Episode 109: How Practices are Facing the Ongoing Reality of COVID

As we look ahead to the new year, COVID is still very much a reality. However, vaccinations and changes in processes have allowed for more flexibility with practice operations, providing patient care, and attending conferences. In this episode, we’ll discuss what practices are doing now as compared to a year ago, and our plans for the year ahead as in-person conferences open back up.

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Full Transcript

Announcer: It’s time to think differently about healthcare, but how do we keep up? The days of yesterday’s medicine are long gone and we’re left trying to figure out where to go from here. With all the talk about politics and technology it can be easy to forget that healthcare is still all about humans. And many of those humans have unbelievable stories to tell. Here we leave the policy debates to the other guys and focus instead on the people and ideas that are changing the way we address our health. It’s time to navigate the new landscape of healthcare together and hear some amazing stories along the way. Ready for a breath of fresh air? It’s time for your Paradigm Shift.

Michael: Welcome to the Paradigm Shift of Healthcare and thank you for listening. I’m Michael Roberts joined here today with my co-host Scott Zeitzer. Today, we’re recording episode 109, and we’re actually going to be wrapping up the show at episode 110. So we’ve been recording for about two and a half years now, and we’ll be ending our podcasting journey for the time being, though we’ve still got quite a bit of practice marketing still to come. We’re still over there at P3 Practice Marketing, and please find us at .com.

All of that said, we came into the show thinking about consumerization of healthcare and how much of an impact that was having, and how much things were changing because of all that. And then COVID. And here we are much later into this process, and we’ve been talking about how COVID has been impacting practices this whole time. Still looking at how things are changing. As we look at the year ahead, COVID is still the reality. There are things are much better than they were a year and a half ago, but things are still happening there. Vaccinations, changes in process, have allowed for more flexibility with practice operations, and we can provide patient care. We can attend conferences.

So we’re going to be talking about what practices are doing now as compared to a year ago, and what it looks like as we go into 2022 with in-person conferences opening back up and all of that good stuff.

Scott: Yeah. We’ve been dealing with COVID for nearly two years, and there are a lot of things that have almost become permanent changes with practices. Most of the practices we work with still require patients to wear masks in the office, regardless of local regulations. Things like extra sanitizing, social distancing, those wonderful stations where you get more sanitizer on your hands, they’ve all remained in place in most practices. And many hospitals are requiring employees to get vaccinated. I know that’s a touchy subject. We’re not trying to be political, it’s just a fact. Most practices who started offering telemedicine at the beginning of COVID are still doing so as an option for patients. And I have to say our friend, Dr. Ira Kirschenbaum is running telemedicine services over at BronxCare. So I think for surgical practices, ASCs have really become the standard for surgeries whenever possible.

More surgeons are working with ambulatory surgical centers, even for joint replacement procedures. Technologies and processes have improved tremendously over the years to make outpatient surgery possible for most orthopedic procedures or I’ll stick with many. I don’t know, I don’t want to overstate. And with all that, it’s important to communicate with patients on how you’re keeping them safe. And Michael, this is one of those areas where the web is so good, online is so good for easy, quick communication regarding the changing landscape.

I remember I made a mistake when COVID first hit and when it’s over, and we were all like, no. Yeah. And so I think COVID is here to stay. I think really what it comes down to is how we adapt to the ever changing landscape that is COVID. Because I think it’ll come in waves and all that other stuff. And I think I feel really good after my booster shot. So I’ve got three shots in me. I don’t know if it’s a false sense of security or not, but I think that’ll be ongoing. Don’t you?

Michael: Yeah. I think it is here to stay. We talked to in our last episode about things like web accessibility. We talked about how much that compares to things like having accessibility in your practice. You’ve got on-ramps. You’ve got all of these different things that you do, the ramps up to the door and all that kind of stuff. You’ve got all those things to take care of your patients. Communicating about what COVID safety features are or just cleanliness and safety going forward. I think it’s really going to get to a point where we start talking about just, this is like general hygiene almost, just general ways of trying to keep people safe from everything that’s going on. And yeah, COVID is a part of that too.

So I think that the sort of awareness and just thinking about this kind of stuff more, even through cold and flu season, through all these kinds of things. I’d be really curious to see what flu vaccination rates are over the last couple of years to years prior, because we are thinking about this stuff so much. We’ve had the cold sickness kind of stuff go around in our house, but I cannot tell you how much easier it is for me to not touch my face. Some of those just processes that were like when COVID start, it was just like, don’t touch your face. And the only thing you could think to do is touch your eyeball or something. Why would you do that?

We’re getting trained to think that way. We’re starting to shift. And this is a part of care now. This is a part of what it looks like. And we’ve had some practices that we’ve talked with, going back to the online component of this. Where some practices have said, let’s just go ahead and pull the COVID stuff off the site. And generally we’re trying to discourage that kind of removal there.

Scott: Yeah. It’s interesting. There was one particular practice, good friend of mine. He was like, “We’re taking it off, man. It’s done. We’re caught up. We’re all vaccinated here. They know it.” Okay. But a lot of people don’t know that. And about two weeks later, he called me back and this was before any wave or whatever, he goes, “I’m getting too many questions. I put it back up.” I’m like, “Okay.”

Michael: Just convenience overall.

Scott: Yeah. I do go back to that because I know that there’s a political charge to this that I’m trying to avoid having that conversation about. And I’m just sticking to the science and also just put yourself in the shoes of your patients, your customers, and try to make life easier for everybody. Rather than taking down the COVID information, perhaps just be very specific about what you’re doing so that your team doesn’t have to answer the same questions all the time. It’s very similar to what we talked about when I always suggest to my customers that, hey, you have the same conversations about particular procedures all the… If you’re a total knee surgeon, there is a certain conversation that you’re going to have about the procedure, what to expect perioperatively afterwards, et cetera, et cetera. And get that information online. You’ll make like the easier for everybody.

And it’s the same thing with the COVID aspect of it. Don’t hide from it. Don’t make it some sort of worrisome thing about whether you should say anything or not. So no, just put the information up there about how you’re managing your practice, whatever that is, so that you can set good expectations. It’s like everything else that we tell them to do. Right Michael?

Michael: Yeah, absolutely. Absolutely. So we’ve got this sort of, hey, it’s here to stay. I’ve been trying to stay away from the words “new normal” so hard, trying to strike that out.

Scott: I stopped myself from saying it just now.

Michael: We’re here. We’re moving ahead. And practices are really back to going for it with their marketing that they’re getting out there at “pre-pandemic levels” and trying to get those campaigns back active and running ad campaigns, reputation marketing. If they’ve got campaigns for medical tourism, which is still tricky as all get out, depending on what that looks like, what the current environment is with all that kind of stuff. But all of these pieces are back up and running. And do you think it’s like, hey, it’s just the same as it was before at this stage?

Scott: No.

Michael: It is still different with all those things.

Scott: It is different. We talked about a few things that I think are going to be here to stay. I mean, I don’t know for sure, but I really do believe that telehealth is here to stay. Now, how much it’s used, how it evolves, questions. We have questions about that. The fact that more and more work is being pushed off to an ambulatory surgical center, I think that’s going to be, I almost said the new normal, but I think that is another evolution in care that’s here to stay.

You mentioned stuff about masks not being so unusual because when it’s flu and cold season. If you happened to be lucky enough to get to travel and vacation in a pre-pandemic that was fairly normal. Somebody had a cold, it was actually considered rude not to have a mask on if you had a cold. And so they were actually able to deal a little bit quicker with the whole COVID transmission issue. And here in America, we just didn’t do that. And I wonder how much that will change. But from a care of the patient work flow, et cetera, I think some of those things are here for now. I don’t think that will change. I don’t think that will be back.

Michael: In the midst of all this where some of the surgeons that we’re working with, they’re now booked up for months again. That is some of the things that are back to where they were. There were so many procedures that were on hold, all of that kind of stuff. Now we’re trying to figure out that, hey, how do you get patients in soon enough? Because people did maybe put things off, all that kind of stuff. There’s a lot that’s changed on the practice side, everything from communication to just, hey, we’re back to full campaigns running and everything like that.

Let’s pivot. Let’s talk about conferences for a bit because we’re actually, we’re coming up on going to one here in a few weeks, depending on the release cycle of this. I can’t remember if this is coming up before or after we’ll be there, but we are going to the OSET convention there out in Las Vegas.

Scott: Orthopedic Surgery and Emerging Technologies in December in Las Vegas. Yes, yes.

Michael: Yeah, absolutely for orthopedics. So practices are getting back out there. There are these kind of hybrid models that are coming up with conferences going forward. It’s something that we’ve been talking about quite a bit, whether it makes sense for us to be in person at all these things. And some of that has to do with just being cautious around things like COVID, but some of it’s just cost. It’s time. It’s what kind of level of commitment do we need to have? So there are some different avenues for flexibility that we’re also getting out of all this, the silver lining, I guess we could look at.

Scott: Remote is probably here to stay. I think a lot of companies are embracing that. We at our company have hired some employees that are very happily working from home. And I don’t think that’s going to change a lot. There’s quite a few banks out there and institutions that I thought would never have remote. And I think that will come into play with a lot of practices where maybe the billing person doesn’t have to come in, that kind of conversation. Obviously the doctor still needs to come and see you, but you go back to telehealth and why are we making people run around for specific things? So how that evolves, we’ll come to that.

Going over to the conferences, they’re pretty packed from what I understand. They’re pretty full. And I do think that the success of a lot of these conferences will be dependent upon how they embrace what is happening now. This particular conference we’re going to you are to have a vaccination which I’m happy about. You’re required to even have a negative PCR test before you come over. How long will that last? So it made us feel, Michael, I know you and I are going, if for anybody coming to that meeting, or if you were there, I’m not sure, like you said Michael, when it’s coming out, we’ll have a big spinning wheel with lights on it. I’m not sure what’s going to go on with that.

But I think that we’re going to come back to some sort of sense of people traveling again, of people adapting. And I also think part of where we’re at now is this new adapting. Being used to the fact that it looks like this month, it’s going to be tough because of X, whatever variant is coming out, et cetera, or there’s a particular area of the country that’s worse than others, et cetera. But I think that most of the surgeons that I’ve been talking to basically are at the point where they’re just trying to keep up with the amount of surgeries that people have put off. And I will send out a little warning to all the practices out there that are listening around this. Michael, you and I have talked about this too.

So when, if you’re a surgeon and you’re like, hey man, I’m booked for three months. I said, that’s good, but it should also be an internal warning sign because how you process through that work, how you work and set expectations with your patients, how you train your staff to help do that, that’s really… So, especially for those, we work with a lot of surgeons where it’s like they’re not about volume anymore. They’re about value. And so just because you’re booked with all these surgeries, hey, that’s great. And I know you want to take care of everybody, but you might be losing on some key patients that you’re really want. Whether that’s a particular procedure that you want or because, wow, yeah, they do pay better. So that’s something to put in the back of your head about how you’re managing all that.

Michael: Yeah, absolutely.

Michael: So if you’re just joining us, this is the Paradigm Shift of Healthcare. I’m Michael Roberts, and this is Scott Zeitzer. We’re talking through just where we’re at, where practices are at in dealing with how COVID has impacted them. We are nearly two years into this process of adapting and continuing to adapt. So Scott, we’ve actually blazed through a lot of points here pretty quickly.

Scott: Absolutely.

Michael: And I’d like to think more just what next year can look like.

Scott: Sure.

Michael: For practices that we’re working with, the things that we’re hearing, there’s a pretty decent established pattern of, this is what marketing looks like. These are the things that you should be covering off on. But thinking a little bit more as we’ve been working with practices so long, we’re getting into some of those deeper levels of conversations. Like here’s kind of our general prescription. Make sure you have these features. Make sure you have these things up on your site. And then you do have those people that are willing to do a little bit more. They’re willing to kind of explore what they can do with their practice marketing, with their communication.

What are some of the things that you think are interesting that’s happening right now with clients? Some of the things that people are exploring beyond just I’ve got a website and I’ve got ads running.

Scott: Just to reiterate the ABCs, right? Here’s my website. You need a good website. You need good content on the website. You need reputation marketing. And the next step normally is some sort of ad campaign, be it a combination of Google, Facebook, et cetera. And I think what I’m seeing, so now they’re getting word of mouth out. That’s working. So you have to have that. So now you really want to start figuring how to get that word of mouth out and take it to the next level. And what I’m seeing more of is the medical tourism side of things, where you’re starting to reassure patients that it’s okay to come to me, because I happen to be one of the few people doing whatever that is. And putting more good information about that online.

I think video is becoming a bigger thing as well. It’s easier to take videos now. You don’t need the fancy videographer. Although I will say a shout out to our videographer that we use quite a bit, Max Cusimano, who’s an awesome videographer depending on what you need to do. But that being said, hey man, if you’ve got a good iPhone, you can take some decent shots. Max will the first guy to say that. Max will take it another level. But hey, I see video. I see doing a little bit more focused medical tourism, a little bit deeper dive into what you’re putting on Facebook or social media have been very helpful along those lines.

I also think that really aggressively doing reputation marketing. We have found a lot of our customers, surgeons, have gotten quite a bit out of. Because we got quite a few surgeons who say, oh, I don’t need reputation marketing. I’m really good at what I do. And it’s not really what we’re talking about here.

Michael: Yeah. And even to back up just a bit, so the concept of medical tourism, what we mean specifically, because there are a few different ways to talk about that. Right? There’s medical tourism-

Scott: I’m go into Central or South America to get procedure X because it’s a lot cheaper. That’s not, Michael, what I’m talking about. And I thank you for saving me on that, Michael. What we’re talking about is let’s just say that you’re the only one doing a particular type of surgery, and it doesn’t have to be so niche. It could just be that it’s just conferred that they have to go there, quote, “to get it done.” And you’re very well trained. You’re very well experienced at this particular procedure and you just wish more people would come in to do it. And when we talk about medical tourism, we’re talking about people may be driving and/or even flying depending on the type of procedure to come and visit with you, stay at the hotel nearby, get surgery, and either get the rehab there or get the rehab remotely depending on the type of procedure.

So that’s what we mean by medical tourism. There’s quite a few practices out there that have done quite well with that. And frankly, from a cost perspective, from getting paid perspective, these particular patients are more valuable, Michael. And when you combine that with the ambulatory surgical center and the prospect of being able to get them in and out the way that you want them to get in, the way that you want them treated specifically, because I always go back to hospitals are awesome. They’re awesome because they can take care of almost everybody who’s very sick, but that’s the negative side.

So when you go to an ambulatory surgical center for I’ll stick with total knee, hey everybody in there, they’re just doing total knees. There’s not an obstetrical nurse to be found. There’s nothing wrong with an obstetrical nurse helping out on another case in a hospital because that’s what makes hospitals great. But in this particular case that specialization and that rote over and over doing it the same. You can refer to an earlier podcast with Dr. Ballard where he gets into all that. He loves an ASC. But I think that combo medical tourism and ASCs, and then highlighting both online correctly because that’s a nuanced conversation in itself.

Michael: Yeah. Making sure that the patient feels confident every step of the way. Wait, is this another building that I have to go to? Do I now go back to the hospital? Am I going to the… That whole journey that the patient has to follow. And there are so many drop off points along the way. I don’t want to just make this like a, remember when we talked to, kind of episode because there’s so many people, I mean, we’ve done this for two and a half years now. There are different people that we’ve talked to along the way. We’ve talked to a patient advocate who talked about being there and sitting with a patient all the way through the process. And then we’ve talked with Jessica over at Care Sherpa who talks about just trying to guide people through that process more seamlessly on behalf of the practice.

So there are a lot of ways that people are trying to tackle this, but this kind of overall customer care, customer service kind of approach is still just massively important here because we have had so many changes. We have had so many things that from two and a half years ago to today are drastically different.

Scott: Yeah. The consumerization of medicine is here. It’s done. It’s not a conversation about whether it’s happening. It’s here. Now it’ll continue to evolve. It’ll continue to change. I think some CVS locations are now hiring. It was normally just a place where you’d get your prescriptions and milk. You’re going to at least have an RN there and maybe even have an MD there. So many emergency care centers where you just run in instead of going to the emergency room. I think that the fact that so many of our successful clients who embrace online as another way to get word of mouth out, they are jumping ahead of the competition. Because it’s just a fact of life now that patients who are coming to see the doctor, whether that’s a GP all the way up to some niche surgical, et cetera, practitioner, they are online checking you out.

Michael: Yeah, absolutely.

Scott: So the days of you just, you should go see doc whatever, those are over. Just take this blue pill and call me in the morning, it’s done. I don’t see that happening. I get it, there’s always going to be some population that’s going to go the way that they’re going. But in reality, the percentage now is so much higher. So if you are avoiding these conversations, I just hope you’re near retirement.

Michael: Yeah.

Scott: Like that’s fine. That’s fine. Run it any way you want, man. But if you’re just starting or you’re just coming into, I talk about this a lot where you get out of residency and you’re just trying to pay off the student loans and just get started with your life, and you’ll see everybody. It doesn’t matter. And then a few years into it, it’s, “man, this is good, but I really want to start focusing on what I’m great at, and really fine tune and hone my practice, and take advantage of the fact that I’m doing better.” And that’s our sweet spot. And I’m telling you if you’re in that spot, Michael, you’re going to have to embrace getting good information, good content, and treating your patients better.

Michael: Yeah.

Scott: You’re in a lot of trouble.

Michael: So to throw in, as we’re getting ready to wrap up here for today, throwing in one kind of curve ball to all this.

Scott: Go ahead.

Michael: Because I’m a hundred percent with you. Man, make it easier to communicate. Make it easier for people to find things they need. And all of that said-

Scott: Go ahead.

Michael: … I want to call. I want to be able to talk to somebody on the phone. Right?

Scott: Sure.

Michael: That’s still a major thing. And the funny thing is for so many of us in digital marketing, we’ve for years and years, we’re like, oh, that’s going to change.

Scott: It’s a chat bot.

Michael: Just nothing but chat bots and forms and everybody will be fine.

Scott: It’s not much of a curve ball in my opinion.

Michael: Well, you’re also the extrovert that wants to call and talk to everybody. I’m like, “Dear God, don’t make me pick up the telephone.”

Scott: I do say this. It’s like, if you’re going to spend whatever you’re spending to run your practice, we’re a small part of that getting the word out online. Goodness gracious, train your staff. I’ve said this a million times over either train your staff, hire, outsource, whatever it is. Because if you’re in that sweet spot, that zone, and you got this website, where you’re highlighting what you’re all about, and you got ad campaigns running and social media running. And if the person answering the phone says something along the lines of, “Doctor’s office,” man, you spent a lot of money, spent a lot of time, lifted a lot of heavy objects. And the person answering the phone doesn’t know what the procedure is, only knows that next Tuesday at 3:00 is available.

Michael: Right.

Scott: Doesn’t call back. You know what, man? Shame on you. Right?

Michael: Yeah.

Scott: So I get it. It’s a pain. It’s costly. It’s part of the cost of doing business. It’s just the way it is.

Michael: And there’s some major things, and just to a quick tag there. The reason I brought that up, there’s actually a survey that just came out this week, that we were actually passing around on Slack where it was still talking about there’s actually a slightly higher percentage of people in this one particular survey, but there’s this actually slightly higher percentage saying, “I want to be able to talk to somebody.” So it’s not trending down. It’s still trending back up that, yes, people actually want to talk to people. And especially if remote is the only option, sometimes you want to just be able to get that extra level of personalization.

I was going to say, there’s just overall there’s the technology side of things and how people are interacting with that technology that’s drastically changing things. Layer that on top of all that COVID has been for these past couple years and all that it will continue to be, there’s a lot to be thinking about, and how you’re communicating with your patients, and how you’re continuing to get that story out there. And that’s really what I’m trying to highlight.

Scott: Yeah. I was going to jump in with, “Don’t forget that we’re social animals at our core.”

Michael: Yeah.

Scott: And that for the last two years, we’ve all been in some way hiding. And everybody’s coming back out and they’ve read a lot of stuff, but in reality, and look I am, I’m an extrovert. I’m an introverted extrovert. I don’t even know what that means, but I’m an extrovert. And I like talking to people. I’m looking forward to being at this meeting coming up. I do usually pick up the phone before you guys do. I shouldn’t make fun of you because you don’t. And I think you need to be prepared for that. I just go back to you really got to put yourself in your patients shoes. And once you really do that, I can’t tell you how many surgeons I’ve spoken to over the years that never ever call the main line. They just call the back line. Why would they call the main line? I don’t want to wait. And it’s like, guess what? Your patients don’t want to wait either.

And I get it. A lot of surgeons listening right now are going, “Yeah, but they’ll wait to see me.” And to some degree they will, but there is a breaking point where you just lost four or five people because they couldn’t schedule the case or they couldn’t just get a human to talk to them, or they couldn’t get someone to call them back. I’m telling you it’s a concern.

Michael: For sure.

Scott: So really go hand in hand. When you’re budgeting whether it’s just time and effort as well as money or for online marketing or any type of market, you got to budget time and energy, and money to train your staff.

Michael: Absolutely. All right, that’s going to wrap for today. Scott, thanks so much for your time and as always, thank you everybody for listening.

Announcer: Thanks again for tuning in to the Paradigm Shift of Healthcare. This program is brought to you by Health Connective, custom marketing solutions for med tech and pharma. Subscribe on Apple Podcasts, Google Play, or anywhere you listen to podcasts.