Neil H. Baum, MD

With this article, we intend to illustrate the value of having a social media presence and how you can use social media to attract new patients. One of us (NHB) has been using social media to promote his medical practice for 3 years and can be found on the first page of Google search results for several of the medical conditions he treats. As a result of these high search rankings, he is able to generate two to four new patient visits every day.

You can achieve the same results using the techniques described in this article. You certainly can buy banner ads and buy traffic to your page, but we want to show you how to get on the first page of Google using the natural, organic method.

PUSH VS PULL
Social media can be used in different ways to build your practice. What you employ depends on what you want to accomplish and the time and energy you want to devote to each of these social media opportunities.

By its very definition, social media is social engagement—and what is known as a “pull” technology. There are two ways to share your information with people on the Internet:

1. “Pull” Web site surfers to your information
2. “Push” your information to them.

Push occurs when you initiate the process by placing your information in front of the Web site surfer. They get it or see it because of the actions you have taken. Sending e-mails is one way to push information to your target audience, or potential patients, to your practice. Another way to push your Web site and its contents is to get listed on the first page of search engine results. You want to “push” your Web site in plain view of the person who has typed in keywords or keyword phrases that relate to your practice (ie, “OBGYN” plus “<your city>,” “tubal ligation” plus “<your city>,” or “loss of urine” plus “<your zip code>.” Push techniques are the best way to market your services and offer the best return on your marketing investment.

Using social media, you are able to “pull” your audience of potential patients to you and your practice. In other words, your target market of potential patients has to take the time and make the effort to type in your Web site address in order to come to you. The information or message you have on your social media sites has to be strong enough and of sufficient compelling interest that patients want to come to read what you have to say. Web surfers are looking for online relationships for information sharing. It is this interaction with your potential patients that makes social media unique. Using this pull technology, you have the opportunity to interact and develop a relationship with a patient before she picks up the phone to make an appointment, before she comes to the office to see you eyeball to eyeball.

FACEBOOK AND HOW IT RELATES TO YOUR PRACTICE
Originally, Facebook was developed as a way for people to see what was going on in each other’s lives, a method to stay in contact with one another. In the beginning, it was friends, family members, or groups of like-minded individuals frequenting each other’s Facebook pages. Typically, they would keep tabs on who was having a party or post pictures of their kids for family members to see.

Facebook has evolved. Today, companies, businesses, and, yes, medical practices are trying to “pull” more Web site visitors to their Facebook pages. To do this, they hold contests with prizes; offer great content, coupons, and videos; and provide special offers to get Web surfers to their site. Large companies and large group practices like the Mayo Clinic, Cleveland Clinic, and MD Anderson Cancer Center, have whole social media departments that post regularly, respond to comments left on their pages, and answer questions posted by those who “like” their page or site.

Individual practicing clinicians, and most smaller ObGyn practices, do not have the budget for a social media team. They also don’t have the time or the training to write effective copy that is so compelling that Web surfers are drawn or “pulled” to their Facebook page. The reality is, your patients expect you to have a Facebook page, and they expect you to have quality information that is helpful and relevant to their well-being. But, the question remains…

Related article: Four pillars of a successful practice: 1. Keep your current patients happy Neal H. Baum, MD (Practice Management, March 2013)

Can Facebook generate new patients?
You and your practice certainly can place a lot of information and pictures on Facebook, and potential patients can leave comments or ask questions easily. You can start a dialog with a patient without providing medical advice and motivate her to see that you are providing medical value before the doctor–patient relationship is established. Still, does a Facebook page generate new patients? It depends on the information you post and how you use Facebook to acquire new patients.

For instance, your practice is probably restricted to a local area—a few zip codes surrounding your office and hospital—which means you really only want patients who are in your area to visit your practice’s Facebook page because those are the only ones who are likely to call and make an appointment. Unless you are highly specialized in a particular field, such as fistula repair, robotic surgery, or the treatment of mesh complications, the Facebook surfer from New York isn’t likely to hop on a plane to come to your practice on the West Coast for gynecologic or obstetric care.

Related article: Four pillars of a successful practice: 2. Attract new patients Neal H. Baum, MD (Practice Management, May 2013)

On the surface, it appears that it is impossible to compete with larger practices and hospitals that have more dedicated staff to draw prospective patients to a practice through Facebook. However, the real, overarching challenge is to improve your Web site rankings on the major search engines, to be on the first page of Google, Bing, and Yahoo search results. And what we do know is that Google has placed a high value on Web site rankings through social media sites like Facebook, Twitter, and YouTube—that is, of course, as long as your Facebook page provides content that has keywords relevant to your target market and the content on your page links back to your Web site.

Therefore, it is not necessary to devote an inordinate amount of time to your social media presence to obtain results. You will, on the other hand, get more visitors to your Web site if it is found on the first page of search engine results because of your Facebook posts. Of course, if your Web site is not set up properly for easy visitor navigation and visitor conversion, you may not be able to obtain the desired result of gaining new patients even if they do find your site. You need to have a Web site with marketing and patient conversion systems built into it; don’t overlook the layout of your Web site. For more on this issue, see Part 1 of this series.

Related article: Using the Internet in your practice. Part 1: Why social media are important and how to get started Neal H. Baum, MD, and Ron Romano (Practice Management, February 2014)

YOUTUBE VIDEOS AND YOUR PRACTICE
YouTube has become a significant search engine for virtually every product and service you offer your patients. There are millions of videos on YouTube, and you can search topics simply by typing in any topic that your patients might be interested in, from birth control to cancer.

There are five ways your practice can benefit from a video posted on YouTube:

1. Web site traffic driver. To achieve this “pull,” you must label your posted video correctly, with keyword phrases that are relevant to the type of patient or conditions you are looking for, and offer a description that would make a viewer want to see the video. You also must provide a link back to your Web site, which increases your chances of gaining a new patient from YouTube.
2. Boost your search engine optimization. Google places a high-ranking factor on videos posted to YouTube that are keyword-relevant.
3. A video library can position you as an expert in the field. You can create your own YouTube channel and keep adding videos. One of us (NHB) has more than
   70 medical videos on his YouTube channel. If someone views one of these videos, they will have immediate access to the rest of the video collection even though they may be labelled with other keywords. This further positions you as the knowledgeable expert in your field.
4. Video embedding capability. Any video you have posted to YouTube can be placed on your Web site, in a format that keeps the viewer on your site. This means the viewer has less of a chance of getting distracted with other video offerings and landing on someone else’s Web site.
5. Free video storage. Because you have stored the video on YouTube, you are not using the resources on your Web site when someone, or several people, view the video at the same time.

Getting started with YouTube
Making a video can be easier than you think. First, a video can simply be a PowerPoint presentation. Studies have demonstrated that it is more about the content of the video than a physician being in front of a camera. There are lots of Web sites you can use to record a presentation; one of the most popular and easy to use is http://www.GoToWebinar.com. There are computer programs that make it easy to record and then simply upload the recording to YouTube. Cam Studio (http://camstudio.org) is a free open-source program available that has a lot of flexibility for editing audio and video files, and it is easy to use. Camtasia (http://www.techsmith.com/camtasia.html) is a popular program that costs about $300 and has a lot of features for advanced editing. Camtasia also has a simple navigation system for the nontechnical person.

Content is key. You can select a few frequently asked questions (FAQs) that your patients regularly ask and simply record yourself giving the answers. Take a look at what is new, relevant, or controversial in regard to the procedures you perform. Or just look at all the pages on your Web site that have the procedures and services you provide and make a video on those topics. The ideal video is 3 to 5 minutes in length.

ATTRACTING PATIENTS VIA TWITTER
The most amazing example of social media and building a fan base is Twitter. Here’s a question: Who are the people that have the biggest following on Twitter? The answer: Celebrities, rock stars, and athletes. As a society, we are obsessed with these groups and want to know their every thought, what they like, what they had for lunch, what they think, and who they think about.

Now how, as a practicing ObGyn, do you expect to build a base of Web site surfers who want to know your every thought on urinary incontinence? The harsh reality is, if you think you are going to get new patients by making posts on Twitter of 140 characters or less every day, you will be disappointed.

However, the return from using Twitter is, similar to Facebook and YouTube, related to the fact that Twitter is one of the top accessed Web sites in the world. Linking your own content from such a Web site increases the search placement of your content when a potential patient performs a general Google search.

ARE SOCIAL MEDIA EFFECTIVE?
The effective use of social media can result in attracting new patients every day to your practice—if you post quality information on a regular basis that is helpful to your existing patients and especially to potential new patients. Overall, social media can help you get new patients through search engine rankings. Even if you don’t want to do any work on your social media sites, you can hire companies that will do it for you.

However, the return from using Twitter is, similar to Facebook and YouTube, related to the fact that Twitter is one of the top accessed Web sites in the world. Linking your own content from such a Web site increases the search placement of your content when a potential patient performs a general Google search.

The bottom line
There will be many ObGyns who will read this article, throw up their hands and say, “Makes sense, but this is over my head.” Because it sounds so technical, many clinicians will just ignore social media and hope it goes away. If your plans for the next 5 years include practicing medicine, we don’t recommend that you take that approach. The Internet and social media are the “places” in which patients of today are searching for their doctors. Trust us—potential new patients are no longer using the Yellow Pages.

The patients of tomorrow will be increasingly technologically sophisticated, and these social media techniques will continue to evolve. Don’t get left behind. And don’t let your competitors dominate one of the most important sources of new patients you have, along with patient referrals and physician referrals. Jump into this world yourself, and you will be richly rewarded. The social media train is leaving the station, and we hope that we have shown you how to hitch a ride. See you online!

WE WANT TO HEAR FROM YOU!
Drop us a line and let us know what you think about this or other current articles, which topics you'd like to see covered in future issues, and what challenges you face in daily practice. Tell us what you think by emailing us at: [email protected] Please include your name, city and state.

With this article, we intend to illustrate the value of having a social media presence and how you can use social media to attract new patients. One of us (NHB) has been using social media to promote his medical practice for 3 years and can be found on the first page of Google search results for several of the medical conditions he treats. As a result of these high search rankings, he is able to generate two to four new patient visits every day.

You can achieve the same results using the techniques described in this article. You certainly can buy banner ads and buy traffic to your page, but we want to show you how to get on the first page of Google using the natural, organic method.

PUSH VS PULL
Social media can be used in different ways to build your practice. What you employ depends on what you want to accomplish and the time and energy you want to devote to each of these social media opportunities.

By its very definition, social media is social engagement—and what is known as a “pull” technology. There are two ways to share your information with people on the Internet:

1. “Pull” Web site surfers to your information
2. “Push” your information to them.

Push occurs when you initiate the process by placing your information in front of the Web site surfer. They get it or see it because of the actions you have taken. Sending e-mails is one way to push information to your target audience, or potential patients, to your practice. Another way to push your Web site and its contents is to get listed on the first page of search engine results. You want to “push” your Web site in plain view of the person who has typed in keywords or keyword phrases that relate to your practice (ie, “OBGYN” plus “<your city>,” “tubal ligation” plus “<your city>,” or “loss of urine” plus “<your zip code>.” Push techniques are the best way to market your services and offer the best return on your marketing investment.

Using social media, you are able to “pull” your audience of potential patients to you and your practice. In other words, your target market of potential patients has to take the time and make the effort to type in your Web site address in order to come to you. The information or message you have on your social media sites has to be strong enough and of sufficient compelling interest that patients want to come to read what you have to say. Web surfers are looking for online relationships for information sharing. It is this interaction with your potential patients that makes social media unique. Using this pull technology, you have the opportunity to interact and develop a relationship with a patient before she picks up the phone to make an appointment, before she comes to the office to see you eyeball to eyeball.

FACEBOOK AND HOW IT RELATES TO YOUR PRACTICE
Originally, Facebook was developed as a way for people to see what was going on in each other’s lives, a method to stay in contact with one another. In the beginning, it was friends, family members, or groups of like-minded individuals frequenting each other’s Facebook pages. Typically, they would keep tabs on who was having a party or post pictures of their kids for family members to see.

Facebook has evolved. Today, companies, businesses, and, yes, medical practices are trying to “pull” more Web site visitors to their Facebook pages. To do this, they hold contests with prizes; offer great content, coupons, and videos; and provide special offers to get Web surfers to their site. Large companies and large group practices like the Mayo Clinic, Cleveland Clinic, and MD Anderson Cancer Center, have whole social media departments that post regularly, respond to comments left on their pages, and answer questions posted by those who “like” their page or site.

Individual practicing clinicians, and most smaller ObGyn practices, do not have the budget for a social media team. They also don’t have the time or the training to write effective copy that is so compelling that Web surfers are drawn or “pulled” to their Facebook page. The reality is, your patients expect you to have a Facebook page, and they expect you to have quality information that is helpful and relevant to their well-being. But, the question remains…

Related article: Four pillars of a successful practice: 1. Keep your current patients happy Neal H. Baum, MD (Practice Management, March 2013)

Can Facebook generate new patients?
You and your practice certainly can place a lot of information and pictures on Facebook, and potential patients can leave comments or ask questions easily. You can start a dialog with a patient without providing medical advice and motivate her to see that you are providing medical value before the doctor–patient relationship is established. Still, does a Facebook page generate new patients? It depends on the information you post and how you use Facebook to acquire new patients.

For instance, your practice is probably restricted to a local area—a few zip codes surrounding your office and hospital—which means you really only want patients who are in your area to visit your practice’s Facebook page because those are the only ones who are likely to call and make an appointment. Unless you are highly specialized in a particular field, such as fistula repair, robotic surgery, or the treatment of mesh complications, the Facebook surfer from New York isn’t likely to hop on a plane to come to your practice on the West Coast for gynecologic or obstetric care.

Related article: Four pillars of a successful practice: 2. Attract new patients Neal H. Baum, MD (Practice Management, May 2013)

On the surface, it appears that it is impossible to compete with larger practices and hospitals that have more dedicated staff to draw prospective patients to a practice through Facebook. However, the real, overarching challenge is to improve your Web site rankings on the major search engines, to be on the first page of Google, Bing, and Yahoo search results. And what we do know is that Google has placed a high value on Web site rankings through social media sites like Facebook, Twitter, and YouTube—that is, of course, as long as your Facebook page provides content that has keywords relevant to your target market and the content on your page links back to your Web site.

Therefore, it is not necessary to devote an inordinate amount of time to your social media presence to obtain results. You will, on the other hand, get more visitors to your Web site if it is found on the first page of search engine results because of your Facebook posts. Of course, if your Web site is not set up properly for easy visitor navigation and visitor conversion, you may not be able to obtain the desired result of gaining new patients even if they do find your site. You need to have a Web site with marketing and patient conversion systems built into it; don’t overlook the layout of your Web site. For more on this issue, see Part 1 of this series.

Related article: Using the Internet in your practice. Part 1: Why social media are important and how to get started Neal H. Baum, MD, and Ron Romano (Practice Management, February 2014)

YOUTUBE VIDEOS AND YOUR PRACTICE
YouTube has become a significant search engine for virtually every product and service you offer your patients. There are millions of videos on YouTube, and you can search topics simply by typing in any topic that your patients might be interested in, from birth control to cancer.

There are five ways your practice can benefit from a video posted on YouTube:

1. Web site traffic driver. To achieve this “pull,” you must label your posted video correctly, with keyword phrases that are relevant to the type of patient or conditions you are looking for, and offer a description that would make a viewer want to see the video. You also must provide a link back to your Web site, which increases your chances of gaining a new patient from YouTube.
2. Boost your search engine optimization. Google places a high-ranking factor on videos posted to YouTube that are keyword-relevant.
3. A video library can position you as an expert in the field. You can create your own YouTube channel and keep adding videos. One of us (NHB) has more than
   70 medical videos on his YouTube channel. If someone views one of these videos, they will have immediate access to the rest of the video collection even though they may be labelled with other keywords. This further positions you as the knowledgeable expert in your field.
4. Video embedding capability. Any video you have posted to YouTube can be placed on your Web site, in a format that keeps the viewer on your site. This means the viewer has less of a chance of getting distracted with other video offerings and landing on someone else’s Web site.
5. Free video storage. Because you have stored the video on YouTube, you are not using the resources on your Web site when someone, or several people, view the video at the same time.

Getting started with YouTube
Making a video can be easier than you think. First, a video can simply be a PowerPoint presentation. Studies have demonstrated that it is more about the content of the video than a physician being in front of a camera. There are lots of Web sites you can use to record a presentation; one of the most popular and easy to use is http://www.GoToWebinar.com. There are computer programs that make it easy to record and then simply upload the recording to YouTube. Cam Studio (http://camstudio.org) is a free open-source program available that has a lot of flexibility for editing audio and video files, and it is easy to use. Camtasia (http://www.techsmith.com/camtasia.html) is a popular program that costs about $300 and has a lot of features for advanced editing. Camtasia also has a simple navigation system for the nontechnical person.

Content is key. You can select a few frequently asked questions (FAQs) that your patients regularly ask and simply record yourself giving the answers. Take a look at what is new, relevant, or controversial in regard to the procedures you perform. Or just look at all the pages on your Web site that have the procedures and services you provide and make a video on those topics. The ideal video is 3 to 5 minutes in length.

ATTRACTING PATIENTS VIA TWITTER
The most amazing example of social media and building a fan base is Twitter. Here’s a question: Who are the people that have the biggest following on Twitter? The answer: Celebrities, rock stars, and athletes. As a society, we are obsessed with these groups and want to know their every thought, what they like, what they had for lunch, what they think, and who they think about.

Now how, as a practicing ObGyn, do you expect to build a base of Web site surfers who want to know your every thought on urinary incontinence? The harsh reality is, if you think you are going to get new patients by making posts on Twitter of 140 characters or less every day, you will be disappointed.

However, the return from using Twitter is, similar to Facebook and YouTube, related to the fact that Twitter is one of the top accessed Web sites in the world. Linking your own content from such a Web site increases the search placement of your content when a potential patient performs a general Google search.

ARE SOCIAL MEDIA EFFECTIVE?
The effective use of social media can result in attracting new patients every day to your practice—if you post quality information on a regular basis that is helpful to your existing patients and especially to potential new patients. Overall, social media can help you get new patients through search engine rankings. Even if you don’t want to do any work on your social media sites, you can hire companies that will do it for you.

However, the return from using Twitter is, similar to Facebook and YouTube, related to the fact that Twitter is one of the top accessed Web sites in the world. Linking your own content from such a Web site increases the search placement of your content when a potential patient performs a general Google search.

The bottom line
There will be many ObGyns who will read this article, throw up their hands and say, “Makes sense, but this is over my head.” Because it sounds so technical, many clinicians will just ignore social media and hope it goes away. If your plans for the next 5 years include practicing medicine, we don’t recommend that you take that approach. The Internet and social media are the “places” in which patients of today are searching for their doctors. Trust us—potential new patients are no longer using the Yellow Pages.

The patients of tomorrow will be increasingly technologically sophisticated, and these social media techniques will continue to evolve. Don’t get left behind. And don’t let your competitors dominate one of the most important sources of new patients you have, along with patient referrals and physician referrals. Jump into this world yourself, and you will be richly rewarded. The social media train is leaving the station, and we hope that we have shown you how to hitch a ride. See you online!

WE WANT TO HEAR FROM YOU!
Drop us a line and let us know what you think about this or other current articles, which topics you'd like to see covered in future issues, and what challenges you face in daily practice. Tell us what you think by emailing us at: [email protected] Please include your name, city and state.

With this article, we intend to illustrate the value of having a social media presence and how you can use social media to attract new patients. One of us (NHB) has been using social media to promote his medical practice for 3 years and can be found on the first page of Google search results for several of the medical conditions he treats. As a result of these high search rankings, he is able to generate two to four new patient visits every day.

You can achieve the same results using the techniques described in this article. You certainly can buy banner ads and buy traffic to your page, but we want to show you how to get on the first page of Google using the natural, organic method.

PUSH VS PULL
Social media can be used in different ways to build your practice. What you employ depends on what you want to accomplish and the time and energy you want to devote to each of these social media opportunities.

By its very definition, social media is social engagement—and what is known as a “pull” technology. There are two ways to share your information with people on the Internet:

1. “Pull” Web site surfers to your information
2. “Push” your information to them.

Push occurs when you initiate the process by placing your information in front of the Web site surfer. They get it or see it because of the actions you have taken. Sending e-mails is one way to push information to your target audience, or potential patients, to your practice. Another way to push your Web site and its contents is to get listed on the first page of search engine results. You want to “push” your Web site in plain view of the person who has typed in keywords or keyword phrases that relate to your practice (ie, “OBGYN” plus “<your city>,” “tubal ligation” plus “<your city>,” or “loss of urine” plus “<your zip code>.” Push techniques are the best way to market your services and offer the best return on your marketing investment.

Using social media, you are able to “pull” your audience of potential patients to you and your practice. In other words, your target market of potential patients has to take the time and make the effort to type in your Web site address in order to come to you. The information or message you have on your social media sites has to be strong enough and of sufficient compelling interest that patients want to come to read what you have to say. Web surfers are looking for online relationships for information sharing. It is this interaction with your potential patients that makes social media unique. Using this pull technology, you have the opportunity to interact and develop a relationship with a patient before she picks up the phone to make an appointment, before she comes to the office to see you eyeball to eyeball.

FACEBOOK AND HOW IT RELATES TO YOUR PRACTICE
Originally, Facebook was developed as a way for people to see what was going on in each other’s lives, a method to stay in contact with one another. In the beginning, it was friends, family members, or groups of like-minded individuals frequenting each other’s Facebook pages. Typically, they would keep tabs on who was having a party or post pictures of their kids for family members to see.

Facebook has evolved. Today, companies, businesses, and, yes, medical practices are trying to “pull” more Web site visitors to their Facebook pages. To do this, they hold contests with prizes; offer great content, coupons, and videos; and provide special offers to get Web surfers to their site. Large companies and large group practices like the Mayo Clinic, Cleveland Clinic, and MD Anderson Cancer Center, have whole social media departments that post regularly, respond to comments left on their pages, and answer questions posted by those who “like” their page or site.

Individual practicing clinicians, and most smaller ObGyn practices, do not have the budget for a social media team. They also don’t have the time or the training to write effective copy that is so compelling that Web surfers are drawn or “pulled” to their Facebook page. The reality is, your patients expect you to have a Facebook page, and they expect you to have quality information that is helpful and relevant to their well-being. But, the question remains…

Related article: Four pillars of a successful practice: 1. Keep your current patients happy Neal H. Baum, MD (Practice Management, March 2013)

Can Facebook generate new patients?
You and your practice certainly can place a lot of information and pictures on Facebook, and potential patients can leave comments or ask questions easily. You can start a dialog with a patient without providing medical advice and motivate her to see that you are providing medical value before the doctor–patient relationship is established. Still, does a Facebook page generate new patients? It depends on the information you post and how you use Facebook to acquire new patients.

For instance, your practice is probably restricted to a local area—a few zip codes surrounding your office and hospital—which means you really only want patients who are in your area to visit your practice’s Facebook page because those are the only ones who are likely to call and make an appointment. Unless you are highly specialized in a particular field, such as fistula repair, robotic surgery, or the treatment of mesh complications, the Facebook surfer from New York isn’t likely to hop on a plane to come to your practice on the West Coast for gynecologic or obstetric care.

Related article: Four pillars of a successful practice: 2. Attract new patients Neal H. Baum, MD (Practice Management, May 2013)

On the surface, it appears that it is impossible to compete with larger practices and hospitals that have more dedicated staff to draw prospective patients to a practice through Facebook. However, the real, overarching challenge is to improve your Web site rankings on the major search engines, to be on the first page of Google, Bing, and Yahoo search results. And what we do know is that Google has placed a high value on Web site rankings through social media sites like Facebook, Twitter, and YouTube—that is, of course, as long as your Facebook page provides content that has keywords relevant to your target market and the content on your page links back to your Web site.

Therefore, it is not necessary to devote an inordinate amount of time to your social media presence to obtain results. You will, on the other hand, get more visitors to your Web site if it is found on the first page of search engine results because of your Facebook posts. Of course, if your Web site is not set up properly for easy visitor navigation and visitor conversion, you may not be able to obtain the desired result of gaining new patients even if they do find your site. You need to have a Web site with marketing and patient conversion systems built into it; don’t overlook the layout of your Web site. For more on this issue, see Part 1 of this series.

Related article: Using the Internet in your practice. Part 1: Why social media are important and how to get started Neal H. Baum, MD, and Ron Romano (Practice Management, February 2014)

YOUTUBE VIDEOS AND YOUR PRACTICE
YouTube has become a significant search engine for virtually every product and service you offer your patients. There are millions of videos on YouTube, and you can search topics simply by typing in any topic that your patients might be interested in, from birth control to cancer.

There are five ways your practice can benefit from a video posted on YouTube:

1. Web site traffic driver. To achieve this “pull,” you must label your posted video correctly, with keyword phrases that are relevant to the type of patient or conditions you are looking for, and offer a description that would make a viewer want to see the video. You also must provide a link back to your Web site, which increases your chances of gaining a new patient from YouTube.
2. Boost your search engine optimization. Google places a high-ranking factor on videos posted to YouTube that are keyword-relevant.
3. A video library can position you as an expert in the field. You can create your own YouTube channel and keep adding videos. One of us (NHB) has more than
   70 medical videos on his YouTube channel. If someone views one of these videos, they will have immediate access to the rest of the video collection even though they may be labelled with other keywords. This further positions you as the knowledgeable expert in your field.
4. Video embedding capability. Any video you have posted to YouTube can be placed on your Web site, in a format that keeps the viewer on your site. This means the viewer has less of a chance of getting distracted with other video offerings and landing on someone else’s Web site.
5. Free video storage. Because you have stored the video on YouTube, you are not using the resources on your Web site when someone, or several people, view the video at the same time.

Getting started with YouTube
Making a video can be easier than you think. First, a video can simply be a PowerPoint presentation. Studies have demonstrated that it is more about the content of the video than a physician being in front of a camera. There are lots of Web sites you can use to record a presentation; one of the most popular and easy to use is http://www.GoToWebinar.com. There are computer programs that make it easy to record and then simply upload the recording to YouTube. Cam Studio (http://camstudio.org) is a free open-source program available that has a lot of flexibility for editing audio and video files, and it is easy to use. Camtasia (http://www.techsmith.com/camtasia.html) is a popular program that costs about $300 and has a lot of features for advanced editing. Camtasia also has a simple navigation system for the nontechnical person.

Content is key. You can select a few frequently asked questions (FAQs) that your patients regularly ask and simply record yourself giving the answers. Take a look at what is new, relevant, or controversial in regard to the procedures you perform. Or just look at all the pages on your Web site that have the procedures and services you provide and make a video on those topics. The ideal video is 3 to 5 minutes in length.

ATTRACTING PATIENTS VIA TWITTER
The most amazing example of social media and building a fan base is Twitter. Here’s a question: Who are the people that have the biggest following on Twitter? The answer: Celebrities, rock stars, and athletes. As a society, we are obsessed with these groups and want to know their every thought, what they like, what they had for lunch, what they think, and who they think about.

Now how, as a practicing ObGyn, do you expect to build a base of Web site surfers who want to know your every thought on urinary incontinence? The harsh reality is, if you think you are going to get new patients by making posts on Twitter of 140 characters or less every day, you will be disappointed.

However, the return from using Twitter is, similar to Facebook and YouTube, related to the fact that Twitter is one of the top accessed Web sites in the world. Linking your own content from such a Web site increases the search placement of your content when a potential patient performs a general Google search.

ARE SOCIAL MEDIA EFFECTIVE?
The effective use of social media can result in attracting new patients every day to your practice—if you post quality information on a regular basis that is helpful to your existing patients and especially to potential new patients. Overall, social media can help you get new patients through search engine rankings. Even if you don’t want to do any work on your social media sites, you can hire companies that will do it for you.

However, the return from using Twitter is, similar to Facebook and YouTube, related to the fact that Twitter is one of the top accessed Web sites in the world. Linking your own content from such a Web site increases the search placement of your content when a potential patient performs a general Google search.

The bottom line
There will be many ObGyns who will read this article, throw up their hands and say, “Makes sense, but this is over my head.” Because it sounds so technical, many clinicians will just ignore social media and hope it goes away. If your plans for the next 5 years include practicing medicine, we don’t recommend that you take that approach. The Internet and social media are the “places” in which patients of today are searching for their doctors. Trust us—potential new patients are no longer using the Yellow Pages.

The patients of tomorrow will be increasingly technologically sophisticated, and these social media techniques will continue to evolve. Don’t get left behind. And don’t let your competitors dominate one of the most important sources of new patients you have, along with patient referrals and physician referrals. Jump into this world yourself, and you will be richly rewarded. The social media train is leaving the station, and we hope that we have shown you how to hitch a ride. See you online!

WE WANT TO HEAR FROM YOU!
Drop us a line and let us know what you think about this or other current articles, which topics you'd like to see covered in future issues, and what challenges you face in daily practice. Tell us what you think by emailing us at: [email protected] Please include your name, city and state.

Let’s rewind to the year 2000, the dawning of a new millennium. It was then that many physicians decided the time was ripe to establish a Web presence. It wasn’t that difficult, after all: Just take the practice’s three-color, trifold brochure and convert it into a Web-site template. A teenager could do it—and many did, sometimes guided by a college student in computer sciences.

These early implementers were confident that they could cruise into the 21st Century with this new technology. They had no idea how much the Internet would change…or how fast…but their basic impulse was a wise one, to harness the power of the Internet for the good of their patients and their practices.

In this four-part series, we focus on the rapidly expanding utilization of the Internet for health-related purposes. In Part 1, we focus on why it’s important to address the Web, particularly social media, and we zoom in on creating a blog for your practice. In Part 2, our focus will be the “big three”: Facebook, Twitter, and YouTube. We will take up search engine optimization and online reputation management in Parts 3 and 4, respectively.

WHY IS THE INTERNET IMPORTANT?
It isn’t uncommon for patients to arrive in their doctor’s office with a stack of pages downloaded from the Internet that describe their disease state or tests they are about to undergo. Many patients also are beginning to expect to interact with their physicians through Web sites, blogs, and Facebook and Twitter accounts.

Related Article: Why (and how) you should encourage your patients' search for health information on the Web Jennifer Gunter, MD (December 2011)

In fact, so much of health care is moving online that many physicians assume that everybody uses the Internet. The most recent data from the Pew Internet & American Life Project indicate that, in the United States, one in three adults have gone online to find out more about a medical condition, and 59% of all adults use the Internet to search for health information (TABLE 1).^1,2 Eight in 10 people who regularly use the Internet look online for health information, making it the third most popular online pursuit tracked by the Pew project, after reading and sending email and using a search engine.

What types of health information do US adults look for online? Most people (66%) who use the Web to search for health information look for information on a specific disease or medical problem (see TABLE 2 for a list of other common health topics).³ 

The Pew Research Center also found that some demographic groups are more likely than others to seek health information online. They include:

• adults who have provided unpaid care to a parent, child, friend, or other loved one in the past 12 months
• women
• white adults
• adults aged 18 to 49 years
• adults with at least some college education
• adults in higher-income households.¹

Check out the QUICK POLL on the OBG Management home page. To give your answer and see how other physicians have responded, Click Here.

WHAT ARE SOCIAL MEDIA AND WHY DO WE NEED THEM?
Social media encompass Web sites and other online communication applications used for social networking. Three of the most widely used media are Facebook, Twitter, and YouTube.

When someone once asked hockey great Wayne Gretzky about his sport strategy, he replied: “I don’t skate to where the puck is or where the puck has been; I skate to where the puck is going to be.” Social media are where the puck (ie, our patients) are going to be today and tomorrow.

If we review other media launches, we discover that it took nearly 40 years for radio to attract 50 million listeners, and 13 years for television to reach 50 million viewers. But it took only 4 years for the Internet to achieve 50 million users. Facebook alone reached 100 million users in just 9 months!

Just a decade ago, the Mayo Clinic relied on standard marketing techniques using radio, TV, and print media to attract new patients. Today, the Mayo Clinic makes use of Facebook, Twitter, YouTube, podcasts, and blogging. The Mayo Clinic even has developed a Center for Social Media to focus on the use of social media for its centers in Rochester, Minnesota; Jacksonville, Florida; and Phoenix, Arizona. If something is good for the Mayo Clinic, it has to be OK for the rest of us.

Social media also make it possible for smaller practices to compete with much larger practices that have huge marketing budgets. With very little expense, small practices—even solo practices—can develop a social media presence that can rival those of larger competitors.

HOW TO GET STARTED
There are four major social media programs to consider: Facebook, Twitter, YouTube, and blogging. We suggest that ObGyns who are ready to develop a social media presence begin with blogging, the focus of this article. We will cover Facebook, Twitter, and YouTube in Part 2 of this series.

Blogging is the easiest way to enter the world of social media. It’s free, can be accomplished reasonably quickly, and allows you to communicate with existing patients and attract new patients to your practice.

What is a blog? A blog is a Web site that is maintained with regular entries (posts) that invite comments from readers. Blogging allows feedback from people who visit your site and offers you the opportunity to respond to their comments. This creates a dialogue between you, your existing patients, and potential patients that is hard to achieve on an ordinary Web site.

The only expense for a blog is the cost of your time. There are several sites that will host your blog:

• WordPress.com offers free traffic stats, anti-spam features, search engine optimization, and more. Its platform is used by many popular blogs, including Forbes, Flickr, and CNN.
• Blogger.com (powered by Google) offers a user-friendly interface and smooth integration with the blogger’s Google account
• Blog.com provides the same basic features as other blog-hosting platforms, including free templates, but it charges a fee to keep ads off your site
• MovableType.com is a high-end hosting platform that charges a fee for its use
• LiveJournal.com provides its basic service at no charge but, like Blog.com, charges a fee to keep ads off your site.

We prefer WordPress.com because it was recommended in The Social Media ­Bible. WordPress.com offers tutorials that help you create a blog, enter content, and publish your material. You can access them at http://learn.wordpress.com.

We suggest that you develop your blog by incorporating a “hook” or other enticement to capture readers’ attention, keep your message relevant to their lives, and link the blog to your Web site so readers can find ­solutions to their medical problems.

Social media experts agree that regular posting is the key to success, particularly in regard to blogging. Commit to posting at least weekly. Visitors are more likely to return to your blog when they can count on regular updates.

Related Article: To blog or not to blog? What's the answer for you and your practice? Jennifer Gunter, MD (August 2011)

How to tell your story
One way to start your post is by offering a startling statistic or analogy. For example, if you are writing about breast cancer, you might begin by observing that more than 1,000 women under age 40 died of the disease in 2013—or that only lung cancer causes more cancer deaths in women.

Humor is another way to engage readers. We have found that people are attracted to funny anecdotes and stories. For example, when Dr. Baum is writing about erectile dysfunction, he might tell a story about arriving at a hotel and finding only 32 cents in his pocket to tip the bellman. When he offered the young bellman a copy of his new book, Impotence: It’s Reversible, the bellman replied, “Dr. Baum, if it’s all right with you, I’d just like to have the 32 cents.” In a blog post about this exchange, Dr. Baum might explain that the article is intended to give readers a little more than 32 cents’ worth of information about erectile dysfunction. The post would carry on from there.

Another option is to relate a compelling story about a recent patient (without using her name) that describes how you identified a problem, made a diagnosis, and resolved the patient’s complaint.

At the end of each blog post, we recommend that you invite readers to submit open-ended questions and comments. This motivates them to respond and starts a dialogue between your practice and potential new patients. Also include a call to action, preferably with a link from your blog to your Web site, inviting readers to visit your site or contact your practice to become a patient.

Most comments on your blog are likely to be positive, or to consist of requests for clarification or specific information. And most blog-hosting platforms allow you to review comments before they are published to your blog site. Any unnecessarily harsh or abusive comments can simply be rejected.

Once you have created a blog and begun to post regularly, we recommend that you check traffic to the site using the built-in analytics available through most hosting platforms. The traffic stats give you information on the number of visitors you have, how long they are spending at your blog, and how many are connecting to your main Web site. You can use this valuable information to identify what is working and tweak your blog posts accordingly.

Catchy titles make a difference
Strive to create titles that will capture the attention of your readers. People often decide whether or not to read a blog post on the basis of its title alone. Think of an effective title as a billboard. Drivers are speeding down the highway and have only 3 or 4 seconds to read the billboard and decide whether they will visit the restaurant, buy the product, or call for more information. The same holds true for titles on your blogs.

For example, Dr. Baum once titled a blog post “Urinary incontinence: Diagnosis and treatment.” It drew few readers. When he changed the title to “Urinary incontinence: You don’t have to depend on Depends,” nearly 1,000 readers commented on the post. Same article, different title.

Four pillars of a successful practice: 2. Attract new patients Neil H. Baum, MD (Four-part series, May 2013)

Pay attention to your practice Web site
We mentioned getting visitors from your blog site to your practice’s Web site. Once they arrive, two strategies are vital:

• visitor navigation
• patient-conversion systems.

Visitor navigation. The visitor comes to your Web site to get information that provides a solution to her problem. Once she lands on your site, you have less than 10 seconds to engage her; otherwise, she’ll leave instantly with the click of the mouse. Make it easy for her to find what she is looking for. For example, are the procedures and treatments you offer listed prominently so that the visitor can see them immediately and click on the link she wants? How about adding an icon, at the top right on every page, that says: “Schedule an appointment” or “Schedule a consultation.” The words you use (and their placement) are critically important if you want the visitor to become a patient!

Related Article: My #1 strategy for retaining patients Neil H. Baum, MD (Audiocast, March 2013)

Patient-conversion systems. Many Web sites are designed by people other than marketers. Even many Web-design companies focus on the look of the site rather than its main purpose: to convert visitors to patients.

If you want to get a Web-site visitor to schedule an appointment, your phone number should be clearly visible (along with the “Schedule an appointment” icon) on every page above the fold. “Above the fold” simply means that the visitor does not have to scroll down the page to see it. Believe it or not, many fancy Web sites fail to put these items in plain view!

And because you want to position yourself as a trusted authority in your field, patient testimonials are an important feature to include on your home page. And keep the information simple—stay away from technical jargon that the visitor will not understand.

Capture the visitor’s email address and use an auto-responder to follow up. You can get the visi­tor’s email address by offering something of value, such as a complimentary medical guide to a common condition. Once you have her email address, you have a way to stay in touch with the prospective patient and build a relationship of trust and confidence in your ability to solve her problem. 

BOTTOM LINE: SOCIAL MEDIA ARE WORTH THE EFFORT
Social media marketing is a tool that most medical practices will be considering in the near future. A blog is a social media tool that can educate and inform existing patients and attract new ones to your practice. It is inexpensive, effective, and well worth the time and effort required to create a presence.

WE WANT TO HEAR FROM YOU!
Drop us a line and let us know what you think about current articles, which topics you'd like to see covered in future issues, and what challenges you face in daily practice. Tell us what you think by emailing us at: [email protected]

Let’s rewind to the year 2000, the dawning of a new millennium. It was then that many physicians decided the time was ripe to establish a Web presence. It wasn’t that difficult, after all: Just take the practice’s three-color, trifold brochure and convert it into a Web-site template. A teenager could do it—and many did, sometimes guided by a college student in computer sciences.

These early implementers were confident that they could cruise into the 21st Century with this new technology. They had no idea how much the Internet would change…or how fast…but their basic impulse was a wise one, to harness the power of the Internet for the good of their patients and their practices.

In this four-part series, we focus on the rapidly expanding utilization of the Internet for health-related purposes. In Part 1, we focus on why it’s important to address the Web, particularly social media, and we zoom in on creating a blog for your practice. In Part 2, our focus will be the “big three”: Facebook, Twitter, and YouTube. We will take up search engine optimization and online reputation management in Parts 3 and 4, respectively.

WHY IS THE INTERNET IMPORTANT?
It isn’t uncommon for patients to arrive in their doctor’s office with a stack of pages downloaded from the Internet that describe their disease state or tests they are about to undergo. Many patients also are beginning to expect to interact with their physicians through Web sites, blogs, and Facebook and Twitter accounts.

Related Article: Why (and how) you should encourage your patients' search for health information on the Web Jennifer Gunter, MD (December 2011)

In fact, so much of health care is moving online that many physicians assume that everybody uses the Internet. The most recent data from the Pew Internet & American Life Project indicate that, in the United States, one in three adults have gone online to find out more about a medical condition, and 59% of all adults use the Internet to search for health information (TABLE 1).^1,2 Eight in 10 people who regularly use the Internet look online for health information, making it the third most popular online pursuit tracked by the Pew project, after reading and sending email and using a search engine.

What types of health information do US adults look for online? Most people (66%) who use the Web to search for health information look for information on a specific disease or medical problem (see TABLE 2 for a list of other common health topics).³ 

The Pew Research Center also found that some demographic groups are more likely than others to seek health information online. They include:

• adults who have provided unpaid care to a parent, child, friend, or other loved one in the past 12 months
• women
• white adults
• adults aged 18 to 49 years
• adults with at least some college education
• adults in higher-income households.¹

Check out the QUICK POLL on the OBG Management home page. To give your answer and see how other physicians have responded, Click Here.

WHAT ARE SOCIAL MEDIA AND WHY DO WE NEED THEM?
Social media encompass Web sites and other online communication applications used for social networking. Three of the most widely used media are Facebook, Twitter, and YouTube.

When someone once asked hockey great Wayne Gretzky about his sport strategy, he replied: “I don’t skate to where the puck is or where the puck has been; I skate to where the puck is going to be.” Social media are where the puck (ie, our patients) are going to be today and tomorrow.

If we review other media launches, we discover that it took nearly 40 years for radio to attract 50 million listeners, and 13 years for television to reach 50 million viewers. But it took only 4 years for the Internet to achieve 50 million users. Facebook alone reached 100 million users in just 9 months!

Just a decade ago, the Mayo Clinic relied on standard marketing techniques using radio, TV, and print media to attract new patients. Today, the Mayo Clinic makes use of Facebook, Twitter, YouTube, podcasts, and blogging. The Mayo Clinic even has developed a Center for Social Media to focus on the use of social media for its centers in Rochester, Minnesota; Jacksonville, Florida; and Phoenix, Arizona. If something is good for the Mayo Clinic, it has to be OK for the rest of us.

Social media also make it possible for smaller practices to compete with much larger practices that have huge marketing budgets. With very little expense, small practices—even solo practices—can develop a social media presence that can rival those of larger competitors.

HOW TO GET STARTED
There are four major social media programs to consider: Facebook, Twitter, YouTube, and blogging. We suggest that ObGyns who are ready to develop a social media presence begin with blogging, the focus of this article. We will cover Facebook, Twitter, and YouTube in Part 2 of this series.

Blogging is the easiest way to enter the world of social media. It’s free, can be accomplished reasonably quickly, and allows you to communicate with existing patients and attract new patients to your practice.

What is a blog? A blog is a Web site that is maintained with regular entries (posts) that invite comments from readers. Blogging allows feedback from people who visit your site and offers you the opportunity to respond to their comments. This creates a dialogue between you, your existing patients, and potential patients that is hard to achieve on an ordinary Web site.

The only expense for a blog is the cost of your time. There are several sites that will host your blog:

• WordPress.com offers free traffic stats, anti-spam features, search engine optimization, and more. Its platform is used by many popular blogs, including Forbes, Flickr, and CNN.
• Blogger.com (powered by Google) offers a user-friendly interface and smooth integration with the blogger’s Google account
• Blog.com provides the same basic features as other blog-hosting platforms, including free templates, but it charges a fee to keep ads off your site
• MovableType.com is a high-end hosting platform that charges a fee for its use
• LiveJournal.com provides its basic service at no charge but, like Blog.com, charges a fee to keep ads off your site.

We prefer WordPress.com because it was recommended in The Social Media ­Bible. WordPress.com offers tutorials that help you create a blog, enter content, and publish your material. You can access them at http://learn.wordpress.com.

We suggest that you develop your blog by incorporating a “hook” or other enticement to capture readers’ attention, keep your message relevant to their lives, and link the blog to your Web site so readers can find ­solutions to their medical problems.

Social media experts agree that regular posting is the key to success, particularly in regard to blogging. Commit to posting at least weekly. Visitors are more likely to return to your blog when they can count on regular updates.

Related Article: To blog or not to blog? What's the answer for you and your practice? Jennifer Gunter, MD (August 2011)

How to tell your story
One way to start your post is by offering a startling statistic or analogy. For example, if you are writing about breast cancer, you might begin by observing that more than 1,000 women under age 40 died of the disease in 2013—or that only lung cancer causes more cancer deaths in women.

Humor is another way to engage readers. We have found that people are attracted to funny anecdotes and stories. For example, when Dr. Baum is writing about erectile dysfunction, he might tell a story about arriving at a hotel and finding only 32 cents in his pocket to tip the bellman. When he offered the young bellman a copy of his new book, Impotence: It’s Reversible, the bellman replied, “Dr. Baum, if it’s all right with you, I’d just like to have the 32 cents.” In a blog post about this exchange, Dr. Baum might explain that the article is intended to give readers a little more than 32 cents’ worth of information about erectile dysfunction. The post would carry on from there.

Another option is to relate a compelling story about a recent patient (without using her name) that describes how you identified a problem, made a diagnosis, and resolved the patient’s complaint.

At the end of each blog post, we recommend that you invite readers to submit open-ended questions and comments. This motivates them to respond and starts a dialogue between your practice and potential new patients. Also include a call to action, preferably with a link from your blog to your Web site, inviting readers to visit your site or contact your practice to become a patient.

Most comments on your blog are likely to be positive, or to consist of requests for clarification or specific information. And most blog-hosting platforms allow you to review comments before they are published to your blog site. Any unnecessarily harsh or abusive comments can simply be rejected.

Once you have created a blog and begun to post regularly, we recommend that you check traffic to the site using the built-in analytics available through most hosting platforms. The traffic stats give you information on the number of visitors you have, how long they are spending at your blog, and how many are connecting to your main Web site. You can use this valuable information to identify what is working and tweak your blog posts accordingly.

Catchy titles make a difference
Strive to create titles that will capture the attention of your readers. People often decide whether or not to read a blog post on the basis of its title alone. Think of an effective title as a billboard. Drivers are speeding down the highway and have only 3 or 4 seconds to read the billboard and decide whether they will visit the restaurant, buy the product, or call for more information. The same holds true for titles on your blogs.

For example, Dr. Baum once titled a blog post “Urinary incontinence: Diagnosis and treatment.” It drew few readers. When he changed the title to “Urinary incontinence: You don’t have to depend on Depends,” nearly 1,000 readers commented on the post. Same article, different title.

Four pillars of a successful practice: 2. Attract new patients Neil H. Baum, MD (Four-part series, May 2013)

Pay attention to your practice Web site
We mentioned getting visitors from your blog site to your practice’s Web site. Once they arrive, two strategies are vital:

• visitor navigation
• patient-conversion systems.

Visitor navigation. The visitor comes to your Web site to get information that provides a solution to her problem. Once she lands on your site, you have less than 10 seconds to engage her; otherwise, she’ll leave instantly with the click of the mouse. Make it easy for her to find what she is looking for. For example, are the procedures and treatments you offer listed prominently so that the visitor can see them immediately and click on the link she wants? How about adding an icon, at the top right on every page, that says: “Schedule an appointment” or “Schedule a consultation.” The words you use (and their placement) are critically important if you want the visitor to become a patient!

Related Article: My #1 strategy for retaining patients Neil H. Baum, MD (Audiocast, March 2013)

Patient-conversion systems. Many Web sites are designed by people other than marketers. Even many Web-design companies focus on the look of the site rather than its main purpose: to convert visitors to patients.

If you want to get a Web-site visitor to schedule an appointment, your phone number should be clearly visible (along with the “Schedule an appointment” icon) on every page above the fold. “Above the fold” simply means that the visitor does not have to scroll down the page to see it. Believe it or not, many fancy Web sites fail to put these items in plain view!

And because you want to position yourself as a trusted authority in your field, patient testimonials are an important feature to include on your home page. And keep the information simple—stay away from technical jargon that the visitor will not understand.

Capture the visitor’s email address and use an auto-responder to follow up. You can get the visi­tor’s email address by offering something of value, such as a complimentary medical guide to a common condition. Once you have her email address, you have a way to stay in touch with the prospective patient and build a relationship of trust and confidence in your ability to solve her problem. 

BOTTOM LINE: SOCIAL MEDIA ARE WORTH THE EFFORT
Social media marketing is a tool that most medical practices will be considering in the near future. A blog is a social media tool that can educate and inform existing patients and attract new ones to your practice. It is inexpensive, effective, and well worth the time and effort required to create a presence.

WE WANT TO HEAR FROM YOU!
Drop us a line and let us know what you think about current articles, which topics you'd like to see covered in future issues, and what challenges you face in daily practice. Tell us what you think by emailing us at: [email protected]

Let’s rewind to the year 2000, the dawning of a new millennium. It was then that many physicians decided the time was ripe to establish a Web presence. It wasn’t that difficult, after all: Just take the practice’s three-color, trifold brochure and convert it into a Web-site template. A teenager could do it—and many did, sometimes guided by a college student in computer sciences.

These early implementers were confident that they could cruise into the 21st Century with this new technology. They had no idea how much the Internet would change…or how fast…but their basic impulse was a wise one, to harness the power of the Internet for the good of their patients and their practices.

In this four-part series, we focus on the rapidly expanding utilization of the Internet for health-related purposes. In Part 1, we focus on why it’s important to address the Web, particularly social media, and we zoom in on creating a blog for your practice. In Part 2, our focus will be the “big three”: Facebook, Twitter, and YouTube. We will take up search engine optimization and online reputation management in Parts 3 and 4, respectively.

WHY IS THE INTERNET IMPORTANT?
It isn’t uncommon for patients to arrive in their doctor’s office with a stack of pages downloaded from the Internet that describe their disease state or tests they are about to undergo. Many patients also are beginning to expect to interact with their physicians through Web sites, blogs, and Facebook and Twitter accounts.

Related Article: Why (and how) you should encourage your patients' search for health information on the Web Jennifer Gunter, MD (December 2011)

In fact, so much of health care is moving online that many physicians assume that everybody uses the Internet. The most recent data from the Pew Internet & American Life Project indicate that, in the United States, one in three adults have gone online to find out more about a medical condition, and 59% of all adults use the Internet to search for health information (TABLE 1).^1,2 Eight in 10 people who regularly use the Internet look online for health information, making it the third most popular online pursuit tracked by the Pew project, after reading and sending email and using a search engine.

What types of health information do US adults look for online? Most people (66%) who use the Web to search for health information look for information on a specific disease or medical problem (see TABLE 2 for a list of other common health topics).³ 

The Pew Research Center also found that some demographic groups are more likely than others to seek health information online. They include:

• adults who have provided unpaid care to a parent, child, friend, or other loved one in the past 12 months
• women
• white adults
• adults aged 18 to 49 years
• adults with at least some college education
• adults in higher-income households.¹

Check out the QUICK POLL on the OBG Management home page. To give your answer and see how other physicians have responded, Click Here.

WHAT ARE SOCIAL MEDIA AND WHY DO WE NEED THEM?
Social media encompass Web sites and other online communication applications used for social networking. Three of the most widely used media are Facebook, Twitter, and YouTube.

When someone once asked hockey great Wayne Gretzky about his sport strategy, he replied: “I don’t skate to where the puck is or where the puck has been; I skate to where the puck is going to be.” Social media are where the puck (ie, our patients) are going to be today and tomorrow.

If we review other media launches, we discover that it took nearly 40 years for radio to attract 50 million listeners, and 13 years for television to reach 50 million viewers. But it took only 4 years for the Internet to achieve 50 million users. Facebook alone reached 100 million users in just 9 months!

Just a decade ago, the Mayo Clinic relied on standard marketing techniques using radio, TV, and print media to attract new patients. Today, the Mayo Clinic makes use of Facebook, Twitter, YouTube, podcasts, and blogging. The Mayo Clinic even has developed a Center for Social Media to focus on the use of social media for its centers in Rochester, Minnesota; Jacksonville, Florida; and Phoenix, Arizona. If something is good for the Mayo Clinic, it has to be OK for the rest of us.

Social media also make it possible for smaller practices to compete with much larger practices that have huge marketing budgets. With very little expense, small practices—even solo practices—can develop a social media presence that can rival those of larger competitors.

HOW TO GET STARTED
There are four major social media programs to consider: Facebook, Twitter, YouTube, and blogging. We suggest that ObGyns who are ready to develop a social media presence begin with blogging, the focus of this article. We will cover Facebook, Twitter, and YouTube in Part 2 of this series.

Blogging is the easiest way to enter the world of social media. It’s free, can be accomplished reasonably quickly, and allows you to communicate with existing patients and attract new patients to your practice.

What is a blog? A blog is a Web site that is maintained with regular entries (posts) that invite comments from readers. Blogging allows feedback from people who visit your site and offers you the opportunity to respond to their comments. This creates a dialogue between you, your existing patients, and potential patients that is hard to achieve on an ordinary Web site.

The only expense for a blog is the cost of your time. There are several sites that will host your blog:

• WordPress.com offers free traffic stats, anti-spam features, search engine optimization, and more. Its platform is used by many popular blogs, including Forbes, Flickr, and CNN.
• Blogger.com (powered by Google) offers a user-friendly interface and smooth integration with the blogger’s Google account
• Blog.com provides the same basic features as other blog-hosting platforms, including free templates, but it charges a fee to keep ads off your site
• MovableType.com is a high-end hosting platform that charges a fee for its use
• LiveJournal.com provides its basic service at no charge but, like Blog.com, charges a fee to keep ads off your site.

We prefer WordPress.com because it was recommended in The Social Media ­Bible. WordPress.com offers tutorials that help you create a blog, enter content, and publish your material. You can access them at http://learn.wordpress.com.

We suggest that you develop your blog by incorporating a “hook” or other enticement to capture readers’ attention, keep your message relevant to their lives, and link the blog to your Web site so readers can find ­solutions to their medical problems.

Social media experts agree that regular posting is the key to success, particularly in regard to blogging. Commit to posting at least weekly. Visitors are more likely to return to your blog when they can count on regular updates.

Related Article: To blog or not to blog? What's the answer for you and your practice? Jennifer Gunter, MD (August 2011)

How to tell your story
One way to start your post is by offering a startling statistic or analogy. For example, if you are writing about breast cancer, you might begin by observing that more than 1,000 women under age 40 died of the disease in 2013—or that only lung cancer causes more cancer deaths in women.

Humor is another way to engage readers. We have found that people are attracted to funny anecdotes and stories. For example, when Dr. Baum is writing about erectile dysfunction, he might tell a story about arriving at a hotel and finding only 32 cents in his pocket to tip the bellman. When he offered the young bellman a copy of his new book, Impotence: It’s Reversible, the bellman replied, “Dr. Baum, if it’s all right with you, I’d just like to have the 32 cents.” In a blog post about this exchange, Dr. Baum might explain that the article is intended to give readers a little more than 32 cents’ worth of information about erectile dysfunction. The post would carry on from there.

Another option is to relate a compelling story about a recent patient (without using her name) that describes how you identified a problem, made a diagnosis, and resolved the patient’s complaint.

At the end of each blog post, we recommend that you invite readers to submit open-ended questions and comments. This motivates them to respond and starts a dialogue between your practice and potential new patients. Also include a call to action, preferably with a link from your blog to your Web site, inviting readers to visit your site or contact your practice to become a patient.

Most comments on your blog are likely to be positive, or to consist of requests for clarification or specific information. And most blog-hosting platforms allow you to review comments before they are published to your blog site. Any unnecessarily harsh or abusive comments can simply be rejected.

Once you have created a blog and begun to post regularly, we recommend that you check traffic to the site using the built-in analytics available through most hosting platforms. The traffic stats give you information on the number of visitors you have, how long they are spending at your blog, and how many are connecting to your main Web site. You can use this valuable information to identify what is working and tweak your blog posts accordingly.

Catchy titles make a difference
Strive to create titles that will capture the attention of your readers. People often decide whether or not to read a blog post on the basis of its title alone. Think of an effective title as a billboard. Drivers are speeding down the highway and have only 3 or 4 seconds to read the billboard and decide whether they will visit the restaurant, buy the product, or call for more information. The same holds true for titles on your blogs.

For example, Dr. Baum once titled a blog post “Urinary incontinence: Diagnosis and treatment.” It drew few readers. When he changed the title to “Urinary incontinence: You don’t have to depend on Depends,” nearly 1,000 readers commented on the post. Same article, different title.

Four pillars of a successful practice: 2. Attract new patients Neil H. Baum, MD (Four-part series, May 2013)

Pay attention to your practice Web site
We mentioned getting visitors from your blog site to your practice’s Web site. Once they arrive, two strategies are vital:

• visitor navigation
• patient-conversion systems.

Visitor navigation. The visitor comes to your Web site to get information that provides a solution to her problem. Once she lands on your site, you have less than 10 seconds to engage her; otherwise, she’ll leave instantly with the click of the mouse. Make it easy for her to find what she is looking for. For example, are the procedures and treatments you offer listed prominently so that the visitor can see them immediately and click on the link she wants? How about adding an icon, at the top right on every page, that says: “Schedule an appointment” or “Schedule a consultation.” The words you use (and their placement) are critically important if you want the visitor to become a patient!

Related Article: My #1 strategy for retaining patients Neil H. Baum, MD (Audiocast, March 2013)

Patient-conversion systems. Many Web sites are designed by people other than marketers. Even many Web-design companies focus on the look of the site rather than its main purpose: to convert visitors to patients.

If you want to get a Web-site visitor to schedule an appointment, your phone number should be clearly visible (along with the “Schedule an appointment” icon) on every page above the fold. “Above the fold” simply means that the visitor does not have to scroll down the page to see it. Believe it or not, many fancy Web sites fail to put these items in plain view!

And because you want to position yourself as a trusted authority in your field, patient testimonials are an important feature to include on your home page. And keep the information simple—stay away from technical jargon that the visitor will not understand.

Capture the visitor’s email address and use an auto-responder to follow up. You can get the visi­tor’s email address by offering something of value, such as a complimentary medical guide to a common condition. Once you have her email address, you have a way to stay in touch with the prospective patient and build a relationship of trust and confidence in your ability to solve her problem. 

BOTTOM LINE: SOCIAL MEDIA ARE WORTH THE EFFORT
Social media marketing is a tool that most medical practices will be considering in the near future. A blog is a social media tool that can educate and inform existing patients and attract new ones to your practice. It is inexpensive, effective, and well worth the time and effort required to create a presence.

WE WANT TO HEAR FROM YOU!
Drop us a line and let us know what you think about current articles, which topics you'd like to see covered in future issues, and what challenges you face in daily practice. Tell us what you think by emailing us at: [email protected]

More and more ObGyns are adopting electronic health records (EHRs), not only to meet a government mandate but also with the hope of making their practice more efficient and productive. While it is likely that EHRs enhance qualitative benefits, such as safety, patient satisfaction, 24/7 availability of medical records, and patient access to medical data, it isn’t always clear how they boost the financial bottom line. For this reason, we recommend that every practice “run the numbers” before making the transition from paper to paperless records. That means estimating the cost, expenses, and potential for added income associated with the EHR before embarking on the change.

In this article, we explain five ways a switch to EHRs can reduce costs. We also offer strategies for choosing and implementing an EHR, from information gathering to motivating your staff. 

Transcription costs are lower
The estimated cost of dictating a letter to a referring physician using conventional means is $12 to $15. That estimate includes the doctor’s time, the cost of the transcriptionist, the stationery, and the postage or cost of faxing the letter. An ObGyn may generate five to 10 letters per day. That’s $60 to $150 in expenses.

Most EHRs can generate a referral letter at no additional cost, provided the diagnosis, prescribed medications, and treatment plan have been entered in the system. Not only that, but each referral letter can be transmitted immediately to the recipient by email (or fax; the referring doctor’s preference). In the past, it may have taken as long as several weeks for the letter to be generated and make its way to the recipient by conventional means.

This use of the EHR can save a practice as much as $1,000 per physician every month.

Chart maintenance is no longer an issue
It sometimes can be a challenge for an ObGyn office to locate a paper chart. Any record lost in the “black hole” can wreak havoc with the schedule. It becomes even more problematic if the practice has multiple locations where charts are kept, delaying its recovery.

When a temporary chart must be created, it costs the practice time and dollars. It also becomes necessary to transfer the data into the permanent record, once it is located—another expense—not to mention the need to create a chart for every new patient.

It is not unusual for a busy practice to misplace as many as five charts a day, representing expenses of $25 to $50 per chart. With an EHR, this expense is reduced to $0, and the chart can be accessed 24/7 from multiple locations, including the physician’s home or mobile phone, provided the EHR is networked between practices and the data are secured on the cloud (with encryption to ensure patient confidentiality and compliance with the Health Insurance Portability and Accountability Act, or HIPAA).

Another expense with paper records: pulling charts for the day’s patients and returning them to the file rack at the conclusion of the day. These steps require additional employees and do nothing to improve patient care.

Coding is more accurate with an EHR
Prior to the development of EHRs, physicians had to guess the level of care that was provided and tended to “under-code” the visit, leading to a loss of income that the physician rightfully earned but didn’t document fully. As one coding expert has noted, if you didn’t document it, you didn’t do it, and if the record reflects that you didn’t do it, you can’t be paid for it.

In general, the higher the level of care and the higher the code used, the more extensive documentation should be. Today’s EHRs can automatically calculate the code best supported by the documentation entered at the time of the visit. After implementing an EHR, an ObGyn can ensure that accurate codes are submitted to payers, with higher levels of reimbursement honestly and ethically achieved.

A shift to EHRs frees up valuable square footage
It is not unusual for a practice to consume several hundred square feet of space for the storage of conventional medical records. Once a practice transitions to electronic records, however, these files are stored at a ­remote site or shredded once the entire paper record has been scanned into the EHR. The office space once required for paper record storage can then be converted into examination rooms or devoted to a laboratory, imaging center, or procedure room to generate ancillary income.

There’s an incentive involved
On February 17, 2009, the US government passed the Health Information Technology for Economic and Clinical Health (HITECH) Act in an effort to reduce the barriers to EHR implementation by outlining programs for standardization and funding of EHR programs.^1,2 The HITECH Act contained meaningful-use incentives to reward participants for the adoption of EHRs, with payments disbursed through Medicare and Medicaid.² By meeting several core objectives, individuals in private practice can earn as much as $44,000 over 5 years through the Medicare EHR incentive program and $63,750 over 6 years by participating in the Medicaid incentive program.³ Hospitals can earn more than $2 million over the same period. The objectives differ slightly for hospitals and individuals but are intended to improve quality, coordination, and safety of care while promoting patient involvement and public health.³

Related article: The Affordable Care Act and the drive for EHRs: Are small practices being squeezed? Lucia DiVenere, MD (July 2013)

The HITECH Act also sought to increase the security of EHRs to ensure patient privacy through standardization of EHR products. To become eligible for meaningful-use incentives, EHR software must meet government standards and specifications.³ Common requirements include the ability to document:

• vital signs
• test results
• all medications and allergies.

Another requirement is the ability to generate lists of patients with common conditions.³

By standardizing the EHR format, the HITECH Act improved networking by physicians by ensuring common capabilities among various EHR products.

The funding and standardization established by the HITECH Act increased the usage of EHRs among physicians to 57% by 2011.²

How did we get here? A history of the EHR
Computers and electronics originally were used for administrative purposes and did not offer meaningful clinical applications when they first were introduced to health care during the 1960s and 70s.⁸ These early machines were large, expensive, and slow and did not meet the practical needs of clinicians. During the 1980s and 90s, however, with networking capability and development of the World Wide Web, the potential for an electronic health record (EHR) became clearer. In 1991, an Institute of Medicine (IOM) report listed the “computer-based patient record” as “an essential technology for health care.”⁸ The authors of the IOM report envisioned a true network of practices and hospitals that seamlessly and efficiently share information and insight to increase quality of care, reduce medical errors, and improve patient safety.¹

Despite advances in EHR technology, one major hurdle remained: cost. For many clinicians, the time and resources required for installation of the program, transfer of records to the electronic format, and training of staff was too high. By 2001, only 18% of physicians had incorporated the EHR.² Today, nearly 60% of practices use an EHR.

Related article: EHRS and medicolegal risk: How they help, when they could hurt Martin Gimovsky, MD, and Baohuong N. Tran, DO (March 2013)

How to implement an EHR
The first step is to narrow your options to a few vendors that best suit the needs of your office. This process is beyond the scope of this article, but your ultimate objective should be to choose a user-friendly interface from a vendor that offers excellent document security, customer assistance, and support.⁴

Form an implementation team for your practice, and have it begin by consulting ObGyn practices of similar size that have recently installed one of the EHRs you are considering. By asking about other practices’ experiences and any pitfalls they encountered, you can greatly ease your transition to EHRs.

If possible, the physicians in your practice should visit the office of any colleagues who have implemented one of the EHRs you are considering to see how they like the product. Your office manager, nurses, and receptionist also should visit their counterparts in the other practice to ask about their experiences and opinions. The more information you glean from other ObGyn practices, the easier it will be to make your decision.

Be sure to check with your hospital to ensure compatibility with its system.

Ensure adequate technical support
One of the most important considerations in selecting a product is the availability and quality of tech support from the home office of the vendor. When you talk to other users of a product, ask how quickly tech support calls are returned and how efficiently problems are solved.

There will always be technical problems during the transition away from paper records. Ensuring their prompt resolution will be critical to your success.

Assign project management
After deciding on a particular product, create a project team to manage the complex, lengthy implementation process.^4–6 This team should include a project manager who has the experience and skills to coordinate a complex plan, a well-respected product champion who can help maintain staff support for the change, and several information technology (IT) specialists who can manage the software and hardware challenges.^4–6

Related article: What can "meaningful use" of an EHR mean for your bottom line? Robert L. Barbieri, MD (Editorial, February 2011)

Rally the troops
The most vital part of any implementation plan is staff “buy-in.”^4–6 It is incumbent upon the project-management team to determine what effects EHR implementation will have on workflow and to explain to employees how the process ultimately will increase efficiency and reduce work time and cost. And the project champion must remind employees of these goals during the transition.^4–6

Develop a backup system
Work with your IT staff to create a backup system for the EHR to protect against system malfunction.⁴ In the past, offices backed up their data to tapes or disks. Today, it probably is safer to back up to the cloud. Cloud computing, which allows for automatic back-up, is tightly regulated by HIPAA, so be sure to choose an approved vendor.⁷

Preload your data
Before going live with the EHR, data must be integrated and preloaded into the electronic format. This means integrating billing, lab results, orders, scheduling, and encounter templates into the EHR interface.^4,6 When data are preloaded, employees can practice on the software before the launch date, ensuring a seamless transition.⁶

No “teeth-gnashing” necessary
The transition to an EHR system can be intimidating and may affect your staff’s productivity, efficiency, and morale. By following a few careful steps, the process can proceed without teeth-gnashing and loss of productivity. In fact, the suggestions offered here should improve productivity, office efficiency, and patient safety over the long term.

Who could ask for anything more?

We want to hear from you!  Tell us what you think.

More and more ObGyns are adopting electronic health records (EHRs), not only to meet a government mandate but also with the hope of making their practice more efficient and productive. While it is likely that EHRs enhance qualitative benefits, such as safety, patient satisfaction, 24/7 availability of medical records, and patient access to medical data, it isn’t always clear how they boost the financial bottom line. For this reason, we recommend that every practice “run the numbers” before making the transition from paper to paperless records. That means estimating the cost, expenses, and potential for added income associated with the EHR before embarking on the change.

In this article, we explain five ways a switch to EHRs can reduce costs. We also offer strategies for choosing and implementing an EHR, from information gathering to motivating your staff. 

Transcription costs are lower
The estimated cost of dictating a letter to a referring physician using conventional means is $12 to $15. That estimate includes the doctor’s time, the cost of the transcriptionist, the stationery, and the postage or cost of faxing the letter. An ObGyn may generate five to 10 letters per day. That’s $60 to $150 in expenses.

Most EHRs can generate a referral letter at no additional cost, provided the diagnosis, prescribed medications, and treatment plan have been entered in the system. Not only that, but each referral letter can be transmitted immediately to the recipient by email (or fax; the referring doctor’s preference). In the past, it may have taken as long as several weeks for the letter to be generated and make its way to the recipient by conventional means.

This use of the EHR can save a practice as much as $1,000 per physician every month.

Chart maintenance is no longer an issue
It sometimes can be a challenge for an ObGyn office to locate a paper chart. Any record lost in the “black hole” can wreak havoc with the schedule. It becomes even more problematic if the practice has multiple locations where charts are kept, delaying its recovery.

When a temporary chart must be created, it costs the practice time and dollars. It also becomes necessary to transfer the data into the permanent record, once it is located—another expense—not to mention the need to create a chart for every new patient.

It is not unusual for a busy practice to misplace as many as five charts a day, representing expenses of $25 to $50 per chart. With an EHR, this expense is reduced to $0, and the chart can be accessed 24/7 from multiple locations, including the physician’s home or mobile phone, provided the EHR is networked between practices and the data are secured on the cloud (with encryption to ensure patient confidentiality and compliance with the Health Insurance Portability and Accountability Act, or HIPAA).

Another expense with paper records: pulling charts for the day’s patients and returning them to the file rack at the conclusion of the day. These steps require additional employees and do nothing to improve patient care.

Coding is more accurate with an EHR
Prior to the development of EHRs, physicians had to guess the level of care that was provided and tended to “under-code” the visit, leading to a loss of income that the physician rightfully earned but didn’t document fully. As one coding expert has noted, if you didn’t document it, you didn’t do it, and if the record reflects that you didn’t do it, you can’t be paid for it.

In general, the higher the level of care and the higher the code used, the more extensive documentation should be. Today’s EHRs can automatically calculate the code best supported by the documentation entered at the time of the visit. After implementing an EHR, an ObGyn can ensure that accurate codes are submitted to payers, with higher levels of reimbursement honestly and ethically achieved.

A shift to EHRs frees up valuable square footage
It is not unusual for a practice to consume several hundred square feet of space for the storage of conventional medical records. Once a practice transitions to electronic records, however, these files are stored at a ­remote site or shredded once the entire paper record has been scanned into the EHR. The office space once required for paper record storage can then be converted into examination rooms or devoted to a laboratory, imaging center, or procedure room to generate ancillary income.

There’s an incentive involved
On February 17, 2009, the US government passed the Health Information Technology for Economic and Clinical Health (HITECH) Act in an effort to reduce the barriers to EHR implementation by outlining programs for standardization and funding of EHR programs.^1,2 The HITECH Act contained meaningful-use incentives to reward participants for the adoption of EHRs, with payments disbursed through Medicare and Medicaid.² By meeting several core objectives, individuals in private practice can earn as much as $44,000 over 5 years through the Medicare EHR incentive program and $63,750 over 6 years by participating in the Medicaid incentive program.³ Hospitals can earn more than $2 million over the same period. The objectives differ slightly for hospitals and individuals but are intended to improve quality, coordination, and safety of care while promoting patient involvement and public health.³

Related article: The Affordable Care Act and the drive for EHRs: Are small practices being squeezed? Lucia DiVenere, MD (July 2013)

The HITECH Act also sought to increase the security of EHRs to ensure patient privacy through standardization of EHR products. To become eligible for meaningful-use incentives, EHR software must meet government standards and specifications.³ Common requirements include the ability to document:

• vital signs
• test results
• all medications and allergies.

Another requirement is the ability to generate lists of patients with common conditions.³

By standardizing the EHR format, the HITECH Act improved networking by physicians by ensuring common capabilities among various EHR products.

The funding and standardization established by the HITECH Act increased the usage of EHRs among physicians to 57% by 2011.²

How did we get here? A history of the EHR
Computers and electronics originally were used for administrative purposes and did not offer meaningful clinical applications when they first were introduced to health care during the 1960s and 70s.⁸ These early machines were large, expensive, and slow and did not meet the practical needs of clinicians. During the 1980s and 90s, however, with networking capability and development of the World Wide Web, the potential for an electronic health record (EHR) became clearer. In 1991, an Institute of Medicine (IOM) report listed the “computer-based patient record” as “an essential technology for health care.”⁸ The authors of the IOM report envisioned a true network of practices and hospitals that seamlessly and efficiently share information and insight to increase quality of care, reduce medical errors, and improve patient safety.¹

Despite advances in EHR technology, one major hurdle remained: cost. For many clinicians, the time and resources required for installation of the program, transfer of records to the electronic format, and training of staff was too high. By 2001, only 18% of physicians had incorporated the EHR.² Today, nearly 60% of practices use an EHR.

Related article: EHRS and medicolegal risk: How they help, when they could hurt Martin Gimovsky, MD, and Baohuong N. Tran, DO (March 2013)

How to implement an EHR
The first step is to narrow your options to a few vendors that best suit the needs of your office. This process is beyond the scope of this article, but your ultimate objective should be to choose a user-friendly interface from a vendor that offers excellent document security, customer assistance, and support.⁴

Form an implementation team for your practice, and have it begin by consulting ObGyn practices of similar size that have recently installed one of the EHRs you are considering. By asking about other practices’ experiences and any pitfalls they encountered, you can greatly ease your transition to EHRs.

If possible, the physicians in your practice should visit the office of any colleagues who have implemented one of the EHRs you are considering to see how they like the product. Your office manager, nurses, and receptionist also should visit their counterparts in the other practice to ask about their experiences and opinions. The more information you glean from other ObGyn practices, the easier it will be to make your decision.

Be sure to check with your hospital to ensure compatibility with its system.

Ensure adequate technical support
One of the most important considerations in selecting a product is the availability and quality of tech support from the home office of the vendor. When you talk to other users of a product, ask how quickly tech support calls are returned and how efficiently problems are solved.

There will always be technical problems during the transition away from paper records. Ensuring their prompt resolution will be critical to your success.

Assign project management
After deciding on a particular product, create a project team to manage the complex, lengthy implementation process.^4–6 This team should include a project manager who has the experience and skills to coordinate a complex plan, a well-respected product champion who can help maintain staff support for the change, and several information technology (IT) specialists who can manage the software and hardware challenges.^4–6

Related article: What can "meaningful use" of an EHR mean for your bottom line? Robert L. Barbieri, MD (Editorial, February 2011)

Rally the troops
The most vital part of any implementation plan is staff “buy-in.”^4–6 It is incumbent upon the project-management team to determine what effects EHR implementation will have on workflow and to explain to employees how the process ultimately will increase efficiency and reduce work time and cost. And the project champion must remind employees of these goals during the transition.^4–6

Develop a backup system
Work with your IT staff to create a backup system for the EHR to protect against system malfunction.⁴ In the past, offices backed up their data to tapes or disks. Today, it probably is safer to back up to the cloud. Cloud computing, which allows for automatic back-up, is tightly regulated by HIPAA, so be sure to choose an approved vendor.⁷

Preload your data
Before going live with the EHR, data must be integrated and preloaded into the electronic format. This means integrating billing, lab results, orders, scheduling, and encounter templates into the EHR interface.^4,6 When data are preloaded, employees can practice on the software before the launch date, ensuring a seamless transition.⁶

No “teeth-gnashing” necessary
The transition to an EHR system can be intimidating and may affect your staff’s productivity, efficiency, and morale. By following a few careful steps, the process can proceed without teeth-gnashing and loss of productivity. In fact, the suggestions offered here should improve productivity, office efficiency, and patient safety over the long term.

Who could ask for anything more?

We want to hear from you!  Tell us what you think.

More and more ObGyns are adopting electronic health records (EHRs), not only to meet a government mandate but also with the hope of making their practice more efficient and productive. While it is likely that EHRs enhance qualitative benefits, such as safety, patient satisfaction, 24/7 availability of medical records, and patient access to medical data, it isn’t always clear how they boost the financial bottom line. For this reason, we recommend that every practice “run the numbers” before making the transition from paper to paperless records. That means estimating the cost, expenses, and potential for added income associated with the EHR before embarking on the change.

In this article, we explain five ways a switch to EHRs can reduce costs. We also offer strategies for choosing and implementing an EHR, from information gathering to motivating your staff. 

Transcription costs are lower
The estimated cost of dictating a letter to a referring physician using conventional means is $12 to $15. That estimate includes the doctor’s time, the cost of the transcriptionist, the stationery, and the postage or cost of faxing the letter. An ObGyn may generate five to 10 letters per day. That’s $60 to $150 in expenses.

Most EHRs can generate a referral letter at no additional cost, provided the diagnosis, prescribed medications, and treatment plan have been entered in the system. Not only that, but each referral letter can be transmitted immediately to the recipient by email (or fax; the referring doctor’s preference). In the past, it may have taken as long as several weeks for the letter to be generated and make its way to the recipient by conventional means.

This use of the EHR can save a practice as much as $1,000 per physician every month.

Chart maintenance is no longer an issue
It sometimes can be a challenge for an ObGyn office to locate a paper chart. Any record lost in the “black hole” can wreak havoc with the schedule. It becomes even more problematic if the practice has multiple locations where charts are kept, delaying its recovery.

When a temporary chart must be created, it costs the practice time and dollars. It also becomes necessary to transfer the data into the permanent record, once it is located—another expense—not to mention the need to create a chart for every new patient.

It is not unusual for a busy practice to misplace as many as five charts a day, representing expenses of $25 to $50 per chart. With an EHR, this expense is reduced to $0, and the chart can be accessed 24/7 from multiple locations, including the physician’s home or mobile phone, provided the EHR is networked between practices and the data are secured on the cloud (with encryption to ensure patient confidentiality and compliance with the Health Insurance Portability and Accountability Act, or HIPAA).

Another expense with paper records: pulling charts for the day’s patients and returning them to the file rack at the conclusion of the day. These steps require additional employees and do nothing to improve patient care.

Coding is more accurate with an EHR
Prior to the development of EHRs, physicians had to guess the level of care that was provided and tended to “under-code” the visit, leading to a loss of income that the physician rightfully earned but didn’t document fully. As one coding expert has noted, if you didn’t document it, you didn’t do it, and if the record reflects that you didn’t do it, you can’t be paid for it.

In general, the higher the level of care and the higher the code used, the more extensive documentation should be. Today’s EHRs can automatically calculate the code best supported by the documentation entered at the time of the visit. After implementing an EHR, an ObGyn can ensure that accurate codes are submitted to payers, with higher levels of reimbursement honestly and ethically achieved.

A shift to EHRs frees up valuable square footage
It is not unusual for a practice to consume several hundred square feet of space for the storage of conventional medical records. Once a practice transitions to electronic records, however, these files are stored at a ­remote site or shredded once the entire paper record has been scanned into the EHR. The office space once required for paper record storage can then be converted into examination rooms or devoted to a laboratory, imaging center, or procedure room to generate ancillary income.

There’s an incentive involved
On February 17, 2009, the US government passed the Health Information Technology for Economic and Clinical Health (HITECH) Act in an effort to reduce the barriers to EHR implementation by outlining programs for standardization and funding of EHR programs.^1,2 The HITECH Act contained meaningful-use incentives to reward participants for the adoption of EHRs, with payments disbursed through Medicare and Medicaid.² By meeting several core objectives, individuals in private practice can earn as much as $44,000 over 5 years through the Medicare EHR incentive program and $63,750 over 6 years by participating in the Medicaid incentive program.³ Hospitals can earn more than $2 million over the same period. The objectives differ slightly for hospitals and individuals but are intended to improve quality, coordination, and safety of care while promoting patient involvement and public health.³

Related article: The Affordable Care Act and the drive for EHRs: Are small practices being squeezed? Lucia DiVenere, MD (July 2013)

The HITECH Act also sought to increase the security of EHRs to ensure patient privacy through standardization of EHR products. To become eligible for meaningful-use incentives, EHR software must meet government standards and specifications.³ Common requirements include the ability to document:

• vital signs
• test results
• all medications and allergies.

Another requirement is the ability to generate lists of patients with common conditions.³

By standardizing the EHR format, the HITECH Act improved networking by physicians by ensuring common capabilities among various EHR products.

The funding and standardization established by the HITECH Act increased the usage of EHRs among physicians to 57% by 2011.²

How did we get here? A history of the EHR
Computers and electronics originally were used for administrative purposes and did not offer meaningful clinical applications when they first were introduced to health care during the 1960s and 70s.⁸ These early machines were large, expensive, and slow and did not meet the practical needs of clinicians. During the 1980s and 90s, however, with networking capability and development of the World Wide Web, the potential for an electronic health record (EHR) became clearer. In 1991, an Institute of Medicine (IOM) report listed the “computer-based patient record” as “an essential technology for health care.”⁸ The authors of the IOM report envisioned a true network of practices and hospitals that seamlessly and efficiently share information and insight to increase quality of care, reduce medical errors, and improve patient safety.¹

Despite advances in EHR technology, one major hurdle remained: cost. For many clinicians, the time and resources required for installation of the program, transfer of records to the electronic format, and training of staff was too high. By 2001, only 18% of physicians had incorporated the EHR.² Today, nearly 60% of practices use an EHR.

Related article: EHRS and medicolegal risk: How they help, when they could hurt Martin Gimovsky, MD, and Baohuong N. Tran, DO (March 2013)

How to implement an EHR
The first step is to narrow your options to a few vendors that best suit the needs of your office. This process is beyond the scope of this article, but your ultimate objective should be to choose a user-friendly interface from a vendor that offers excellent document security, customer assistance, and support.⁴

Form an implementation team for your practice, and have it begin by consulting ObGyn practices of similar size that have recently installed one of the EHRs you are considering. By asking about other practices’ experiences and any pitfalls they encountered, you can greatly ease your transition to EHRs.

If possible, the physicians in your practice should visit the office of any colleagues who have implemented one of the EHRs you are considering to see how they like the product. Your office manager, nurses, and receptionist also should visit their counterparts in the other practice to ask about their experiences and opinions. The more information you glean from other ObGyn practices, the easier it will be to make your decision.

Be sure to check with your hospital to ensure compatibility with its system.

Ensure adequate technical support
One of the most important considerations in selecting a product is the availability and quality of tech support from the home office of the vendor. When you talk to other users of a product, ask how quickly tech support calls are returned and how efficiently problems are solved.

There will always be technical problems during the transition away from paper records. Ensuring their prompt resolution will be critical to your success.

Assign project management
After deciding on a particular product, create a project team to manage the complex, lengthy implementation process.^4–6 This team should include a project manager who has the experience and skills to coordinate a complex plan, a well-respected product champion who can help maintain staff support for the change, and several information technology (IT) specialists who can manage the software and hardware challenges.^4–6

Related article: What can "meaningful use" of an EHR mean for your bottom line? Robert L. Barbieri, MD (Editorial, February 2011)

Rally the troops
The most vital part of any implementation plan is staff “buy-in.”^4–6 It is incumbent upon the project-management team to determine what effects EHR implementation will have on workflow and to explain to employees how the process ultimately will increase efficiency and reduce work time and cost. And the project champion must remind employees of these goals during the transition.^4–6

Develop a backup system
Work with your IT staff to create a backup system for the EHR to protect against system malfunction.⁴ In the past, offices backed up their data to tapes or disks. Today, it probably is safer to back up to the cloud. Cloud computing, which allows for automatic back-up, is tightly regulated by HIPAA, so be sure to choose an approved vendor.⁷

Preload your data
Before going live with the EHR, data must be integrated and preloaded into the electronic format. This means integrating billing, lab results, orders, scheduling, and encounter templates into the EHR interface.^4,6 When data are preloaded, employees can practice on the software before the launch date, ensuring a seamless transition.⁶

No “teeth-gnashing” necessary
The transition to an EHR system can be intimidating and may affect your staff’s productivity, efficiency, and morale. By following a few careful steps, the process can proceed without teeth-gnashing and loss of productivity. In fact, the suggestions offered here should improve productivity, office efficiency, and patient safety over the long term.

Who could ask for anything more?

We want to hear from you!  Tell us what you think.

READ THE REST OF THE SERIES
Pillar 1: Keep your current patients happy (March 2013)
Dr. Baum describes his number one strategy to retain patients (Audiocast, March 2013)
Pillar 2: Attract new patients (May 2013)
Pillar 3: Obtain and maintain physician referrals (June 2013)

The success of any medical practice and any marketing program begins and ends with the staff. You can gain new patients, forge excellent relationships with referring physicians, and maintain a plentiful number of existing patients—but if you don’t have a staff that is excited, enthusiastic, and knowledgeable when answering the telephone and managing patients, your marketing plan will be ineffective, and you will be disappointed in your practice.

In this article, I review the importance of motivating employees by providing measurable, written goals in the form of a succinct, effective mission statement and policy manual. I also offer practical strategies to inspire your employees by sharing the power, vision, and rewards.

Start with your mission statement
Nearly every successful practice and every successful business has a well-defined vision, mission, goal, or objective. The mission statement should spell out the purpose of the practice and the methods of achieving it. It serves as the road map, providing direction to all members of the staff, doctors included.

The mission statement for my practice is:
     We are committed to:

• excellence
• providing the best urologic health care for our patients
• persistent and consistent attention to the little details because they make a big difference.

Develop a policy manual
Every practice should have a manual that contains its rules and regulations. Ideally, this manual should also serve as a guide for any new or temporary employee who comes to work in the office.

The manual should cover job descriptions, the dress code, hours of operation, the division of office responsibilities, vacation and sick days, and emergency telephone numbers.

In my practice, we summarize our policy manual with this expectation:
     Dr. Baum’s policy manual statement:
     Rule #1— The patient is always right.
     Rule #2— If you think the patient is wrong, reread rule #1.
     ALL OTHER POLICIES ARE NULL AND VOID.

We post the mission statement in prominent places throughout the office (the reception area and most of the examination rooms, our Web site, and on a large banner in the employee lounge) to remind us and our patients of our dedication to excellent customer service.

Whenever a mistake or problem occurs, the first question we ask each other is, “Did we adhere to the mission statement and the policy statement?” Usually, we discover that we did not. We use the mission statement and the policy statement to refocus us on our number one priority: our patients.

10 LOW-COST WAYS TO MOTIVATE STAFF
A well-motivated staff creates an effective team environment. Most enlightened businesses have discovered that team management leads to increased output and productivity. Your employees want to be valued as human beings and individuals, not just as workers. The more you include them in the process of running the office, the more invested they become in helping to improve the way it works.

1. Review staff performance regularly
Employees like to know where they stand and how they can improve performance on the job. Motivated staff members appreciate feedback on their progress—or, even, their lack of it. The best way to furnish this important feedback is by conducting periodic performance reviews.

I suggest that you meet with your employees on a scheduled basis every 3 to 4 months. Give each employee a worksheet before the scheduled review (see Worksheet below), and then go over her responses during the review. You can learn a lot about what motivates her during this process.

I always end each performance review on a positive note, by telling the employee how great an asset she is to the practice. I document these meetings in the employee’s file.

2. Encourage continuing education
Just as physicians need continuing medical education to stay up to date, your staff members require continuing motivational experiences. Encourage your staff to participate in continuing education courses and support their efforts financially—you’ll get a favorable return on your investment.

I suggest that you offer to pay the fees for any seminars and classes your employees take. You may want to suggest courses in computers, social media, marketing, or any other subject area that will help the practice grow and prosper.

To make these educational experiences even more effective, ask employees to share what they have learned with other staff members. This can be done at a staff meeting. Simply ask the employee who attended a seminar or a course to share the information with the rest of the staff by briefly reviewing the course or describing what he learned and how it applies to the practice.

3. Empower your staff
Office management is complicated. Few ObGyns have a thorough understanding of all business aspects of a medical practice. Most successful ObGyns have learned to delegate the responsibility of running the office and to empower their employees to take control and assume responsibility for their decisions and actions.

In my practice, I empower any employee to make financial decisions up to a limit of $200 without consulting me. For instance, if the office needs a new telephone answering machine, I expect my employees to consider which features we need, check the machines that are available, and compare prices at the local electronics outlet, office supply store, and online retailers to find the best machine at the lowest price.

The take-home message: More than ever before, ObGyns should do what we are best trained to do—diagnose and treat diseases. Very few ObGyns are experts on fax machines. Don’t waste time on activities that your staff members can do.

4. Promote a positive mental attitude
As Ralph Waldo Emerson once said, “Nothing great was ever achieved without enthusiasm.” This is also true of the practice of medicine. When the doctor has a positive mental attitude, employees are motivated by the example. When a doctor is easily irritable and carries problems from home to the office and takes her frustration out on the staff, the employees will, in turn, take it out on the patients.

I have an attitude that employees are on stage. The moment they walk in the door in the morning, they have to leave all other problems and concerns behind them. They need to believe that they are responsible for making sure that each patient has a positive experience with the office at every contact point. That includes the telephone, the receptionist who welcomes patients to the practice, the nurse taking the patient into the exam room, the billing clerk who handles the patient’s bill, and, yes, the doctor, too! We all contribute to the patient’s experience, and we all need to have a positive attitude.

5. Recognize achievement
Nothing is more motivating for an employee than for the doctor to recognize his achievements and accomplishments. When an employee improves in job performance, tell him directly. You will satisfy that employee’s need for self-esteem, improve his confidence, and help him fulfill the need for self-esteem from fellow employees.

6. Show your staff that you care
Your employees need to know that you care about them not just as workers but as individuals with their own personal lives. When one of my employees is sick, or one of her family members is ill, I call her at home to check on her and make sure that she has access to adequate medical care. If someone gets sick in the office, I call another medical office and get the employee seen immediately.

7. Catch your employees doing things right
My philosophy is to praise in public, pan in private. When I catch an employee doing something right, I send a thank-you note to her home address, making sure that it arrives on a Saturday. I hope the employee will show my note to family and friends. I use a specially created card or a “thanks a million” check (a non-negotiable replication of a check that is made out to the employee and says, “Thanks a million,” with my name signed at the bottom).

You will be amazed at how appreciative the employee is that you not only recognized her superior service but took the time to put your recognition in writing.

8. Reward your staff for saving money
If a staff member comes up with an idea that saves the practice money, give her a bonus. For example, in my practice, the 15-year-old autoclave broke down. When I tried to get parts, I was informed that the machine is no longer made. The nurse in our office took the autoclave to the hospital’s biomedical engineering department, where workers installed a $30 part that saved me from buying a new $2,000 machine. The nurse deserved to be rewarded for that, so I gave her a $50 check on the spot.

I try to motivate my staff not just to earn more money for the practice but to reduce expenses, so I pay them when they identify and design money-saving ideas.

9. Involve your employees in decision making
Ask your employees for advice. Then make sure you follow it. Your staff members are on the front line; they want the office routine to go well. Include them in the decision-making process, whether the task is writing a mission statement or policy manual, determining a change in procedures, implementing an electronic health record, or meeting new job candidates. By including them, you make them feel like part of the team.

10. Have fun!
Surprise is the spice of life. Whenever you can provide an unexpected perk for your staff, you can be sure the gesture will be appreciated. For example, during a week in which two of my employees were unable to work (due to vacation and illness), the rest of us had to take up the slack. Despite being short-handed, we were able to function at regular speed and capacity without affecting the quality of care. I was so impressed by the extra effort that I arranged for a massage therapist to visit our practice at the end of the week and give everyone a 15- to 20-minute massage. It was my way of saying, “Thank you.”

THE BOTTOM LINE
Encourage team spirit. It makes good business sense. When your employees have a personal investment in problem-solving and decision-making, they will go the extra mile for your patients and your practice.

This is the last article in this four-part series on promoting your practice and increasing productivity. I hope you have identified the four pillars of success for your practice—and that I have helped you understand the importance of all four pillars. They represent the strength and stability of a successful ObGyn practice.

READ THE REST OF THE SERIES
Pillar 1: Keep your current patients happy (March 2013)
Dr. Baum describes his number one strategy to retain patients (Audiocast, March 2013)
Pillar 2: Attract new patients (May 2013)
Pillar 3: Obtain and maintain physician referrals (June 2013)

The success of any medical practice and any marketing program begins and ends with the staff. You can gain new patients, forge excellent relationships with referring physicians, and maintain a plentiful number of existing patients—but if you don’t have a staff that is excited, enthusiastic, and knowledgeable when answering the telephone and managing patients, your marketing plan will be ineffective, and you will be disappointed in your practice.

In this article, I review the importance of motivating employees by providing measurable, written goals in the form of a succinct, effective mission statement and policy manual. I also offer practical strategies to inspire your employees by sharing the power, vision, and rewards.

Start with your mission statement
Nearly every successful practice and every successful business has a well-defined vision, mission, goal, or objective. The mission statement should spell out the purpose of the practice and the methods of achieving it. It serves as the road map, providing direction to all members of the staff, doctors included.

The mission statement for my practice is:
     We are committed to:

• excellence
• providing the best urologic health care for our patients
• persistent and consistent attention to the little details because they make a big difference.

Develop a policy manual
Every practice should have a manual that contains its rules and regulations. Ideally, this manual should also serve as a guide for any new or temporary employee who comes to work in the office.

The manual should cover job descriptions, the dress code, hours of operation, the division of office responsibilities, vacation and sick days, and emergency telephone numbers.

In my practice, we summarize our policy manual with this expectation:
     Dr. Baum’s policy manual statement:
     Rule #1— The patient is always right.
     Rule #2— If you think the patient is wrong, reread rule #1.
     ALL OTHER POLICIES ARE NULL AND VOID.

We post the mission statement in prominent places throughout the office (the reception area and most of the examination rooms, our Web site, and on a large banner in the employee lounge) to remind us and our patients of our dedication to excellent customer service.

Whenever a mistake or problem occurs, the first question we ask each other is, “Did we adhere to the mission statement and the policy statement?” Usually, we discover that we did not. We use the mission statement and the policy statement to refocus us on our number one priority: our patients.

10 LOW-COST WAYS TO MOTIVATE STAFF
A well-motivated staff creates an effective team environment. Most enlightened businesses have discovered that team management leads to increased output and productivity. Your employees want to be valued as human beings and individuals, not just as workers. The more you include them in the process of running the office, the more invested they become in helping to improve the way it works.

1. Review staff performance regularly
Employees like to know where they stand and how they can improve performance on the job. Motivated staff members appreciate feedback on their progress—or, even, their lack of it. The best way to furnish this important feedback is by conducting periodic performance reviews.

I suggest that you meet with your employees on a scheduled basis every 3 to 4 months. Give each employee a worksheet before the scheduled review (see Worksheet below), and then go over her responses during the review. You can learn a lot about what motivates her during this process.

I always end each performance review on a positive note, by telling the employee how great an asset she is to the practice. I document these meetings in the employee’s file.

2. Encourage continuing education
Just as physicians need continuing medical education to stay up to date, your staff members require continuing motivational experiences. Encourage your staff to participate in continuing education courses and support their efforts financially—you’ll get a favorable return on your investment.

I suggest that you offer to pay the fees for any seminars and classes your employees take. You may want to suggest courses in computers, social media, marketing, or any other subject area that will help the practice grow and prosper.

To make these educational experiences even more effective, ask employees to share what they have learned with other staff members. This can be done at a staff meeting. Simply ask the employee who attended a seminar or a course to share the information with the rest of the staff by briefly reviewing the course or describing what he learned and how it applies to the practice.

3. Empower your staff
Office management is complicated. Few ObGyns have a thorough understanding of all business aspects of a medical practice. Most successful ObGyns have learned to delegate the responsibility of running the office and to empower their employees to take control and assume responsibility for their decisions and actions.

In my practice, I empower any employee to make financial decisions up to a limit of $200 without consulting me. For instance, if the office needs a new telephone answering machine, I expect my employees to consider which features we need, check the machines that are available, and compare prices at the local electronics outlet, office supply store, and online retailers to find the best machine at the lowest price.

The take-home message: More than ever before, ObGyns should do what we are best trained to do—diagnose and treat diseases. Very few ObGyns are experts on fax machines. Don’t waste time on activities that your staff members can do.

4. Promote a positive mental attitude
As Ralph Waldo Emerson once said, “Nothing great was ever achieved without enthusiasm.” This is also true of the practice of medicine. When the doctor has a positive mental attitude, employees are motivated by the example. When a doctor is easily irritable and carries problems from home to the office and takes her frustration out on the staff, the employees will, in turn, take it out on the patients.

I have an attitude that employees are on stage. The moment they walk in the door in the morning, they have to leave all other problems and concerns behind them. They need to believe that they are responsible for making sure that each patient has a positive experience with the office at every contact point. That includes the telephone, the receptionist who welcomes patients to the practice, the nurse taking the patient into the exam room, the billing clerk who handles the patient’s bill, and, yes, the doctor, too! We all contribute to the patient’s experience, and we all need to have a positive attitude.

5. Recognize achievement
Nothing is more motivating for an employee than for the doctor to recognize his achievements and accomplishments. When an employee improves in job performance, tell him directly. You will satisfy that employee’s need for self-esteem, improve his confidence, and help him fulfill the need for self-esteem from fellow employees.

6. Show your staff that you care
Your employees need to know that you care about them not just as workers but as individuals with their own personal lives. When one of my employees is sick, or one of her family members is ill, I call her at home to check on her and make sure that she has access to adequate medical care. If someone gets sick in the office, I call another medical office and get the employee seen immediately.

7. Catch your employees doing things right
My philosophy is to praise in public, pan in private. When I catch an employee doing something right, I send a thank-you note to her home address, making sure that it arrives on a Saturday. I hope the employee will show my note to family and friends. I use a specially created card or a “thanks a million” check (a non-negotiable replication of a check that is made out to the employee and says, “Thanks a million,” with my name signed at the bottom).

You will be amazed at how appreciative the employee is that you not only recognized her superior service but took the time to put your recognition in writing.

8. Reward your staff for saving money
If a staff member comes up with an idea that saves the practice money, give her a bonus. For example, in my practice, the 15-year-old autoclave broke down. When I tried to get parts, I was informed that the machine is no longer made. The nurse in our office took the autoclave to the hospital’s biomedical engineering department, where workers installed a $30 part that saved me from buying a new $2,000 machine. The nurse deserved to be rewarded for that, so I gave her a $50 check on the spot.

I try to motivate my staff not just to earn more money for the practice but to reduce expenses, so I pay them when they identify and design money-saving ideas.

9. Involve your employees in decision making
Ask your employees for advice. Then make sure you follow it. Your staff members are on the front line; they want the office routine to go well. Include them in the decision-making process, whether the task is writing a mission statement or policy manual, determining a change in procedures, implementing an electronic health record, or meeting new job candidates. By including them, you make them feel like part of the team.

10. Have fun!
Surprise is the spice of life. Whenever you can provide an unexpected perk for your staff, you can be sure the gesture will be appreciated. For example, during a week in which two of my employees were unable to work (due to vacation and illness), the rest of us had to take up the slack. Despite being short-handed, we were able to function at regular speed and capacity without affecting the quality of care. I was so impressed by the extra effort that I arranged for a massage therapist to visit our practice at the end of the week and give everyone a 15- to 20-minute massage. It was my way of saying, “Thank you.”

THE BOTTOM LINE
Encourage team spirit. It makes good business sense. When your employees have a personal investment in problem-solving and decision-making, they will go the extra mile for your patients and your practice.

This is the last article in this four-part series on promoting your practice and increasing productivity. I hope you have identified the four pillars of success for your practice—and that I have helped you understand the importance of all four pillars. They represent the strength and stability of a successful ObGyn practice.

READ THE REST OF THE SERIES
Pillar 1: Keep your current patients happy (March 2013)
Dr. Baum describes his number one strategy to retain patients (Audiocast, March 2013)
Pillar 2: Attract new patients (May 2013)
Pillar 3: Obtain and maintain physician referrals (June 2013)

The success of any medical practice and any marketing program begins and ends with the staff. You can gain new patients, forge excellent relationships with referring physicians, and maintain a plentiful number of existing patients—but if you don’t have a staff that is excited, enthusiastic, and knowledgeable when answering the telephone and managing patients, your marketing plan will be ineffective, and you will be disappointed in your practice.

In this article, I review the importance of motivating employees by providing measurable, written goals in the form of a succinct, effective mission statement and policy manual. I also offer practical strategies to inspire your employees by sharing the power, vision, and rewards.

Start with your mission statement
Nearly every successful practice and every successful business has a well-defined vision, mission, goal, or objective. The mission statement should spell out the purpose of the practice and the methods of achieving it. It serves as the road map, providing direction to all members of the staff, doctors included.

The mission statement for my practice is:
     We are committed to:

• excellence
• providing the best urologic health care for our patients
• persistent and consistent attention to the little details because they make a big difference.

Develop a policy manual
Every practice should have a manual that contains its rules and regulations. Ideally, this manual should also serve as a guide for any new or temporary employee who comes to work in the office.

The manual should cover job descriptions, the dress code, hours of operation, the division of office responsibilities, vacation and sick days, and emergency telephone numbers.

In my practice, we summarize our policy manual with this expectation:
     Dr. Baum’s policy manual statement:
     Rule #1— The patient is always right.
     Rule #2— If you think the patient is wrong, reread rule #1.
     ALL OTHER POLICIES ARE NULL AND VOID.

We post the mission statement in prominent places throughout the office (the reception area and most of the examination rooms, our Web site, and on a large banner in the employee lounge) to remind us and our patients of our dedication to excellent customer service.

Whenever a mistake or problem occurs, the first question we ask each other is, “Did we adhere to the mission statement and the policy statement?” Usually, we discover that we did not. We use the mission statement and the policy statement to refocus us on our number one priority: our patients.

10 LOW-COST WAYS TO MOTIVATE STAFF
A well-motivated staff creates an effective team environment. Most enlightened businesses have discovered that team management leads to increased output and productivity. Your employees want to be valued as human beings and individuals, not just as workers. The more you include them in the process of running the office, the more invested they become in helping to improve the way it works.

1. Review staff performance regularly
Employees like to know where they stand and how they can improve performance on the job. Motivated staff members appreciate feedback on their progress—or, even, their lack of it. The best way to furnish this important feedback is by conducting periodic performance reviews.

I suggest that you meet with your employees on a scheduled basis every 3 to 4 months. Give each employee a worksheet before the scheduled review (see Worksheet below), and then go over her responses during the review. You can learn a lot about what motivates her during this process.

I always end each performance review on a positive note, by telling the employee how great an asset she is to the practice. I document these meetings in the employee’s file.

2. Encourage continuing education
Just as physicians need continuing medical education to stay up to date, your staff members require continuing motivational experiences. Encourage your staff to participate in continuing education courses and support their efforts financially—you’ll get a favorable return on your investment.

I suggest that you offer to pay the fees for any seminars and classes your employees take. You may want to suggest courses in computers, social media, marketing, or any other subject area that will help the practice grow and prosper.

To make these educational experiences even more effective, ask employees to share what they have learned with other staff members. This can be done at a staff meeting. Simply ask the employee who attended a seminar or a course to share the information with the rest of the staff by briefly reviewing the course or describing what he learned and how it applies to the practice.

3. Empower your staff
Office management is complicated. Few ObGyns have a thorough understanding of all business aspects of a medical practice. Most successful ObGyns have learned to delegate the responsibility of running the office and to empower their employees to take control and assume responsibility for their decisions and actions.

In my practice, I empower any employee to make financial decisions up to a limit of $200 without consulting me. For instance, if the office needs a new telephone answering machine, I expect my employees to consider which features we need, check the machines that are available, and compare prices at the local electronics outlet, office supply store, and online retailers to find the best machine at the lowest price.

The take-home message: More than ever before, ObGyns should do what we are best trained to do—diagnose and treat diseases. Very few ObGyns are experts on fax machines. Don’t waste time on activities that your staff members can do.

4. Promote a positive mental attitude
As Ralph Waldo Emerson once said, “Nothing great was ever achieved without enthusiasm.” This is also true of the practice of medicine. When the doctor has a positive mental attitude, employees are motivated by the example. When a doctor is easily irritable and carries problems from home to the office and takes her frustration out on the staff, the employees will, in turn, take it out on the patients.

I have an attitude that employees are on stage. The moment they walk in the door in the morning, they have to leave all other problems and concerns behind them. They need to believe that they are responsible for making sure that each patient has a positive experience with the office at every contact point. That includes the telephone, the receptionist who welcomes patients to the practice, the nurse taking the patient into the exam room, the billing clerk who handles the patient’s bill, and, yes, the doctor, too! We all contribute to the patient’s experience, and we all need to have a positive attitude.

5. Recognize achievement
Nothing is more motivating for an employee than for the doctor to recognize his achievements and accomplishments. When an employee improves in job performance, tell him directly. You will satisfy that employee’s need for self-esteem, improve his confidence, and help him fulfill the need for self-esteem from fellow employees.

6. Show your staff that you care
Your employees need to know that you care about them not just as workers but as individuals with their own personal lives. When one of my employees is sick, or one of her family members is ill, I call her at home to check on her and make sure that she has access to adequate medical care. If someone gets sick in the office, I call another medical office and get the employee seen immediately.

7. Catch your employees doing things right
My philosophy is to praise in public, pan in private. When I catch an employee doing something right, I send a thank-you note to her home address, making sure that it arrives on a Saturday. I hope the employee will show my note to family and friends. I use a specially created card or a “thanks a million” check (a non-negotiable replication of a check that is made out to the employee and says, “Thanks a million,” with my name signed at the bottom).

You will be amazed at how appreciative the employee is that you not only recognized her superior service but took the time to put your recognition in writing.

8. Reward your staff for saving money
If a staff member comes up with an idea that saves the practice money, give her a bonus. For example, in my practice, the 15-year-old autoclave broke down. When I tried to get parts, I was informed that the machine is no longer made. The nurse in our office took the autoclave to the hospital’s biomedical engineering department, where workers installed a $30 part that saved me from buying a new $2,000 machine. The nurse deserved to be rewarded for that, so I gave her a $50 check on the spot.

I try to motivate my staff not just to earn more money for the practice but to reduce expenses, so I pay them when they identify and design money-saving ideas.

9. Involve your employees in decision making
Ask your employees for advice. Then make sure you follow it. Your staff members are on the front line; they want the office routine to go well. Include them in the decision-making process, whether the task is writing a mission statement or policy manual, determining a change in procedures, implementing an electronic health record, or meeting new job candidates. By including them, you make them feel like part of the team.

10. Have fun!
Surprise is the spice of life. Whenever you can provide an unexpected perk for your staff, you can be sure the gesture will be appreciated. For example, during a week in which two of my employees were unable to work (due to vacation and illness), the rest of us had to take up the slack. Despite being short-handed, we were able to function at regular speed and capacity without affecting the quality of care. I was so impressed by the extra effort that I arranged for a massage therapist to visit our practice at the end of the week and give everyone a 15- to 20-minute massage. It was my way of saying, “Thank you.”

THE BOTTOM LINE
Encourage team spirit. It makes good business sense. When your employees have a personal investment in problem-solving and decision-making, they will go the extra mile for your patients and your practice.

This is the last article in this four-part series on promoting your practice and increasing productivity. I hope you have identified the four pillars of success for your practice—and that I have helped you understand the importance of all four pillars. They represent the strength and stability of a successful ObGyn practice.

External marketing is nothing more than making potential patients aware of your service and areas of expertise. The public truly does not mind marketing, as long as it believes you are communicating useful information and providing value. Nevertheless, such marketing—getting the word out to the public and potential referring physicians—takes some physicians out of their comfort zone. Some doctors think that marketing is synonymous with advertising.

The truth is, you can make the public aware of your services and expertise in an ethical and professional fashion without spending large amounts of money on advertising or hiring an expensive consultant.

How?

The essence of external marketing is writing, speaking, and making use of the Internet. In this article, I review simple, inexpensive techniques to increase your visibility among your peers and in your community. These techniques do not require additional staff or anything more than minimal assistance from your hospital’s public relations and marketing departments and the creation of a few PowerPoint slides that will hold the attention of your audience. A future article will describe Internet marketing strategies.

Try your hand at public speaking

Few of us are natural-born orators, but if you get started on the speaking circuit and acquire effective skills, you’ll be amazed at the demand for your presentations and the commensurate number of new patients filling your appointment book. When you take your message to the podium, audiences have an opportunity not only to learn more about your medical topic and how it applies to their health and wellness, but also to interact with you before and after the presentation.

Most of us have been asked to give a presentation to a lay audience at some time or another. How many of us have set off with a PowerPoint presentation from a pharmaceutical company that contains information far too technical for a nonmedical audience? Is it any wonder that so few talks motivate new patients to call our practices?

How to get invited to speak at local events

Even if you have a knack for public speaking, you still need to generate invitations for speaking engagements. I systematically contact meeting planners at various churches, service organizations like the Junior League, women’s book clubs, and patient advocacy groups, such as the American Cancer Society and American Diabetes Association. A list of these organizations and clubs can be obtained from the Chamber of Commerce in your community.

When I began public speaking, I created a public relations packet and sent it to meeting planners in the community. The packet contained a brief biography that outlined my credentials, listed organizations or groups to which I have given talks in the past, and provided a few testimonials from previous audience members. I also included a fact sheet (see the box on this page) and several articles on the topic to be covered. The articles were written by me for local outlets or written by others for publication in national magazines or other lay publications.

After I delivered a talk, I hung around to answer questions. I also made sure to have plenty of business cards to hand out, as well as my practice brochure and articles that pertained to the topic I had just presented.

Don’t overlook support groups and group appointments

Conducting a support group is an excellent way to target a specific diagnosis or disease state. If you can identify women who have a chronic problem, such as pelvic pain, incontinence, or endometriosis, and invite them to a meeting, you’ll find that they appreciate your interest and expertise and often become patients in your practice. Women who attend these meetings get to know who you are, what you do, and where to find you.

Start by organizing your current patients. I have discovered that it is easiest to start with patients in your own practice when organizing these meetings. These women know others with similar problems and soon invite them to your group.

How to start a support group

Choose a date for your meeting. Keep the following in mind:

• Select a date 2 or 3 months in the future. Decide on several possible alternative dates as well. Don’t choose a date near a major holiday. Because I practice in New Orleans, for example, I would never pick a date a week before or after Mardi Gras.
• Tuesday and Wednesday evenings are the best nights of the week. Most people do not schedule social engagements during the middle of the week.
• If your target audience is senior citizens, they may not be able to attend or drive at night. A Saturday morning or weekday afternoon meeting might be better for them.
• At the meeting, provide a sign-in sheet to record the names and email addresses of all who attend. You can use this list to contact attendees later through an online newsletter.

Within 1 week after your support group presentation, send a follow-up email and appropriate additional information to attendees on your sign-in sheet. The letter should thank them for attending and let them know you are available to answer any questions. You can then add their names to your database and contact them periodically when new treatments or diagnostic techniques become available.

Ethnic communities require special attention

With so many different ethnicities in many US metropolitan areas, you may have an opportunity to attract new patients from these groups. If possible, try to learn to speak the language of the ethnic group you primarily serve—you will have an advantage in attracting foreign-born immigrants if you can speak their language. Alternatively, you can serve their needs by having someone on staff who can translate for you.

Be aware, however, that professional medical interpreters recommend employing a trained medical professional to manage the translation. Without specific training in the language and familiarity with the nuances of translating during a medical examination, diagnostic cues and treatment recommendations may be missed or misinterpreted.

Some translation services specialize in medical translation. You can contact the service and request a translator in nearly any language, including Vietnamese, Russian, Serbian, and Afrikaans, and they will arrange for a translator to arrive at a designated time. The fees are reasonable, and using such a service ensures that you can communicate with patients when neither you nor a staffer speaks the language.

It is still a good idea for you to learn some basic vocabulary, such as greetings, farewells, and the names of body parts. Not only will this make diagnoses more efficient, it will make your patients feel welcome.

Provide translations of your educational materials for patients who are more comfortable with a language besides English. If these materials are not already available from pharmaceutical or medical manufacturing companies, have the most frequently used information translated. The nearest university or college might be a good resource. The language departments at these institutions often can refer you to people who do translations on a freelance basis.

Be sure to add information to your Web site and other social media that makes it clear that you accept patients who speak other languages.

Consider writing articles for lay publications

How many referrals or new patients do you get from articles you have written for professional journals?

There is a good chance that your answer is the same as mine: “None.”

My CV lists nearly 175 articles that have been published in peer-reviewed professional journals, but I have not seen a single referral or new patient as a result. However, I have written several hundred articles for local newspapers and magazines that have generated hundreds of new patient visits to my practice.

Become a media resource: Write, be proactive, be responsive

By writing articles for the local press, you can easily become a media resource. Reporters and editors will notice your pieces. Often they will contact you for articles or ask you for quotations to be included in articles they are writing. If you are responsive, they will keep you in their database as an expert to call on whenever your specialty is in the news.

You can promote this transition yourself. When Whoopi Goldberg shared her experience with urinary incontinence on the television talk show The View, I contacted my local paper, the Times-Picayune, and offered to provide information about the problems of incontinence and overactive bladder and how an outpatient evaluation can often lead to cure of this disease.

What should you write about?

Topics of interest to lay readers in your community undoubtedly include wellness, menopause, cancer prevention, female sexual dysfunction, and vaginal rejuvenation. You can create an interesting article about new procedures, new treatments, a unique case with an excellent result, or the use of new technologies, such as new in-office procedures for permanent contraception.

Like medical skills, writing skills can be learned and polished. The more you do it, the better you get. The better you get, the more women you will attract to your practice.

Use your Web site to attract new patients

For most ObGyns, the majority of patients they serve come from within their community. A clinician’s service area usually encompasses no more than three to five zip codes or a 25- to 50-mile radius. All of us enjoy seeing a patient who has traveled more than 100 miles to see us for a gynecologic problem. Imagine the excitement when a patient from 1,000, 5,000, or even 10,000 miles away contacts your office for an appointment. This is exactly what a Web site can do for you and your practice. (Note: In a future article, I will focus on Internet marketing.)

Blogging offers an opportunity to engage potential patients

If you have a Web site, then you’ve already taken the most critical step toward marketing your practice in an increasingly Internet-savvy age. Today’s patients rely on the Internet for personal health information; they also expect a level of interaction and communication from their clinician on the Web. That’s because popular social media platforms, like Facebook and Twitter, are growing rapidly, enabling patients to use a variety of social media resources for support, education, and treatment decisions. A static Web site that consists only of your practice name, staff biographies, your office address and phone numbers, and a map to guide patients to your practice won’t cut it any longer in terms of patient expectations.

Health-care practitioners are just beginning to embrace social media—Facebook, Twitter, YouTube, and blogging—as an important component of their Internet marketing strategy. Blogging is easy, quick, and free. In many cases, a blog already is integrated with the rest of your professionally designed Web site. To get started, you just need to contribute content to the blog.

Although a blog won’t deliver an instant return on investment, it can, with time, build awareness of your practice and help promote your services to existing and potential patients. Blogs are driven by content, and a blog tied to your practice gives you the freedom to write and publish content that is unique to you and your practice. Written effectively, blogs present the perfect opportunity to interact with your patients while promoting your services.

Blogs also can improve your search engine ranking significantly. By adding new content to your blog on a regular basis, you ensure that search engines “crawl” your site more often. More important, blogs make it possible to dually publish content on other social media sites, functioning as the nucleus of your social media maintenance. Regular posts to your blog can be synced with your Facebook and Twitter accounts for seamless social networking.

Choose a snappy headline

Few patients will read a blog post with a headline that doesn’t entice them in some way. A compelling headline is essential to get your visitor to read the rest of the article and revisit your blog for new posts in the future.

Think of your blog title as a billboard. Consider that you are trying to attract the attention of drivers who have only a few seconds to look at your signage. The same is true for the title of your blog. Visitors often read the title and make a decision about whether to read the rest of the content. For example, an article entitled “Evaluation and treatment of urinary incontinence” probably would not get the eyeballs to stick, compared with a headline like “You don’t have to depend on Depends!” Doctors tend to think conservatively and may generate bland titles more suitable for a medical journal. I suggest that you think more like a tabloid journalist to attract readers to your blog.

Keep blog posts lay-friendly

Because patients will be reading your blog, remember to write for them and not for your colleagues. Be conversational and avoid overusing medical terminology that your readers won’t appreciate or understand. Try to target your writing to the 10th grade level so that you attract both educated and less educated readers. Some blog sites evaluate your writing to determine its grade level and will assist you in keeping your material understandable by most readers.

For example, Writing Sample Analyzer uses syllable counts and sentence length to determine the average grade level of your material (http://sarahktyler.com/code/sam ple.php). And the Readability Calculator at http://www.online-utility.org/english/readability_test_and_improve.jsp is also useful. In general, these tools penalize writers for polysyllabic words and long, complex sentences. Your writing will score higher when you use simpler diction and write short sentences.

Educate, rather than advertise.

Blogs should be used to support your online marketing efforts and provide patients with important information about your practice and services. A blog is not designed to be an advertising tool. Using it as such a tool will cause readers to lose interest fast. If you think education first, your material will be attractive to readers and they may call your office for an appointment.

Some organizational pointers:

• Avoid lengthy blog posts; they can lose reader interest. Pages with a lot of white space are easier to scan and more likely to keep patients reading. Say enough to get your point across, but don’t lose your readers’ attention with irrelevant information.
• Include subheadings and bullet points every few paragraphs so readers can quickly browse your post for the information they want.

Provide fresh, unique content that is new and interesting. Offer advice and tips for improved health, and inform patients about new technology and treatments that are specific to your practice. For example, if you offer a noninvasive approach to a medical problem using a procedure that is new in your community, write a post on this topic and include a testimonial from one of your treated patients. This strategy is very effective at generating new patients.

Don’t let your content get stale

Post to your blog regularly, providing new and updated content. Once you develop an audience, keep them coming back by adhering to a schedule. Every update you make to your blog counts as fresh content—a significant factor search engines use to rank Web sites. I suggest that you consider blogging at a minimum of once a week.

We are in the age of social media. The social media train is leaving the station, and you better get on board. The easiest way to start is by creating and posting regularly on your blog site.

External marketing to attract new patients to your ObGyn practice basically consists of writing and speaking. If you want to market outside your practice, you need to think about putting your writing and speaking skills into action. So, speak up and get your pen or computer working!

We want to hear from you! Tell us what you think.

External marketing is nothing more than making potential patients aware of your service and areas of expertise. The public truly does not mind marketing, as long as it believes you are communicating useful information and providing value. Nevertheless, such marketing—getting the word out to the public and potential referring physicians—takes some physicians out of their comfort zone. Some doctors think that marketing is synonymous with advertising.

The truth is, you can make the public aware of your services and expertise in an ethical and professional fashion without spending large amounts of money on advertising or hiring an expensive consultant.

How?

The essence of external marketing is writing, speaking, and making use of the Internet. In this article, I review simple, inexpensive techniques to increase your visibility among your peers and in your community. These techniques do not require additional staff or anything more than minimal assistance from your hospital’s public relations and marketing departments and the creation of a few PowerPoint slides that will hold the attention of your audience. A future article will describe Internet marketing strategies.

Try your hand at public speaking

Few of us are natural-born orators, but if you get started on the speaking circuit and acquire effective skills, you’ll be amazed at the demand for your presentations and the commensurate number of new patients filling your appointment book. When you take your message to the podium, audiences have an opportunity not only to learn more about your medical topic and how it applies to their health and wellness, but also to interact with you before and after the presentation.

Most of us have been asked to give a presentation to a lay audience at some time or another. How many of us have set off with a PowerPoint presentation from a pharmaceutical company that contains information far too technical for a nonmedical audience? Is it any wonder that so few talks motivate new patients to call our practices?

How to get invited to speak at local events

Even if you have a knack for public speaking, you still need to generate invitations for speaking engagements. I systematically contact meeting planners at various churches, service organizations like the Junior League, women’s book clubs, and patient advocacy groups, such as the American Cancer Society and American Diabetes Association. A list of these organizations and clubs can be obtained from the Chamber of Commerce in your community.

When I began public speaking, I created a public relations packet and sent it to meeting planners in the community. The packet contained a brief biography that outlined my credentials, listed organizations or groups to which I have given talks in the past, and provided a few testimonials from previous audience members. I also included a fact sheet (see the box on this page) and several articles on the topic to be covered. The articles were written by me for local outlets or written by others for publication in national magazines or other lay publications.

After I delivered a talk, I hung around to answer questions. I also made sure to have plenty of business cards to hand out, as well as my practice brochure and articles that pertained to the topic I had just presented.

Don’t overlook support groups and group appointments

Conducting a support group is an excellent way to target a specific diagnosis or disease state. If you can identify women who have a chronic problem, such as pelvic pain, incontinence, or endometriosis, and invite them to a meeting, you’ll find that they appreciate your interest and expertise and often become patients in your practice. Women who attend these meetings get to know who you are, what you do, and where to find you.

Start by organizing your current patients. I have discovered that it is easiest to start with patients in your own practice when organizing these meetings. These women know others with similar problems and soon invite them to your group.

How to start a support group

Choose a date for your meeting. Keep the following in mind:

• Select a date 2 or 3 months in the future. Decide on several possible alternative dates as well. Don’t choose a date near a major holiday. Because I practice in New Orleans, for example, I would never pick a date a week before or after Mardi Gras.
• Tuesday and Wednesday evenings are the best nights of the week. Most people do not schedule social engagements during the middle of the week.
• If your target audience is senior citizens, they may not be able to attend or drive at night. A Saturday morning or weekday afternoon meeting might be better for them.
• At the meeting, provide a sign-in sheet to record the names and email addresses of all who attend. You can use this list to contact attendees later through an online newsletter.

Within 1 week after your support group presentation, send a follow-up email and appropriate additional information to attendees on your sign-in sheet. The letter should thank them for attending and let them know you are available to answer any questions. You can then add their names to your database and contact them periodically when new treatments or diagnostic techniques become available.

Ethnic communities require special attention

With so many different ethnicities in many US metropolitan areas, you may have an opportunity to attract new patients from these groups. If possible, try to learn to speak the language of the ethnic group you primarily serve—you will have an advantage in attracting foreign-born immigrants if you can speak their language. Alternatively, you can serve their needs by having someone on staff who can translate for you.

Be aware, however, that professional medical interpreters recommend employing a trained medical professional to manage the translation. Without specific training in the language and familiarity with the nuances of translating during a medical examination, diagnostic cues and treatment recommendations may be missed or misinterpreted.

Some translation services specialize in medical translation. You can contact the service and request a translator in nearly any language, including Vietnamese, Russian, Serbian, and Afrikaans, and they will arrange for a translator to arrive at a designated time. The fees are reasonable, and using such a service ensures that you can communicate with patients when neither you nor a staffer speaks the language.

It is still a good idea for you to learn some basic vocabulary, such as greetings, farewells, and the names of body parts. Not only will this make diagnoses more efficient, it will make your patients feel welcome.

Provide translations of your educational materials for patients who are more comfortable with a language besides English. If these materials are not already available from pharmaceutical or medical manufacturing companies, have the most frequently used information translated. The nearest university or college might be a good resource. The language departments at these institutions often can refer you to people who do translations on a freelance basis.

Be sure to add information to your Web site and other social media that makes it clear that you accept patients who speak other languages.

Consider writing articles for lay publications

How many referrals or new patients do you get from articles you have written for professional journals?

There is a good chance that your answer is the same as mine: “None.”

My CV lists nearly 175 articles that have been published in peer-reviewed professional journals, but I have not seen a single referral or new patient as a result. However, I have written several hundred articles for local newspapers and magazines that have generated hundreds of new patient visits to my practice.

Become a media resource: Write, be proactive, be responsive

By writing articles for the local press, you can easily become a media resource. Reporters and editors will notice your pieces. Often they will contact you for articles or ask you for quotations to be included in articles they are writing. If you are responsive, they will keep you in their database as an expert to call on whenever your specialty is in the news.

You can promote this transition yourself. When Whoopi Goldberg shared her experience with urinary incontinence on the television talk show The View, I contacted my local paper, the Times-Picayune, and offered to provide information about the problems of incontinence and overactive bladder and how an outpatient evaluation can often lead to cure of this disease.

What should you write about?

Topics of interest to lay readers in your community undoubtedly include wellness, menopause, cancer prevention, female sexual dysfunction, and vaginal rejuvenation. You can create an interesting article about new procedures, new treatments, a unique case with an excellent result, or the use of new technologies, such as new in-office procedures for permanent contraception.

Like medical skills, writing skills can be learned and polished. The more you do it, the better you get. The better you get, the more women you will attract to your practice.

Use your Web site to attract new patients

For most ObGyns, the majority of patients they serve come from within their community. A clinician’s service area usually encompasses no more than three to five zip codes or a 25- to 50-mile radius. All of us enjoy seeing a patient who has traveled more than 100 miles to see us for a gynecologic problem. Imagine the excitement when a patient from 1,000, 5,000, or even 10,000 miles away contacts your office for an appointment. This is exactly what a Web site can do for you and your practice. (Note: In a future article, I will focus on Internet marketing.)

Blogging offers an opportunity to engage potential patients

If you have a Web site, then you’ve already taken the most critical step toward marketing your practice in an increasingly Internet-savvy age. Today’s patients rely on the Internet for personal health information; they also expect a level of interaction and communication from their clinician on the Web. That’s because popular social media platforms, like Facebook and Twitter, are growing rapidly, enabling patients to use a variety of social media resources for support, education, and treatment decisions. A static Web site that consists only of your practice name, staff biographies, your office address and phone numbers, and a map to guide patients to your practice won’t cut it any longer in terms of patient expectations.

Health-care practitioners are just beginning to embrace social media—Facebook, Twitter, YouTube, and blogging—as an important component of their Internet marketing strategy. Blogging is easy, quick, and free. In many cases, a blog already is integrated with the rest of your professionally designed Web site. To get started, you just need to contribute content to the blog.

Although a blog won’t deliver an instant return on investment, it can, with time, build awareness of your practice and help promote your services to existing and potential patients. Blogs are driven by content, and a blog tied to your practice gives you the freedom to write and publish content that is unique to you and your practice. Written effectively, blogs present the perfect opportunity to interact with your patients while promoting your services.

Blogs also can improve your search engine ranking significantly. By adding new content to your blog on a regular basis, you ensure that search engines “crawl” your site more often. More important, blogs make it possible to dually publish content on other social media sites, functioning as the nucleus of your social media maintenance. Regular posts to your blog can be synced with your Facebook and Twitter accounts for seamless social networking.

Choose a snappy headline

Few patients will read a blog post with a headline that doesn’t entice them in some way. A compelling headline is essential to get your visitor to read the rest of the article and revisit your blog for new posts in the future.

Think of your blog title as a billboard. Consider that you are trying to attract the attention of drivers who have only a few seconds to look at your signage. The same is true for the title of your blog. Visitors often read the title and make a decision about whether to read the rest of the content. For example, an article entitled “Evaluation and treatment of urinary incontinence” probably would not get the eyeballs to stick, compared with a headline like “You don’t have to depend on Depends!” Doctors tend to think conservatively and may generate bland titles more suitable for a medical journal. I suggest that you think more like a tabloid journalist to attract readers to your blog.

Keep blog posts lay-friendly

Because patients will be reading your blog, remember to write for them and not for your colleagues. Be conversational and avoid overusing medical terminology that your readers won’t appreciate or understand. Try to target your writing to the 10th grade level so that you attract both educated and less educated readers. Some blog sites evaluate your writing to determine its grade level and will assist you in keeping your material understandable by most readers.

For example, Writing Sample Analyzer uses syllable counts and sentence length to determine the average grade level of your material (http://sarahktyler.com/code/sam ple.php). And the Readability Calculator at http://www.online-utility.org/english/readability_test_and_improve.jsp is also useful. In general, these tools penalize writers for polysyllabic words and long, complex sentences. Your writing will score higher when you use simpler diction and write short sentences.

Educate, rather than advertise.

Blogs should be used to support your online marketing efforts and provide patients with important information about your practice and services. A blog is not designed to be an advertising tool. Using it as such a tool will cause readers to lose interest fast. If you think education first, your material will be attractive to readers and they may call your office for an appointment.

Some organizational pointers:

• Avoid lengthy blog posts; they can lose reader interest. Pages with a lot of white space are easier to scan and more likely to keep patients reading. Say enough to get your point across, but don’t lose your readers’ attention with irrelevant information.
• Include subheadings and bullet points every few paragraphs so readers can quickly browse your post for the information they want.

Provide fresh, unique content that is new and interesting. Offer advice and tips for improved health, and inform patients about new technology and treatments that are specific to your practice. For example, if you offer a noninvasive approach to a medical problem using a procedure that is new in your community, write a post on this topic and include a testimonial from one of your treated patients. This strategy is very effective at generating new patients.

Don’t let your content get stale

Post to your blog regularly, providing new and updated content. Once you develop an audience, keep them coming back by adhering to a schedule. Every update you make to your blog counts as fresh content—a significant factor search engines use to rank Web sites. I suggest that you consider blogging at a minimum of once a week.

We are in the age of social media. The social media train is leaving the station, and you better get on board. The easiest way to start is by creating and posting regularly on your blog site.

External marketing to attract new patients to your ObGyn practice basically consists of writing and speaking. If you want to market outside your practice, you need to think about putting your writing and speaking skills into action. So, speak up and get your pen or computer working!

We want to hear from you! Tell us what you think.

External marketing is nothing more than making potential patients aware of your service and areas of expertise. The public truly does not mind marketing, as long as it believes you are communicating useful information and providing value. Nevertheless, such marketing—getting the word out to the public and potential referring physicians—takes some physicians out of their comfort zone. Some doctors think that marketing is synonymous with advertising.

The truth is, you can make the public aware of your services and expertise in an ethical and professional fashion without spending large amounts of money on advertising or hiring an expensive consultant.

How?

The essence of external marketing is writing, speaking, and making use of the Internet. In this article, I review simple, inexpensive techniques to increase your visibility among your peers and in your community. These techniques do not require additional staff or anything more than minimal assistance from your hospital’s public relations and marketing departments and the creation of a few PowerPoint slides that will hold the attention of your audience. A future article will describe Internet marketing strategies.

Try your hand at public speaking

Few of us are natural-born orators, but if you get started on the speaking circuit and acquire effective skills, you’ll be amazed at the demand for your presentations and the commensurate number of new patients filling your appointment book. When you take your message to the podium, audiences have an opportunity not only to learn more about your medical topic and how it applies to their health and wellness, but also to interact with you before and after the presentation.

Most of us have been asked to give a presentation to a lay audience at some time or another. How many of us have set off with a PowerPoint presentation from a pharmaceutical company that contains information far too technical for a nonmedical audience? Is it any wonder that so few talks motivate new patients to call our practices?

How to get invited to speak at local events

Even if you have a knack for public speaking, you still need to generate invitations for speaking engagements. I systematically contact meeting planners at various churches, service organizations like the Junior League, women’s book clubs, and patient advocacy groups, such as the American Cancer Society and American Diabetes Association. A list of these organizations and clubs can be obtained from the Chamber of Commerce in your community.

When I began public speaking, I created a public relations packet and sent it to meeting planners in the community. The packet contained a brief biography that outlined my credentials, listed organizations or groups to which I have given talks in the past, and provided a few testimonials from previous audience members. I also included a fact sheet (see the box on this page) and several articles on the topic to be covered. The articles were written by me for local outlets or written by others for publication in national magazines or other lay publications.

After I delivered a talk, I hung around to answer questions. I also made sure to have plenty of business cards to hand out, as well as my practice brochure and articles that pertained to the topic I had just presented.

Don’t overlook support groups and group appointments

Conducting a support group is an excellent way to target a specific diagnosis or disease state. If you can identify women who have a chronic problem, such as pelvic pain, incontinence, or endometriosis, and invite them to a meeting, you’ll find that they appreciate your interest and expertise and often become patients in your practice. Women who attend these meetings get to know who you are, what you do, and where to find you.

Start by organizing your current patients. I have discovered that it is easiest to start with patients in your own practice when organizing these meetings. These women know others with similar problems and soon invite them to your group.

How to start a support group

Choose a date for your meeting. Keep the following in mind:

• Select a date 2 or 3 months in the future. Decide on several possible alternative dates as well. Don’t choose a date near a major holiday. Because I practice in New Orleans, for example, I would never pick a date a week before or after Mardi Gras.
• Tuesday and Wednesday evenings are the best nights of the week. Most people do not schedule social engagements during the middle of the week.
• If your target audience is senior citizens, they may not be able to attend or drive at night. A Saturday morning or weekday afternoon meeting might be better for them.
• At the meeting, provide a sign-in sheet to record the names and email addresses of all who attend. You can use this list to contact attendees later through an online newsletter.

Within 1 week after your support group presentation, send a follow-up email and appropriate additional information to attendees on your sign-in sheet. The letter should thank them for attending and let them know you are available to answer any questions. You can then add their names to your database and contact them periodically when new treatments or diagnostic techniques become available.

Ethnic communities require special attention

With so many different ethnicities in many US metropolitan areas, you may have an opportunity to attract new patients from these groups. If possible, try to learn to speak the language of the ethnic group you primarily serve—you will have an advantage in attracting foreign-born immigrants if you can speak their language. Alternatively, you can serve their needs by having someone on staff who can translate for you.

Be aware, however, that professional medical interpreters recommend employing a trained medical professional to manage the translation. Without specific training in the language and familiarity with the nuances of translating during a medical examination, diagnostic cues and treatment recommendations may be missed or misinterpreted.

Some translation services specialize in medical translation. You can contact the service and request a translator in nearly any language, including Vietnamese, Russian, Serbian, and Afrikaans, and they will arrange for a translator to arrive at a designated time. The fees are reasonable, and using such a service ensures that you can communicate with patients when neither you nor a staffer speaks the language.

It is still a good idea for you to learn some basic vocabulary, such as greetings, farewells, and the names of body parts. Not only will this make diagnoses more efficient, it will make your patients feel welcome.

Provide translations of your educational materials for patients who are more comfortable with a language besides English. If these materials are not already available from pharmaceutical or medical manufacturing companies, have the most frequently used information translated. The nearest university or college might be a good resource. The language departments at these institutions often can refer you to people who do translations on a freelance basis.

Be sure to add information to your Web site and other social media that makes it clear that you accept patients who speak other languages.

Consider writing articles for lay publications

How many referrals or new patients do you get from articles you have written for professional journals?

There is a good chance that your answer is the same as mine: “None.”

My CV lists nearly 175 articles that have been published in peer-reviewed professional journals, but I have not seen a single referral or new patient as a result. However, I have written several hundred articles for local newspapers and magazines that have generated hundreds of new patient visits to my practice.

Become a media resource: Write, be proactive, be responsive

By writing articles for the local press, you can easily become a media resource. Reporters and editors will notice your pieces. Often they will contact you for articles or ask you for quotations to be included in articles they are writing. If you are responsive, they will keep you in their database as an expert to call on whenever your specialty is in the news.

You can promote this transition yourself. When Whoopi Goldberg shared her experience with urinary incontinence on the television talk show The View, I contacted my local paper, the Times-Picayune, and offered to provide information about the problems of incontinence and overactive bladder and how an outpatient evaluation can often lead to cure of this disease.

What should you write about?

Topics of interest to lay readers in your community undoubtedly include wellness, menopause, cancer prevention, female sexual dysfunction, and vaginal rejuvenation. You can create an interesting article about new procedures, new treatments, a unique case with an excellent result, or the use of new technologies, such as new in-office procedures for permanent contraception.

Like medical skills, writing skills can be learned and polished. The more you do it, the better you get. The better you get, the more women you will attract to your practice.

Use your Web site to attract new patients

For most ObGyns, the majority of patients they serve come from within their community. A clinician’s service area usually encompasses no more than three to five zip codes or a 25- to 50-mile radius. All of us enjoy seeing a patient who has traveled more than 100 miles to see us for a gynecologic problem. Imagine the excitement when a patient from 1,000, 5,000, or even 10,000 miles away contacts your office for an appointment. This is exactly what a Web site can do for you and your practice. (Note: In a future article, I will focus on Internet marketing.)

Blogging offers an opportunity to engage potential patients

If you have a Web site, then you’ve already taken the most critical step toward marketing your practice in an increasingly Internet-savvy age. Today’s patients rely on the Internet for personal health information; they also expect a level of interaction and communication from their clinician on the Web. That’s because popular social media platforms, like Facebook and Twitter, are growing rapidly, enabling patients to use a variety of social media resources for support, education, and treatment decisions. A static Web site that consists only of your practice name, staff biographies, your office address and phone numbers, and a map to guide patients to your practice won’t cut it any longer in terms of patient expectations.

Health-care practitioners are just beginning to embrace social media—Facebook, Twitter, YouTube, and blogging—as an important component of their Internet marketing strategy. Blogging is easy, quick, and free. In many cases, a blog already is integrated with the rest of your professionally designed Web site. To get started, you just need to contribute content to the blog.

Although a blog won’t deliver an instant return on investment, it can, with time, build awareness of your practice and help promote your services to existing and potential patients. Blogs are driven by content, and a blog tied to your practice gives you the freedom to write and publish content that is unique to you and your practice. Written effectively, blogs present the perfect opportunity to interact with your patients while promoting your services.

Blogs also can improve your search engine ranking significantly. By adding new content to your blog on a regular basis, you ensure that search engines “crawl” your site more often. More important, blogs make it possible to dually publish content on other social media sites, functioning as the nucleus of your social media maintenance. Regular posts to your blog can be synced with your Facebook and Twitter accounts for seamless social networking.

Choose a snappy headline

Few patients will read a blog post with a headline that doesn’t entice them in some way. A compelling headline is essential to get your visitor to read the rest of the article and revisit your blog for new posts in the future.

Think of your blog title as a billboard. Consider that you are trying to attract the attention of drivers who have only a few seconds to look at your signage. The same is true for the title of your blog. Visitors often read the title and make a decision about whether to read the rest of the content. For example, an article entitled “Evaluation and treatment of urinary incontinence” probably would not get the eyeballs to stick, compared with a headline like “You don’t have to depend on Depends!” Doctors tend to think conservatively and may generate bland titles more suitable for a medical journal. I suggest that you think more like a tabloid journalist to attract readers to your blog.

Keep blog posts lay-friendly

Because patients will be reading your blog, remember to write for them and not for your colleagues. Be conversational and avoid overusing medical terminology that your readers won’t appreciate or understand. Try to target your writing to the 10th grade level so that you attract both educated and less educated readers. Some blog sites evaluate your writing to determine its grade level and will assist you in keeping your material understandable by most readers.

For example, Writing Sample Analyzer uses syllable counts and sentence length to determine the average grade level of your material (http://sarahktyler.com/code/sam ple.php). And the Readability Calculator at http://www.online-utility.org/english/readability_test_and_improve.jsp is also useful. In general, these tools penalize writers for polysyllabic words and long, complex sentences. Your writing will score higher when you use simpler diction and write short sentences.

Educate, rather than advertise.

Blogs should be used to support your online marketing efforts and provide patients with important information about your practice and services. A blog is not designed to be an advertising tool. Using it as such a tool will cause readers to lose interest fast. If you think education first, your material will be attractive to readers and they may call your office for an appointment.

Some organizational pointers:

• Avoid lengthy blog posts; they can lose reader interest. Pages with a lot of white space are easier to scan and more likely to keep patients reading. Say enough to get your point across, but don’t lose your readers’ attention with irrelevant information.
• Include subheadings and bullet points every few paragraphs so readers can quickly browse your post for the information they want.

Provide fresh, unique content that is new and interesting. Offer advice and tips for improved health, and inform patients about new technology and treatments that are specific to your practice. For example, if you offer a noninvasive approach to a medical problem using a procedure that is new in your community, write a post on this topic and include a testimonial from one of your treated patients. This strategy is very effective at generating new patients.

Don’t let your content get stale

Post to your blog regularly, providing new and updated content. Once you develop an audience, keep them coming back by adhering to a schedule. Every update you make to your blog counts as fresh content—a significant factor search engines use to rank Web sites. I suggest that you consider blogging at a minimum of once a week.

We are in the age of social media. The social media train is leaving the station, and you better get on board. The easiest way to start is by creating and posting regularly on your blog site.

External marketing to attract new patients to your ObGyn practice basically consists of writing and speaking. If you want to market outside your practice, you need to think about putting your writing and speaking skills into action. So, speak up and get your pen or computer working!

We want to hear from you! Tell us what you think.

Related article Four pillars of a successful practice: 1. Keep your current patients happy Neil H. Baum (March 2013)

Related article Four pillars of a successful practice: 1. Keep your current patients happy Neil H. Baum (March 2013)

Related article Four pillars of a successful practice: 1. Keep your current patients happy Neil H. Baum (March 2013)

The medical landscape has changed. No one is quite certain what the future will hold. One thing we do know: 20 million more Americans, half of them women, will enter the health-care system in the very near future, as the Affordable Care Act continues to unfold. This flood of new patients will affect nearly every ObGyn practice in the country because we lack an adequate increase in the number of physicians to care for them. In the meantime, what can you do to ensure the continued success of your practice? This series focuses on four key areas. I call them the “four pillars”:

• Keep existing patients happy
• Attract new patients
• Nurture relationships with your medical colleagues and other health-care providers, such as physician assistants and nurse practitioners
• Maintain the morale of your staff.

No pillar is more important than the others; all four are necessary to guarantee success.

It is more cost-effective to keep an existing customer than to attract
a new one

In this article, I explain why it is vital to ensure that every patient has a positive experience of your practice, from the moment they make their first telephone call for an appointment, through their wait in the reception area, to the moment they are seen by the staff or the physician, and beyond—when they tell others about their stellar experience.

It’s nice to get new patients, but it is more important to keep the ones you already have. In most professions and businesses, the cost of keeping an established customer is one-fifth the cost of acquiring a new one. Medical practices are no exception. If you are not doing a good job with the patients you already have, spending thousands of dollars on a marketing plan to bring in new patients is pointless. The patients you have right now are the backbone of your practice.

Give your practice a checkup

Look at your practice from your patients’ perspective

Today, it is critical to know the needs and expectations of your patients and referring physicians. The best way to do this is to ask your patients what they think, which also will reveal your practice’s strengths and weaknesses. This information can be obtained easily by surveying patients about various aspects of your practice. (Even practices that are full or closed need to evaluate their services periodically and listen to their patients. Changes always occur, and the cup may not “runneth over” forever.)

Tom Peters, the nationally renowned author of In Search of Excellence, has described two keys to success in business:

• Find out what the customer (patient) wants and give him or her more of it
• Find out what the customer (patient) does not want and be sure to avoid it.

Techniques to gather the patient’s perspective

There are five effective techniques for determining how patients perceive your practice and for evaluating your performance and reputation:

• Conduct personal interviews
• Conduct patient surveys
• Create a focus group
• Use a suggestion box
• Commission evaluation by a mystery shopper.

Although I have used all five techniques, my favorite and most cost-effective involves a survey card that is given to every patient on every office visit (FIGURE 1). The card is given to the patient when she checks in, and she can complete it in the reception area or exam room and return it to the receptionist before leaving the practice. The cards are reviewed by a nurse, who addresses positive and negative comments. Most negative comments are addressed with a phone call. If necessary, I respond to the patient’s complaint.

FIGURE 1: Patient survey card

There is another benefit to the survey card. The flip side of the card prompts the patient to write down the three questions she would like you to address on her current visit to the office (FIGURE 2). Conducting the appointment according to these concerns can help keep patients from initiating a last-minute discussion, often after you have closed the chart or electronic medical record, that you don’t have time to address adequately. Since my office has implemented use of this survey card, we seldom get follow-up phone calls from patients about issues they forgot to ask about. The survey card demonstrates that we are listening to the patient and want to be certain that all her questions have been answered at the time of her office visit.

FIGURE 2: Focus of the appointment

Develop an on-time practice philosophy

You know the adage: Timeliness is next to godliness. (Actually, it’s cleanliness that’s next to godliness, but timeliness is vital, too.) The most common complaint patients have about the health-care experience is “waiting for the doctor.” Spending time in the reception area probably accounts for more patient dissatisfaction than any other aspect of medical care. In one recent survey, nearly one in four patients (24%) claimed to have waited 30 minutes or longer. With so many more women entering the marketplace, this statistic is only going to get worse.

In order to gain an accurate picture of what is happening in regard to the schedule in your practice, I suggest conducting a “time and motion” study. For a period of 3 to 5 days, place a sheet on each patient’s record or superbill and log in the following:

• time of her appointment
• time she arrived
• time she left the office
• how much time she spent with her physician.

You will be amazed to discover that patients are waiting 1 or 2 hours or longer to see the physician, and that the physician is spending only 5 minutes with the patient. Ask any patient on a survey if she feels she is getting bang for her buck, and she will answer, “No!”

By conducting a time and motion study, you will discover that there are predictable periods when backlogs occur. Often, these delays are the result of “working a patient in” to the schedule. Unscheduled patients who call to report vaginal bleeding, pelvic pain, urinary tract infection, or another problem are often told to come in without an appointment, but they inevitably displace women already scheduled and delay their visit. This problem affects almost every ObGyn.

One way to avoid this scenario is to create “sacred” time slots. These are 15-minute intervals at the end of the morning or afternoon in which unscheduled patients can be worked into the round of visits. Instead of telling the patient to “just come in,” I tell her to report at a specific time. These time slots cannot be filled with routine appointments. Nor can they be filled prior to 9 am each day. This leaves two or three slots open for patients who must be seen immediately.

Few ObGyns can change health-care policy. But all of us can be more sensitive to our patients’ time and make an effort to see them as soon as possible, thereby eliminating one of patients’ most common complaints: the long wait to see their doctor.

Make the patient’s experience memorable

All of us can provide a diagnosis and treatment strategy for most women’s medical problems. But how many of us can make the experience memorable for the woman? Often, it is a few little things that can be easily and inexpensively performed that make a big difference.

Go with cloth, not paper. There’s a sharp contrast between a paper sheet, a paper gown, and a soft robe. You don’t step out of the shower in a fine hotel and put on a paper robe. If you are offering five-star service, you need to offer five-star amenities. If you want to attract special patients, treat your patients special. It doesn’t cost that much to add a few dozen robes to your office supplies, laundering them after each use and placing them on hangers or in a plastic bag that each patient can use during her visit. I can assure you that this single idea will set you apart from most other ObGyns in your community.

Stirrups are cold! Here’s another idea: Use pads to cover the metal of the stirrups for the pelvic exam. Those stirrups are cold steel, and no woman who is already naked and concerned about her dignity wants to place her feet on those chilly structures. You can have lamb’s wool pads created by a seamstress for a few dollars—or if you prefer to go low-tech, you can use potholders to cover the stirrups.

Warm the speculum. My wife shared with me how uncomfortable it is to have a metal speculum inserted and how much she appreciated her gynecologist warming the instrument with tap water before its insertion. I have found that this saves on the use of lubricant jelly, too, because the water serves as a lubricant!

Keep the temperature in mind. Most medical offices are kept at 70° to 72° F to keep the doctor and staff comfortable. However, when a woman puts on her gown or robe, she often becomes cold and uncomfortable. On days when it is cold outside or the office is cold, use an inexpensive heater to make the room comfortable for the patient.

Talk to your patient “eyeball to eyeball.” You make big points with your patient if you speak to her when she is fully dressed and when your eyes are at the same level as hers. A woman lying on her back in a gown or robe does not hear or recall what her doctor is telling her. However, if the doctor and nurse leave the room and allow the patient to get dressed, and if the doctor sits with the patient without barriers between them, she is far more likely to listen and recall what has been discussed.

Pick up the telephone. I am often asked for my “best” idea to keep patients happy. My numero uno suggestion is to take a few minutes to call the patient at home. Which patients should you call? Women undergoing outpatient studies or procedures, those recently discharged from the hospital, and those who require a little more hand holding and attention. You can be sure that every patient who undergoes a procedure or is discharged from the hospital has questions about the findings, any precautions, medications, and follow-up. A call from a nurse or doctor does a lot to allay her apprehension—and it often keeps the patient from calling the office with her questions and concerns.

My nurse identifies key patients and contacts them at the end of the workday. She is usually able to answer all the questions but may identify two or three that require my attention. She tells the patient what time I will call so she can keep the phone line free.

Calling patients usually takes no more than 5 to 10 minutes a day and provides me with great satisfaction. Patients are usually shocked—and happy—that their physician is calling them at home. The advantages of this strategy include:

• fewer calls from your patients
• more efficient use of your time
• deep appreciation by the patient.

One patient I called at home wrote me a note that I think is worth mentioning: “This is the first time a member of your profession has taken the time to call me at home and check on my condition. Undoubtedly, it will foster a better relationship between you and me.”

The bottom line

Word of mouth was the time-honored method of attracting new patients for thousands of years. That method still works today. Ensuring that your patients have an outstanding experience during their visit is one of the smartest strategies to market and promote your practice.

We want to hear from you! Tell us what you think.

The medical landscape has changed. No one is quite certain what the future will hold. One thing we do know: 20 million more Americans, half of them women, will enter the health-care system in the very near future, as the Affordable Care Act continues to unfold. This flood of new patients will affect nearly every ObGyn practice in the country because we lack an adequate increase in the number of physicians to care for them. In the meantime, what can you do to ensure the continued success of your practice? This series focuses on four key areas. I call them the “four pillars”:

• Keep existing patients happy
• Attract new patients
• Nurture relationships with your medical colleagues and other health-care providers, such as physician assistants and nurse practitioners
• Maintain the morale of your staff.

No pillar is more important than the others; all four are necessary to guarantee success.

It is more cost-effective to keep an existing customer than to attract
a new one

In this article, I explain why it is vital to ensure that every patient has a positive experience of your practice, from the moment they make their first telephone call for an appointment, through their wait in the reception area, to the moment they are seen by the staff or the physician, and beyond—when they tell others about their stellar experience.

It’s nice to get new patients, but it is more important to keep the ones you already have. In most professions and businesses, the cost of keeping an established customer is one-fifth the cost of acquiring a new one. Medical practices are no exception. If you are not doing a good job with the patients you already have, spending thousands of dollars on a marketing plan to bring in new patients is pointless. The patients you have right now are the backbone of your practice.

Give your practice a checkup

Look at your practice from your patients’ perspective

Today, it is critical to know the needs and expectations of your patients and referring physicians. The best way to do this is to ask your patients what they think, which also will reveal your practice’s strengths and weaknesses. This information can be obtained easily by surveying patients about various aspects of your practice. (Even practices that are full or closed need to evaluate their services periodically and listen to their patients. Changes always occur, and the cup may not “runneth over” forever.)

Tom Peters, the nationally renowned author of In Search of Excellence, has described two keys to success in business:

• Find out what the customer (patient) wants and give him or her more of it
• Find out what the customer (patient) does not want and be sure to avoid it.

Techniques to gather the patient’s perspective

There are five effective techniques for determining how patients perceive your practice and for evaluating your performance and reputation:

• Conduct personal interviews
• Conduct patient surveys
• Create a focus group
• Use a suggestion box
• Commission evaluation by a mystery shopper.

Although I have used all five techniques, my favorite and most cost-effective involves a survey card that is given to every patient on every office visit (FIGURE 1). The card is given to the patient when she checks in, and she can complete it in the reception area or exam room and return it to the receptionist before leaving the practice. The cards are reviewed by a nurse, who addresses positive and negative comments. Most negative comments are addressed with a phone call. If necessary, I respond to the patient’s complaint.

FIGURE 1: Patient survey card

There is another benefit to the survey card. The flip side of the card prompts the patient to write down the three questions she would like you to address on her current visit to the office (FIGURE 2). Conducting the appointment according to these concerns can help keep patients from initiating a last-minute discussion, often after you have closed the chart or electronic medical record, that you don’t have time to address adequately. Since my office has implemented use of this survey card, we seldom get follow-up phone calls from patients about issues they forgot to ask about. The survey card demonstrates that we are listening to the patient and want to be certain that all her questions have been answered at the time of her office visit.

FIGURE 2: Focus of the appointment

Develop an on-time practice philosophy

You know the adage: Timeliness is next to godliness. (Actually, it’s cleanliness that’s next to godliness, but timeliness is vital, too.) The most common complaint patients have about the health-care experience is “waiting for the doctor.” Spending time in the reception area probably accounts for more patient dissatisfaction than any other aspect of medical care. In one recent survey, nearly one in four patients (24%) claimed to have waited 30 minutes or longer. With so many more women entering the marketplace, this statistic is only going to get worse.

In order to gain an accurate picture of what is happening in regard to the schedule in your practice, I suggest conducting a “time and motion” study. For a period of 3 to 5 days, place a sheet on each patient’s record or superbill and log in the following:

• time of her appointment
• time she arrived
• time she left the office
• how much time she spent with her physician.

You will be amazed to discover that patients are waiting 1 or 2 hours or longer to see the physician, and that the physician is spending only 5 minutes with the patient. Ask any patient on a survey if she feels she is getting bang for her buck, and she will answer, “No!”

By conducting a time and motion study, you will discover that there are predictable periods when backlogs occur. Often, these delays are the result of “working a patient in” to the schedule. Unscheduled patients who call to report vaginal bleeding, pelvic pain, urinary tract infection, or another problem are often told to come in without an appointment, but they inevitably displace women already scheduled and delay their visit. This problem affects almost every ObGyn.

One way to avoid this scenario is to create “sacred” time slots. These are 15-minute intervals at the end of the morning or afternoon in which unscheduled patients can be worked into the round of visits. Instead of telling the patient to “just come in,” I tell her to report at a specific time. These time slots cannot be filled with routine appointments. Nor can they be filled prior to 9 am each day. This leaves two or three slots open for patients who must be seen immediately.

Few ObGyns can change health-care policy. But all of us can be more sensitive to our patients’ time and make an effort to see them as soon as possible, thereby eliminating one of patients’ most common complaints: the long wait to see their doctor.

Make the patient’s experience memorable

All of us can provide a diagnosis and treatment strategy for most women’s medical problems. But how many of us can make the experience memorable for the woman? Often, it is a few little things that can be easily and inexpensively performed that make a big difference.

Go with cloth, not paper. There’s a sharp contrast between a paper sheet, a paper gown, and a soft robe. You don’t step out of the shower in a fine hotel and put on a paper robe. If you are offering five-star service, you need to offer five-star amenities. If you want to attract special patients, treat your patients special. It doesn’t cost that much to add a few dozen robes to your office supplies, laundering them after each use and placing them on hangers or in a plastic bag that each patient can use during her visit. I can assure you that this single idea will set you apart from most other ObGyns in your community.

Stirrups are cold! Here’s another idea: Use pads to cover the metal of the stirrups for the pelvic exam. Those stirrups are cold steel, and no woman who is already naked and concerned about her dignity wants to place her feet on those chilly structures. You can have lamb’s wool pads created by a seamstress for a few dollars—or if you prefer to go low-tech, you can use potholders to cover the stirrups.

Warm the speculum. My wife shared with me how uncomfortable it is to have a metal speculum inserted and how much she appreciated her gynecologist warming the instrument with tap water before its insertion. I have found that this saves on the use of lubricant jelly, too, because the water serves as a lubricant!

Keep the temperature in mind. Most medical offices are kept at 70° to 72° F to keep the doctor and staff comfortable. However, when a woman puts on her gown or robe, she often becomes cold and uncomfortable. On days when it is cold outside or the office is cold, use an inexpensive heater to make the room comfortable for the patient.

Talk to your patient “eyeball to eyeball.” You make big points with your patient if you speak to her when she is fully dressed and when your eyes are at the same level as hers. A woman lying on her back in a gown or robe does not hear or recall what her doctor is telling her. However, if the doctor and nurse leave the room and allow the patient to get dressed, and if the doctor sits with the patient without barriers between them, she is far more likely to listen and recall what has been discussed.

Pick up the telephone. I am often asked for my “best” idea to keep patients happy. My numero uno suggestion is to take a few minutes to call the patient at home. Which patients should you call? Women undergoing outpatient studies or procedures, those recently discharged from the hospital, and those who require a little more hand holding and attention. You can be sure that every patient who undergoes a procedure or is discharged from the hospital has questions about the findings, any precautions, medications, and follow-up. A call from a nurse or doctor does a lot to allay her apprehension—and it often keeps the patient from calling the office with her questions and concerns.

My nurse identifies key patients and contacts them at the end of the workday. She is usually able to answer all the questions but may identify two or three that require my attention. She tells the patient what time I will call so she can keep the phone line free.

Calling patients usually takes no more than 5 to 10 minutes a day and provides me with great satisfaction. Patients are usually shocked—and happy—that their physician is calling them at home. The advantages of this strategy include:

• fewer calls from your patients
• more efficient use of your time
• deep appreciation by the patient.

One patient I called at home wrote me a note that I think is worth mentioning: “This is the first time a member of your profession has taken the time to call me at home and check on my condition. Undoubtedly, it will foster a better relationship between you and me.”

The bottom line

Word of mouth was the time-honored method of attracting new patients for thousands of years. That method still works today. Ensuring that your patients have an outstanding experience during their visit is one of the smartest strategies to market and promote your practice.

We want to hear from you! Tell us what you think.

The medical landscape has changed. No one is quite certain what the future will hold. One thing we do know: 20 million more Americans, half of them women, will enter the health-care system in the very near future, as the Affordable Care Act continues to unfold. This flood of new patients will affect nearly every ObGyn practice in the country because we lack an adequate increase in the number of physicians to care for them. In the meantime, what can you do to ensure the continued success of your practice? This series focuses on four key areas. I call them the “four pillars”:

• Keep existing patients happy
• Attract new patients
• Nurture relationships with your medical colleagues and other health-care providers, such as physician assistants and nurse practitioners
• Maintain the morale of your staff.

No pillar is more important than the others; all four are necessary to guarantee success.

It is more cost-effective to keep an existing customer than to attract
a new one

In this article, I explain why it is vital to ensure that every patient has a positive experience of your practice, from the moment they make their first telephone call for an appointment, through their wait in the reception area, to the moment they are seen by the staff or the physician, and beyond—when they tell others about their stellar experience.

It’s nice to get new patients, but it is more important to keep the ones you already have. In most professions and businesses, the cost of keeping an established customer is one-fifth the cost of acquiring a new one. Medical practices are no exception. If you are not doing a good job with the patients you already have, spending thousands of dollars on a marketing plan to bring in new patients is pointless. The patients you have right now are the backbone of your practice.

Give your practice a checkup

Look at your practice from your patients’ perspective

Today, it is critical to know the needs and expectations of your patients and referring physicians. The best way to do this is to ask your patients what they think, which also will reveal your practice’s strengths and weaknesses. This information can be obtained easily by surveying patients about various aspects of your practice. (Even practices that are full or closed need to evaluate their services periodically and listen to their patients. Changes always occur, and the cup may not “runneth over” forever.)

Tom Peters, the nationally renowned author of In Search of Excellence, has described two keys to success in business:

• Find out what the customer (patient) wants and give him or her more of it
• Find out what the customer (patient) does not want and be sure to avoid it.

Techniques to gather the patient’s perspective

There are five effective techniques for determining how patients perceive your practice and for evaluating your performance and reputation:

• Conduct personal interviews
• Conduct patient surveys
• Create a focus group
• Use a suggestion box
• Commission evaluation by a mystery shopper.

Although I have used all five techniques, my favorite and most cost-effective involves a survey card that is given to every patient on every office visit (FIGURE 1). The card is given to the patient when she checks in, and she can complete it in the reception area or exam room and return it to the receptionist before leaving the practice. The cards are reviewed by a nurse, who addresses positive and negative comments. Most negative comments are addressed with a phone call. If necessary, I respond to the patient’s complaint.

FIGURE 1: Patient survey card

There is another benefit to the survey card. The flip side of the card prompts the patient to write down the three questions she would like you to address on her current visit to the office (FIGURE 2). Conducting the appointment according to these concerns can help keep patients from initiating a last-minute discussion, often after you have closed the chart or electronic medical record, that you don’t have time to address adequately. Since my office has implemented use of this survey card, we seldom get follow-up phone calls from patients about issues they forgot to ask about. The survey card demonstrates that we are listening to the patient and want to be certain that all her questions have been answered at the time of her office visit.

FIGURE 2: Focus of the appointment

Develop an on-time practice philosophy

You know the adage: Timeliness is next to godliness. (Actually, it’s cleanliness that’s next to godliness, but timeliness is vital, too.) The most common complaint patients have about the health-care experience is “waiting for the doctor.” Spending time in the reception area probably accounts for more patient dissatisfaction than any other aspect of medical care. In one recent survey, nearly one in four patients (24%) claimed to have waited 30 minutes or longer. With so many more women entering the marketplace, this statistic is only going to get worse.

In order to gain an accurate picture of what is happening in regard to the schedule in your practice, I suggest conducting a “time and motion” study. For a period of 3 to 5 days, place a sheet on each patient’s record or superbill and log in the following:

• time of her appointment
• time she arrived
• time she left the office
• how much time she spent with her physician.

You will be amazed to discover that patients are waiting 1 or 2 hours or longer to see the physician, and that the physician is spending only 5 minutes with the patient. Ask any patient on a survey if she feels she is getting bang for her buck, and she will answer, “No!”

By conducting a time and motion study, you will discover that there are predictable periods when backlogs occur. Often, these delays are the result of “working a patient in” to the schedule. Unscheduled patients who call to report vaginal bleeding, pelvic pain, urinary tract infection, or another problem are often told to come in without an appointment, but they inevitably displace women already scheduled and delay their visit. This problem affects almost every ObGyn.

One way to avoid this scenario is to create “sacred” time slots. These are 15-minute intervals at the end of the morning or afternoon in which unscheduled patients can be worked into the round of visits. Instead of telling the patient to “just come in,” I tell her to report at a specific time. These time slots cannot be filled with routine appointments. Nor can they be filled prior to 9 am each day. This leaves two or three slots open for patients who must be seen immediately.

Few ObGyns can change health-care policy. But all of us can be more sensitive to our patients’ time and make an effort to see them as soon as possible, thereby eliminating one of patients’ most common complaints: the long wait to see their doctor.

Make the patient’s experience memorable

All of us can provide a diagnosis and treatment strategy for most women’s medical problems. But how many of us can make the experience memorable for the woman? Often, it is a few little things that can be easily and inexpensively performed that make a big difference.

Go with cloth, not paper. There’s a sharp contrast between a paper sheet, a paper gown, and a soft robe. You don’t step out of the shower in a fine hotel and put on a paper robe. If you are offering five-star service, you need to offer five-star amenities. If you want to attract special patients, treat your patients special. It doesn’t cost that much to add a few dozen robes to your office supplies, laundering them after each use and placing them on hangers or in a plastic bag that each patient can use during her visit. I can assure you that this single idea will set you apart from most other ObGyns in your community.

Stirrups are cold! Here’s another idea: Use pads to cover the metal of the stirrups for the pelvic exam. Those stirrups are cold steel, and no woman who is already naked and concerned about her dignity wants to place her feet on those chilly structures. You can have lamb’s wool pads created by a seamstress for a few dollars—or if you prefer to go low-tech, you can use potholders to cover the stirrups.

Warm the speculum. My wife shared with me how uncomfortable it is to have a metal speculum inserted and how much she appreciated her gynecologist warming the instrument with tap water before its insertion. I have found that this saves on the use of lubricant jelly, too, because the water serves as a lubricant!

Keep the temperature in mind. Most medical offices are kept at 70° to 72° F to keep the doctor and staff comfortable. However, when a woman puts on her gown or robe, she often becomes cold and uncomfortable. On days when it is cold outside or the office is cold, use an inexpensive heater to make the room comfortable for the patient.

Talk to your patient “eyeball to eyeball.” You make big points with your patient if you speak to her when she is fully dressed and when your eyes are at the same level as hers. A woman lying on her back in a gown or robe does not hear or recall what her doctor is telling her. However, if the doctor and nurse leave the room and allow the patient to get dressed, and if the doctor sits with the patient without barriers between them, she is far more likely to listen and recall what has been discussed.

Pick up the telephone. I am often asked for my “best” idea to keep patients happy. My numero uno suggestion is to take a few minutes to call the patient at home. Which patients should you call? Women undergoing outpatient studies or procedures, those recently discharged from the hospital, and those who require a little more hand holding and attention. You can be sure that every patient who undergoes a procedure or is discharged from the hospital has questions about the findings, any precautions, medications, and follow-up. A call from a nurse or doctor does a lot to allay her apprehension—and it often keeps the patient from calling the office with her questions and concerns.

My nurse identifies key patients and contacts them at the end of the workday. She is usually able to answer all the questions but may identify two or three that require my attention. She tells the patient what time I will call so she can keep the phone line free.

Calling patients usually takes no more than 5 to 10 minutes a day and provides me with great satisfaction. Patients are usually shocked—and happy—that their physician is calling them at home. The advantages of this strategy include:

• fewer calls from your patients
• more efficient use of your time
• deep appreciation by the patient.

One patient I called at home wrote me a note that I think is worth mentioning: “This is the first time a member of your profession has taken the time to call me at home and check on my condition. Undoubtedly, it will foster a better relationship between you and me.”

The bottom line

Word of mouth was the time-honored method of attracting new patients for thousands of years. That method still works today. Ensuring that your patients have an outstanding experience during their visit is one of the smartest strategies to market and promote your practice.

We want to hear from you! Tell us what you think.