Barlow/McCarthy Blog

Check back often to hear from our talented team of consultants. Topics covered include: Physician Relations, Physician Recruitment, Practice Marketing, Medical Staff Development, Community Health Needs Assessments, etc.

  • By: Allison McCarthy, MBA | amccarthy@barlowmccarthy.com

    I’ve been a fan of Bravo Network’s Inside the Actors Studio for some time. This Emmy nominated show is a course at the Actors Studio Drama School of Pace University. Hosted by James Lipton, each episode features a different actor, actress, director or cast being interviewed about their craft and sharing insights with an audience of master degree students.

    Interviewees are a cross section of men, women, well known and not, seasoned and new, drama versus comedy, theater, big screen and/or television, etc. Mr. Lipton takes everyone through their early years – and what initially influenced their craft. From there he explores each guest’s various projects inquiring about their reasons for choosing the engagement, how they prepared for the project and what they learned from it. Each story is both interesting and entertaining.

    Experts have long suggested that we can learn just as much from those outside our profession as within it. And I must say that I learn something from nearly every episode. Here are a few recent takeaways worth pondering.

    • Paul Newman“Everyone has talent but what you need is character. And I think tenaciousness is the single most important character trait. I’ve seen people with talent who simply think that’s enough. It needs to be combined with fierce determination to build it to optimum excellence.”
    • Alan Alda“Listening is being able to be changed by the other person – to really let them in and influence your response.”
    • Helen Hunt“I’m ok with losing a part if I do everything I can to get it. If I don’t do my all then I’m tortured. I’m always taking a class when I can or hiring a coach for voice, dance or a specific part. I write lots of notes in my scripts as reminders. It doesn’t all come naturally.”
    • Richard Dreyfuss“If I’m playing a character that I don’t necessarily like, as long as I can understand him and empathize with him I’m ok.”
    • Barbra Streisand“It’s not enough to have a preconception. You must look around and see what the reality is – what you can capture for real.  There isn’t unlimited money – there are boundaries. I love that challenge and required discipline.”  

    What lessons have you learned from those outside your profession?

  • By: Kriss Barlow, RN, MBA | kbarlow@barlowmccarthy.com

    When I saw this quote on LinkedIn, I just loved it. Of course in the case of practice marketing the “chase” and “bite” need to be expressed a bit differently! But if we look closely there is some wisdom here that works.

    Practice marketing has different levels of interest for marketing. The challenge is: the budget is generally tight, message control is variable, issues of access complicate the deliverables and let’s face it the plate was full before this was added to the mix. Just for fun, I opted to take these great shark actions and translate them into some simple reminders for the practice marketing strategy. See how “shark like” you are.

    Up Early: New practice ramp-up drives many great marketers nuts. Not because of the work involved; that’s OK. It’s the promises made without marketing or often its a lack of time to prepare. This is a system issue that becomes a marketing issue. Here’s what we’ve seen work best:

    • Create a new practice onboarding plan and then get input and commitment
    • Put it on the intranet with peoples names and process
    • Get involved early through a meeting with the physician(s) so they understand what marketing does- and does not do. Name and face count, so one personal meeting will make up for weeks of email.
    • Report on effectiveness in plan implementation

    Chasing: You need to chase the right bait. Take the time to assess the market, the need/opportunity and their aptitude for growth. Some basics belong in every practice plan while other tactics are used by need. Draw your customized tactics from a “bank” of effective marketing techniques that have worked for other practices. The chase is about optimizing the effectiveness for time spent. For example:

    • Every practice needs a solid web presence, a digital strategy and clear call to action
    • Print is optional in today’s environment. Consider the audience and the have a stable of 3-5 go-to print offerings if the audience (not the doctor) is older or if you have niche offerings that demand more education
    • Social may be a priority if your new practice is in a young, commuter market

    Setup the plan so you can pick and choose according to the market needs and streamline the implementation and dollars spent.

    Biting: If you do it, measure it. Set up systems of measurement alongside the plan so everyone will understand that some tactics will create awareness while others will encourage appointments. Practices often look at two numbers, the patient acquition cost (PAC) and  return on investment (ROI). Make sure you know expectations, your part and the practices’ role and the math- what goes into the calculation. Some organizations rely on scheduling systems, sometimes the practice has a role. Cajoling practices to help with this is painful, so put it in the plan, get them to sign off (literally) on their part and work to get ahead of this.

    Reminding: Take credit for the role that marketing plays in successful integration and growth of the employed practices. While most of the rhetoric is about pain points with our employed practices… we sure seem to continue to align! When doing your report, make sure to call out the impact you have in: involvement and engagement, communication, awareness and practice growth.

    Whether it’s Monday or another day, I like the shark analogy. While the world swirls around us, today we know that employed physicians are integral to the health system. What has worked for you to remind your stakeholders that you’re chasing, biting or reminding them of our contribution to the practice side?

  • By: Allison McCarthy, MBA | amccarthy@barlowmccarthy.com

    My husband, Joe, has mastered the art of saying “no.”  It’s his “default” response to most things – providing him with time to decide if “yes” or “no” is his final choice.  But saying “no” doesn’t come as easily to me.  It’s a much bigger challenge.

    Experts say “no” is hard because we don’t want to disappoint others and hurt our relationships.  But I’ve learned that saying no is essential if I am to successfully deliver expected results.

    Physician recruiters constantly face the “no” challenge given increasing search volume plus with growing responsibilities for onboarding and retention.  It’s particularly intense within health systems expanding by acquiring other hospitals.  The new hospital entities come with the expectation that the larger entity will improve their physician recruitment success – given the system’s brand strength and dedicated physician recruitment resources.

    Yet, nothing changes within the system’s physician recruitment function.  The team continues doing things in the same way and readily saying “yes” to more search volume – all the while expressing concern about the team’s ability to deliver results.

    I’ve learned that saying “no” can be done while still maintaining good working relationships and retaining credibility.  Its more about “how” it’s done.   Here’s what the experts suggest.

    Clarify Priorities

    Define what is most important – from both the organization’s perspective and yours by:

    • Meeting with leadership to prioritize searches based on the entities’ strategic plan or service line initiatives.
    • The Power of Focus by Jack Canfield, Mark Victor Hansen and Les Hewitt recommends a technique like the “March Madness” bracket exercise. Number each of your priorities (ex. 1-8).  Then decide which priority trumps the next and moves on to the next round.  For example, is #1 more important than #2 – that priority moves on to the next level.   Continue with #3 versus #4 until the first round is completed.  You now have identified the top 4 priorities.  Repeat the process and you have now rank ordered your priorities.
    • Defining those tasks that only you can do and delegate the rest. Practice managers, marketing colleagues or credentialing staff may not manage a site visit or nurture an onboarding physician as you would.  But it may be time to move away from the “ideal” and share more of the workload – with you providing training and facilitation support.

    Learn to Present Alternatives

    By providing options – rather than assuming full responsibility – you can demonstrate that you are a good team player and adaptable to change.  It just requires some creative thinking to identify those other approaches.  Responses to common requests might be:

    • To bring a “full court press” to this search, I would need to pull back on efforts to recruit _______, ________ and ____________. Or we could look at (resource) to help with that search.  What would be your preference?
    • I can create an (onboarding/recruitment/retention) plan and facilitate/coach/organize a team to work on this. When would you like to meet to talk through those recommendations?
    • We have several searches that are not yet fully defined and it hinders our ability to effectively “sell” physician prospects in our initial conversations. I recommend these searches be put on hold until they are ready to market.

    As a next step, set aside a few minutes and prioritize your responsibilities.  Then with that in place, the next time you’re asked to add something else to your agenda, pause and ask yourself, “Will this harm my capacity to focus on the most important things?” If yes, then consider other potential solutions and voice those as your “No.”

     

     

  • By: Kriss Barlow, RN, MBA | kbarlow@barlowmccarthy.com

    I just heard it from a Vice President this morning, “The pressure is on to make sure physician relations is delivering the right results.” Teams are fine-tuning their analytics, field skills, and metrics and really ratcheting up the talent. The result? We’re ready for success- or are we? Maximum field effort gets business to the door. But, have you ever crossed your fingers or said a little prayer that someone answers and tends to their referral needs when your prospect calls? We all have. Granted, physician relations staff can’t over-promise, yet internal obligations can make or break the difference. Here are a few of the tried and true internal alignment needs that support long-term success.

    Leader Commitment. Top-down commitment is not just a program blessing, it is visible support. The leader understands that referral growth requires more than a field team. Culture, implementation and enhanced communication impact repeat business. While physician relations can call attention to external expectations, with multitudes of priorities facing departments, even the well-intended often struggle. We end up with workarounds that result in inconsistencies. Or, one department is great, but others are not. The right tone and message from leadership puts the right level of attention on the physician relations need. When the prospective physician’s eyes are on the organization, efforts to recognize the needs of the referring physician make a difference.

    By the way, if the internal stakeholders step up, the field team has to demonstrate results. It’s a stab in the heart of the program if the field team continues to throw up roadblocks. Swallow a few, if it were perfect inside, they probably would not need field sales!

    What’s your plan to earn the right level of leader commitment? Where do you start and with whom?  Are you really ready to do your part if they do theirs? What if you don’t get the buy-in of leadership?

    Are We Ready? Today our country is filled with different physician relations needs. For some, it’s about leakage. Others’ need referral growth in a very specific market or a specific clinical area. Still, others are working on alignment. The customized physician business strategy necessitates analytics, systems, process, and functions to support the expectations of the organization and the referring physician. If you have not recently done this, evaluate:

    • Goals vs. targets. Have you refined your targeting to ensure you are reaching the right audience for the desired, specific goal?
      • Is there a desire for a selective type of growth? Some organizations are at capacity in a clinical area or for a type of payor. However, they still need selective growth. Make sure you prioritize the relationships with those you value/need most.
      • Is your organization actively moving toward value-based payment? The type of referral relationship and field knowledge will be very different for this audience.
      • Leader expectations are important. Do you know what they expect? We have some clients that will say straight up, “I need volume,” some say that they need better intelligence from the private practices. Make sure that you are set up to deliver what they expect.
    • Put the best foot forward
      • Understand how challenging it is for a referring physician to get a patient to your facility. We don’t get to decide if we are “easy enough,” the customer does.
      • Specialists buy-in and commitment is a critical link in the system. This starts with their field support, communication, ability to “work in a referral” and extends to advocacy for the program and the needs of the referring audience.
      • Once accepted, do our internal systems work? This includes communication back to the referral source, patient experience, scheduling processes, etc.  Stops and starts are really hard on the program and morale.
    • Measurement – what’s valued
      • The quickest way to a CFO’s heart is to show impact in the language they speak. Their support bolsters your value internally. Assuming you know the program is adding real value, then show it.
      • Some organizations are all about contribution margin, others want to see total volume of a specific procedure, while others might like to see shifts in payor mix. What’s the “big number” at your place and how do you show your impact on growing that number?

    Internal trust. Beyond operations and your internal specialists, can other departments like IT and planning be counted on for support? A physician relations program is reminiscent of an old saying, “No man is an island.” The most effective programs are collaborative efforts with many departments lending their expertise to create an environment that recognizes the role of the physician as a valued customer.

    If you don’t have all the elements moving in the right direction, there are choices to be made. Can you educate and gain commitment from senior leadership? What elements of readiness need attention? Can you target areas where you believe you can get some quick wins so you are allowed to develop the program with a long-term focus?

    Get creative. If you need help, get it. If the barriers are too large, continue to work with the internal team and position the value of the relationship program. Start measuring your success and encourage feedback from physicians. Soon, you’ll be positioned for success inside and out.

    Looking for more Physician Relations insight? Check out my recently completed Physician Relations Leader’s Guide. It is a complete workbook that walks you through the process of improving your physician relations skills. Valuable for both liaisons and leadership. Learn more here: Physician Relations Leader’s Guide.

  • By: Allison McCarthy, MBA | amccarthy@barlowmccarthy.com

    Does the term “onboarding” best represent the activities involved in bringing new physicians into an organization?  That was a question raised at a recent Onboarding and Retention (OAR) Chapter meeting.

    OAR members were concerned that the title “onboarding” was diminishing the function that integrates new physicians into an organization – especially with senior leaders who may perceive “onboarding” to be another word for “orientation.”

    Those responsible for new physician onboarding know it’s so much more than orientation.  It includes all the tactical activities needed to launch and grow a new physician in practice alongside the relationship building efforts needed for long-term engagement.

    Organizations with well-established onboarding programs, including the right tracking metrics, go beyond orientation by focusing on the social, relational and fulfillment needs that achieve new physician satisfaction, productivity and long-term retention. More specifically, that means working on:

    • Transfer of knowledge – helping the new physician become quickly familiar with the organizational “rules of the road.”
    • Building connections – ensuring the new physician builds a solid network of personal and professional relationships.
    • Immersion in the Organizational Strategy – by understanding how their role fits into the organization’s goals and objectives, they will feel important to the organization and a part of its success.

    While admittedly some of this is orientation, onboarding primarily centers on practice development and physician engagement.

    The OAR group considered other words to describe the startup and integration of a new physician into his/her practice.  Because “onboarding” is the term widely used by other industries to describe the same for other professional employees, the OAR members decided to hang on to that descriptor.  The challenge is not the title, but having health system leaders appreciate the full scope of onboarding.

    For more on this and other topics, consider purchasing a copy of the Leader’s Guide for Physician Recruitment. The Leader’s Guide is a comprehensive workbook designed to help you in your role as a physician recruiter. We have more details and purchasing information here: Leader’s Guide for Physician Recruitment.

  • By: Kriss Barlow RN, MBA | kbarlow@barlowmccarthy.com

    As summer wraps up we have fresh memories of getting in and out of very hot cars, people you need being away on vacation and the daily distractions of summer. We all have positive and not so positive things about our jobs. But these are not necessarily the same as feeling unhappy in the job. Forbes reports that three of four employees report that their boss is the worst and most stressful part of their job. Doing sales calls in a hot car has nothing on this stat!

    This is a tender topic to even write about. No leader sets out to demotivate their staff. Managers want to be successful and they recognize that effective staff are central to the process. But, many managers have not actively done the field role. So, while they have a great sense of the organization, the data and doctors and goals for the field effort, they often have a gap in what works in the field.

    While it has been “more than a couple” of years since I’ve been a field rep, my ears are open and my conversations with field staff are frequent. Here’s what they say.

    1. Be responsive. Field staff are motivated when they get consistent response at two levels.
    • First is timely communication within the team. Effective managers are consistent in letting team members know when and how they will respond. They offer tools for self-management where situations require it. And, they communicate how to bypass the usual systems if there is an immediate need.
    • The second need is at the organizational level.  A key gripe of a liaison is when they need to respond to a doctor and an internal reply is late or not forthcoming. They cajole, remind, ask and ask until they feel like nags and at a point it feels like others have no interest in earning the relationship and referral.
    1. Take care of the referral. Today it takes between 4-6 visits to earn an acute care referral. Field staff get really frustrated when the internal team drops the ball. Back in the day we could ask the doctor to try us again. Today, it’s one and done.
    2. Value my expertise. Field sales is a job filled with rejection. We work in a normal state of rejection that nobody else experiences, except maybe your bill collector. Feedback is essential, but field staff are a tough on the outside, tender on the inside group. They are more motivated when the conversation starts with their perceptions and things they are working on. In fact, that may be solid advice for managers in general.
    3. Manage “out of the field” requests. Everyone wants everything right now and it’s often kicked down the chain of command until it lands in the lap of the field staff. Managing impromptu requests several times a month is different for those in a field role than an office. It can drive field staff out of the field and to their desks or require after hours work. We all get that it happens occasionally. The key question is, when does occasional become repetitive and, dare we say, annoying.
    4. Consistent, involved goals. The boss sets clear goals in all good physician relations programs. It’s right and good, but can be problematic when it is done in a vacuum. Goals need to be thoughtfully created, achievable and consistent. Good field staff want to exceed expectations, so a moving target often results in motivation problems.
    5. My work, my glory. Back to the ego side of great field staff. Making others look good is foundational to a field role. Every day is spent talking up their doctors and organization. It is motivating when the team member’s story is consistently told with their name or when they are called out and given credit for a new success.
    6. Investment. People want to know that you are willing to invest in their success. For some it is skill-building, for others it’s getting them connected to the right clinical knowledge. For many leaders, it is a business or financial decision. However, for many field staff, it feels personal. While it may be a big investment to send someone to a national conference, small call outs that recognize them for great work can pay large dividends.

    If you are a staff person, likely there are a few that pop to the top of the list. Recognition is often the first step in effective change. For field staff, we can work on taking things a little less personal if most other attributes of the job are pretty good.  For managers, I suspect we all see areas where there’s more to the story. And perhaps a few topics that will resonate and need attention.

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