objectives as they might pertain to the attendees’ patients and practices. At this time, we take questions from the audience, even if some were asked during the presentation. We repeat each question when it is asked so that everyone can hear it. (This also gives us a few seconds to think about it and frame our answer.) If it appears that many questions will be asked, we assure everyone that we plan to finish on time and will remain after the program is over to answer additional questions.

Tips on fielding questions. When responding to a question, direct your attention initially to the person who asked it. After that, spend about 20% of the time focused on that person and 80% of the time on the rest of the audience. If you focus only on the questioner, it becomes a one-on-one conversation. You want to end your response with your eyes on the group and not on the questioner. Looking at the group will also act as a bridge to the next question. Although we used to reply to an inquiry with, “That’s a great question,” we now suggest avoiding this comment. Why? Because it is unlikely that you’ll keep using that line, and the next questioner who does not receive the same compliment might feel slighted.

Wrap up. When you announce, “I would like to conclude my program with…,” this is the magical time when you hold the complete attention of the audience. Often, the speaker’s last words are the ones the audience remembers the longest. So this is the time to offer your take-home message. For example, a talk on how to motivate your staff might conclude, “Remember, your staff members are the people that patients encounter first and the ones they see last as they leave the office. Every patient can have a positive experience with you and your practice if you ensure that your personnel are highly motivated. This happens in part by your effort to recognize their accomplishments.” Then hold up your hands and spread out your arms as you end with “Thank you.” The audience likely will applaud and, if your speech is truly exceptional, you might receive a gratifying standing ovation!

Be seated

Renowned for his speeches, Franklin Delano Roosevelt summarized the art of effective speaking when he said, “Be sincere. Be brief. Be seated.” When your time is up, turn the program back over to the meeting host and take a seat.

In the final article in this public speaking series, we will discuss the follow-up steps to take once the program is over, including the call to action or what you want the audience to do after you have left the podium or the speaking venue.

Share your thoughts! Send your Letter to the Editor to [email protected]. Please include your name and the city and state in which you practice.

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Public speaking fundamentals. Preparation: Tips that lead to a solid, engaging presentation

 

 

According to most studies, people's number one fear is public speaking. Number two is death...This means to the average person, if you go to a funeral, you're better off in the casket than doing the eulogy.  -- Jerry Seinfeld

Public speaking is one of the best ways to market and promote your skills as a physician. It is an ethical way of communicating and showcasing your areas of interest and expertise to professional or lay audiences. Most physicians and health care professionals take pride in their ability to communicate. After all, that is how we take a history, discuss our findings with patients, and educate individuals on restoring or maintaining their health. Public speaking, though, for the most part is a learned skill. Except for presentations to faculty at bedside or at grand rounds, we have received little training in public speaking.

Few of us are naturally comfortable in front of a live audience or a TV or video camera. But with a little practice and diligent preparation, we can become good or even excellent, confident public speakers. This article—the first in a series of 3—provides you with preparatory tips and techniques to enhance your public speaking skills.

First, know your audience
Whether you are presenting to a group of 20 or 200, you can do certain things in advance to ensure that your presentation achieves the desired response. Most important: Know your audience. Don’t assume the audience is like you. To connect with them, you need to understand why your topic is important to them. What do they expect to learn from the presentation? Each attendee will be asking, “What’s in it for me?”

To keep listeners interested and engaged, you also must know their level of knowledge about the topic. If you are speaking to a group of residents about pelvic organ prolapse, you would use different language and content than if you were speaking to practicing primary care doctors; and these elements would be different again if you were speaking to a group of practicing urogynecologists. It’s insulting to recite basic information to highly knowledgeable physicians, or to present sophisticated technical content and complicated slides to novice physicians or lay people.

When presenting in a foreign country, learn how the culture of the audience differs from yours. How do they dress? What style of humor do they favor? How do they typically communicate? What gestures are appropriate or inappropriate? Are there religious influences to consider?

Practical steps. Before the meeting or event, speak to the organizer or meeting planner and find out the audience’s level of knowledge on the topic. Ask about audience expectations as well as demographics (such as age and background). If you are speaking at an industry event, research the event’s website and familiarize yourself with the mission of the event and who are the typical attendees. If you are presenting to a corporation, learn as much as you can about it by visiting its website, reading news reports, and reviewing associated blogs.

In addition to knowing the needs of the audience, ask the meeting planner about the goals and objectives for the program to make certain you can deliver on the requests.

Know your talk stem to stern
Review your slide material thoroughly. Understand each slide in the presentation and be comfortable with its content.

Avoid reading from slides. Reciting content that viewers can read for themselves breeds boredom and makes them lose interest. Further, when you are looking at the slides, you are not making eye contact with the audience and risk losing their attention. Good speakers are so comfortable with their slides that they can discuss each one without having to look at it.

Rehearse. The best way to achieve the foregoing is to rehearse. Your audience will be able to tell if you took the slide deck directly from a CD and loaded it into a computer and are giving the talk for the first time. You’ll need to know how long the program is to last and how long you are to speak. We suggest you practice with a timer to be certain you do not exceed the allotted time. Rehearse your talk aloud several times with all the props and audiovisual equipment you plan to use. This practice will help to curb filler words such as “ah” and “um.” It is also helpful to practice slide transitions, pauses, and even your breathing.

Prepare for the unexpected, too. Dinner meetings, for instance, may not start on time due to office or hospital delays for attending physicians, possibly resulting in a need to shorten your presentation.

 

 

Ask about the meeting agenda. If a meal is to be served, will you be speaking beforehand? This is the least favorable time slot, as you are holding people hostage before they can eat. Our preference is to speak after the appetizer is served and the orders have been taken by the wait staff. This way, attendees are not starving and they have something to drink. You can assure the waiters they won’t be disturbing you, and you can ask them to avoid walking in front of the projector. Ideally, you should end your presentation before dessert arrives and use the remaining time to field questions.

We suggest that you prepare a handout to be distributed at the end of the program, not before. You want your audience focused on you and your slides as you are speaking. Tell the audience you will be providing a handout of your presentation, which will minimize note-taking during your talk.

Your speech opening
The first and last 30 seconds of any speech probably have the most impact.1 Give extra thought, time, and effort to your opening and closing remarks. Do not open with “Good evening, it is a pleasure to be here tonight.” That wastes precious seconds.

While opening a speech with a joke or funny story is the conventional wisdom, ask yourself1:

 

  • Is my selection appropriate to the occasion and for this audience?
  • Is it in good taste?
  • Does it relate to me (my service) or to the event or the group? Does it support my topic or its key points?

A humorous story or inspirational vignette that relates to your topic or audience can grab the audience’s attention. If you feel that demands more presentation skill than you possess at the outset of your public-speaking career, give the audience what you know and what they most want to hear. You know the questions that you have heard most at cocktail receptions or professional society meetings. So, put the answers to those questions in your speech.

For example. A scientist working with a major corporation was preparing a speech for a lay audience. Since most of the audience did not know what scientists do, he offered the following analogy: “Being a scientist is like doing a jigsaw puzzle in a snowstorm at night...you don’t have all the pieces...and you don’t have the picture on the front of the box to work from.” You can say more with less.1

Your closing
The closing is an important aspect of your speech. Summarize the key elements to your presentation. If you are going to take questions, a good approach is to say, “Before my closing remarks, are there any questions?” Following the questions, finish with a takeaway message that ties into your theme.1

Prepare an autobiographical introduction
We suggest that you write your own introduction and e-mail it to the person who will be introducing you. Let them know it is a suggestion that they are welcome to modify. We have found that most emcees or meeting planners are delighted to have the introduction and will use it just as you have written it. Also bring hard copy with you; many emcees will have forgotten to download what you sent. The figure shows an example of the introduction that one of us (NHB) uses, and you are welcome to modify it for your own use.

Ask about and confirm audiovisual support
Ask the meeting planner ahead of time if they will be providing the computer, projector, and screen. And if, for instance, they will provide a projector but not a computer, make sure the computer you will bring is compatible with their projector. Also, you will probably not require a microphone for a small group, but if you are speaking in a loud restaurant, a portable microphone-speaker system may be helpful.

Arrive early at the program venue to make sure the computers, projector, screen placement, and seating arrangement are all in order. Nothing can sidetrack a speaker (even a seasoned one) like a problem with the computer or equipment setup—for example, your flash drive requiring a USB port cannot connect to the sponsor’s computer, or your program created on a Mac does not run on the sponsor’s PC. 

Show time: Getting ready
Another benefit in arriving early, besides being able to check on the equipment, is the chance to greet the audience members as they enter. It is easier to speak to a group of friends than strangers. And if you can remember their names, you can call on them and ask their opinion or how they might manage a patient who has the condition you are discussing. You also could suggest to the meeting planner that name tags for attendees would be helpful.

 

 

Warming up. A public speaker, like an athlete, needs to warm up physically before the event. If the facility has an anteroom available, use it for the following exercises suggested by public speaking coach Patricia Fripp1:

 

  • Stand on one leg and shake the other (remove high heels first). When you place your raised foot back on the floor, it will feel lighter than the other one. Repeat the exercise using the other leg. Imagine your energy going down through the floor and up out of your head. While this sounds quite comical, it is not. It is a practical technique used by actors.
  • Shake your hands vigorously. Hold them above your head, bending your wrists and elbows, then return your arms to your sides. This will make your hand movements more natural.
  • Warm up your facial muscles by chewing in a highly exaggerated way. Do shoulder and neck rolls. Imagine you are at eye level with a clock. As you look at 12 o’clock, pull as much of your face up to the 12 as you can; move your eyes to 3 and repeat, then down to 6, and finally over to 9.

Not only do these exercises warm you up but they also relax you. The exaggerated movements help your movements to flow more naturally.1

This is just the start
Thorough preparation is key to making a solid presentation. But other factors are important too. Your goal is for the audience to take action or to implement suggestions from your presentation. In part 2 of this series, we will share tips on elements of the presentation itself that will encourage audience engagement and message retention. We will discuss how to make your message “stick” and how to make a dynamic, effective presentation that holds your audience’s attention for your entire talk.

Share your thoughts! Send your Letter to the Editor to [email protected]. Please include your name and the city and state in which you practice.

References

Reference

 

  1. Fripp P. Add credibility to your business reputation through public speaking. Patricia Fripp website. http://www.fripp.com/add-credibility-to-your-business-reputation-through-public-speaking/. Accessed June 15, 2016.
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Mickey M. Karram, MD, and Neil H. Baum, MD

Dr. Karram is Professor of Obstetrics and Gynecology and Urology, University of Cincinnati School of Medicine, and Director, Urogynecology, The Christ Hospital, Cincinnati, Ohio.

Dr. Baum practices urology in New Orleans, Louisiana, and is Associate Clinical Professor of Urology, Tulane Medical School and Louisiana State University School of Medicine, New Orleans. Dr. Baum is an OBG Management Contributing Editor. 

The authors report no financial relationships relevant to this article.

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Mickey M. Karram, MD, and Neil H. Baum, MD

Dr. Karram is Professor of Obstetrics and Gynecology and Urology, University of Cincinnati School of Medicine, and Director, Urogynecology, The Christ Hospital, Cincinnati, Ohio.

Dr. Baum practices urology in New Orleans, Louisiana, and is Associate Clinical Professor of Urology, Tulane Medical School and Louisiana State University School of Medicine, New Orleans. Dr. Baum is an OBG Management Contributing Editor. 

The authors report no financial relationships relevant to this article.

Author and Disclosure Information

 

Mickey M. Karram, MD, and Neil H. Baum, MD

Dr. Karram is Professor of Obstetrics and Gynecology and Urology, University of Cincinnati School of Medicine, and Director, Urogynecology, The Christ Hospital, Cincinnati, Ohio.

Dr. Baum practices urology in New Orleans, Louisiana, and is Associate Clinical Professor of Urology, Tulane Medical School and Louisiana State University School of Medicine, New Orleans. Dr. Baum is an OBG Management Contributing Editor. 

The authors report no financial relationships relevant to this article.

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According to most studies, people's number one fear is public speaking. Number two is death...This means to the average person, if you go to a funeral, you're better off in the casket than doing the eulogy.  -- Jerry Seinfeld

Public speaking is one of the best ways to market and promote your skills as a physician. It is an ethical way of communicating and showcasing your areas of interest and expertise to professional or lay audiences. Most physicians and health care professionals take pride in their ability to communicate. After all, that is how we take a history, discuss our findings with patients, and educate individuals on restoring or maintaining their health. Public speaking, though, for the most part is a learned skill. Except for presentations to faculty at bedside or at grand rounds, we have received little training in public speaking.

Few of us are naturally comfortable in front of a live audience or a TV or video camera. But with a little practice and diligent preparation, we can become good or even excellent, confident public speakers. This article—the first in a series of 3—provides you with preparatory tips and techniques to enhance your public speaking skills.

First, know your audience
Whether you are presenting to a group of 20 or 200, you can do certain things in advance to ensure that your presentation achieves the desired response. Most important: Know your audience. Don’t assume the audience is like you. To connect with them, you need to understand why your topic is important to them. What do they expect to learn from the presentation? Each attendee will be asking, “What’s in it for me?”

To keep listeners interested and engaged, you also must know their level of knowledge about the topic. If you are speaking to a group of residents about pelvic organ prolapse, you would use different language and content than if you were speaking to practicing primary care doctors; and these elements would be different again if you were speaking to a group of practicing urogynecologists. It’s insulting to recite basic information to highly knowledgeable physicians, or to present sophisticated technical content and complicated slides to novice physicians or lay people.

When presenting in a foreign country, learn how the culture of the audience differs from yours. How do they dress? What style of humor do they favor? How do they typically communicate? What gestures are appropriate or inappropriate? Are there religious influences to consider?

Practical steps. Before the meeting or event, speak to the organizer or meeting planner and find out the audience’s level of knowledge on the topic. Ask about audience expectations as well as demographics (such as age and background). If you are speaking at an industry event, research the event’s website and familiarize yourself with the mission of the event and who are the typical attendees. If you are presenting to a corporation, learn as much as you can about it by visiting its website, reading news reports, and reviewing associated blogs.

In addition to knowing the needs of the audience, ask the meeting planner about the goals and objectives for the program to make certain you can deliver on the requests.

Know your talk stem to stern
Review your slide material thoroughly. Understand each slide in the presentation and be comfortable with its content.

Avoid reading from slides. Reciting content that viewers can read for themselves breeds boredom and makes them lose interest. Further, when you are looking at the slides, you are not making eye contact with the audience and risk losing their attention. Good speakers are so comfortable with their slides that they can discuss each one without having to look at it.

Rehearse. The best way to achieve the foregoing is to rehearse. Your audience will be able to tell if you took the slide deck directly from a CD and loaded it into a computer and are giving the talk for the first time. You’ll need to know how long the program is to last and how long you are to speak. We suggest you practice with a timer to be certain you do not exceed the allotted time. Rehearse your talk aloud several times with all the props and audiovisual equipment you plan to use. This practice will help to curb filler words such as “ah” and “um.” It is also helpful to practice slide transitions, pauses, and even your breathing.

Prepare for the unexpected, too. Dinner meetings, for instance, may not start on time due to office or hospital delays for attending physicians, possibly resulting in a need to shorten your presentation.

 

 

Ask about the meeting agenda. If a meal is to be served, will you be speaking beforehand? This is the least favorable time slot, as you are holding people hostage before they can eat. Our preference is to speak after the appetizer is served and the orders have been taken by the wait staff. This way, attendees are not starving and they have something to drink. You can assure the waiters they won’t be disturbing you, and you can ask them to avoid walking in front of the projector. Ideally, you should end your presentation before dessert arrives and use the remaining time to field questions.

We suggest that you prepare a handout to be distributed at the end of the program, not before. You want your audience focused on you and your slides as you are speaking. Tell the audience you will be providing a handout of your presentation, which will minimize note-taking during your talk.

Your speech opening
The first and last 30 seconds of any speech probably have the most impact.1 Give extra thought, time, and effort to your opening and closing remarks. Do not open with “Good evening, it is a pleasure to be here tonight.” That wastes precious seconds.

While opening a speech with a joke or funny story is the conventional wisdom, ask yourself1:

 

  • Is my selection appropriate to the occasion and for this audience?
  • Is it in good taste?
  • Does it relate to me (my service) or to the event or the group? Does it support my topic or its key points?

A humorous story or inspirational vignette that relates to your topic or audience can grab the audience’s attention. If you feel that demands more presentation skill than you possess at the outset of your public-speaking career, give the audience what you know and what they most want to hear. You know the questions that you have heard most at cocktail receptions or professional society meetings. So, put the answers to those questions in your speech.

For example. A scientist working with a major corporation was preparing a speech for a lay audience. Since most of the audience did not know what scientists do, he offered the following analogy: “Being a scientist is like doing a jigsaw puzzle in a snowstorm at night...you don’t have all the pieces...and you don’t have the picture on the front of the box to work from.” You can say more with less.1

Your closing
The closing is an important aspect of your speech. Summarize the key elements to your presentation. If you are going to take questions, a good approach is to say, “Before my closing remarks, are there any questions?” Following the questions, finish with a takeaway message that ties into your theme.1

Prepare an autobiographical introduction
We suggest that you write your own introduction and e-mail it to the person who will be introducing you. Let them know it is a suggestion that they are welcome to modify. We have found that most emcees or meeting planners are delighted to have the introduction and will use it just as you have written it. Also bring hard copy with you; many emcees will have forgotten to download what you sent. The figure shows an example of the introduction that one of us (NHB) uses, and you are welcome to modify it for your own use.

Ask about and confirm audiovisual support
Ask the meeting planner ahead of time if they will be providing the computer, projector, and screen. And if, for instance, they will provide a projector but not a computer, make sure the computer you will bring is compatible with their projector. Also, you will probably not require a microphone for a small group, but if you are speaking in a loud restaurant, a portable microphone-speaker system may be helpful.

Arrive early at the program venue to make sure the computers, projector, screen placement, and seating arrangement are all in order. Nothing can sidetrack a speaker (even a seasoned one) like a problem with the computer or equipment setup—for example, your flash drive requiring a USB port cannot connect to the sponsor’s computer, or your program created on a Mac does not run on the sponsor’s PC. 

Show time: Getting ready
Another benefit in arriving early, besides being able to check on the equipment, is the chance to greet the audience members as they enter. It is easier to speak to a group of friends than strangers. And if you can remember their names, you can call on them and ask their opinion or how they might manage a patient who has the condition you are discussing. You also could suggest to the meeting planner that name tags for attendees would be helpful.

 

 

Warming up. A public speaker, like an athlete, needs to warm up physically before the event. If the facility has an anteroom available, use it for the following exercises suggested by public speaking coach Patricia Fripp1:

 

  • Stand on one leg and shake the other (remove high heels first). When you place your raised foot back on the floor, it will feel lighter than the other one. Repeat the exercise using the other leg. Imagine your energy going down through the floor and up out of your head. While this sounds quite comical, it is not. It is a practical technique used by actors.
  • Shake your hands vigorously. Hold them above your head, bending your wrists and elbows, then return your arms to your sides. This will make your hand movements more natural.
  • Warm up your facial muscles by chewing in a highly exaggerated way. Do shoulder and neck rolls. Imagine you are at eye level with a clock. As you look at 12 o’clock, pull as much of your face up to the 12 as you can; move your eyes to 3 and repeat, then down to 6, and finally over to 9.

Not only do these exercises warm you up but they also relax you. The exaggerated movements help your movements to flow more naturally.1

This is just the start
Thorough preparation is key to making a solid presentation. But other factors are important too. Your goal is for the audience to take action or to implement suggestions from your presentation. In part 2 of this series, we will share tips on elements of the presentation itself that will encourage audience engagement and message retention. We will discuss how to make your message “stick” and how to make a dynamic, effective presentation that holds your audience’s attention for your entire talk.

Share your thoughts! Send your Letter to the Editor to [email protected]. Please include your name and the city and state in which you practice.

 

 

According to most studies, people's number one fear is public speaking. Number two is death...This means to the average person, if you go to a funeral, you're better off in the casket than doing the eulogy.  -- Jerry Seinfeld

Public speaking is one of the best ways to market and promote your skills as a physician. It is an ethical way of communicating and showcasing your areas of interest and expertise to professional or lay audiences. Most physicians and health care professionals take pride in their ability to communicate. After all, that is how we take a history, discuss our findings with patients, and educate individuals on restoring or maintaining their health. Public speaking, though, for the most part is a learned skill. Except for presentations to faculty at bedside or at grand rounds, we have received little training in public speaking.

Few of us are naturally comfortable in front of a live audience or a TV or video camera. But with a little practice and diligent preparation, we can become good or even excellent, confident public speakers. This article—the first in a series of 3—provides you with preparatory tips and techniques to enhance your public speaking skills.

First, know your audience
Whether you are presenting to a group of 20 or 200, you can do certain things in advance to ensure that your presentation achieves the desired response. Most important: Know your audience. Don’t assume the audience is like you. To connect with them, you need to understand why your topic is important to them. What do they expect to learn from the presentation? Each attendee will be asking, “What’s in it for me?”

To keep listeners interested and engaged, you also must know their level of knowledge about the topic. If you are speaking to a group of residents about pelvic organ prolapse, you would use different language and content than if you were speaking to practicing primary care doctors; and these elements would be different again if you were speaking to a group of practicing urogynecologists. It’s insulting to recite basic information to highly knowledgeable physicians, or to present sophisticated technical content and complicated slides to novice physicians or lay people.

When presenting in a foreign country, learn how the culture of the audience differs from yours. How do they dress? What style of humor do they favor? How do they typically communicate? What gestures are appropriate or inappropriate? Are there religious influences to consider?

Practical steps. Before the meeting or event, speak to the organizer or meeting planner and find out the audience’s level of knowledge on the topic. Ask about audience expectations as well as demographics (such as age and background). If you are speaking at an industry event, research the event’s website and familiarize yourself with the mission of the event and who are the typical attendees. If you are presenting to a corporation, learn as much as you can about it by visiting its website, reading news reports, and reviewing associated blogs.

In addition to knowing the needs of the audience, ask the meeting planner about the goals and objectives for the program to make certain you can deliver on the requests.

Know your talk stem to stern
Review your slide material thoroughly. Understand each slide in the presentation and be comfortable with its content.

Avoid reading from slides. Reciting content that viewers can read for themselves breeds boredom and makes them lose interest. Further, when you are looking at the slides, you are not making eye contact with the audience and risk losing their attention. Good speakers are so comfortable with their slides that they can discuss each one without having to look at it.

Rehearse. The best way to achieve the foregoing is to rehearse. Your audience will be able to tell if you took the slide deck directly from a CD and loaded it into a computer and are giving the talk for the first time. You’ll need to know how long the program is to last and how long you are to speak. We suggest you practice with a timer to be certain you do not exceed the allotted time. Rehearse your talk aloud several times with all the props and audiovisual equipment you plan to use. This practice will help to curb filler words such as “ah” and “um.” It is also helpful to practice slide transitions, pauses, and even your breathing.

Prepare for the unexpected, too. Dinner meetings, for instance, may not start on time due to office or hospital delays for attending physicians, possibly resulting in a need to shorten your presentation.

 

 

Ask about the meeting agenda. If a meal is to be served, will you be speaking beforehand? This is the least favorable time slot, as you are holding people hostage before they can eat. Our preference is to speak after the appetizer is served and the orders have been taken by the wait staff. This way, attendees are not starving and they have something to drink. You can assure the waiters they won’t be disturbing you, and you can ask them to avoid walking in front of the projector. Ideally, you should end your presentation before dessert arrives and use the remaining time to field questions.

We suggest that you prepare a handout to be distributed at the end of the program, not before. You want your audience focused on you and your slides as you are speaking. Tell the audience you will be providing a handout of your presentation, which will minimize note-taking during your talk.

Your speech opening
The first and last 30 seconds of any speech probably have the most impact.1 Give extra thought, time, and effort to your opening and closing remarks. Do not open with “Good evening, it is a pleasure to be here tonight.” That wastes precious seconds.

While opening a speech with a joke or funny story is the conventional wisdom, ask yourself1:

 

  • Is my selection appropriate to the occasion and for this audience?
  • Is it in good taste?
  • Does it relate to me (my service) or to the event or the group? Does it support my topic or its key points?

A humorous story or inspirational vignette that relates to your topic or audience can grab the audience’s attention. If you feel that demands more presentation skill than you possess at the outset of your public-speaking career, give the audience what you know and what they most want to hear. You know the questions that you have heard most at cocktail receptions or professional society meetings. So, put the answers to those questions in your speech.

For example. A scientist working with a major corporation was preparing a speech for a lay audience. Since most of the audience did not know what scientists do, he offered the following analogy: “Being a scientist is like doing a jigsaw puzzle in a snowstorm at night...you don’t have all the pieces...and you don’t have the picture on the front of the box to work from.” You can say more with less.1

Your closing
The closing is an important aspect of your speech. Summarize the key elements to your presentation. If you are going to take questions, a good approach is to say, “Before my closing remarks, are there any questions?” Following the questions, finish with a takeaway message that ties into your theme.1

Prepare an autobiographical introduction
We suggest that you write your own introduction and e-mail it to the person who will be introducing you. Let them know it is a suggestion that they are welcome to modify. We have found that most emcees or meeting planners are delighted to have the introduction and will use it just as you have written it. Also bring hard copy with you; many emcees will have forgotten to download what you sent. The figure shows an example of the introduction that one of us (NHB) uses, and you are welcome to modify it for your own use.

Ask about and confirm audiovisual support
Ask the meeting planner ahead of time if they will be providing the computer, projector, and screen. And if, for instance, they will provide a projector but not a computer, make sure the computer you will bring is compatible with their projector. Also, you will probably not require a microphone for a small group, but if you are speaking in a loud restaurant, a portable microphone-speaker system may be helpful.

Arrive early at the program venue to make sure the computers, projector, screen placement, and seating arrangement are all in order. Nothing can sidetrack a speaker (even a seasoned one) like a problem with the computer or equipment setup—for example, your flash drive requiring a USB port cannot connect to the sponsor’s computer, or your program created on a Mac does not run on the sponsor’s PC. 

Show time: Getting ready
Another benefit in arriving early, besides being able to check on the equipment, is the chance to greet the audience members as they enter. It is easier to speak to a group of friends than strangers. And if you can remember their names, you can call on them and ask their opinion or how they might manage a patient who has the condition you are discussing. You also could suggest to the meeting planner that name tags for attendees would be helpful.

 

 

Warming up. A public speaker, like an athlete, needs to warm up physically before the event. If the facility has an anteroom available, use it for the following exercises suggested by public speaking coach Patricia Fripp1:

 

  • Stand on one leg and shake the other (remove high heels first). When you place your raised foot back on the floor, it will feel lighter than the other one. Repeat the exercise using the other leg. Imagine your energy going down through the floor and up out of your head. While this sounds quite comical, it is not. It is a practical technique used by actors.
  • Shake your hands vigorously. Hold them above your head, bending your wrists and elbows, then return your arms to your sides. This will make your hand movements more natural.
  • Warm up your facial muscles by chewing in a highly exaggerated way. Do shoulder and neck rolls. Imagine you are at eye level with a clock. As you look at 12 o’clock, pull as much of your face up to the 12 as you can; move your eyes to 3 and repeat, then down to 6, and finally over to 9.

Not only do these exercises warm you up but they also relax you. The exaggerated movements help your movements to flow more naturally.1

This is just the start
Thorough preparation is key to making a solid presentation. But other factors are important too. Your goal is for the audience to take action or to implement suggestions from your presentation. In part 2 of this series, we will share tips on elements of the presentation itself that will encourage audience engagement and message retention. We will discuss how to make your message “stick” and how to make a dynamic, effective presentation that holds your audience’s attention for your entire talk.

Share your thoughts! Send your Letter to the Editor to [email protected]. Please include your name and the city and state in which you practice.

References

Reference

 

  1. Fripp P. Add credibility to your business reputation through public speaking. Patricia Fripp website. http://www.fripp.com/add-credibility-to-your-business-reputation-through-public-speaking/. Accessed June 15, 2016.
References

Reference

 

  1. Fripp P. Add credibility to your business reputation through public speaking. Patricia Fripp website. http://www.fripp.com/add-credibility-to-your-business-reputation-through-public-speaking/. Accessed June 15, 2016.
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Using videos to educate your ObGyn patients

Patient barriers to optimal health-care outcomes are well documented. According to a 2003 estimate from the National Center for Education Statistics, 9 in 10 individuals do not know how to adequately access information readily available for their own health care.1 A December 7, 2013, report in Modern Healthcare stated, “When patients are in doctors’ offices, they (might) hear 50% of what’s being said and maybe their relative hears another 30%, but they walk away without 20%.”2

In addition, patients often do not fill or refill their prescriptions. More than 31% of about 37,000 prescriptions written in a primary care setting for nearly 16,000 patients were not filled.3 Reasons may be poor health literacy, a medication’s expense, or disappointment with lack of drug efficacy. In a 2010 Commonwealth Fund survey, 23.1% of US patients reported not filling a drug prescription in the previous 12 months due to cost,4 and in 2012, 27% did not follow through with recommended testing or treatment.5

On the physician side, the advent of managed care, electronic health records, and requirements to document extraneous information have shortened “face time” with patients. This means less time to educate patients about their conditions and treatments. And patients who have insufficient information may have trouble adhering with recommendations and experience unsatisfactory outcomes.

Using focused patient-education videos can help you circumvent in-office time constraints and inform patients of their conditions and your recommendations, thereby increasing practice efficiency and improving patient outcomes. There are certain considerations you should keep in mind when implementing and executing videos for patients.

Planning your video
With videos, you can convey to patients the exact message you want them to receive. This is far more effective and more appreciatedthan videos distributed by pharmaceutical companies and vendors of equipment used in your office or hospital. If you do not have the time to create patient videos, purchasing professionally created videos could be worth the cost; however, those created by physicians are far better and can be a source of enhanced communication when patients see their own physician on the screen discussing the condition, procedure, or medications prescribed.

We suggest selecting topics you regularly discuss with patients. If the topic of prolapse arises several times a day or week, a video presentation about it would be appropriate. Other topics of interest to gynecology patients are shown in the TABLE. The topics included are those that many of our colleagues find that they discuss with patients frequently and are in need of an instructional video.

Example video topics for patient viewing
• Evaluation of urinary incontinence
• Recurrent urinary tract infection
• Infertility evaluation
• Options for hysterectomy
• Management of menometrorrhagia
• Contraception options (including bilateral tubal ligation)
• Pros and cons of hormone replacement therapy
• Breast self examination

One of us (NB) likes to select topics that are receiving lots of publicity. For example, when flibanserin was approved by the US Food and Drug Administration in 2015 and patients were asking about it, we created a video with a handout that summarized the drug’s actions and its adverse effects and that emphasized the precaution about using flibanserin in conjunction with alcohol.

Production elements
The script.

 

  • Define the problem/condition
  • Offer how the problem is evaluated
  • Discuss treatment options
  • Go over risks and complications
  • Include a summary.

Embedding details of these bullet points into a PowerPoint presentation can serve as your teleprompter. Each video might end with the statement, “I hope you have found this video on <name of topic> informative. If you open the door at the end of the video, I will return to the examination room and provide you with a summary of the <topic> and answer any questions you may have.” We refer to this as the “sandwich technique,” in which the physician interacts with the patient first and performs the examination, invites the patient to watch the video, and returns to the room to conclude the patient visit.

The recording device. Recording can be accomplished easily with technology available in nearly every ObGyn office. You can use a video camera, the webcam on your computer, or a smart phone (probably the easiest choice). The quality of video created with the Apple, Samsung, or Motorola devices is excellent. The only other piece of equipment we recommend is a flexible tripod to hold the phone. Several such tripod stands are available for purchase, but the type with a flexible stand can be beneficial (FIGURE 1). These are available for purchase on Amazon.

 

FIGURE 1 Our recommended tripod stand

  

The TriFlex Mini Phone Tripod Stand, available for purchase at retailers and at Amazon (http://www.amazon.com/dp/B017NA7V1U?psc=1).

 

 

Putting it all together. With the smartphone in the tripod attached to the computer and the PowerPoint program serving as your notes, you are ready to create a video. We suggest limiting the recording to 5 to 7 minutes, the attention span of most patients. Those who want to produce a more professional looking video can use the editing programs iMovie on the Mac or Movie Maker on the PC.

Videos can be uploaded to your website, your EMR, or onto separate computers in each of your examination rooms. Depending on where you upload your videos (your own website or YouTube), patients can access them from home. An advantage of your own website and YouTube is that the videos can be viewed again and by patients’ significant others (which patients often inquire about the ability to do).

Other considerations
Videos that are conversational in nature, using the pronouns “I” and “we” and using such language as “my opinion” and “our patients” may hold the attention of viewers more than didactic “talking head” videos. In addition, creating videos on controversial topics that patients are interested in and need more information about can benefit patients and your practice.

Creating videos in other languages for your patients is an option as well. If you speak the language, then create your video in both English and the other language. Or you can create the script and ask a patient who speaks the non-English language to assist with the video production or voiceover. Also, there are other language videos for patients on YouTube. An excellent example of a Spanish-language gynecologic video on the pelvic examination is available (https://www.youtube.com/watch?v=IKsGYc-dCSI). It is easy to create a link from your website to a YouTube video. This requires requesting permission from the creator of the video. (We do not recommend showcasing another physician on your website.)

Example Patient education videos
Examples of videos on stress urinary incontinence and treatment with a midurethral sling can be viewed at: https://www.youtube.com/watch?v=BFZj8x3-oCA and https://www.youtube.com/watch?v=-gnOqkXiye0.

Dr. Neil Baum is the author of Social Media for the Healthcare Professional (Greenbranch Publishing, 2012).

Advantages of creating videos
When patients are watching the video, you can conduct visits with other patients and even perform brief office procedures. You can anticipate an up to 15% to 20% improvement in office efficiency by using educational videos. And patients will appreciate the information and the written summary accompanying each video.

Videos and medical-legal protection
Documentation is necessary to protect yourself from litigation. Record the viewing of a video in a patient’s chart, as well as the receipt of pertinent written information. We suggest you also note that all of the patient’s questions were answered before the patient left the office. To confirm that the patient understood the condition, procedure, or surgery, you can ask the patient to fill out a true/false questionnaire after watching the video and also include it in the chart. A questionnaire I (NB) use after the patient watches a video on stress incontinence is shown in FIGURE 2.

A statement to accompany the questionnaire is also a good idea. Example: “<name of patient> watched a video on the treatment of stress incontinence. The video discussed the procedure and its risks and complications, and alternate treatments, including the option to have no treatment. She agrees to proceeding with a midurethral sling using synthetic mesh and understands the risks and complications associated with the use of mesh.”

An additional helpful option is to end your videos with a comment that addresses the statement and consent form you will ask the patient to sign. For instance, “I will return to the examination room and provide you with a summary of the <topic> and answer any questions you may have. I also will ask you to sign a procedure or operative consent form as well as sign a statement that says you have watched the video, understand the content, and have had your questions answered.”

We believe that this makes the video an excellent medical-legal protection tool for the physician and that the video enhances the informed consent process.

Bottom line
We are challenged today to provide quality care in an efficient and cost-effective manner. This is a concern for every ObGyn practice regardless of its size or location or whether it is a solo or group practice or academic or private. We can improve our efficiency and our productivity, maintain quality of care, improve patient adherence, and even improve outcomes using patient videos. So get ready for lights, camera, and action!

 

Share your thoughts! Send your Letter to the Editor to [email protected]. Please include your name and the city and state in which you practice. 

References

 

 

  1. Kutner M, Greenberg E, Jin Y, et al. The Health Literacy of America’s Adults: Results from the 2003 National Assessment of Adult Literacy. Washington, DC: National Center for Education Statistics, US Dept of Education, 2006.
  2. 1NCES publication 2006-483.2. Modern Healthcare. Providers help patients address emotion, money, health literacy. Available at: http://www.modernhealthcare.com/article/20131207/MAGAZINE/312079983. Accessed April 15, 2016.
  3. Tamblyn R, Eguale T, Huang A, Winsdale N, Doran P. The incidence and determinants of primary nonadherence with prescribed medication in primary care: a cohort study. Ann Intern Med. 2014;160(7):441–450.
  4. Morgan S, Kennedy J. Prescription drug accessibility and affordability in the United States and abroad. Issue Brief (Commonw Fund). 2010;89:1012.
  5. Collins SR, Robertson R, Garber T, et al. Insuring the future. Current trends in health coverage and the effects of implementing the Affordable Care Act. Available at: http://www.commonwealthfund.org/~/media/Files/Publications/Fund%20Report/2013/Apr/1681_Collins_insuring_future_biennial_survey_2012_FINAL.pdf. Accessed April 15, 2016.
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Neil H. Baum, MD, and Mickey M. Karram, MD

Dr. Baum practices urology in New Orleans, Louisiana, and is Associate Clinical Professor of Urology, Tulane Medical School and Louisiana State University School of Medicine, New Orleans. Dr. Baum is an OBG Management Contributing Editor.

Dr. Karram is Professor of Obstetrics and Gynecology and Urology, University of Cincinnati School of Medicine, and Director, Urogynecology, The Christ Hospital, Cincinnati, Ohio.

The authors report no financial relationships relevant to this article.

Issue
OBG Management - 28(5)
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16,18,20,22
Legacy Keywords
Neil H. Baum MD,Mickey M. Karram MD,patient video education,medical videos,video patient education,patient education,informed consent,practice efficiency,improving patient outcomes,obstetrics,gynecology,flibanserin,script,urinary incontinence,UTIs,infertility,hysterectomy,contraception,hormone therapy,breast self examination,recording device,PowerPoint slides,video tripod stand,pelvic examination,documentation,sample questionnaire,midurethral sling,treatment options,medical-legal protection,patient adherence,
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Neil H. Baum, MD, and Mickey M. Karram, MD

Dr. Baum practices urology in New Orleans, Louisiana, and is Associate Clinical Professor of Urology, Tulane Medical School and Louisiana State University School of Medicine, New Orleans. Dr. Baum is an OBG Management Contributing Editor.

Dr. Karram is Professor of Obstetrics and Gynecology and Urology, University of Cincinnati School of Medicine, and Director, Urogynecology, The Christ Hospital, Cincinnati, Ohio.

The authors report no financial relationships relevant to this article.

Author and Disclosure Information

 

Neil H. Baum, MD, and Mickey M. Karram, MD

Dr. Baum practices urology in New Orleans, Louisiana, and is Associate Clinical Professor of Urology, Tulane Medical School and Louisiana State University School of Medicine, New Orleans. Dr. Baum is an OBG Management Contributing Editor.

Dr. Karram is Professor of Obstetrics and Gynecology and Urology, University of Cincinnati School of Medicine, and Director, Urogynecology, The Christ Hospital, Cincinnati, Ohio.

The authors report no financial relationships relevant to this article.

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Related Articles

Patient barriers to optimal health-care outcomes are well documented. According to a 2003 estimate from the National Center for Education Statistics, 9 in 10 individuals do not know how to adequately access information readily available for their own health care.1 A December 7, 2013, report in Modern Healthcare stated, “When patients are in doctors’ offices, they (might) hear 50% of what’s being said and maybe their relative hears another 30%, but they walk away without 20%.”2

In addition, patients often do not fill or refill their prescriptions. More than 31% of about 37,000 prescriptions written in a primary care setting for nearly 16,000 patients were not filled.3 Reasons may be poor health literacy, a medication’s expense, or disappointment with lack of drug efficacy. In a 2010 Commonwealth Fund survey, 23.1% of US patients reported not filling a drug prescription in the previous 12 months due to cost,4 and in 2012, 27% did not follow through with recommended testing or treatment.5

On the physician side, the advent of managed care, electronic health records, and requirements to document extraneous information have shortened “face time” with patients. This means less time to educate patients about their conditions and treatments. And patients who have insufficient information may have trouble adhering with recommendations and experience unsatisfactory outcomes.

Using focused patient-education videos can help you circumvent in-office time constraints and inform patients of their conditions and your recommendations, thereby increasing practice efficiency and improving patient outcomes. There are certain considerations you should keep in mind when implementing and executing videos for patients.

Planning your video
With videos, you can convey to patients the exact message you want them to receive. This is far more effective and more appreciatedthan videos distributed by pharmaceutical companies and vendors of equipment used in your office or hospital. If you do not have the time to create patient videos, purchasing professionally created videos could be worth the cost; however, those created by physicians are far better and can be a source of enhanced communication when patients see their own physician on the screen discussing the condition, procedure, or medications prescribed.

We suggest selecting topics you regularly discuss with patients. If the topic of prolapse arises several times a day or week, a video presentation about it would be appropriate. Other topics of interest to gynecology patients are shown in the TABLE. The topics included are those that many of our colleagues find that they discuss with patients frequently and are in need of an instructional video.

Example video topics for patient viewing
• Evaluation of urinary incontinence
• Recurrent urinary tract infection
• Infertility evaluation
• Options for hysterectomy
• Management of menometrorrhagia
• Contraception options (including bilateral tubal ligation)
• Pros and cons of hormone replacement therapy
• Breast self examination

One of us (NB) likes to select topics that are receiving lots of publicity. For example, when flibanserin was approved by the US Food and Drug Administration in 2015 and patients were asking about it, we created a video with a handout that summarized the drug’s actions and its adverse effects and that emphasized the precaution about using flibanserin in conjunction with alcohol.

Production elements
The script.

 

  • Define the problem/condition
  • Offer how the problem is evaluated
  • Discuss treatment options
  • Go over risks and complications
  • Include a summary.

Embedding details of these bullet points into a PowerPoint presentation can serve as your teleprompter. Each video might end with the statement, “I hope you have found this video on <name of topic> informative. If you open the door at the end of the video, I will return to the examination room and provide you with a summary of the <topic> and answer any questions you may have.” We refer to this as the “sandwich technique,” in which the physician interacts with the patient first and performs the examination, invites the patient to watch the video, and returns to the room to conclude the patient visit.

The recording device. Recording can be accomplished easily with technology available in nearly every ObGyn office. You can use a video camera, the webcam on your computer, or a smart phone (probably the easiest choice). The quality of video created with the Apple, Samsung, or Motorola devices is excellent. The only other piece of equipment we recommend is a flexible tripod to hold the phone. Several such tripod stands are available for purchase, but the type with a flexible stand can be beneficial (FIGURE 1). These are available for purchase on Amazon.

 

FIGURE 1 Our recommended tripod stand

  

The TriFlex Mini Phone Tripod Stand, available for purchase at retailers and at Amazon (http://www.amazon.com/dp/B017NA7V1U?psc=1).

 

 

Putting it all together. With the smartphone in the tripod attached to the computer and the PowerPoint program serving as your notes, you are ready to create a video. We suggest limiting the recording to 5 to 7 minutes, the attention span of most patients. Those who want to produce a more professional looking video can use the editing programs iMovie on the Mac or Movie Maker on the PC.

Videos can be uploaded to your website, your EMR, or onto separate computers in each of your examination rooms. Depending on where you upload your videos (your own website or YouTube), patients can access them from home. An advantage of your own website and YouTube is that the videos can be viewed again and by patients’ significant others (which patients often inquire about the ability to do).

Other considerations
Videos that are conversational in nature, using the pronouns “I” and “we” and using such language as “my opinion” and “our patients” may hold the attention of viewers more than didactic “talking head” videos. In addition, creating videos on controversial topics that patients are interested in and need more information about can benefit patients and your practice.

Creating videos in other languages for your patients is an option as well. If you speak the language, then create your video in both English and the other language. Or you can create the script and ask a patient who speaks the non-English language to assist with the video production or voiceover. Also, there are other language videos for patients on YouTube. An excellent example of a Spanish-language gynecologic video on the pelvic examination is available (https://www.youtube.com/watch?v=IKsGYc-dCSI). It is easy to create a link from your website to a YouTube video. This requires requesting permission from the creator of the video. (We do not recommend showcasing another physician on your website.)

Example Patient education videos
Examples of videos on stress urinary incontinence and treatment with a midurethral sling can be viewed at: https://www.youtube.com/watch?v=BFZj8x3-oCA and https://www.youtube.com/watch?v=-gnOqkXiye0.

Dr. Neil Baum is the author of Social Media for the Healthcare Professional (Greenbranch Publishing, 2012).

Advantages of creating videos
When patients are watching the video, you can conduct visits with other patients and even perform brief office procedures. You can anticipate an up to 15% to 20% improvement in office efficiency by using educational videos. And patients will appreciate the information and the written summary accompanying each video.

Videos and medical-legal protection
Documentation is necessary to protect yourself from litigation. Record the viewing of a video in a patient’s chart, as well as the receipt of pertinent written information. We suggest you also note that all of the patient’s questions were answered before the patient left the office. To confirm that the patient understood the condition, procedure, or surgery, you can ask the patient to fill out a true/false questionnaire after watching the video and also include it in the chart. A questionnaire I (NB) use after the patient watches a video on stress incontinence is shown in FIGURE 2.

A statement to accompany the questionnaire is also a good idea. Example: “<name of patient> watched a video on the treatment of stress incontinence. The video discussed the procedure and its risks and complications, and alternate treatments, including the option to have no treatment. She agrees to proceeding with a midurethral sling using synthetic mesh and understands the risks and complications associated with the use of mesh.”

An additional helpful option is to end your videos with a comment that addresses the statement and consent form you will ask the patient to sign. For instance, “I will return to the examination room and provide you with a summary of the <topic> and answer any questions you may have. I also will ask you to sign a procedure or operative consent form as well as sign a statement that says you have watched the video, understand the content, and have had your questions answered.”

We believe that this makes the video an excellent medical-legal protection tool for the physician and that the video enhances the informed consent process.

Bottom line
We are challenged today to provide quality care in an efficient and cost-effective manner. This is a concern for every ObGyn practice regardless of its size or location or whether it is a solo or group practice or academic or private. We can improve our efficiency and our productivity, maintain quality of care, improve patient adherence, and even improve outcomes using patient videos. So get ready for lights, camera, and action!

 

Share your thoughts! Send your Letter to the Editor to [email protected]. Please include your name and the city and state in which you practice. 

Patient barriers to optimal health-care outcomes are well documented. According to a 2003 estimate from the National Center for Education Statistics, 9 in 10 individuals do not know how to adequately access information readily available for their own health care.1 A December 7, 2013, report in Modern Healthcare stated, “When patients are in doctors’ offices, they (might) hear 50% of what’s being said and maybe their relative hears another 30%, but they walk away without 20%.”2

In addition, patients often do not fill or refill their prescriptions. More than 31% of about 37,000 prescriptions written in a primary care setting for nearly 16,000 patients were not filled.3 Reasons may be poor health literacy, a medication’s expense, or disappointment with lack of drug efficacy. In a 2010 Commonwealth Fund survey, 23.1% of US patients reported not filling a drug prescription in the previous 12 months due to cost,4 and in 2012, 27% did not follow through with recommended testing or treatment.5

On the physician side, the advent of managed care, electronic health records, and requirements to document extraneous information have shortened “face time” with patients. This means less time to educate patients about their conditions and treatments. And patients who have insufficient information may have trouble adhering with recommendations and experience unsatisfactory outcomes.

Using focused patient-education videos can help you circumvent in-office time constraints and inform patients of their conditions and your recommendations, thereby increasing practice efficiency and improving patient outcomes. There are certain considerations you should keep in mind when implementing and executing videos for patients.

Planning your video
With videos, you can convey to patients the exact message you want them to receive. This is far more effective and more appreciatedthan videos distributed by pharmaceutical companies and vendors of equipment used in your office or hospital. If you do not have the time to create patient videos, purchasing professionally created videos could be worth the cost; however, those created by physicians are far better and can be a source of enhanced communication when patients see their own physician on the screen discussing the condition, procedure, or medications prescribed.

We suggest selecting topics you regularly discuss with patients. If the topic of prolapse arises several times a day or week, a video presentation about it would be appropriate. Other topics of interest to gynecology patients are shown in the TABLE. The topics included are those that many of our colleagues find that they discuss with patients frequently and are in need of an instructional video.

Example video topics for patient viewing
• Evaluation of urinary incontinence
• Recurrent urinary tract infection
• Infertility evaluation
• Options for hysterectomy
• Management of menometrorrhagia
• Contraception options (including bilateral tubal ligation)
• Pros and cons of hormone replacement therapy
• Breast self examination

One of us (NB) likes to select topics that are receiving lots of publicity. For example, when flibanserin was approved by the US Food and Drug Administration in 2015 and patients were asking about it, we created a video with a handout that summarized the drug’s actions and its adverse effects and that emphasized the precaution about using flibanserin in conjunction with alcohol.

Production elements
The script.

 

  • Define the problem/condition
  • Offer how the problem is evaluated
  • Discuss treatment options
  • Go over risks and complications
  • Include a summary.

Embedding details of these bullet points into a PowerPoint presentation can serve as your teleprompter. Each video might end with the statement, “I hope you have found this video on <name of topic> informative. If you open the door at the end of the video, I will return to the examination room and provide you with a summary of the <topic> and answer any questions you may have.” We refer to this as the “sandwich technique,” in which the physician interacts with the patient first and performs the examination, invites the patient to watch the video, and returns to the room to conclude the patient visit.

The recording device. Recording can be accomplished easily with technology available in nearly every ObGyn office. You can use a video camera, the webcam on your computer, or a smart phone (probably the easiest choice). The quality of video created with the Apple, Samsung, or Motorola devices is excellent. The only other piece of equipment we recommend is a flexible tripod to hold the phone. Several such tripod stands are available for purchase, but the type with a flexible stand can be beneficial (FIGURE 1). These are available for purchase on Amazon.

 

FIGURE 1 Our recommended tripod stand

  

The TriFlex Mini Phone Tripod Stand, available for purchase at retailers and at Amazon (http://www.amazon.com/dp/B017NA7V1U?psc=1).

 

 

Putting it all together. With the smartphone in the tripod attached to the computer and the PowerPoint program serving as your notes, you are ready to create a video. We suggest limiting the recording to 5 to 7 minutes, the attention span of most patients. Those who want to produce a more professional looking video can use the editing programs iMovie on the Mac or Movie Maker on the PC.

Videos can be uploaded to your website, your EMR, or onto separate computers in each of your examination rooms. Depending on where you upload your videos (your own website or YouTube), patients can access them from home. An advantage of your own website and YouTube is that the videos can be viewed again and by patients’ significant others (which patients often inquire about the ability to do).

Other considerations
Videos that are conversational in nature, using the pronouns “I” and “we” and using such language as “my opinion” and “our patients” may hold the attention of viewers more than didactic “talking head” videos. In addition, creating videos on controversial topics that patients are interested in and need more information about can benefit patients and your practice.

Creating videos in other languages for your patients is an option as well. If you speak the language, then create your video in both English and the other language. Or you can create the script and ask a patient who speaks the non-English language to assist with the video production or voiceover. Also, there are other language videos for patients on YouTube. An excellent example of a Spanish-language gynecologic video on the pelvic examination is available (https://www.youtube.com/watch?v=IKsGYc-dCSI). It is easy to create a link from your website to a YouTube video. This requires requesting permission from the creator of the video. (We do not recommend showcasing another physician on your website.)

Example Patient education videos
Examples of videos on stress urinary incontinence and treatment with a midurethral sling can be viewed at: https://www.youtube.com/watch?v=BFZj8x3-oCA and https://www.youtube.com/watch?v=-gnOqkXiye0.

Dr. Neil Baum is the author of Social Media for the Healthcare Professional (Greenbranch Publishing, 2012).

Advantages of creating videos
When patients are watching the video, you can conduct visits with other patients and even perform brief office procedures. You can anticipate an up to 15% to 20% improvement in office efficiency by using educational videos. And patients will appreciate the information and the written summary accompanying each video.

Videos and medical-legal protection
Documentation is necessary to protect yourself from litigation. Record the viewing of a video in a patient’s chart, as well as the receipt of pertinent written information. We suggest you also note that all of the patient’s questions were answered before the patient left the office. To confirm that the patient understood the condition, procedure, or surgery, you can ask the patient to fill out a true/false questionnaire after watching the video and also include it in the chart. A questionnaire I (NB) use after the patient watches a video on stress incontinence is shown in FIGURE 2.

A statement to accompany the questionnaire is also a good idea. Example: “<name of patient> watched a video on the treatment of stress incontinence. The video discussed the procedure and its risks and complications, and alternate treatments, including the option to have no treatment. She agrees to proceeding with a midurethral sling using synthetic mesh and understands the risks and complications associated with the use of mesh.”

An additional helpful option is to end your videos with a comment that addresses the statement and consent form you will ask the patient to sign. For instance, “I will return to the examination room and provide you with a summary of the <topic> and answer any questions you may have. I also will ask you to sign a procedure or operative consent form as well as sign a statement that says you have watched the video, understand the content, and have had your questions answered.”

We believe that this makes the video an excellent medical-legal protection tool for the physician and that the video enhances the informed consent process.

Bottom line
We are challenged today to provide quality care in an efficient and cost-effective manner. This is a concern for every ObGyn practice regardless of its size or location or whether it is a solo or group practice or academic or private. We can improve our efficiency and our productivity, maintain quality of care, improve patient adherence, and even improve outcomes using patient videos. So get ready for lights, camera, and action!

 

Share your thoughts! Send your Letter to the Editor to [email protected]. Please include your name and the city and state in which you practice. 

References

 

 

  1. Kutner M, Greenberg E, Jin Y, et al. The Health Literacy of America’s Adults: Results from the 2003 National Assessment of Adult Literacy. Washington, DC: National Center for Education Statistics, US Dept of Education, 2006.
  2. 1NCES publication 2006-483.2. Modern Healthcare. Providers help patients address emotion, money, health literacy. Available at: http://www.modernhealthcare.com/article/20131207/MAGAZINE/312079983. Accessed April 15, 2016.
  3. Tamblyn R, Eguale T, Huang A, Winsdale N, Doran P. The incidence and determinants of primary nonadherence with prescribed medication in primary care: a cohort study. Ann Intern Med. 2014;160(7):441–450.
  4. Morgan S, Kennedy J. Prescription drug accessibility and affordability in the United States and abroad. Issue Brief (Commonw Fund). 2010;89:1012.
  5. Collins SR, Robertson R, Garber T, et al. Insuring the future. Current trends in health coverage and the effects of implementing the Affordable Care Act. Available at: http://www.commonwealthfund.org/~/media/Files/Publications/Fund%20Report/2013/Apr/1681_Collins_insuring_future_biennial_survey_2012_FINAL.pdf. Accessed April 15, 2016.
References

 

 

  1. Kutner M, Greenberg E, Jin Y, et al. The Health Literacy of America’s Adults: Results from the 2003 National Assessment of Adult Literacy. Washington, DC: National Center for Education Statistics, US Dept of Education, 2006.
  2. 1NCES publication 2006-483.2. Modern Healthcare. Providers help patients address emotion, money, health literacy. Available at: http://www.modernhealthcare.com/article/20131207/MAGAZINE/312079983. Accessed April 15, 2016.
  3. Tamblyn R, Eguale T, Huang A, Winsdale N, Doran P. The incidence and determinants of primary nonadherence with prescribed medication in primary care: a cohort study. Ann Intern Med. 2014;160(7):441–450.
  4. Morgan S, Kennedy J. Prescription drug accessibility and affordability in the United States and abroad. Issue Brief (Commonw Fund). 2010;89:1012.
  5. Collins SR, Robertson R, Garber T, et al. Insuring the future. Current trends in health coverage and the effects of implementing the Affordable Care Act. Available at: http://www.commonwealthfund.org/~/media/Files/Publications/Fund%20Report/2013/Apr/1681_Collins_insuring_future_biennial_survey_2012_FINAL.pdf. Accessed April 15, 2016.
Issue
OBG Management - 28(5)
Issue
OBG Management - 28(5)
Page Number
16,18,20,22
Page Number
16,18,20,22
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Using videos to educate your ObGyn patients
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Using videos to educate your ObGyn patients
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Neil H. Baum MD,Mickey M. Karram MD,patient video education,medical videos,video patient education,patient education,informed consent,practice efficiency,improving patient outcomes,obstetrics,gynecology,flibanserin,script,urinary incontinence,UTIs,infertility,hysterectomy,contraception,hormone therapy,breast self examination,recording device,PowerPoint slides,video tripod stand,pelvic examination,documentation,sample questionnaire,midurethral sling,treatment options,medical-legal protection,patient adherence,
Legacy Keywords
Neil H. Baum MD,Mickey M. Karram MD,patient video education,medical videos,video patient education,patient education,informed consent,practice efficiency,improving patient outcomes,obstetrics,gynecology,flibanserin,script,urinary incontinence,UTIs,infertility,hysterectomy,contraception,hormone therapy,breast self examination,recording device,PowerPoint slides,video tripod stand,pelvic examination,documentation,sample questionnaire,midurethral sling,treatment options,medical-legal protection,patient adherence,
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In this article

 

• Producing a patient education video
• Videos and medical-legal protection
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4 technology tools ObGyns 
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4 technology tools ObGyns 
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Over the past 15 years a technological tsunami has swept through the health care industry, and few physicians were prepared for the changes wrought by this tidal wave. It now is clear, however, that we are and will have to continue to navigate a future increasingly powered and populated by technology if we are to be successful clinicians. In addition, we must learn to take advantage of all that technology has to offer without compromising the quality of care and compassion we offer our patients. We are fortunate that technology has much to offer to enhance patient care.

One big change under way: Technology 
is leveling the playing field between 
doctors—once the high priests of medicine—and ordinary people. SMART (social, mobile, aware, and real-time) technologies such as cloud computing will broaden the setting of health care interventions from hospital rooms and doctors’ offices to patients’ everyday lives. Cloud computing involves the use of a network of remote servers hosted on the Internet to store, manage, and process data, rather than a local server or a desktop computer located in the doctor’s office. It is possible that, instead of being episodic, health care will be conducted continuously—and anywhere the patient wants it.

Without a doubt, the pace at which new technology affects our lives is increasing at lightning speeds. Today, 29% of Americans say their phone is the first and the last thing they look at each day, a telling sign of how dependent we are becoming on technology.1 In this article, we look at 4 technologies that can be effective in the clinical setting, attracting new patients and enhancing productivity, communication, and patient care.

1. A mobile-friendly Web site

According to Wikipedia, there are 
327,577,529 mobile phones in the 
United States, give or take a few thousand. As of July 4, 2014, the US population was 318,881,992. That means there are more mobile phones in this country than there 
are people!2

Mobile phones are becoming more like personal assistants than phones. People are not just making calls, they’re buying movie tickets, checking the weather, sending and receiving emails, texting, making reservations, checking Web sites … and the list goes on.

According to a recent report from the Pew Research Center, almost two-thirds of Americans own a smartphone, and 62% of smartphone owners have used it to look up information on a health condition.3 Moreover, 15% of smartphone owners say they have a limited number of ways to access the Internet other than their cell phone.3

All the more reason for your Web site to be mobile-friendly. With a mobile- 
friendly site, the content is displayed in a more streamlined fashion on mobile phones, with larger type to make it more readable. See, for example, the FIGURE, which shows Dr. Baum’s regular Web site side by side with the mobile-friendly view.

The Web site of Neil H. Baum, MD, as viewed from a desktop or laptop computer (A) and a smartphone (B).

There is another reason why you should ensure that your site is mobile-friendly: Google recently changed its algorithms so that, when someone searches for information on a mobile phone, only mobile- 
friendly sites make it into the top search results. Google wants mobile phone users to have a positive experience online. It is so adamant about this desire that it will lower your rankings or not show your Web site at all in search results if you fail to comply.

New patient acquisition is critical for any ObGyn practice, and we already know that just about everyone goes online to search for health information and solutions to their medical problems. If you want your practice to survive and thrive, you need to attract new patients online. If a visitor to your site cannot read the text and has to keep resizing the screen and scrolling left and right, you will lose that visitor in a hurry.

We all want to find what we are looking for quickly. In our experience, when we check Google Analytics reports for our 
ObGyn clients, we find that visitors to a nonresponsive site spend much less time there and do not visit as many pages as they do when a site is mobile-responsive.

To check your Web site’s mobile rating, go to http://www.google.com/webmasters/tools/mobile-friendly. Google also offers tips on making your site mobile-friendly at https://support.google.com/webmasters/answer/6001177?hl=en.

Once your site is up to snuff, you should test it from multiple devices to ensure that the pages are easily readable on all types of phones and computers.

 

 

2. Voice recognition software

Speech recognition is the ability of a machine or program to identify words and phrases in spoken language and convert them to a digital format. This tool can help you generate clinical notes and charting without having to stop and type into a computer. This can enhance your interactions with patients by freeing you from the computer during examinations and counseling and allows you to look at the patient and not at the computer.

According to data from June 2000, approximately 5% of physicians used speech recognition to generate text in their offices.4 A white paper from 2008 found that approximately 20% of physicians are using more advanced, more reliable voice recognition technology and saving both time and money.5 This report cited 2007 data showing that:

  • 76% of clinicians who used “desktop speech recognition” (directly controlling an electronic health record [EHR] system via speech) reported faster turnaround time, better patient care, and quicker reimbursement
  • Nearly 30% reported lower costs and increased productivity as benefits. The lower costs arise from reduced transcription and overhead expenses associated with billings and collection.5

The voice recognition software used in Dr. Neil Baum’s office is Dragon 
Medical Practice Edition 2 (www.dragonmedicalpractice.com). Dragon requires a good processor and a minimum of 4 gigabytes of RAM and will run with VMware, Boot Camp, Parallels, and other programs for Mac users. The software contains 80 subspecialty medical vocabularies and is easy to install. After a few minutes, the program learns how you speak and will understand you well with remarkable accuracy. However, to get the greatest benefit from the technology, you will need to invest in training, implementation, and workflow services to allow you to use the program to its full potential in record time.

Dr. Baum uses The Dragon People voice recognition software (www.thedragonpeople.com).

Although voice recognition software can reduce or eliminate transcription costs, improve documentation time, and boost the quality of medical notes, it is critical that you investigate how a particular program fits with your EHR prior to purchasing it—and a salesperson may try to gloss over this issue. In addition, the more you use voice recognition instead of checking off pull-down boxes for your clinical notes, the more difficult it will be to mine your data for quality metrics and pay-for-performance information. For that reason, voice recognition technology may be strongly discouraged by your employer or governing organization.

3. Online lab result reporting

TeleVox’s automated lab results (www
.televox.com/lab-test-results-delivery) allow physicians or staff to assign lab result messages quickly and easily with the click of a mouse. Patients call an 800 number or use an Internet connection to retrieve their results, using a unique PIN to ensure privacy.

Practices that implement this technology see immediate improvements in 3 areas:

  • Streamlined operations. This technology allows lab result messages to be assigned to patients with a few mouse clicks, saving time spent on phone calls and mailing coordination.
  • Reduced costs. Automated lab result reporting reduces staff labor and mailing costs.
  • Ease of access. Patients have round-the-clock access to their information—no more waiting for mail delivery or a phone call. Patients also can choose to be notified when their results are ready, which helps alleviate anxiety.

4. Automated wait-time notification

The most common complaint patients have about their health care experience is the excessive wait times they often experience. Now there are technologies that can provide automated information to let patients know how long they will have to wait to be seen.

A program such as MedWaitTime (www.medwaittime.com) can alert patients about the estimated wait time at a cost of approximately $50 per month per physician. Patients access the service for free.

In addition, many EHRs include practice management features to notify the staff and physician whether he or she is on time. These features may include a tie-in to alert patients as well.

The bottom line

Carefully selected technological tools have much to offer busy clinicians. By ensuring that your practice Web site is mobile- 
friendly, you stand to attract new patients. And the time you save with voice recognition software and computerized lab test result notification can allow you to spend more time with your patients. It can also help eliminate the lag in your patient schedule, keeping the women in your waiting room happy. Remember, a happy patient means a happy doctor!

Share your thoughts! Send your Letter to the Editor to [email protected]. Please include your name and the city and state in which you practice.

References

  1. Your Wireless Life: Results of TIME’s Mobility Poll. http://content.time.com/time/interactive/0,31813,2122187,00.html. Accessed July 29, 2015.
  2. Wikipedia: List of Countries by Number of Mobile Phones in Use. https://en.wikipedia.org/wiki/List_of_countries_by_number_of_mobile_phones_in_use. Accessed July 29, 2015.
  3. Smith A. US Smartphone Use in 2015. Pew Research Center. http://www.pewinternet.org/2015/04/01/us-smartphone-use-in-2015. Published April 1, 2015. Accessed July 29, 2015.
  4. Maisel JM, Wisnicki HJ. Documenting the medical encounter with speech recognition. Ophthalmol Times. 2002;27(5):38.
  5. Nuance Communications. Speech recognition: accelerating the adoption of electronic medical records. http://www.nuance.com/healthcare/pdf/wp_healthcareMDEMRadopt.pdf. Published 2008. Accessed July 30, 2015.
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Ron Romano and Neil H. Baum, MD

Mr. Romano is President of www.YourInternetDoctor.com and CEO of Instant Marketing Systems. He co-authored The Internet Survival Guide for Doctors (2014, Instant Marketing Systems) and No B.S. Direct Marketing (2006, Entrepreneur Press) and contributed to the Walking with the Wise series (2004, Mentors Publishing). He is an Internet marketing consultant, speaker, and creator of “The Implementation Blueprint System.”

Dr. Baum practices urology in New Orleans, Louisiana. He is Associate Clinical Professor of Urology at Tulane Medical School and Louisiana State University School of Medicine, both in New Orleans. He is also on the medical staff at Touro Infirmary in New Orleans, and East Jefferson General Hospital in Metairie, Louisiana. He is the author of several books, including Social Media for the Healthcare Professional (2012, Greenbranch) and Marketing Your Clinical Practice: Ethically, Effectively, Economically (4th edition, 2009; Jones & Bartlett).Dr. Baum is a Contributing Editor for OBG Management.

Mr. Romano reports that he is CEO of Instant Marketing Systems, which provides consulting advice, marketing plans, and Internet marketing services for businesses and medical practices. Dr. Baum reports no financial relationships relevant to  
this article.

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Ron Romano and Neil H. Baum, MD

Mr. Romano is President of www.YourInternetDoctor.com and CEO of Instant Marketing Systems. He co-authored The Internet Survival Guide for Doctors (2014, Instant Marketing Systems) and No B.S. Direct Marketing (2006, Entrepreneur Press) and contributed to the Walking with the Wise series (2004, Mentors Publishing). He is an Internet marketing consultant, speaker, and creator of “The Implementation Blueprint System.”

Dr. Baum practices urology in New Orleans, Louisiana. He is Associate Clinical Professor of Urology at Tulane Medical School and Louisiana State University School of Medicine, both in New Orleans. He is also on the medical staff at Touro Infirmary in New Orleans, and East Jefferson General Hospital in Metairie, Louisiana. He is the author of several books, including Social Media for the Healthcare Professional (2012, Greenbranch) and Marketing Your Clinical Practice: Ethically, Effectively, Economically (4th edition, 2009; Jones & Bartlett).Dr. Baum is a Contributing Editor for OBG Management.

Mr. Romano reports that he is CEO of Instant Marketing Systems, which provides consulting advice, marketing plans, and Internet marketing services for businesses and medical practices. Dr. Baum reports no financial relationships relevant to  
this article.

Author and Disclosure Information

Ron Romano and Neil H. Baum, MD

Mr. Romano is President of www.YourInternetDoctor.com and CEO of Instant Marketing Systems. He co-authored The Internet Survival Guide for Doctors (2014, Instant Marketing Systems) and No B.S. Direct Marketing (2006, Entrepreneur Press) and contributed to the Walking with the Wise series (2004, Mentors Publishing). He is an Internet marketing consultant, speaker, and creator of “The Implementation Blueprint System.”

Dr. Baum practices urology in New Orleans, Louisiana. He is Associate Clinical Professor of Urology at Tulane Medical School and Louisiana State University School of Medicine, both in New Orleans. He is also on the medical staff at Touro Infirmary in New Orleans, and East Jefferson General Hospital in Metairie, Louisiana. He is the author of several books, including Social Media for the Healthcare Professional (2012, Greenbranch) and Marketing Your Clinical Practice: Ethically, Effectively, Economically (4th edition, 2009; Jones & Bartlett).Dr. Baum is a Contributing Editor for OBG Management.

Mr. Romano reports that he is CEO of Instant Marketing Systems, which provides consulting advice, marketing plans, and Internet marketing services for businesses and medical practices. Dr. Baum reports no financial relationships relevant to  
this article.

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Related Articles

Over the past 15 years a technological tsunami has swept through the health care industry, and few physicians were prepared for the changes wrought by this tidal wave. It now is clear, however, that we are and will have to continue to navigate a future increasingly powered and populated by technology if we are to be successful clinicians. In addition, we must learn to take advantage of all that technology has to offer without compromising the quality of care and compassion we offer our patients. We are fortunate that technology has much to offer to enhance patient care.

One big change under way: Technology 
is leveling the playing field between 
doctors—once the high priests of medicine—and ordinary people. SMART (social, mobile, aware, and real-time) technologies such as cloud computing will broaden the setting of health care interventions from hospital rooms and doctors’ offices to patients’ everyday lives. Cloud computing involves the use of a network of remote servers hosted on the Internet to store, manage, and process data, rather than a local server or a desktop computer located in the doctor’s office. It is possible that, instead of being episodic, health care will be conducted continuously—and anywhere the patient wants it.

Without a doubt, the pace at which new technology affects our lives is increasing at lightning speeds. Today, 29% of Americans say their phone is the first and the last thing they look at each day, a telling sign of how dependent we are becoming on technology.1 In this article, we look at 4 technologies that can be effective in the clinical setting, attracting new patients and enhancing productivity, communication, and patient care.

1. A mobile-friendly Web site

According to Wikipedia, there are 
327,577,529 mobile phones in the 
United States, give or take a few thousand. As of July 4, 2014, the US population was 318,881,992. That means there are more mobile phones in this country than there 
are people!2

Mobile phones are becoming more like personal assistants than phones. People are not just making calls, they’re buying movie tickets, checking the weather, sending and receiving emails, texting, making reservations, checking Web sites … and the list goes on.

According to a recent report from the Pew Research Center, almost two-thirds of Americans own a smartphone, and 62% of smartphone owners have used it to look up information on a health condition.3 Moreover, 15% of smartphone owners say they have a limited number of ways to access the Internet other than their cell phone.3

All the more reason for your Web site to be mobile-friendly. With a mobile- 
friendly site, the content is displayed in a more streamlined fashion on mobile phones, with larger type to make it more readable. See, for example, the FIGURE, which shows Dr. Baum’s regular Web site side by side with the mobile-friendly view.

The Web site of Neil H. Baum, MD, as viewed from a desktop or laptop computer (A) and a smartphone (B).

There is another reason why you should ensure that your site is mobile-friendly: Google recently changed its algorithms so that, when someone searches for information on a mobile phone, only mobile- 
friendly sites make it into the top search results. Google wants mobile phone users to have a positive experience online. It is so adamant about this desire that it will lower your rankings or not show your Web site at all in search results if you fail to comply.

New patient acquisition is critical for any ObGyn practice, and we already know that just about everyone goes online to search for health information and solutions to their medical problems. If you want your practice to survive and thrive, you need to attract new patients online. If a visitor to your site cannot read the text and has to keep resizing the screen and scrolling left and right, you will lose that visitor in a hurry.

We all want to find what we are looking for quickly. In our experience, when we check Google Analytics reports for our 
ObGyn clients, we find that visitors to a nonresponsive site spend much less time there and do not visit as many pages as they do when a site is mobile-responsive.

To check your Web site’s mobile rating, go to http://www.google.com/webmasters/tools/mobile-friendly. Google also offers tips on making your site mobile-friendly at https://support.google.com/webmasters/answer/6001177?hl=en.

Once your site is up to snuff, you should test it from multiple devices to ensure that the pages are easily readable on all types of phones and computers.

 

 

2. Voice recognition software

Speech recognition is the ability of a machine or program to identify words and phrases in spoken language and convert them to a digital format. This tool can help you generate clinical notes and charting without having to stop and type into a computer. This can enhance your interactions with patients by freeing you from the computer during examinations and counseling and allows you to look at the patient and not at the computer.

According to data from June 2000, approximately 5% of physicians used speech recognition to generate text in their offices.4 A white paper from 2008 found that approximately 20% of physicians are using more advanced, more reliable voice recognition technology and saving both time and money.5 This report cited 2007 data showing that:

  • 76% of clinicians who used “desktop speech recognition” (directly controlling an electronic health record [EHR] system via speech) reported faster turnaround time, better patient care, and quicker reimbursement
  • Nearly 30% reported lower costs and increased productivity as benefits. The lower costs arise from reduced transcription and overhead expenses associated with billings and collection.5

The voice recognition software used in Dr. Neil Baum’s office is Dragon 
Medical Practice Edition 2 (www.dragonmedicalpractice.com). Dragon requires a good processor and a minimum of 4 gigabytes of RAM and will run with VMware, Boot Camp, Parallels, and other programs for Mac users. The software contains 80 subspecialty medical vocabularies and is easy to install. After a few minutes, the program learns how you speak and will understand you well with remarkable accuracy. However, to get the greatest benefit from the technology, you will need to invest in training, implementation, and workflow services to allow you to use the program to its full potential in record time.

Dr. Baum uses The Dragon People voice recognition software (www.thedragonpeople.com).

Although voice recognition software can reduce or eliminate transcription costs, improve documentation time, and boost the quality of medical notes, it is critical that you investigate how a particular program fits with your EHR prior to purchasing it—and a salesperson may try to gloss over this issue. In addition, the more you use voice recognition instead of checking off pull-down boxes for your clinical notes, the more difficult it will be to mine your data for quality metrics and pay-for-performance information. For that reason, voice recognition technology may be strongly discouraged by your employer or governing organization.

3. Online lab result reporting

TeleVox’s automated lab results (www
.televox.com/lab-test-results-delivery) allow physicians or staff to assign lab result messages quickly and easily with the click of a mouse. Patients call an 800 number or use an Internet connection to retrieve their results, using a unique PIN to ensure privacy.

Practices that implement this technology see immediate improvements in 3 areas:

  • Streamlined operations. This technology allows lab result messages to be assigned to patients with a few mouse clicks, saving time spent on phone calls and mailing coordination.
  • Reduced costs. Automated lab result reporting reduces staff labor and mailing costs.
  • Ease of access. Patients have round-the-clock access to their information—no more waiting for mail delivery or a phone call. Patients also can choose to be notified when their results are ready, which helps alleviate anxiety.

4. Automated wait-time notification

The most common complaint patients have about their health care experience is the excessive wait times they often experience. Now there are technologies that can provide automated information to let patients know how long they will have to wait to be seen.

A program such as MedWaitTime (www.medwaittime.com) can alert patients about the estimated wait time at a cost of approximately $50 per month per physician. Patients access the service for free.

In addition, many EHRs include practice management features to notify the staff and physician whether he or she is on time. These features may include a tie-in to alert patients as well.

The bottom line

Carefully selected technological tools have much to offer busy clinicians. By ensuring that your practice Web site is mobile- 
friendly, you stand to attract new patients. And the time you save with voice recognition software and computerized lab test result notification can allow you to spend more time with your patients. It can also help eliminate the lag in your patient schedule, keeping the women in your waiting room happy. Remember, a happy patient means a happy doctor!

Share your thoughts! Send your Letter to the Editor to [email protected]. Please include your name and the city and state in which you practice.

Over the past 15 years a technological tsunami has swept through the health care industry, and few physicians were prepared for the changes wrought by this tidal wave. It now is clear, however, that we are and will have to continue to navigate a future increasingly powered and populated by technology if we are to be successful clinicians. In addition, we must learn to take advantage of all that technology has to offer without compromising the quality of care and compassion we offer our patients. We are fortunate that technology has much to offer to enhance patient care.

One big change under way: Technology 
is leveling the playing field between 
doctors—once the high priests of medicine—and ordinary people. SMART (social, mobile, aware, and real-time) technologies such as cloud computing will broaden the setting of health care interventions from hospital rooms and doctors’ offices to patients’ everyday lives. Cloud computing involves the use of a network of remote servers hosted on the Internet to store, manage, and process data, rather than a local server or a desktop computer located in the doctor’s office. It is possible that, instead of being episodic, health care will be conducted continuously—and anywhere the patient wants it.

Without a doubt, the pace at which new technology affects our lives is increasing at lightning speeds. Today, 29% of Americans say their phone is the first and the last thing they look at each day, a telling sign of how dependent we are becoming on technology.1 In this article, we look at 4 technologies that can be effective in the clinical setting, attracting new patients and enhancing productivity, communication, and patient care.

1. A mobile-friendly Web site

According to Wikipedia, there are 
327,577,529 mobile phones in the 
United States, give or take a few thousand. As of July 4, 2014, the US population was 318,881,992. That means there are more mobile phones in this country than there 
are people!2

Mobile phones are becoming more like personal assistants than phones. People are not just making calls, they’re buying movie tickets, checking the weather, sending and receiving emails, texting, making reservations, checking Web sites … and the list goes on.

According to a recent report from the Pew Research Center, almost two-thirds of Americans own a smartphone, and 62% of smartphone owners have used it to look up information on a health condition.3 Moreover, 15% of smartphone owners say they have a limited number of ways to access the Internet other than their cell phone.3

All the more reason for your Web site to be mobile-friendly. With a mobile- 
friendly site, the content is displayed in a more streamlined fashion on mobile phones, with larger type to make it more readable. See, for example, the FIGURE, which shows Dr. Baum’s regular Web site side by side with the mobile-friendly view.

The Web site of Neil H. Baum, MD, as viewed from a desktop or laptop computer (A) and a smartphone (B).

There is another reason why you should ensure that your site is mobile-friendly: Google recently changed its algorithms so that, when someone searches for information on a mobile phone, only mobile- 
friendly sites make it into the top search results. Google wants mobile phone users to have a positive experience online. It is so adamant about this desire that it will lower your rankings or not show your Web site at all in search results if you fail to comply.

New patient acquisition is critical for any ObGyn practice, and we already know that just about everyone goes online to search for health information and solutions to their medical problems. If you want your practice to survive and thrive, you need to attract new patients online. If a visitor to your site cannot read the text and has to keep resizing the screen and scrolling left and right, you will lose that visitor in a hurry.

We all want to find what we are looking for quickly. In our experience, when we check Google Analytics reports for our 
ObGyn clients, we find that visitors to a nonresponsive site spend much less time there and do not visit as many pages as they do when a site is mobile-responsive.

To check your Web site’s mobile rating, go to http://www.google.com/webmasters/tools/mobile-friendly. Google also offers tips on making your site mobile-friendly at https://support.google.com/webmasters/answer/6001177?hl=en.

Once your site is up to snuff, you should test it from multiple devices to ensure that the pages are easily readable on all types of phones and computers.

 

 

2. Voice recognition software

Speech recognition is the ability of a machine or program to identify words and phrases in spoken language and convert them to a digital format. This tool can help you generate clinical notes and charting without having to stop and type into a computer. This can enhance your interactions with patients by freeing you from the computer during examinations and counseling and allows you to look at the patient and not at the computer.

According to data from June 2000, approximately 5% of physicians used speech recognition to generate text in their offices.4 A white paper from 2008 found that approximately 20% of physicians are using more advanced, more reliable voice recognition technology and saving both time and money.5 This report cited 2007 data showing that:

  • 76% of clinicians who used “desktop speech recognition” (directly controlling an electronic health record [EHR] system via speech) reported faster turnaround time, better patient care, and quicker reimbursement
  • Nearly 30% reported lower costs and increased productivity as benefits. The lower costs arise from reduced transcription and overhead expenses associated with billings and collection.5

The voice recognition software used in Dr. Neil Baum’s office is Dragon 
Medical Practice Edition 2 (www.dragonmedicalpractice.com). Dragon requires a good processor and a minimum of 4 gigabytes of RAM and will run with VMware, Boot Camp, Parallels, and other programs for Mac users. The software contains 80 subspecialty medical vocabularies and is easy to install. After a few minutes, the program learns how you speak and will understand you well with remarkable accuracy. However, to get the greatest benefit from the technology, you will need to invest in training, implementation, and workflow services to allow you to use the program to its full potential in record time.

Dr. Baum uses The Dragon People voice recognition software (www.thedragonpeople.com).

Although voice recognition software can reduce or eliminate transcription costs, improve documentation time, and boost the quality of medical notes, it is critical that you investigate how a particular program fits with your EHR prior to purchasing it—and a salesperson may try to gloss over this issue. In addition, the more you use voice recognition instead of checking off pull-down boxes for your clinical notes, the more difficult it will be to mine your data for quality metrics and pay-for-performance information. For that reason, voice recognition technology may be strongly discouraged by your employer or governing organization.

3. Online lab result reporting

TeleVox’s automated lab results (www
.televox.com/lab-test-results-delivery) allow physicians or staff to assign lab result messages quickly and easily with the click of a mouse. Patients call an 800 number or use an Internet connection to retrieve their results, using a unique PIN to ensure privacy.

Practices that implement this technology see immediate improvements in 3 areas:

  • Streamlined operations. This technology allows lab result messages to be assigned to patients with a few mouse clicks, saving time spent on phone calls and mailing coordination.
  • Reduced costs. Automated lab result reporting reduces staff labor and mailing costs.
  • Ease of access. Patients have round-the-clock access to their information—no more waiting for mail delivery or a phone call. Patients also can choose to be notified when their results are ready, which helps alleviate anxiety.

4. Automated wait-time notification

The most common complaint patients have about their health care experience is the excessive wait times they often experience. Now there are technologies that can provide automated information to let patients know how long they will have to wait to be seen.

A program such as MedWaitTime (www.medwaittime.com) can alert patients about the estimated wait time at a cost of approximately $50 per month per physician. Patients access the service for free.

In addition, many EHRs include practice management features to notify the staff and physician whether he or she is on time. These features may include a tie-in to alert patients as well.

The bottom line

Carefully selected technological tools have much to offer busy clinicians. By ensuring that your practice Web site is mobile- 
friendly, you stand to attract new patients. And the time you save with voice recognition software and computerized lab test result notification can allow you to spend more time with your patients. It can also help eliminate the lag in your patient schedule, keeping the women in your waiting room happy. Remember, a happy patient means a happy doctor!

Share your thoughts! Send your Letter to the Editor to [email protected]. Please include your name and the city and state in which you practice.

References

  1. Your Wireless Life: Results of TIME’s Mobility Poll. http://content.time.com/time/interactive/0,31813,2122187,00.html. Accessed July 29, 2015.
  2. Wikipedia: List of Countries by Number of Mobile Phones in Use. https://en.wikipedia.org/wiki/List_of_countries_by_number_of_mobile_phones_in_use. Accessed July 29, 2015.
  3. Smith A. US Smartphone Use in 2015. Pew Research Center. http://www.pewinternet.org/2015/04/01/us-smartphone-use-in-2015. Published April 1, 2015. Accessed July 29, 2015.
  4. Maisel JM, Wisnicki HJ. Documenting the medical encounter with speech recognition. Ophthalmol Times. 2002;27(5):38.
  5. Nuance Communications. Speech recognition: accelerating the adoption of electronic medical records. http://www.nuance.com/healthcare/pdf/wp_healthcareMDEMRadopt.pdf. Published 2008. Accessed July 30, 2015.
References

  1. Your Wireless Life: Results of TIME’s Mobility Poll. http://content.time.com/time/interactive/0,31813,2122187,00.html. Accessed July 29, 2015.
  2. Wikipedia: List of Countries by Number of Mobile Phones in Use. https://en.wikipedia.org/wiki/List_of_countries_by_number_of_mobile_phones_in_use. Accessed July 29, 2015.
  3. Smith A. US Smartphone Use in 2015. Pew Research Center. http://www.pewinternet.org/2015/04/01/us-smartphone-use-in-2015. Published April 1, 2015. Accessed July 29, 2015.
  4. Maisel JM, Wisnicki HJ. Documenting the medical encounter with speech recognition. Ophthalmol Times. 2002;27(5):38.
  5. Nuance Communications. Speech recognition: accelerating the adoption of electronic medical records. http://www.nuance.com/healthcare/pdf/wp_healthcareMDEMRadopt.pdf. Published 2008. Accessed July 30, 2015.
Issue
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4 technology tools ObGyns 
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Get more patients with backlinks

The medical profession has its jargon. So does the Internet world. Some of that jargon can be important to your success. “Backlinks” or “inbound links” are terms that should get your attention.

Why?

By developing them, you can attract more patients to your practice.

Backlinks are one piece of the Internet marketing puzzle that can help get your Web site on the first page of Google search results.

And just how important is it to be on page 1?

Well, consider that 91.5% of Web surfers do not go beyond the first page of results. That’s what an online advertising network called Chitika found when it examined tens of millions of online ad impressions in which the user was referred to the page via a Google search.1

Just what are backlinks? They are links to your Web page from another site. In basic link terminology, a backlink is any link received by a Web page, directory, Web site, or top-level domain from another, similar site. In this article we discuss the importance of these links and ways to use them in your social media to attract new patients to your site and your practice.

Start with good site design
If you can get listed on the first page of Google search results for the keywords your patients are using, more traffic will come to your Web site. That won’t help if you have a poorly designed site that has no patient conversion strategies, techniques, and systems to transform Web site visitors to patients.

You see, everything has to work together in a coordinated, integrated manner if you want to increase the number of patients who are looking for your services online. We’ve covered many of the basics in earlier articles on Web site design and improvement (see the box below). If you have a nonoptimal site, consider starting with these articles.


Articles on Web design and Internet usage by Ron Romano and Neil H. Baum, MD

5 ways to wake up your Web site
April 2015

Using the Internet in your practice
Part 1: Why social media are important and how to get started
February 2014

Part 2: Generating new patients using social media
April 2014

Part 3: Maximizing your online reach through SEO and pay-per-click
September 2014

Part 4: Reputation management: How to gather kudos and combat negative online reviews
December 2014

These articles are available in the archive at obgmanagement.com

Why backlinks are important
Google uses more than 200 algorithms to rank your Web site. Some are more important than others and have a greater influence on search engine positioning. Backlinks are one of those important influencers.

The number of backlinks you have is an indication of the popularity or importance of your Web site. Google considers a site more significant or relevant than others if it has a large number of quality backlinks from other directories, ezines, blogs, and social media Web sites. These backlinks must be relevant to your keywords. For example, because you are a medical professional, a link to your site from the American Cancer Society or the Mayo Clinic is considered more credible than a link from a local spa or health club.

A search engine such as Google considers the content of the sites it places at the top of the search results page. When links to your site come from other credible and popular sites, and those sites have content related to your site, these backlinks are considered more relevant to your site.

If backlinks come from sites with unrelated content, they are considered less relevant. You may even be penalized by Google for adding backlinks that have no content value.

For example, if a Web master has a site that focuses on urinary incontinence and receives a backlink from another site with information or articles about urinary incontinence, that backlink will be considered more relevant than a link from a site about mortgages that somehow also includes urinary incontinence on its page. Therefore, the higher the relevance of the site linking back to yours, the better the quality of that link.

Top 7 inbound links—and how to obtain them
1. Directories
Directories are indexes of online sites, typically organized by category. You want to ensure that each of your keywords is manually submitted to each directory so it is listed separately. This way you get maximum link value for each keyword.

Links back to your site from directories such as Yahoo Directory and DMOZ.org are valuable. DMOZ.org is edited by humans. Although it is free, it may take some time for your site to be added. A listing in Yahoo’s Directory costs $299 per year.

 

 

2. Press releases
If you are writing press releases, make sure they contain keywords that someone would use to find a business like yours. Also ensure that they include links back to your site.

Once the press release is written, submit it to all the news agencies. Then you must wait and see if any of them pick it up and publish it.

You may want to consider having a press release professionally written and distributed by a public relations firm to boost your chances of having the release picked up. PRWeb.com has an excellent reputation. Its distribution network includes the search engines Google, Yahoo, and Bing; media outlets such as USA Today, CNN, and the Wall Street Journal; Associated Press distribution through major newspapers; and health and medical digests such as the Mayo Clinic, WebMD, Women’s Health, and many more.

3. Article directories
By writing and distributing articles through high-traffic article directories, such as EzineArticles.com, Articles.org, and Hubpages.com, you can attract valuable inbound links from a high-traffic site. Craft an effective link at the close of your article to drive traffic back to your site. An example of what your link might say is, “To view a short video on Kegel exercises for pelvic organ prolapse, visit our Web site at www.neilbaum.com/videos.”

4. Social bookmarking
Like Web browser bookmarks, social bookmarking sites such as Digg.com, Reddit.com, and Del.icio.us.com store individual pages (bookmarks) online and allow users to tag (with keywords), organize, search, and manage these bookmarks as well as share them with others. If you bookmark your content on these sites, you get a link from the service. By producing content that your readers enjoy and bookmark to their friends, you gain a link that increases in search engine optimization (SEO) value.

5. Blog comments
To find blog posts on which to comment, you can use blog-specific search engines such as Google Blog Search. Make sure these are blogs read by your target market, not your colleagues. Brand yourself by always using the same name and remember to link back to your site. Always leave a comment that adds to the conversation.

6. Social media
Google also indexes your Twitter updates and social networking profiles. Add that to Web 2.0 hubsites like Scribd or HubPage and you’ve got a way to create many inbound links in a very short time. Scribd is a digital library featuring an ebook and audiobook subscription service that includes New York Times best sellers and classics. HubPages is a user-generated content, revenue-sharing Web site.

7. Video syndication
YouTube is one of the most visited sites online, and the number of sites that syndicate videos is growing every day. These sites often allow you to link to your site in your video’s description, on your profile page, or both.

The importance of being consistent—and honest
For best results, you need to build these links monthly with regularity, and over time, you will reap the benefits of improved rankings. While it is fairly easy to modify your Web pages to make them more SEO-friendly, it is harder to influence other Web sites and get them to link to yours. This is the reason search engines consider backlinks such an important factor.

Moreover, search engines’ criteria for quality backlinks have gotten tougher, thanks to unscrupulous Web masters trying to achieve these backlinks by deceptive techniques, such as hidden links or automatically generated pages whose sole purpose is to provide backlinks to Web sites. These pages are called link farms. Not only are they disregarded by search engines, but linking to one could get your site banned entirely. This strategy is often referred to as “black hat” linking and is to be avoided.

“White hat” methods to increase backlinks
Blog posting is one of the easiest, least expensive, and most effective ways to garner links from other sites. However, to reap this benefit, you must post blog entries consistently. We suggest posting at least once weekly. Your blog will gain more attention if you have something newsworthy to report. For example, if you attend a meeting where a revolutionary new development is reported, and you write about it before the media, you can be sure others will want to connect and link to your site.

Conduct a survey and share your results on your site. Others will want to link to your report.

Share any templates your office uses to be more efficient and productive. For example, Dr. Baum has a template, or checklist, for starting and ending every day in the office. It is shared on his Web site so that other sites can link to it and make use of it.

 

 

Show your funny bone. Humor often travels in a viral direction. If something funny happens in your practice, share it with others and they will frequently link to the source.

Join a forum. Forums are a great source of high-quality traffic and links. You can use a forum to reach out to a specific community.By placing valid, useful contributions, you gain legitimate authority for your site.

The bottom line
You want to attract as many visitors to your Web site as possible. Your own content and the frequency of your postings are mainstays of making your Web site relevant to existing and potential patients. Also useful are backlinks. The number and quality of your inbound links are major factors in SEO. Search engines place high value on trust and authority, and an inbound link from a very high-ranking and trusted Web site tells the search engine that someone trusted also trusts you. So start linking.

References

Reference
1. The value of Google result positioning. Chitika.com. http://chitika.com/google-positioning-value. Updated June 12, 2013. Accessed June 9, 2015.

Article PDF
Author and Disclosure Information

Ron Romano and Neil H. Baum, MD

Mr. Romano is President of YourInternetDoctor.com and CEO of Instant Marketing Systems. He co-authored The Internet Survival Guide for Doctors (2014, Instant Marketing Systems) and No B.S. Direct Marketing (2006, Entrepreneur Press) and contributed to the Walking with the Wise series (2004, Mentors Publishing). He is an Internet marketing consultant, speaker, and creator of “The Implementation Blueprint System.”

Dr. Baum practices urology in New Orleans, Louisiana. He is Associate Clinical Professor of Urology at Tulane Medical School and Louisiana State University School of Medicine, both in New Orleans. He is also on the medical staff at Touro Infirmary in New Orleans, and East Jefferson General Hospital in Metairie, Louisiana. And he is the author of several books, including Social Media for the Healthcare Professional (2012, Greenbranch), and Marketing Your Clinical Practice: Ethically, Effectively, Economically (4th edition, 2009; Jones & Bartlett). Dr. Baum is a Contributing Editor for OBG Management. 

Mr. Romano reports that he is CEO of Instant Marketing Systems, which provides consulting advice, marketing plans, and Internet marketing services for businesses and medical practices. Dr. Baum reports no financial relationships relevant to this article.

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OBG Management - 27(7)
Publications
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e1–e4
Legacy Keywords
Ron Romano, Neil H. Baum MD, backlinks, Web site, practice management, visibility in Google search results, Google search, attract patients, inbound links, Chitka, Web page, Web directory, top-level domain, good site design, search engine, search engine optimization, SEO, press releases, article directories, Web browser bookmarks, social booking sites, blogs, social media, hubsites, video syndication, honesty, SEO-friendly, white hat, black hat, link farms, survey, templates, forum
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Author and Disclosure Information

Ron Romano and Neil H. Baum, MD

Mr. Romano is President of YourInternetDoctor.com and CEO of Instant Marketing Systems. He co-authored The Internet Survival Guide for Doctors (2014, Instant Marketing Systems) and No B.S. Direct Marketing (2006, Entrepreneur Press) and contributed to the Walking with the Wise series (2004, Mentors Publishing). He is an Internet marketing consultant, speaker, and creator of “The Implementation Blueprint System.”

Dr. Baum practices urology in New Orleans, Louisiana. He is Associate Clinical Professor of Urology at Tulane Medical School and Louisiana State University School of Medicine, both in New Orleans. He is also on the medical staff at Touro Infirmary in New Orleans, and East Jefferson General Hospital in Metairie, Louisiana. And he is the author of several books, including Social Media for the Healthcare Professional (2012, Greenbranch), and Marketing Your Clinical Practice: Ethically, Effectively, Economically (4th edition, 2009; Jones & Bartlett). Dr. Baum is a Contributing Editor for OBG Management. 

Mr. Romano reports that he is CEO of Instant Marketing Systems, which provides consulting advice, marketing plans, and Internet marketing services for businesses and medical practices. Dr. Baum reports no financial relationships relevant to this article.

Author and Disclosure Information

Ron Romano and Neil H. Baum, MD

Mr. Romano is President of YourInternetDoctor.com and CEO of Instant Marketing Systems. He co-authored The Internet Survival Guide for Doctors (2014, Instant Marketing Systems) and No B.S. Direct Marketing (2006, Entrepreneur Press) and contributed to the Walking with the Wise series (2004, Mentors Publishing). He is an Internet marketing consultant, speaker, and creator of “The Implementation Blueprint System.”

Dr. Baum practices urology in New Orleans, Louisiana. He is Associate Clinical Professor of Urology at Tulane Medical School and Louisiana State University School of Medicine, both in New Orleans. He is also on the medical staff at Touro Infirmary in New Orleans, and East Jefferson General Hospital in Metairie, Louisiana. And he is the author of several books, including Social Media for the Healthcare Professional (2012, Greenbranch), and Marketing Your Clinical Practice: Ethically, Effectively, Economically (4th edition, 2009; Jones & Bartlett). Dr. Baum is a Contributing Editor for OBG Management. 

Mr. Romano reports that he is CEO of Instant Marketing Systems, which provides consulting advice, marketing plans, and Internet marketing services for businesses and medical practices. Dr. Baum reports no financial relationships relevant to this article.

Article PDF
Article PDF
Related Articles

The medical profession has its jargon. So does the Internet world. Some of that jargon can be important to your success. “Backlinks” or “inbound links” are terms that should get your attention.

Why?

By developing them, you can attract more patients to your practice.

Backlinks are one piece of the Internet marketing puzzle that can help get your Web site on the first page of Google search results.

And just how important is it to be on page 1?

Well, consider that 91.5% of Web surfers do not go beyond the first page of results. That’s what an online advertising network called Chitika found when it examined tens of millions of online ad impressions in which the user was referred to the page via a Google search.1

Just what are backlinks? They are links to your Web page from another site. In basic link terminology, a backlink is any link received by a Web page, directory, Web site, or top-level domain from another, similar site. In this article we discuss the importance of these links and ways to use them in your social media to attract new patients to your site and your practice.

Start with good site design
If you can get listed on the first page of Google search results for the keywords your patients are using, more traffic will come to your Web site. That won’t help if you have a poorly designed site that has no patient conversion strategies, techniques, and systems to transform Web site visitors to patients.

You see, everything has to work together in a coordinated, integrated manner if you want to increase the number of patients who are looking for your services online. We’ve covered many of the basics in earlier articles on Web site design and improvement (see the box below). If you have a nonoptimal site, consider starting with these articles.


Articles on Web design and Internet usage by Ron Romano and Neil H. Baum, MD

5 ways to wake up your Web site
April 2015

Using the Internet in your practice
Part 1: Why social media are important and how to get started
February 2014

Part 2: Generating new patients using social media
April 2014

Part 3: Maximizing your online reach through SEO and pay-per-click
September 2014

Part 4: Reputation management: How to gather kudos and combat negative online reviews
December 2014

These articles are available in the archive at obgmanagement.com

Why backlinks are important
Google uses more than 200 algorithms to rank your Web site. Some are more important than others and have a greater influence on search engine positioning. Backlinks are one of those important influencers.

The number of backlinks you have is an indication of the popularity or importance of your Web site. Google considers a site more significant or relevant than others if it has a large number of quality backlinks from other directories, ezines, blogs, and social media Web sites. These backlinks must be relevant to your keywords. For example, because you are a medical professional, a link to your site from the American Cancer Society or the Mayo Clinic is considered more credible than a link from a local spa or health club.

A search engine such as Google considers the content of the sites it places at the top of the search results page. When links to your site come from other credible and popular sites, and those sites have content related to your site, these backlinks are considered more relevant to your site.

If backlinks come from sites with unrelated content, they are considered less relevant. You may even be penalized by Google for adding backlinks that have no content value.

For example, if a Web master has a site that focuses on urinary incontinence and receives a backlink from another site with information or articles about urinary incontinence, that backlink will be considered more relevant than a link from a site about mortgages that somehow also includes urinary incontinence on its page. Therefore, the higher the relevance of the site linking back to yours, the better the quality of that link.

Top 7 inbound links—and how to obtain them
1. Directories
Directories are indexes of online sites, typically organized by category. You want to ensure that each of your keywords is manually submitted to each directory so it is listed separately. This way you get maximum link value for each keyword.

Links back to your site from directories such as Yahoo Directory and DMOZ.org are valuable. DMOZ.org is edited by humans. Although it is free, it may take some time for your site to be added. A listing in Yahoo’s Directory costs $299 per year.

 

 

2. Press releases
If you are writing press releases, make sure they contain keywords that someone would use to find a business like yours. Also ensure that they include links back to your site.

Once the press release is written, submit it to all the news agencies. Then you must wait and see if any of them pick it up and publish it.

You may want to consider having a press release professionally written and distributed by a public relations firm to boost your chances of having the release picked up. PRWeb.com has an excellent reputation. Its distribution network includes the search engines Google, Yahoo, and Bing; media outlets such as USA Today, CNN, and the Wall Street Journal; Associated Press distribution through major newspapers; and health and medical digests such as the Mayo Clinic, WebMD, Women’s Health, and many more.

3. Article directories
By writing and distributing articles through high-traffic article directories, such as EzineArticles.com, Articles.org, and Hubpages.com, you can attract valuable inbound links from a high-traffic site. Craft an effective link at the close of your article to drive traffic back to your site. An example of what your link might say is, “To view a short video on Kegel exercises for pelvic organ prolapse, visit our Web site at www.neilbaum.com/videos.”

4. Social bookmarking
Like Web browser bookmarks, social bookmarking sites such as Digg.com, Reddit.com, and Del.icio.us.com store individual pages (bookmarks) online and allow users to tag (with keywords), organize, search, and manage these bookmarks as well as share them with others. If you bookmark your content on these sites, you get a link from the service. By producing content that your readers enjoy and bookmark to their friends, you gain a link that increases in search engine optimization (SEO) value.

5. Blog comments
To find blog posts on which to comment, you can use blog-specific search engines such as Google Blog Search. Make sure these are blogs read by your target market, not your colleagues. Brand yourself by always using the same name and remember to link back to your site. Always leave a comment that adds to the conversation.

6. Social media
Google also indexes your Twitter updates and social networking profiles. Add that to Web 2.0 hubsites like Scribd or HubPage and you’ve got a way to create many inbound links in a very short time. Scribd is a digital library featuring an ebook and audiobook subscription service that includes New York Times best sellers and classics. HubPages is a user-generated content, revenue-sharing Web site.

7. Video syndication
YouTube is one of the most visited sites online, and the number of sites that syndicate videos is growing every day. These sites often allow you to link to your site in your video’s description, on your profile page, or both.

The importance of being consistent—and honest
For best results, you need to build these links monthly with regularity, and over time, you will reap the benefits of improved rankings. While it is fairly easy to modify your Web pages to make them more SEO-friendly, it is harder to influence other Web sites and get them to link to yours. This is the reason search engines consider backlinks such an important factor.

Moreover, search engines’ criteria for quality backlinks have gotten tougher, thanks to unscrupulous Web masters trying to achieve these backlinks by deceptive techniques, such as hidden links or automatically generated pages whose sole purpose is to provide backlinks to Web sites. These pages are called link farms. Not only are they disregarded by search engines, but linking to one could get your site banned entirely. This strategy is often referred to as “black hat” linking and is to be avoided.

“White hat” methods to increase backlinks
Blog posting is one of the easiest, least expensive, and most effective ways to garner links from other sites. However, to reap this benefit, you must post blog entries consistently. We suggest posting at least once weekly. Your blog will gain more attention if you have something newsworthy to report. For example, if you attend a meeting where a revolutionary new development is reported, and you write about it before the media, you can be sure others will want to connect and link to your site.

Conduct a survey and share your results on your site. Others will want to link to your report.

Share any templates your office uses to be more efficient and productive. For example, Dr. Baum has a template, or checklist, for starting and ending every day in the office. It is shared on his Web site so that other sites can link to it and make use of it.

 

 

Show your funny bone. Humor often travels in a viral direction. If something funny happens in your practice, share it with others and they will frequently link to the source.

Join a forum. Forums are a great source of high-quality traffic and links. You can use a forum to reach out to a specific community.By placing valid, useful contributions, you gain legitimate authority for your site.

The bottom line
You want to attract as many visitors to your Web site as possible. Your own content and the frequency of your postings are mainstays of making your Web site relevant to existing and potential patients. Also useful are backlinks. The number and quality of your inbound links are major factors in SEO. Search engines place high value on trust and authority, and an inbound link from a very high-ranking and trusted Web site tells the search engine that someone trusted also trusts you. So start linking.

The medical profession has its jargon. So does the Internet world. Some of that jargon can be important to your success. “Backlinks” or “inbound links” are terms that should get your attention.

Why?

By developing them, you can attract more patients to your practice.

Backlinks are one piece of the Internet marketing puzzle that can help get your Web site on the first page of Google search results.

And just how important is it to be on page 1?

Well, consider that 91.5% of Web surfers do not go beyond the first page of results. That’s what an online advertising network called Chitika found when it examined tens of millions of online ad impressions in which the user was referred to the page via a Google search.1

Just what are backlinks? They are links to your Web page from another site. In basic link terminology, a backlink is any link received by a Web page, directory, Web site, or top-level domain from another, similar site. In this article we discuss the importance of these links and ways to use them in your social media to attract new patients to your site and your practice.

Start with good site design
If you can get listed on the first page of Google search results for the keywords your patients are using, more traffic will come to your Web site. That won’t help if you have a poorly designed site that has no patient conversion strategies, techniques, and systems to transform Web site visitors to patients.

You see, everything has to work together in a coordinated, integrated manner if you want to increase the number of patients who are looking for your services online. We’ve covered many of the basics in earlier articles on Web site design and improvement (see the box below). If you have a nonoptimal site, consider starting with these articles.


Articles on Web design and Internet usage by Ron Romano and Neil H. Baum, MD

5 ways to wake up your Web site
April 2015

Using the Internet in your practice
Part 1: Why social media are important and how to get started
February 2014

Part 2: Generating new patients using social media
April 2014

Part 3: Maximizing your online reach through SEO and pay-per-click
September 2014

Part 4: Reputation management: How to gather kudos and combat negative online reviews
December 2014

These articles are available in the archive at obgmanagement.com

Why backlinks are important
Google uses more than 200 algorithms to rank your Web site. Some are more important than others and have a greater influence on search engine positioning. Backlinks are one of those important influencers.

The number of backlinks you have is an indication of the popularity or importance of your Web site. Google considers a site more significant or relevant than others if it has a large number of quality backlinks from other directories, ezines, blogs, and social media Web sites. These backlinks must be relevant to your keywords. For example, because you are a medical professional, a link to your site from the American Cancer Society or the Mayo Clinic is considered more credible than a link from a local spa or health club.

A search engine such as Google considers the content of the sites it places at the top of the search results page. When links to your site come from other credible and popular sites, and those sites have content related to your site, these backlinks are considered more relevant to your site.

If backlinks come from sites with unrelated content, they are considered less relevant. You may even be penalized by Google for adding backlinks that have no content value.

For example, if a Web master has a site that focuses on urinary incontinence and receives a backlink from another site with information or articles about urinary incontinence, that backlink will be considered more relevant than a link from a site about mortgages that somehow also includes urinary incontinence on its page. Therefore, the higher the relevance of the site linking back to yours, the better the quality of that link.

Top 7 inbound links—and how to obtain them
1. Directories
Directories are indexes of online sites, typically organized by category. You want to ensure that each of your keywords is manually submitted to each directory so it is listed separately. This way you get maximum link value for each keyword.

Links back to your site from directories such as Yahoo Directory and DMOZ.org are valuable. DMOZ.org is edited by humans. Although it is free, it may take some time for your site to be added. A listing in Yahoo’s Directory costs $299 per year.

 

 

2. Press releases
If you are writing press releases, make sure they contain keywords that someone would use to find a business like yours. Also ensure that they include links back to your site.

Once the press release is written, submit it to all the news agencies. Then you must wait and see if any of them pick it up and publish it.

You may want to consider having a press release professionally written and distributed by a public relations firm to boost your chances of having the release picked up. PRWeb.com has an excellent reputation. Its distribution network includes the search engines Google, Yahoo, and Bing; media outlets such as USA Today, CNN, and the Wall Street Journal; Associated Press distribution through major newspapers; and health and medical digests such as the Mayo Clinic, WebMD, Women’s Health, and many more.

3. Article directories
By writing and distributing articles through high-traffic article directories, such as EzineArticles.com, Articles.org, and Hubpages.com, you can attract valuable inbound links from a high-traffic site. Craft an effective link at the close of your article to drive traffic back to your site. An example of what your link might say is, “To view a short video on Kegel exercises for pelvic organ prolapse, visit our Web site at www.neilbaum.com/videos.”

4. Social bookmarking
Like Web browser bookmarks, social bookmarking sites such as Digg.com, Reddit.com, and Del.icio.us.com store individual pages (bookmarks) online and allow users to tag (with keywords), organize, search, and manage these bookmarks as well as share them with others. If you bookmark your content on these sites, you get a link from the service. By producing content that your readers enjoy and bookmark to their friends, you gain a link that increases in search engine optimization (SEO) value.

5. Blog comments
To find blog posts on which to comment, you can use blog-specific search engines such as Google Blog Search. Make sure these are blogs read by your target market, not your colleagues. Brand yourself by always using the same name and remember to link back to your site. Always leave a comment that adds to the conversation.

6. Social media
Google also indexes your Twitter updates and social networking profiles. Add that to Web 2.0 hubsites like Scribd or HubPage and you’ve got a way to create many inbound links in a very short time. Scribd is a digital library featuring an ebook and audiobook subscription service that includes New York Times best sellers and classics. HubPages is a user-generated content, revenue-sharing Web site.

7. Video syndication
YouTube is one of the most visited sites online, and the number of sites that syndicate videos is growing every day. These sites often allow you to link to your site in your video’s description, on your profile page, or both.

The importance of being consistent—and honest
For best results, you need to build these links monthly with regularity, and over time, you will reap the benefits of improved rankings. While it is fairly easy to modify your Web pages to make them more SEO-friendly, it is harder to influence other Web sites and get them to link to yours. This is the reason search engines consider backlinks such an important factor.

Moreover, search engines’ criteria for quality backlinks have gotten tougher, thanks to unscrupulous Web masters trying to achieve these backlinks by deceptive techniques, such as hidden links or automatically generated pages whose sole purpose is to provide backlinks to Web sites. These pages are called link farms. Not only are they disregarded by search engines, but linking to one could get your site banned entirely. This strategy is often referred to as “black hat” linking and is to be avoided.

“White hat” methods to increase backlinks
Blog posting is one of the easiest, least expensive, and most effective ways to garner links from other sites. However, to reap this benefit, you must post blog entries consistently. We suggest posting at least once weekly. Your blog will gain more attention if you have something newsworthy to report. For example, if you attend a meeting where a revolutionary new development is reported, and you write about it before the media, you can be sure others will want to connect and link to your site.

Conduct a survey and share your results on your site. Others will want to link to your report.

Share any templates your office uses to be more efficient and productive. For example, Dr. Baum has a template, or checklist, for starting and ending every day in the office. It is shared on his Web site so that other sites can link to it and make use of it.

 

 

Show your funny bone. Humor often travels in a viral direction. If something funny happens in your practice, share it with others and they will frequently link to the source.

Join a forum. Forums are a great source of high-quality traffic and links. You can use a forum to reach out to a specific community.By placing valid, useful contributions, you gain legitimate authority for your site.

The bottom line
You want to attract as many visitors to your Web site as possible. Your own content and the frequency of your postings are mainstays of making your Web site relevant to existing and potential patients. Also useful are backlinks. The number and quality of your inbound links are major factors in SEO. Search engines place high value on trust and authority, and an inbound link from a very high-ranking and trusted Web site tells the search engine that someone trusted also trusts you. So start linking.

References

Reference
1. The value of Google result positioning. Chitika.com. http://chitika.com/google-positioning-value. Updated June 12, 2013. Accessed June 9, 2015.

References

Reference
1. The value of Google result positioning. Chitika.com. http://chitika.com/google-positioning-value. Updated June 12, 2013. Accessed June 9, 2015.

Issue
OBG Management - 27(7)
Issue
OBG Management - 27(7)
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e1–e4
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Get more patients with backlinks
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Get more patients with backlinks
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Ron Romano, Neil H. Baum MD, backlinks, Web site, practice management, visibility in Google search results, Google search, attract patients, inbound links, Chitka, Web page, Web directory, top-level domain, good site design, search engine, search engine optimization, SEO, press releases, article directories, Web browser bookmarks, social booking sites, blogs, social media, hubsites, video syndication, honesty, SEO-friendly, white hat, black hat, link farms, survey, templates, forum
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5 ways to wake up your Web site

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5 ways to wake up your Web site

Web sites are not like wine and cheese—they don’t necessarily get better with age. You may have started your Web page 20 years ago by moving your 3-color trifold brochure onto the Internet. It may have worked then, but to compete today you must have a robust, interactive, attractive Web site that is continuously being updated with new content. What prospective patients are looking for in a Web site has evolved rapidly. How to get these patients to take action and call for an appointment requires a process or a system.

Trying to keep your Web site current can be daunting for most medical practices. If you find that your Web site is not generating new patients and that your existing patients are not using the site in an interactive fashion, then it is time to upgrade. In this article we suggest 5 practical ways to make your Web site a useful adjunct to your medical practice—an automatic patient conversion system.

1. Go mobile
Make your Web site “thumb friendly.” Mobile technology has taken over the desktop and laptop worlds. Now nearly everyone is using a hand-held smartphone or tablet for their Internet needs.

To attract patients your Web page must be responsive to the screen size of a smartphone or tablet—very different from your Web site, which is accessed from a desktop or a laptop computer. The majority of ­users navigate not with a mouse but with their fingers and thumbs. To ensure they can find their way on your Web page on a mobile device, the screen view should adjust automatically to the mobile device being used. Whether that is accomplished through a mobile responsive design or an entirely different mobile Web site, you do not want the user to have to resize, zoom, or pinch their way through the page in order to read the content. All the buttons must be large enough to be easily pressed without having to zoom in, and the font should be easy-to-read in style and size.

Having your current Web site programmed to be responsive to these devices will increase the time a mobile user spends on your site and make it easier for her to make an appointment.

2. Add patient reviews
What others say about you is far more important than anything you can say about yourself. Almost half of prospective patients will check out your online reviews before calling you to schedule an appointment.1 Therefore, it is very important that you ask for positive feedback from your patients and post it to your Web site. We recommend that you capture compliments from your existing patients when they are in the office. Have a computer or iPad handy for them to create a positive review; patients who “promise” to do it when they get back to the office or home rarely follow through. Testimonials should be visible on your homepage and can link to another testimonial page or review site.

According to HealthCareSuccess.com,
“as many as 8 out of 10 people will look online for information about individual doctors. And all of that happens long before they make an appointment … and what they find—positive, negative, neutral or nothing at all—influences their decision to call or not to call.”2

Always invite your patients to evaluate you, your practice partners, and the practice online. There are numerous patient review Web sites, including: Google Plus, http://www.RateMDs.com, http://www.Vitals.com, and http://www.HealthGrades.com. And check out what your patients are saying about you on a regular basis. Just type “Reviews for Dr. <your name>” into your search bar to find the results.

Although we hope they will, happy patients rarely fill out these online reviews. However, it takes just 2 or 3 unhappy patients to ruin your online reputation. That could be costing you tens of thousands of dollars in lost billing.

3. Share your videos
What’s hot and what’s not? To answer that, just take a look at how many people watch videos on YouTube every day! People don’t want to read anymore; they want to be entertained and spoon-fed information.

Take advantage of this trend by placing videos on your homepage. Post a video that introduces your practice, provides testimonials of satisfied patients, explains some of the procedures you perform, or shows you describing the latest breakthrough in medical technology.

Your videos don’t have to be long. One to 2 minutes is plenty. They don’t have to feature you talking about medical symptoms or procedures (what’s called a talking head video). Use a PowerPoint presentation with voice overlay—and you don’t have to be the one talking.

 

 

Your Web site isn’t the only place you’ll want to post your videos. YouTube is second only to Google as the most popular search engine.3 Just about everyone goes to YouTube to view videos on whatever interests them. See our April 2014 article, titled “Using the Internet in your practice. Part 2: Generating new patients using social media,” to learn more on getting started with YouTube.

Videos will improve your Web site rankings and will increase the time visitors spend on the site. When done properly—labeling the videos with relevant keywords, making the videos short, and presenting information in layman’s language with reasons why it is important to seek a professional if the viewer is experiencing these types of symptoms—they are a great way to convert visitors to patients.

4. Hook‘em on the homepage
If you want your Web site to create a favorable first impression, your homepage should reflect that positive impression. Remember, the homepage, as the face of your practice, is the first thing that a patient will see long before she picks up the phone or comes to the office.

A potential patient visiting your site will make a snap judgment within a few seconds. Think of your homepage as a highway billboard. There are about 3 seconds to make an impression and for a driver to decide whether or not she will exit the highway to buy gas or eat at a restaurant or even contact a business in the future by telephone or, most likely, online. A visit to your Web site has the same attraction timing. 

Your homepage must be attractive; provide useful, current information; and have pleasing graphics—all without requiring the visitor to scroll down too far. Your Web site is your opportunity to create a good first impression—an opportunity that won’t happen again.

Use compelling headlines with keyword-related content. You want to make sure you use keywords that a prospective patient might search for in a main headline and in the main body of your home­page. But patients are not the only ones who spot those key terms. Search engines also crawl your Web site for keywords that prospective patients may type into the Google search bar—words like gynecologist, ObGyn, urinary leakage, breast lump, pelvic pain, ­menopause, etc. Using those keywords helps your site to be found more often by patients and helps those prospective patients find information relevant to their medical needs.

5. Place calls to action on every page
Contact us! This is so rudimentary, yet many Web sites do not have easy-to-find contact information on their homepages. Be sure to include your phone number (which could be different than your regular phone office number so you can track how many calls you get from your Web site).

Add a “schedule an appointment” icon in a prominent position on the homepage so the visitor does not have to scroll down to search for it. But don’t just stop at the homepage. Your contact information should be on every page so that, when the visitor is on a page reading about a condition or procedure, the “schedule an appointment” button is right there for her to click.

Be sure to evaluate your contact page. Make sure it’s easy for patients to find multiple ways to connect with you and your office: phone, fax, email, and snail mail.

Interactivity is important. Why not have an “Ask the doctor your question” field? It makes the site interactive and gives you the opportunity to communicate and develop a relationship with your patients.

Additional interactivity
Social media is the new buzz word-of-mouth. Your patients use Facebook, YouTube, blogging, and Twitter every day. It is the easiest way to stay connected and make your practice and your brand part of their daily lives. Social media builds loyalty. Integrating social media into your Web site provides new opportunities to engage your existing patients and to attract new ones to your practice.  

Connect to medical records. Your Web site should have an easy portal for patients to connect to their medical records and laboratory results in a secure, encrypted fashion to comply with HIPAA regulations.

You can do this yourself!
You and your staff should be able to make changes on your Web site without having to contact your Web developer, even if you do not have full-time IT assistance. For example, in Dr. Baum’s practice, his support staff can add testimonials, content, and pictures without contacting the Web developer or knowing code.

Make sure that function is designed into your site and that your Web developer teaches you and your staff how to keep your site updated.

 

 

The bottom line
Web sites are like a farmer’s fence, they are always under construction. Merely having a Web site, regardless of the size, specialty, or location of your practice, is not enough. Be sure your site attracts, holds, and converts viewers into paying patients. We hope you will consider these 5 suggestions as a roadmap to develop a robust site, so that when you ask a patient who referred her to your practice, her answer will be “your Web site” or “the Internet.” This will bring cockles to your heart and bucks in your bank account.


Share your thoughts! Send your Letter to the Editor to [email protected]. Please include your name and the city and state in which you practice.

References


1. Online reputation management for doctors. Vanguard Communications Web site. http://vanguardcommuni cations.net/medical-marketing-portfolio/reputation-management. Accessed March 17, 2015.
2. Gandolf S. Ten commandments of online reputation management for physicians [Part one]. Healthcare Success Web site. http://www.healthcaresuccess.com/blog/internet-marketing-advertising/10-commandments-online-reputation-management-physicians-2.html. Published May 12, 2014. Accessed March 9, 2015.
3. YouTube—The 2nd Largest Search Engine. Mushroom Networks Web site. http://www.mushroomnetworks.com/infographics/youtube---the-2nd-largest-search-engine-infographic. Accessed March 17, 2015.

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Author and Disclosure Information

Ron Romano and Neil H. Baum, MD

Ron Romano is President of www.YourInternetDoctor.com and CEO of Instant Marketing Systems. He co-authored The Internet Survival Guide for Doctors (2014, Instant Marketing Systems) and No B.S. Direct Marketing (2006, Entrepreneur Press) and contributed to the Walking with the Wise series (2004, Mentors Publishing). He is an Internet marketing consultant, speaker, and creator of “The Implementation Blueprint System.”

Neil H. Baum, MD, practices urology in New Orleans, Louisiana. He is Associate Clinical Professor of Urology at Tulane Medical School and Louisiana State University School of Medicine, both in New Orleans. He is also on the medical staff at Touro Infirmary in New Orleans, and East Jefferson General Hospital in Metairie, Louisiana. He is the author of several books, including Social Media for the Healthcare Professional (2012, Greenbranch) and Marketing Your Clinical Practice: Ethically, Effectively, Economically (4th edition, 2009; Jones & Bartlett).

Mr. Romano reports that he is CEO of Instant Marketing Systems, which provides consulting advice, marketing plans, and Internet marketing services for businesses and medical practices. Dr. Baum reports no financial relationships relevant to this article.

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Ron Romano, Neil H. Baum MD, Web site, online patient conversion system, new content, prospective patients, call for an appointment, go mobile, mobile technology, smartphone, tablet, responsive to screen size, patient reviews, patient evaluation, videos, testimonials, procedural videos, YouTube, relevant keywords, homepage, favorable first impression, compelling headlines, keyword-related content, interactivity, calls to action, contact us, schedule an appointment, social media, HIPAA regulations, medical records
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Ron Romano and Neil H. Baum, MD

Ron Romano is President of www.YourInternetDoctor.com and CEO of Instant Marketing Systems. He co-authored The Internet Survival Guide for Doctors (2014, Instant Marketing Systems) and No B.S. Direct Marketing (2006, Entrepreneur Press) and contributed to the Walking with the Wise series (2004, Mentors Publishing). He is an Internet marketing consultant, speaker, and creator of “The Implementation Blueprint System.”

Neil H. Baum, MD, practices urology in New Orleans, Louisiana. He is Associate Clinical Professor of Urology at Tulane Medical School and Louisiana State University School of Medicine, both in New Orleans. He is also on the medical staff at Touro Infirmary in New Orleans, and East Jefferson General Hospital in Metairie, Louisiana. He is the author of several books, including Social Media for the Healthcare Professional (2012, Greenbranch) and Marketing Your Clinical Practice: Ethically, Effectively, Economically (4th edition, 2009; Jones & Bartlett).

Mr. Romano reports that he is CEO of Instant Marketing Systems, which provides consulting advice, marketing plans, and Internet marketing services for businesses and medical practices. Dr. Baum reports no financial relationships relevant to this article.

Author and Disclosure Information

Ron Romano and Neil H. Baum, MD

Ron Romano is President of www.YourInternetDoctor.com and CEO of Instant Marketing Systems. He co-authored The Internet Survival Guide for Doctors (2014, Instant Marketing Systems) and No B.S. Direct Marketing (2006, Entrepreneur Press) and contributed to the Walking with the Wise series (2004, Mentors Publishing). He is an Internet marketing consultant, speaker, and creator of “The Implementation Blueprint System.”

Neil H. Baum, MD, practices urology in New Orleans, Louisiana. He is Associate Clinical Professor of Urology at Tulane Medical School and Louisiana State University School of Medicine, both in New Orleans. He is also on the medical staff at Touro Infirmary in New Orleans, and East Jefferson General Hospital in Metairie, Louisiana. He is the author of several books, including Social Media for the Healthcare Professional (2012, Greenbranch) and Marketing Your Clinical Practice: Ethically, Effectively, Economically (4th edition, 2009; Jones & Bartlett).

Mr. Romano reports that he is CEO of Instant Marketing Systems, which provides consulting advice, marketing plans, and Internet marketing services for businesses and medical practices. Dr. Baum reports no financial relationships relevant to this article.

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Related Articles

Web sites are not like wine and cheese—they don’t necessarily get better with age. You may have started your Web page 20 years ago by moving your 3-color trifold brochure onto the Internet. It may have worked then, but to compete today you must have a robust, interactive, attractive Web site that is continuously being updated with new content. What prospective patients are looking for in a Web site has evolved rapidly. How to get these patients to take action and call for an appointment requires a process or a system.

Trying to keep your Web site current can be daunting for most medical practices. If you find that your Web site is not generating new patients and that your existing patients are not using the site in an interactive fashion, then it is time to upgrade. In this article we suggest 5 practical ways to make your Web site a useful adjunct to your medical practice—an automatic patient conversion system.

1. Go mobile
Make your Web site “thumb friendly.” Mobile technology has taken over the desktop and laptop worlds. Now nearly everyone is using a hand-held smartphone or tablet for their Internet needs.

To attract patients your Web page must be responsive to the screen size of a smartphone or tablet—very different from your Web site, which is accessed from a desktop or a laptop computer. The majority of ­users navigate not with a mouse but with their fingers and thumbs. To ensure they can find their way on your Web page on a mobile device, the screen view should adjust automatically to the mobile device being used. Whether that is accomplished through a mobile responsive design or an entirely different mobile Web site, you do not want the user to have to resize, zoom, or pinch their way through the page in order to read the content. All the buttons must be large enough to be easily pressed without having to zoom in, and the font should be easy-to-read in style and size.

Having your current Web site programmed to be responsive to these devices will increase the time a mobile user spends on your site and make it easier for her to make an appointment.

2. Add patient reviews
What others say about you is far more important than anything you can say about yourself. Almost half of prospective patients will check out your online reviews before calling you to schedule an appointment.1 Therefore, it is very important that you ask for positive feedback from your patients and post it to your Web site. We recommend that you capture compliments from your existing patients when they are in the office. Have a computer or iPad handy for them to create a positive review; patients who “promise” to do it when they get back to the office or home rarely follow through. Testimonials should be visible on your homepage and can link to another testimonial page or review site.

According to HealthCareSuccess.com,
“as many as 8 out of 10 people will look online for information about individual doctors. And all of that happens long before they make an appointment … and what they find—positive, negative, neutral or nothing at all—influences their decision to call or not to call.”2

Always invite your patients to evaluate you, your practice partners, and the practice online. There are numerous patient review Web sites, including: Google Plus, http://www.RateMDs.com, http://www.Vitals.com, and http://www.HealthGrades.com. And check out what your patients are saying about you on a regular basis. Just type “Reviews for Dr. <your name>” into your search bar to find the results.

Although we hope they will, happy patients rarely fill out these online reviews. However, it takes just 2 or 3 unhappy patients to ruin your online reputation. That could be costing you tens of thousands of dollars in lost billing.

3. Share your videos
What’s hot and what’s not? To answer that, just take a look at how many people watch videos on YouTube every day! People don’t want to read anymore; they want to be entertained and spoon-fed information.

Take advantage of this trend by placing videos on your homepage. Post a video that introduces your practice, provides testimonials of satisfied patients, explains some of the procedures you perform, or shows you describing the latest breakthrough in medical technology.

Your videos don’t have to be long. One to 2 minutes is plenty. They don’t have to feature you talking about medical symptoms or procedures (what’s called a talking head video). Use a PowerPoint presentation with voice overlay—and you don’t have to be the one talking.

 

 

Your Web site isn’t the only place you’ll want to post your videos. YouTube is second only to Google as the most popular search engine.3 Just about everyone goes to YouTube to view videos on whatever interests them. See our April 2014 article, titled “Using the Internet in your practice. Part 2: Generating new patients using social media,” to learn more on getting started with YouTube.

Videos will improve your Web site rankings and will increase the time visitors spend on the site. When done properly—labeling the videos with relevant keywords, making the videos short, and presenting information in layman’s language with reasons why it is important to seek a professional if the viewer is experiencing these types of symptoms—they are a great way to convert visitors to patients.

4. Hook‘em on the homepage
If you want your Web site to create a favorable first impression, your homepage should reflect that positive impression. Remember, the homepage, as the face of your practice, is the first thing that a patient will see long before she picks up the phone or comes to the office.

A potential patient visiting your site will make a snap judgment within a few seconds. Think of your homepage as a highway billboard. There are about 3 seconds to make an impression and for a driver to decide whether or not she will exit the highway to buy gas or eat at a restaurant or even contact a business in the future by telephone or, most likely, online. A visit to your Web site has the same attraction timing. 

Your homepage must be attractive; provide useful, current information; and have pleasing graphics—all without requiring the visitor to scroll down too far. Your Web site is your opportunity to create a good first impression—an opportunity that won’t happen again.

Use compelling headlines with keyword-related content. You want to make sure you use keywords that a prospective patient might search for in a main headline and in the main body of your home­page. But patients are not the only ones who spot those key terms. Search engines also crawl your Web site for keywords that prospective patients may type into the Google search bar—words like gynecologist, ObGyn, urinary leakage, breast lump, pelvic pain, ­menopause, etc. Using those keywords helps your site to be found more often by patients and helps those prospective patients find information relevant to their medical needs.

5. Place calls to action on every page
Contact us! This is so rudimentary, yet many Web sites do not have easy-to-find contact information on their homepages. Be sure to include your phone number (which could be different than your regular phone office number so you can track how many calls you get from your Web site).

Add a “schedule an appointment” icon in a prominent position on the homepage so the visitor does not have to scroll down to search for it. But don’t just stop at the homepage. Your contact information should be on every page so that, when the visitor is on a page reading about a condition or procedure, the “schedule an appointment” button is right there for her to click.

Be sure to evaluate your contact page. Make sure it’s easy for patients to find multiple ways to connect with you and your office: phone, fax, email, and snail mail.

Interactivity is important. Why not have an “Ask the doctor your question” field? It makes the site interactive and gives you the opportunity to communicate and develop a relationship with your patients.

Additional interactivity
Social media is the new buzz word-of-mouth. Your patients use Facebook, YouTube, blogging, and Twitter every day. It is the easiest way to stay connected and make your practice and your brand part of their daily lives. Social media builds loyalty. Integrating social media into your Web site provides new opportunities to engage your existing patients and to attract new ones to your practice.  

Connect to medical records. Your Web site should have an easy portal for patients to connect to their medical records and laboratory results in a secure, encrypted fashion to comply with HIPAA regulations.

You can do this yourself!
You and your staff should be able to make changes on your Web site without having to contact your Web developer, even if you do not have full-time IT assistance. For example, in Dr. Baum’s practice, his support staff can add testimonials, content, and pictures without contacting the Web developer or knowing code.

Make sure that function is designed into your site and that your Web developer teaches you and your staff how to keep your site updated.

 

 

The bottom line
Web sites are like a farmer’s fence, they are always under construction. Merely having a Web site, regardless of the size, specialty, or location of your practice, is not enough. Be sure your site attracts, holds, and converts viewers into paying patients. We hope you will consider these 5 suggestions as a roadmap to develop a robust site, so that when you ask a patient who referred her to your practice, her answer will be “your Web site” or “the Internet.” This will bring cockles to your heart and bucks in your bank account.


Share your thoughts! Send your Letter to the Editor to [email protected]. Please include your name and the city and state in which you practice.

Web sites are not like wine and cheese—they don’t necessarily get better with age. You may have started your Web page 20 years ago by moving your 3-color trifold brochure onto the Internet. It may have worked then, but to compete today you must have a robust, interactive, attractive Web site that is continuously being updated with new content. What prospective patients are looking for in a Web site has evolved rapidly. How to get these patients to take action and call for an appointment requires a process or a system.

Trying to keep your Web site current can be daunting for most medical practices. If you find that your Web site is not generating new patients and that your existing patients are not using the site in an interactive fashion, then it is time to upgrade. In this article we suggest 5 practical ways to make your Web site a useful adjunct to your medical practice—an automatic patient conversion system.

1. Go mobile
Make your Web site “thumb friendly.” Mobile technology has taken over the desktop and laptop worlds. Now nearly everyone is using a hand-held smartphone or tablet for their Internet needs.

To attract patients your Web page must be responsive to the screen size of a smartphone or tablet—very different from your Web site, which is accessed from a desktop or a laptop computer. The majority of ­users navigate not with a mouse but with their fingers and thumbs. To ensure they can find their way on your Web page on a mobile device, the screen view should adjust automatically to the mobile device being used. Whether that is accomplished through a mobile responsive design or an entirely different mobile Web site, you do not want the user to have to resize, zoom, or pinch their way through the page in order to read the content. All the buttons must be large enough to be easily pressed without having to zoom in, and the font should be easy-to-read in style and size.

Having your current Web site programmed to be responsive to these devices will increase the time a mobile user spends on your site and make it easier for her to make an appointment.

2. Add patient reviews
What others say about you is far more important than anything you can say about yourself. Almost half of prospective patients will check out your online reviews before calling you to schedule an appointment.1 Therefore, it is very important that you ask for positive feedback from your patients and post it to your Web site. We recommend that you capture compliments from your existing patients when they are in the office. Have a computer or iPad handy for them to create a positive review; patients who “promise” to do it when they get back to the office or home rarely follow through. Testimonials should be visible on your homepage and can link to another testimonial page or review site.

According to HealthCareSuccess.com,
“as many as 8 out of 10 people will look online for information about individual doctors. And all of that happens long before they make an appointment … and what they find—positive, negative, neutral or nothing at all—influences their decision to call or not to call.”2

Always invite your patients to evaluate you, your practice partners, and the practice online. There are numerous patient review Web sites, including: Google Plus, http://www.RateMDs.com, http://www.Vitals.com, and http://www.HealthGrades.com. And check out what your patients are saying about you on a regular basis. Just type “Reviews for Dr. <your name>” into your search bar to find the results.

Although we hope they will, happy patients rarely fill out these online reviews. However, it takes just 2 or 3 unhappy patients to ruin your online reputation. That could be costing you tens of thousands of dollars in lost billing.

3. Share your videos
What’s hot and what’s not? To answer that, just take a look at how many people watch videos on YouTube every day! People don’t want to read anymore; they want to be entertained and spoon-fed information.

Take advantage of this trend by placing videos on your homepage. Post a video that introduces your practice, provides testimonials of satisfied patients, explains some of the procedures you perform, or shows you describing the latest breakthrough in medical technology.

Your videos don’t have to be long. One to 2 minutes is plenty. They don’t have to feature you talking about medical symptoms or procedures (what’s called a talking head video). Use a PowerPoint presentation with voice overlay—and you don’t have to be the one talking.

 

 

Your Web site isn’t the only place you’ll want to post your videos. YouTube is second only to Google as the most popular search engine.3 Just about everyone goes to YouTube to view videos on whatever interests them. See our April 2014 article, titled “Using the Internet in your practice. Part 2: Generating new patients using social media,” to learn more on getting started with YouTube.

Videos will improve your Web site rankings and will increase the time visitors spend on the site. When done properly—labeling the videos with relevant keywords, making the videos short, and presenting information in layman’s language with reasons why it is important to seek a professional if the viewer is experiencing these types of symptoms—they are a great way to convert visitors to patients.

4. Hook‘em on the homepage
If you want your Web site to create a favorable first impression, your homepage should reflect that positive impression. Remember, the homepage, as the face of your practice, is the first thing that a patient will see long before she picks up the phone or comes to the office.

A potential patient visiting your site will make a snap judgment within a few seconds. Think of your homepage as a highway billboard. There are about 3 seconds to make an impression and for a driver to decide whether or not she will exit the highway to buy gas or eat at a restaurant or even contact a business in the future by telephone or, most likely, online. A visit to your Web site has the same attraction timing. 

Your homepage must be attractive; provide useful, current information; and have pleasing graphics—all without requiring the visitor to scroll down too far. Your Web site is your opportunity to create a good first impression—an opportunity that won’t happen again.

Use compelling headlines with keyword-related content. You want to make sure you use keywords that a prospective patient might search for in a main headline and in the main body of your home­page. But patients are not the only ones who spot those key terms. Search engines also crawl your Web site for keywords that prospective patients may type into the Google search bar—words like gynecologist, ObGyn, urinary leakage, breast lump, pelvic pain, ­menopause, etc. Using those keywords helps your site to be found more often by patients and helps those prospective patients find information relevant to their medical needs.

5. Place calls to action on every page
Contact us! This is so rudimentary, yet many Web sites do not have easy-to-find contact information on their homepages. Be sure to include your phone number (which could be different than your regular phone office number so you can track how many calls you get from your Web site).

Add a “schedule an appointment” icon in a prominent position on the homepage so the visitor does not have to scroll down to search for it. But don’t just stop at the homepage. Your contact information should be on every page so that, when the visitor is on a page reading about a condition or procedure, the “schedule an appointment” button is right there for her to click.

Be sure to evaluate your contact page. Make sure it’s easy for patients to find multiple ways to connect with you and your office: phone, fax, email, and snail mail.

Interactivity is important. Why not have an “Ask the doctor your question” field? It makes the site interactive and gives you the opportunity to communicate and develop a relationship with your patients.

Additional interactivity
Social media is the new buzz word-of-mouth. Your patients use Facebook, YouTube, blogging, and Twitter every day. It is the easiest way to stay connected and make your practice and your brand part of their daily lives. Social media builds loyalty. Integrating social media into your Web site provides new opportunities to engage your existing patients and to attract new ones to your practice.  

Connect to medical records. Your Web site should have an easy portal for patients to connect to their medical records and laboratory results in a secure, encrypted fashion to comply with HIPAA regulations.

You can do this yourself!
You and your staff should be able to make changes on your Web site without having to contact your Web developer, even if you do not have full-time IT assistance. For example, in Dr. Baum’s practice, his support staff can add testimonials, content, and pictures without contacting the Web developer or knowing code.

Make sure that function is designed into your site and that your Web developer teaches you and your staff how to keep your site updated.

 

 

The bottom line
Web sites are like a farmer’s fence, they are always under construction. Merely having a Web site, regardless of the size, specialty, or location of your practice, is not enough. Be sure your site attracts, holds, and converts viewers into paying patients. We hope you will consider these 5 suggestions as a roadmap to develop a robust site, so that when you ask a patient who referred her to your practice, her answer will be “your Web site” or “the Internet.” This will bring cockles to your heart and bucks in your bank account.


Share your thoughts! Send your Letter to the Editor to [email protected]. Please include your name and the city and state in which you practice.

References


1. Online reputation management for doctors. Vanguard Communications Web site. http://vanguardcommuni cations.net/medical-marketing-portfolio/reputation-management. Accessed March 17, 2015.
2. Gandolf S. Ten commandments of online reputation management for physicians [Part one]. Healthcare Success Web site. http://www.healthcaresuccess.com/blog/internet-marketing-advertising/10-commandments-online-reputation-management-physicians-2.html. Published May 12, 2014. Accessed March 9, 2015.
3. YouTube—The 2nd Largest Search Engine. Mushroom Networks Web site. http://www.mushroomnetworks.com/infographics/youtube---the-2nd-largest-search-engine-infographic. Accessed March 17, 2015.

References


1. Online reputation management for doctors. Vanguard Communications Web site. http://vanguardcommuni cations.net/medical-marketing-portfolio/reputation-management. Accessed March 17, 2015.
2. Gandolf S. Ten commandments of online reputation management for physicians [Part one]. Healthcare Success Web site. http://www.healthcaresuccess.com/blog/internet-marketing-advertising/10-commandments-online-reputation-management-physicians-2.html. Published May 12, 2014. Accessed March 9, 2015.
3. YouTube—The 2nd Largest Search Engine. Mushroom Networks Web site. http://www.mushroomnetworks.com/infographics/youtube---the-2nd-largest-search-engine-infographic. Accessed March 17, 2015.

Issue
OBG Management - 27(4)
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OBG Management - 27(4)
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Using the Internet in your practice. Part 3: Maximizing your online reach through SEO and pay-per-click

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Using the Internet in your practice. Part 3: Maximizing your online reach through SEO and pay-per-click

It’s high time to go beyond relying on YellowPages.com to attract patients to your practice. According to research and analysis company BIA/Kelsey, “nearly all consumers (97%) now use online media to shop locally.”1 Today’s patients are Internet savvy and expect their ObGyn not only to be a good physician who diagnoses and treats their conditions but also to demonstrate his or her electronic technical abilities, through online communication, a Web site, email newsletter outreach, and, yes, a social media presence.

Yet, being the best in your field or having an incredible Web site won’t matter if your existing patients and potential new patients can’t find you on the Internet. The solution? Get your Web site onto the first page of Google’s search results. Why? Google is still by far the dominant search engine in the United States, and it has the overwhelming ability to offer you an endless supply of patients. And can your practice survive without a steady flow of new patients?

Type a keyword into the Google search window and dozens, hundreds, or thousands of sites may become visible. Google lists 10 sites per page, however, and when was the last time you went to the second, third, or fourth results page looking for something? If your Web site does not appear on the first results page, you are essentially invisible. The good news is that you can easily and inexpensively reach the top of a search engine’s results page by knowing and applying best practices for effective search engine optimization (SEO; a free endeavor, although your time investment should considered) and/or utilizing a pay-per-click (PPC) service (for a fee that’s comparable to what you used to pay for your old Yellow Pages listing). In this article, we aim to provide to you the know-how to embark on these endeavors by defining SEO and PPC and relaying effective principles for marketing your practice to potential new patients.


What is SEO?

SEO refers to techniques that help your Web site rank higher in organic (natural) results, which helps your site, and you, become more visible to people who are seeking your services. Search engines specialize in offering Web surfers the best information about their search terms, or keywords. To do this, Google uses more than 200 different algorithms, some of which we know but most of which are not published.

The algorithms are used to determine where your Web site ranks according to a number of factors relevant to the content and set-up of each page of your Web site (on-page SEO) as well as everything you do outside of your Web site (off-page SEO) to enhance your SEO rankings. This relevance is calculated by looking at both on-page and off-page factors, including:

  • what you are doing in relation to your competition
  • how long your Web site has been active
  • search engine submission
  • article submission
  • directory submission
  • linking strategies.

You have to work on both on-page and off-page factors many times a month to convince the search engines that you are a Web site worth visiting. Over time, your site will start to rise in the rankings and gain qualified traffic. Then you can concentrate on converting those Web site visitors to office-based patients.

A warning: If you use unethical tactics to get your Web site on the first page of the search results, Google will catch up to you—and your Web-site rankings will plummet.

Five important steps to increase SEO

There’s a system to reach the top of any search engine’s results page. The most important steps are to:

  1. Use keywords in your Web site coding, or page description (called meta tags).
  2. Use keywords in your Web site copy.
  3. Develop in-bound links.
  4. Post new keyword-related content regularly—typically accomplished through a blog.
  5. Integrate your keywords in social media postings.

1 and 2. Keywords are key
Keywords are what an Internet surfer enters into a search function and what the search engine crawlers hunt for. The crawlers then direct the surfer to the Web site that is perceived as the best source of information.

Here are the most popular keywords used by potential patients looking for ­ObGyns: obstetrician, gynecologist, gynecology, vaginal discharge, vaginal dryness, breast self-exam, breast cancer screening, prolapsed bladder, pelvic pain, and adolescent gynecology. You also should include your city’s name as a keyword.

Use keywords in Web site coding and copy. Unless you are experienced in Web development, you’re better off hiring a professional who knows Internet coding to help you develop HTML meta tags, anchor text, a sitemap, etc. You easily can incorporate keywords in the copy on your Web site, but the keyword density should be no more than approximately 3% to 5% of the copy. (If it is more than 5%, it is considered “stuffing,” and not looked on kindly by Google.)

 

 

3. In-bound links: Who’s linking to you?
As the search engine crawlers scan Web pages for indexing, they also look for links from other Web sites. The greater number of quality in-bound links a Web site has, the stronger influence or authority it accrues.

In-bound links are weighted differently: a link from a highly authoritative Web site like NYTimes.com will give a Web site a bigger boost than a link from a small blog site. Links from high-ranking sites, such as city directories, hospitals, and online medical directories, improve your Web-site ranking. You should be submitting your Web site address and keyword description to these appropriate directories for in-bound links on a weekly or monthly basis.

4. Develop new content by blogging
Search engines place a high value on new content, and the easiest way to add new keyword-related content is to blog. Writing a 400-word keyword–relevant blog on a regular basis will provide the search engine crawlers with new content to graze.

As an added bonus, there are many medical ezines—small magazines and newsletters distributed by any electronic ­method—that regularly need content. Publication of your blog article will provide additional back-links to your Web site and improve your SEO rankings. This is your opportunity to go “viral,” have your material read by thousands, and increase visits to your Web site. When your name appears on multiple sites, you create the perception of demonstrating your expertise in various topics, techniques, and therapeutic options.

5. Search engines love social media
Newer technologies are given greater weight in determining Web page ranking. Start with blogging and then add Facebook, YouTube, and Twitter. Always remember to link from these sites with relevant keywords to the exact page on your site that contains the best information for those keywords.

Advertise your practice using PPC (Google AdWords)

Google, Yahoo, and other Internet portals make their money by selling advertisements on search-results pages. Both paid and organic listings appear on the search results pages, but they are displayed in different locations. On Google, PPC listings are found on the top and right side of each page under the header “Ads” (FIGURE 1). The organic or natural search (no payment required) is on the left below the ads.

Figure 1 PPC placement on Google

On Google, the PPC function is called ­“AdWords” (http://www.google.com/adwords). On the AdWords page, a listing is found that offers how many times people type in certain words or phrases—keywords. Google AdWords allows the marketplace to bid on keywords; the higher the bid, the closer to the top position on the first page of the Google search results. Depending on monthly search volume, popularity, and competition, you can pay anywhere from pennies to $25 each time a Web surfer clicks on your ad. In FIGURE 2, you can see that a suggested bid for “Gynecologist Miami” is $2.96.

Figure 2: Google AdWords account page

You must constantly monitor and manage your AdWords account. Test different landing pages, adjust your copy, and change offerings to make sure you are converting your paid traffic to patients. Otherwise, you can spend hundreds of dollars each month without achieving the desired outcome.

By doing your own research with Google AdWords’ keyword planner, you will see the variations of keywords that you can use in the copy of your Web site and related content for organic SE

Patient conversion: Your ultimate goal

Google is only one piece of the Internet marketing puzzle. Once you have invested in mastering the SEO rankings (by doing it yourself or by paying for professional help), it’s up to your Web site to convert the visitor to a paying patient. To maximize your return on investment (ROI), implement marketing strategies and a patient conversion system on your Web site. When a prospective patient lands there, you have less than 10 seconds to engage her. In Part 1of this series, we discuss features that will keep your visitor involved while she navigates the site and make it easy for her to make an appointment. Don’t lose her because she can’t find your contact information hidden at the bottom of the page.2

If you don’t want to spend the time and effort to do it yourself, outsourcing is a cost-effective solution, and a trackable and measurable way for you to calculate your ROI.

Bottom line: Be seen on the Internet. We are all connected to the Internet every waking moment. This is where we go for information; this is how we communicate with each other; and this is where we create relationships. If you want to build your practice, you have to be where your patient can find you—on the top of an Internet search results page.

 

 


Share your thoughts on this article! 
Send your Letter to the Editor to [email protected]. Please include your name and the city and state in which you practice.

References

1. Pacheco E, Udowitz R. Nearly all consumers (97%) now use online media to shop locally, according to BIA/Kelsey and ConStat [press release]. BIA/Kelsey Web site. http://www.biakelsey.com/company/press-releases/100310-nearly-all-consumers-now-use-online-media-to-shop-locally.asp. Published March 10, 2010. Accessed August 12, 2014.

2. Baum NH, Romano R. Using the Internet in your practice. Part 1: why social media are important and how to get started. OBG Manag. 2014;26(2):25–36.

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Author and Disclosure Information

Ron Romano and Neil H. Baum, MD

Ron Romano is President of www.YourInternetDoctor.com and CEO of Instant Marketing Systems. He co-authored The Internet Survival Guide for Doctors (2014, Instant Marketing Systems) and No B.S. Direct Marketing (2006, Entrepreneur Press) and contributed to the Walking with the Wise series (2004, Mentors Publishing). He is an Internet marketing consultant, speaker, and creator of “The Implementation Blueprint System.”

Neil H. Baum, MD, practices urology in New Orleans, Louisiana. He is Associate Clinical Professor of Urology at Tulane Medical School and Louisiana State University School of Medicine, both in New Orleans. He is also on the medical staff at Touro Infirmary in New Orleans, and East Jefferson General Hospital in Metairie, Louisiana. And he is the author of Marketing Your Clinical Practice: Ethically, Effectively, Economically (4th edition, 2009; Jones & Bartlett).

Mr. Romano reports that he is CEO of Instant Marketing Systems, which provides consulting advice, marketing plans, and Internet marketing services for businesses and medical practices. Dr. Baum reports no financial relationships relevant to this article.

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Author and Disclosure Information

Ron Romano and Neil H. Baum, MD

Ron Romano is President of www.YourInternetDoctor.com and CEO of Instant Marketing Systems. He co-authored The Internet Survival Guide for Doctors (2014, Instant Marketing Systems) and No B.S. Direct Marketing (2006, Entrepreneur Press) and contributed to the Walking with the Wise series (2004, Mentors Publishing). He is an Internet marketing consultant, speaker, and creator of “The Implementation Blueprint System.”

Neil H. Baum, MD, practices urology in New Orleans, Louisiana. He is Associate Clinical Professor of Urology at Tulane Medical School and Louisiana State University School of Medicine, both in New Orleans. He is also on the medical staff at Touro Infirmary in New Orleans, and East Jefferson General Hospital in Metairie, Louisiana. And he is the author of Marketing Your Clinical Practice: Ethically, Effectively, Economically (4th edition, 2009; Jones & Bartlett).

Mr. Romano reports that he is CEO of Instant Marketing Systems, which provides consulting advice, marketing plans, and Internet marketing services for businesses and medical practices. Dr. Baum reports no financial relationships relevant to this article.

Author and Disclosure Information

Ron Romano and Neil H. Baum, MD

Ron Romano is President of www.YourInternetDoctor.com and CEO of Instant Marketing Systems. He co-authored The Internet Survival Guide for Doctors (2014, Instant Marketing Systems) and No B.S. Direct Marketing (2006, Entrepreneur Press) and contributed to the Walking with the Wise series (2004, Mentors Publishing). He is an Internet marketing consultant, speaker, and creator of “The Implementation Blueprint System.”

Neil H. Baum, MD, practices urology in New Orleans, Louisiana. He is Associate Clinical Professor of Urology at Tulane Medical School and Louisiana State University School of Medicine, both in New Orleans. He is also on the medical staff at Touro Infirmary in New Orleans, and East Jefferson General Hospital in Metairie, Louisiana. And he is the author of Marketing Your Clinical Practice: Ethically, Effectively, Economically (4th edition, 2009; Jones & Bartlett).

Mr. Romano reports that he is CEO of Instant Marketing Systems, which provides consulting advice, marketing plans, and Internet marketing services for businesses and medical practices. Dr. Baum reports no financial relationships relevant to this article.

Article PDF
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Related Articles

It’s high time to go beyond relying on YellowPages.com to attract patients to your practice. According to research and analysis company BIA/Kelsey, “nearly all consumers (97%) now use online media to shop locally.”1 Today’s patients are Internet savvy and expect their ObGyn not only to be a good physician who diagnoses and treats their conditions but also to demonstrate his or her electronic technical abilities, through online communication, a Web site, email newsletter outreach, and, yes, a social media presence.

Yet, being the best in your field or having an incredible Web site won’t matter if your existing patients and potential new patients can’t find you on the Internet. The solution? Get your Web site onto the first page of Google’s search results. Why? Google is still by far the dominant search engine in the United States, and it has the overwhelming ability to offer you an endless supply of patients. And can your practice survive without a steady flow of new patients?

Type a keyword into the Google search window and dozens, hundreds, or thousands of sites may become visible. Google lists 10 sites per page, however, and when was the last time you went to the second, third, or fourth results page looking for something? If your Web site does not appear on the first results page, you are essentially invisible. The good news is that you can easily and inexpensively reach the top of a search engine’s results page by knowing and applying best practices for effective search engine optimization (SEO; a free endeavor, although your time investment should considered) and/or utilizing a pay-per-click (PPC) service (for a fee that’s comparable to what you used to pay for your old Yellow Pages listing). In this article, we aim to provide to you the know-how to embark on these endeavors by defining SEO and PPC and relaying effective principles for marketing your practice to potential new patients.


What is SEO?

SEO refers to techniques that help your Web site rank higher in organic (natural) results, which helps your site, and you, become more visible to people who are seeking your services. Search engines specialize in offering Web surfers the best information about their search terms, or keywords. To do this, Google uses more than 200 different algorithms, some of which we know but most of which are not published.

The algorithms are used to determine where your Web site ranks according to a number of factors relevant to the content and set-up of each page of your Web site (on-page SEO) as well as everything you do outside of your Web site (off-page SEO) to enhance your SEO rankings. This relevance is calculated by looking at both on-page and off-page factors, including:

  • what you are doing in relation to your competition
  • how long your Web site has been active
  • search engine submission
  • article submission
  • directory submission
  • linking strategies.

You have to work on both on-page and off-page factors many times a month to convince the search engines that you are a Web site worth visiting. Over time, your site will start to rise in the rankings and gain qualified traffic. Then you can concentrate on converting those Web site visitors to office-based patients.

A warning: If you use unethical tactics to get your Web site on the first page of the search results, Google will catch up to you—and your Web-site rankings will plummet.

Five important steps to increase SEO

There’s a system to reach the top of any search engine’s results page. The most important steps are to:

  1. Use keywords in your Web site coding, or page description (called meta tags).
  2. Use keywords in your Web site copy.
  3. Develop in-bound links.
  4. Post new keyword-related content regularly—typically accomplished through a blog.
  5. Integrate your keywords in social media postings.

1 and 2. Keywords are key
Keywords are what an Internet surfer enters into a search function and what the search engine crawlers hunt for. The crawlers then direct the surfer to the Web site that is perceived as the best source of information.

Here are the most popular keywords used by potential patients looking for ­ObGyns: obstetrician, gynecologist, gynecology, vaginal discharge, vaginal dryness, breast self-exam, breast cancer screening, prolapsed bladder, pelvic pain, and adolescent gynecology. You also should include your city’s name as a keyword.

Use keywords in Web site coding and copy. Unless you are experienced in Web development, you’re better off hiring a professional who knows Internet coding to help you develop HTML meta tags, anchor text, a sitemap, etc. You easily can incorporate keywords in the copy on your Web site, but the keyword density should be no more than approximately 3% to 5% of the copy. (If it is more than 5%, it is considered “stuffing,” and not looked on kindly by Google.)

 

 

3. In-bound links: Who’s linking to you?
As the search engine crawlers scan Web pages for indexing, they also look for links from other Web sites. The greater number of quality in-bound links a Web site has, the stronger influence or authority it accrues.

In-bound links are weighted differently: a link from a highly authoritative Web site like NYTimes.com will give a Web site a bigger boost than a link from a small blog site. Links from high-ranking sites, such as city directories, hospitals, and online medical directories, improve your Web-site ranking. You should be submitting your Web site address and keyword description to these appropriate directories for in-bound links on a weekly or monthly basis.

4. Develop new content by blogging
Search engines place a high value on new content, and the easiest way to add new keyword-related content is to blog. Writing a 400-word keyword–relevant blog on a regular basis will provide the search engine crawlers with new content to graze.

As an added bonus, there are many medical ezines—small magazines and newsletters distributed by any electronic ­method—that regularly need content. Publication of your blog article will provide additional back-links to your Web site and improve your SEO rankings. This is your opportunity to go “viral,” have your material read by thousands, and increase visits to your Web site. When your name appears on multiple sites, you create the perception of demonstrating your expertise in various topics, techniques, and therapeutic options.

5. Search engines love social media
Newer technologies are given greater weight in determining Web page ranking. Start with blogging and then add Facebook, YouTube, and Twitter. Always remember to link from these sites with relevant keywords to the exact page on your site that contains the best information for those keywords.

Advertise your practice using PPC (Google AdWords)

Google, Yahoo, and other Internet portals make their money by selling advertisements on search-results pages. Both paid and organic listings appear on the search results pages, but they are displayed in different locations. On Google, PPC listings are found on the top and right side of each page under the header “Ads” (FIGURE 1). The organic or natural search (no payment required) is on the left below the ads.

Figure 1 PPC placement on Google

On Google, the PPC function is called ­“AdWords” (http://www.google.com/adwords). On the AdWords page, a listing is found that offers how many times people type in certain words or phrases—keywords. Google AdWords allows the marketplace to bid on keywords; the higher the bid, the closer to the top position on the first page of the Google search results. Depending on monthly search volume, popularity, and competition, you can pay anywhere from pennies to $25 each time a Web surfer clicks on your ad. In FIGURE 2, you can see that a suggested bid for “Gynecologist Miami” is $2.96.

Figure 2: Google AdWords account page

You must constantly monitor and manage your AdWords account. Test different landing pages, adjust your copy, and change offerings to make sure you are converting your paid traffic to patients. Otherwise, you can spend hundreds of dollars each month without achieving the desired outcome.

By doing your own research with Google AdWords’ keyword planner, you will see the variations of keywords that you can use in the copy of your Web site and related content for organic SE

Patient conversion: Your ultimate goal

Google is only one piece of the Internet marketing puzzle. Once you have invested in mastering the SEO rankings (by doing it yourself or by paying for professional help), it’s up to your Web site to convert the visitor to a paying patient. To maximize your return on investment (ROI), implement marketing strategies and a patient conversion system on your Web site. When a prospective patient lands there, you have less than 10 seconds to engage her. In Part 1of this series, we discuss features that will keep your visitor involved while she navigates the site and make it easy for her to make an appointment. Don’t lose her because she can’t find your contact information hidden at the bottom of the page.2

If you don’t want to spend the time and effort to do it yourself, outsourcing is a cost-effective solution, and a trackable and measurable way for you to calculate your ROI.

Bottom line: Be seen on the Internet. We are all connected to the Internet every waking moment. This is where we go for information; this is how we communicate with each other; and this is where we create relationships. If you want to build your practice, you have to be where your patient can find you—on the top of an Internet search results page.

 

 


Share your thoughts on this article! 
Send your Letter to the Editor to [email protected]. Please include your name and the city and state in which you practice.

It’s high time to go beyond relying on YellowPages.com to attract patients to your practice. According to research and analysis company BIA/Kelsey, “nearly all consumers (97%) now use online media to shop locally.”1 Today’s patients are Internet savvy and expect their ObGyn not only to be a good physician who diagnoses and treats their conditions but also to demonstrate his or her electronic technical abilities, through online communication, a Web site, email newsletter outreach, and, yes, a social media presence.

Yet, being the best in your field or having an incredible Web site won’t matter if your existing patients and potential new patients can’t find you on the Internet. The solution? Get your Web site onto the first page of Google’s search results. Why? Google is still by far the dominant search engine in the United States, and it has the overwhelming ability to offer you an endless supply of patients. And can your practice survive without a steady flow of new patients?

Type a keyword into the Google search window and dozens, hundreds, or thousands of sites may become visible. Google lists 10 sites per page, however, and when was the last time you went to the second, third, or fourth results page looking for something? If your Web site does not appear on the first results page, you are essentially invisible. The good news is that you can easily and inexpensively reach the top of a search engine’s results page by knowing and applying best practices for effective search engine optimization (SEO; a free endeavor, although your time investment should considered) and/or utilizing a pay-per-click (PPC) service (for a fee that’s comparable to what you used to pay for your old Yellow Pages listing). In this article, we aim to provide to you the know-how to embark on these endeavors by defining SEO and PPC and relaying effective principles for marketing your practice to potential new patients.


What is SEO?

SEO refers to techniques that help your Web site rank higher in organic (natural) results, which helps your site, and you, become more visible to people who are seeking your services. Search engines specialize in offering Web surfers the best information about their search terms, or keywords. To do this, Google uses more than 200 different algorithms, some of which we know but most of which are not published.

The algorithms are used to determine where your Web site ranks according to a number of factors relevant to the content and set-up of each page of your Web site (on-page SEO) as well as everything you do outside of your Web site (off-page SEO) to enhance your SEO rankings. This relevance is calculated by looking at both on-page and off-page factors, including:

  • what you are doing in relation to your competition
  • how long your Web site has been active
  • search engine submission
  • article submission
  • directory submission
  • linking strategies.

You have to work on both on-page and off-page factors many times a month to convince the search engines that you are a Web site worth visiting. Over time, your site will start to rise in the rankings and gain qualified traffic. Then you can concentrate on converting those Web site visitors to office-based patients.

A warning: If you use unethical tactics to get your Web site on the first page of the search results, Google will catch up to you—and your Web-site rankings will plummet.

Five important steps to increase SEO

There’s a system to reach the top of any search engine’s results page. The most important steps are to:

  1. Use keywords in your Web site coding, or page description (called meta tags).
  2. Use keywords in your Web site copy.
  3. Develop in-bound links.
  4. Post new keyword-related content regularly—typically accomplished through a blog.
  5. Integrate your keywords in social media postings.

1 and 2. Keywords are key
Keywords are what an Internet surfer enters into a search function and what the search engine crawlers hunt for. The crawlers then direct the surfer to the Web site that is perceived as the best source of information.

Here are the most popular keywords used by potential patients looking for ­ObGyns: obstetrician, gynecologist, gynecology, vaginal discharge, vaginal dryness, breast self-exam, breast cancer screening, prolapsed bladder, pelvic pain, and adolescent gynecology. You also should include your city’s name as a keyword.

Use keywords in Web site coding and copy. Unless you are experienced in Web development, you’re better off hiring a professional who knows Internet coding to help you develop HTML meta tags, anchor text, a sitemap, etc. You easily can incorporate keywords in the copy on your Web site, but the keyword density should be no more than approximately 3% to 5% of the copy. (If it is more than 5%, it is considered “stuffing,” and not looked on kindly by Google.)

 

 

3. In-bound links: Who’s linking to you?
As the search engine crawlers scan Web pages for indexing, they also look for links from other Web sites. The greater number of quality in-bound links a Web site has, the stronger influence or authority it accrues.

In-bound links are weighted differently: a link from a highly authoritative Web site like NYTimes.com will give a Web site a bigger boost than a link from a small blog site. Links from high-ranking sites, such as city directories, hospitals, and online medical directories, improve your Web-site ranking. You should be submitting your Web site address and keyword description to these appropriate directories for in-bound links on a weekly or monthly basis.

4. Develop new content by blogging
Search engines place a high value on new content, and the easiest way to add new keyword-related content is to blog. Writing a 400-word keyword–relevant blog on a regular basis will provide the search engine crawlers with new content to graze.

As an added bonus, there are many medical ezines—small magazines and newsletters distributed by any electronic ­method—that regularly need content. Publication of your blog article will provide additional back-links to your Web site and improve your SEO rankings. This is your opportunity to go “viral,” have your material read by thousands, and increase visits to your Web site. When your name appears on multiple sites, you create the perception of demonstrating your expertise in various topics, techniques, and therapeutic options.

5. Search engines love social media
Newer technologies are given greater weight in determining Web page ranking. Start with blogging and then add Facebook, YouTube, and Twitter. Always remember to link from these sites with relevant keywords to the exact page on your site that contains the best information for those keywords.

Advertise your practice using PPC (Google AdWords)

Google, Yahoo, and other Internet portals make their money by selling advertisements on search-results pages. Both paid and organic listings appear on the search results pages, but they are displayed in different locations. On Google, PPC listings are found on the top and right side of each page under the header “Ads” (FIGURE 1). The organic or natural search (no payment required) is on the left below the ads.

Figure 1 PPC placement on Google

On Google, the PPC function is called ­“AdWords” (http://www.google.com/adwords). On the AdWords page, a listing is found that offers how many times people type in certain words or phrases—keywords. Google AdWords allows the marketplace to bid on keywords; the higher the bid, the closer to the top position on the first page of the Google search results. Depending on monthly search volume, popularity, and competition, you can pay anywhere from pennies to $25 each time a Web surfer clicks on your ad. In FIGURE 2, you can see that a suggested bid for “Gynecologist Miami” is $2.96.

Figure 2: Google AdWords account page

You must constantly monitor and manage your AdWords account. Test different landing pages, adjust your copy, and change offerings to make sure you are converting your paid traffic to patients. Otherwise, you can spend hundreds of dollars each month without achieving the desired outcome.

By doing your own research with Google AdWords’ keyword planner, you will see the variations of keywords that you can use in the copy of your Web site and related content for organic SE

Patient conversion: Your ultimate goal

Google is only one piece of the Internet marketing puzzle. Once you have invested in mastering the SEO rankings (by doing it yourself or by paying for professional help), it’s up to your Web site to convert the visitor to a paying patient. To maximize your return on investment (ROI), implement marketing strategies and a patient conversion system on your Web site. When a prospective patient lands there, you have less than 10 seconds to engage her. In Part 1of this series, we discuss features that will keep your visitor involved while she navigates the site and make it easy for her to make an appointment. Don’t lose her because she can’t find your contact information hidden at the bottom of the page.2

If you don’t want to spend the time and effort to do it yourself, outsourcing is a cost-effective solution, and a trackable and measurable way for you to calculate your ROI.

Bottom line: Be seen on the Internet. We are all connected to the Internet every waking moment. This is where we go for information; this is how we communicate with each other; and this is where we create relationships. If you want to build your practice, you have to be where your patient can find you—on the top of an Internet search results page.

 

 


Share your thoughts on this article! 
Send your Letter to the Editor to [email protected]. Please include your name and the city and state in which you practice.

References

1. Pacheco E, Udowitz R. Nearly all consumers (97%) now use online media to shop locally, according to BIA/Kelsey and ConStat [press release]. BIA/Kelsey Web site. http://www.biakelsey.com/company/press-releases/100310-nearly-all-consumers-now-use-online-media-to-shop-locally.asp. Published March 10, 2010. Accessed August 12, 2014.

2. Baum NH, Romano R. Using the Internet in your practice. Part 1: why social media are important and how to get started. OBG Manag. 2014;26(2):25–36.

References

1. Pacheco E, Udowitz R. Nearly all consumers (97%) now use online media to shop locally, according to BIA/Kelsey and ConStat [press release]. BIA/Kelsey Web site. http://www.biakelsey.com/company/press-releases/100310-nearly-all-consumers-now-use-online-media-to-shop-locally.asp. Published March 10, 2010. Accessed August 12, 2014.

2. Baum NH, Romano R. Using the Internet in your practice. Part 1: why social media are important and how to get started. OBG Manag. 2014;26(2):25–36.

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OBG Management - 26(9)
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OBG Management - 26(9)
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Using the Internet in your practice. Part 3: Maximizing your online reach through SEO and pay-per-click
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Using the Internet in your practice. Part 3: Maximizing your online reach through SEO and pay-per-click
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