Episode 13: Highlights and Insights, Part 3

Take a deeper dive into the paradigm shifts discussed by previous guests Debra Stevens (Arizona Care Network), Bonnie Sheeren (Houston Health Advocacy), and Dan Dunlop (Jennings Healthcare Marketing). Join Scott, Michael, and Jared as they examine the themes of being proactive and collaborative when seeking innovation. The best outcomes occur at the intersection of what’s best for the patient and what’s best for the hospital’s business growth.

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Archive of previous episodes: https://www.p3inbound.com/resources/podcast.php

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Show Resources

1. Episode 9 – Value-Based Care Takes Flight: https://www.p3inbound.com/blog/episode-9-value-based-care-takes-flight/
2. Episode 10 – The Rise of Patient Advocacy: https://www.p3inbound.com/blog/episode-10-the-rise-of-patient-advocacy/
3. Episode 11 – The Intersection of Population Health and Marketing: https://www.p3inbound.com/blog/episode-11-the-intersection-of-population-health-and-marketing/

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 here’s 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 with my co-host, Jared Johnson and Scott Zeitzer. On today’s episode, we’re taking a look at some of the themes that have come up in recent episodes. I’d like to talk about how healthcare is doing what it can to shift to a more proactive stance.

Jared: So Michael, I think some of the…those things really have come up a lot throughout the entire season of guests that we’ve had on the program, but particularly in some of these more recent episodes, and I’m glad you brought that up. I think starting with Debra Stevens, who was our guest, you recall from Arizona Care Network, one of the ACOs, kind of a next-gen ACO as she described, and really helped us get a better understanding of what that even means.

But really all the players involved. So this theme of being proactive, it isn’t just by one audience out there, it’s really everybody in healthcare trying to get ahead of the changes that are happening. And from her standpoint, we definitely saw that talking about ACOs that are out there to not just treat individual patients, but groups of patients and not just wait until they get sick, but try to help them stay well. There was a lot of talk about being proactive there.

Then we had Bonnie Sheeren. Bonnie talking about patient advocates. It was a fascinating conversation. You know, that one talking about what that role even means and how it has evolved, and it wasn’t even a role, you know, 10 years to 12 years ago. From her standpoint, how patient advocates are there to come alongside a patient during those difficult times, and really do whatever needs to be done and talk about how different that is for each patient, which I think goes to show a lot about…so the fact that even a patient would bring on an advocate to help them through their healthcare journey says a lot about how proactive that activity is.

And then we talked with Dan Dunlop on the population health side talking about how different groups of people, really a variety of groups involved in the hospital are involved these days with population health, and it’s not just from a single standpoint. In his case, there was a lot that marketing was doing to get really useful health content out there into the world to try and connect that with their target communities to keep people well, keep them healthy, which benefits the hospital when it’s done right. And so yeah, there was definitely a theme of proactivity throughout all those. And I think the interesting thing was how they were all kind of coming from different angles.

Scott: I agree with you. I mean, ultimately, it’s about, again, this changing paradigm that we keep looking at where, hey, in this particular case, we all need to work together, we all need to listen to each other, so that we can do better for the patient. And ultimately, and this was the interesting part, it’s actually more profitable in the end. And when you look at these three different things. So Bonnie, being a patient advocate, from the ground up, “Hey, I’m gonna walk in with the patient and I’m gonna help the patient kind of through this maze that is healthcare,” especially when it’s more complex procedures, or a loved one who’s far away, it could be something fairly simple, but the loved one is far away and it’s just too much information.

And to your point, Jared, it was, hey, man, 10 years, 15 years ago, this person didn’t exist. So I found it funny when she walked in the room. At times it was like, “Who are you?” You know, and at first, like, Michael, the nurse or the doctor would be, like, a little combative. You know, “Who are you?” Right, you know?

Michael: Yeah.

Scott: And then it was like, “Wow, you know, you’re helping me. You’re helping me get the point across. You’re helping me deliver the information, follow-up on it.” You know, there’s a lot of stuff that needs to take place.

Michael: It’s interesting hearing Bonnie talking, and especially as we’re kind of quantifying this in terms of, like, the number of years ago that this person just wasn’t available. We, in our family, received a diagnosis about one of our family members, you know, having a chronic condition. And there was just this huge disconnect between the news that we got and knowing what the heck to do with the next step, you know? And so, there’s so much of, like, where I’ve talked with Bonnie and, you know, gone back and forth with her and I was just like, “I wish so much that I had known that this person existed, but they may not have even existed in our market at the time when we found out about it.” And so, yeah, like these things are changing rapidly, so, so fast.

Scott: They really are and then, you know, you move along. So here’s this thing coming from the ground up. Bonnie is saying, “Hey, I’m gonna help walk through this maze.” And then you look at the ACO, version two, I think as Debra called it, and it is version two. And so you’ve got a very large healthcare system. The other end of the spectrum, that this very large healthcare system being run by a CEO who has a vision, both near term and long term. You know, this is this funny thing, I’m the sales guy in our company and you’re the marketing guy, Michael, in the company, and I’m constantly doing stuff like, “How do we sell it now? How do we sell it now?” And it’s like, “Hey, we have to build our brand, we have to build trust, and then it’ll be easier to do these things.”

And I could see, you know, when the CEO of this ACO is having conversations with the people, the board members, etc., about, “Hey, why are we spending all this time talking about, you know, our brand, or how to be proactive, or what to look out for? Shouldn’t we be focused on how to get more surgeries?” And it’s like, “No, no, not really. Not from a really big picture. Let me show you.”

Michael: Yeah.

Scott: And, you know, Michael, but I think that’s gonna be a big part of the change. Now he’s got a lot of leverage, or she has a lot of leverage. I don’t know who runs the ACO, but that chairperson has a lot of leverage in that, hey, they run the joint, right? Dan has to get everybody together, and he’s almost like a cheerleader in a way. He’s going to a hospital that’s pretty darn big, but not big enough to solve it all. Let’s go work with all these different groups here in New Orleans.

Michael: And he was even taking an example of like a small hospital, like it was a rural hospital.

Scott: That’s right.

Michael: That was they all partnered together with several nonprofits in their area to actually bring about that kind of change. So it’s less, even less “power” to make all these things happen.

Scott: Yep. But ultimately, it really is about the patient, and getting better healthcare to the patient. That is going to be the win. There are a lot of places within healthcare where, hey, we’re not doing as well as we could be doing or should be doing. The mortality rates for certain, like, say, for women who are giving birth, are way too high for our country. Those numbers look terrible. And so it’s not just about like pointing a finger at the OB-GYN, it’s not about pointing a finger at mom.

It’s this whole community coming together to make that better. I’m impressed with how we’re trying to say, “Hey, there’s a problem. Let’s not point fingers. Let’s look at it and figure out how to come up with some solutions.” And often, it’s not one particular doctor, it’s not one healthcare provider, like a hospital. It’s a group of people. Here in New Orleans when Dan was talking about it, he was actually working with like a transportation company. Like, there were a lot of patients who just couldn’t get to care.

Michael: I think that was one of the groups that had actually come together, and he was aware of their story. But yeah, absolutely, and getting transportation for people that couldn’t take care of it. You know what’s interesting, and completely stepping outside of healthcare for a second, like the type of focus that seems to be happening. So all of these businesses recently came together, right? There’s Apple, and there’s several other very, very large companies that came together and said, “We’re not just gonna be here for the shareholders.” You know, there’s that recent news item that happened and so…and how serious they are and how soon anybody will see [crosstalk 00:08:04] change.

Jared: We’ll see, yeah.

Michael: We’re not just, you know, focused on next quarter profits. But this concept of trying to be more focused on the stakeholders, on all the people that are involved, this seems to be the same kind of thing that’s happening within healthcare. It’s not just about the hospital executive. It’s not just about how many surgeries get done. It’s about this overarching, “How do we make all of this better?” And it does require a completely different mode of thinking. It’s not the same framework of just fee-for-service and just, you know, things the way that they’ve always been.

Scott: Yeah, I agree wholeheartedly. I’ve been talking to a lot of our customers, and a lot of them are orthopedic surgeons, and they’re talking a lot about how they get bundled payments together, how they “prove themselves” to be better at providing care as an overall, right? There’s a lot of things that are done in a surgery where, hey, maybe it costs more money in a particular part of a procedure to use a particular drug or to do a particular type of physical therapy, etc., or a particular type of procedure.

And ultimately, when they talk to the insurers, and we’ll be trying to reach out and talk to some insurers as well about how they’re part of this conversation, because they certainly are, it’s like, “Hey, I get it. In the bubble itself, maybe this part, maybe this extra thing that I did, this extra step is another $300,” or whatever that is. But ultimately, it’s going to save money because if you think about how much money we spend to just try to keep kids off of cigarettes and e-cigarettes and, hey, that’s costly to do that.

Michael: Yeah.

Scott: But ultimately, we know it’s gonna save a heck of a lot of money, both in the short term of the pain of trying to get off of it, and the long term of is, God forbid, they can’t get off of these nicotine habits, about trying to take care of their COPD and worse. So I found these last three episodes to be interesting, because it’s not about the short term. It’s about the long term, and it’s not about one person speaking. It’s about a conversation.

Jared: Right, Scott, look at where we’ve come from. I mean, the whole point of the fact that there is a paradigm shift means we’re changing from where we used to be and thinking about where we used to be. And it wasn’t that long ago that there weren’t such things as ACOs, and patient advocates, and population health. I mean, all three of them are relatively new, even by our standards. And all three of them, those conversations all had to start with, “Okay. Hey, define…tell us your definition of this?”

Meaning, it’s still changing and they haven’t even been out there for that long. So I think that goes to show this everything is going to continue to evolve, and we’ve got a long way to go, but it’s that momentum. It’s the fact that there are new resources, there are new ways of thinking that are out there. And it’s crazy. Who knows what’s going to come next?

Scott: You know, Jared, I know you’ve been doing some traveling lately, right? You’ve been to two different meetings in the healthcare area?

Jared: Yes. Yeah. I recently just came back from Content Marketing World and from SHSMD, so the Society for Healthcare Strategy and Market Development. There were 1,900 attendees at SHSMD this year. So…

Scott: God, like you would think that all these marketing guys would come up with a better name than SHSMD, but okay, that’s fine.

Jared: You either giggle when you say it or, you know, you just kind of grin at the very least.

Scott: You gotta grin at the very least.

Jared: You know? Yeah. Yeah. And it turns out that actually wasn’t the name. I heard a little bit of the history about it last night that it was called something different before. I don’t recall what it was. It was some other longish acronym anyway, so I won’t go into that. So here’s the interesting part is that a lot of these pieces, so slightly different audiences or kind of narrowed audiences, right, Content Marketing World, so it was their health summit that was presented by Cleveland Clinic.

So it was very targeted, it was those who are creating health-related content for hospitals and health systems. But the room was full and there were a variety of people there, all sorts of different sizes, and demographics of their hospitals. You know, urban, rural, large, national, regional, small community chains, and so forth.

And everyone there was still trying to solve the exact same issues. And those things had to do with the fact that in my mind, when I kind of look up at what’s the macro trend? Well, I see a little Venn diagram and there’s what the patient wants, and there’s what the hospital needs to stay in business. And there didn’t used to be a whole lot of overlap between those two circles. That overlap is growing. And that’s the feeling I left both conferences with, that it’s growing even more, and that it’s because there are proactive people working to solve problems that end up helping both sides of that diagram, right?

Scott: Yeah, you know, I found it interesting, like, content marketing costs time and money. Good content marketing costs time and money. And most content marketing in healthcare is about educating the patient with good information so they know what to expect. And I remember the conversation with Dr. Smith, a pediatrician. And he had a great conversation where at first they thought he was nuts. Like, “What are you doing wasting time writing all this content? You’re just wasting time and energy. You’re not gonna make more money,” blah, blah, blah.

And again, short term, not thinking about the long-term play. And now he’s built up trust. He’s built a system that actually works and is proven to save money and provide better care. So the guy went from being kind of a pain, I’m sure, to being like a leader, right? And there’s that Venn diagram coming together and overlapping, right? It’s like, I remember talking to one of my customers about this conversation with Dr. Smith. And he pooh-poohed at first. He was like, “No, you know, you don’t need that. Like, that’s just a waste of time, all this stuff.”

Michael: That’s how all of our customers talk.

Scott: It’s just like this, my grandfather in his 80s.

Jared: He was a prospector.

Scott: Yeah. We’re gonna find gold. But he actually did have a raspy voice, so there’s nothing I could do about that. But that being said, he was very, you know, like, “Oh, yeah. I don’t wanna do that.” I kind of walked him through it. I said, “Well, let me explain how this could potentially work.” And by the end of the conversation about it, he was like, “Oh, that actually makes sense.” And I used to actually make a joke with a lot of my customers that if you put good content on your site, and you set appropriate expectations, and you answer the same questions that are asked of you every day about a particular procedure, they are going to happen.

And any doctor who’s listening to this, any surgeon who’s listening to this, etc., they are gonna be nodding their head going, “Yeah. Yeah. Every time I do procedure X, I have to answer these things.” And it’s like, “Yeah, so put it up on your site. Put it there.” And whoever you come home to that night will hug you because you’re home that much sooner. Because the conversations are shorter and better prepared, and better targeted, right? With Dr. Smith, it was like the patients were coming in, all these moms and dads were coming in and going, “Wow, I’m not crazy to ask these questions.” Or, “I would have never thought to ask this question. I would have called you back a half hour later.”

Jared: Yeah. And I think what’s fascinating about that, I can bring that back to these recent guests that we’ve had on the program, you kind of heard between all three of them, none of them have an easy job in my mind. They each have challenging stakeholders. And yet, all three of them were, in my mind, optimistic people in general, right?

Scott: Right. Right.

Jared: And there’s…you know, I consider myself, like, kind of cautiously optimistic, right? I know that it’s commonly said there’s a thin line between optimistic and delusional, you know? So there’s those that are wildly optimistic and rose-colored glasses and all that. I’d still like to think, you know, I’m a glass is half full kind of person, but informed, right? So recognizing that things aren’t always rosy. But look at the progress that these guests have been telling us about how even though there are still challenges with what they have going on, there is progress. That’s a reason to be optimistic. You know, we can just sit here on the sideline. And I guess this is something that all of our guests so far they’ve been good examples of not just sitting back and complaining about something. They are all examples of people who have gone and done something about it.

And with content, and with anything, with digital marketing, or websites, or whatnot, these couple of conferences I just attended, even though those were the kind of the topics, the points that would come up in these sessions would have more to do with the fact of what messaging we have to put out there and why. And the fact that it really can satisfy both sides of that diagram we talked about, making life [crosstalk 00:16:52] for patients and improving the bottom line of the business. Because let’s face it, you know, hospitals going out of business doesn’t help anybody, so we still need to have both.

That’s where a lot of people get stuck. They think it’s one or the other. They think, “Well, if we do these things to make patients happy, then it’s gonna cost us money and, you know, we’re gonna lose our margins, and we’re not gonna meet some business objective.” Yeah, well, not if you’re doing it right. And a lot more hospitals are doing it right. A lot more providers are figuring that out. And they’ve done it because they have been proactive, Michael, like you were saying at the very beginning, that they have found ways to be proactive and go do something, go act on it, and just carve out one part of it that they can do better and make better. And that’s what I found fascinating with all of our guests recently.

Scott: But, you know it’s funny. Michael is our marketer, and I’m the sales guy. And I’ve worked in very large organizations for a very long time. I’ve worked at Pfizer, Johnson & Johnson, Stryker, and then, of course, this small business that I do now. And, you know, the conversation between sales and marketing hasn’t changed a lot, no matter how big or small you are. I’ll come into Michael’s office about, “Something needs to happen now.” And Michael will give that kind of wry smile back to me about like, “Hey, man, I get the short-term conversation here, but we gotta think long term too.”

And so any marketing person that’s listening to this knows that, hey, ultimately, they’re gonna have to prove themselves over time. But those types of proving mechanisms aren’t as “easy.” And I put easy in quotes for a salesperson. A salesperson says, “Hey, you told me I had to sell $1,000 and I sold $1,100. Yay, for me.” Right? And marketing puts together these long decks going, “Hey, man, here’s why it’s helping us in the near future, and here’s why it’s working in the distant future, and here are some measurement tools.” No doubt about it, and it’s part of the thing I love about Martech. But Michael, ultimately, you are still gonna have to sell some of the brand objectives of the positive side of this, right?

Michael: Absolutely. I just actually read before we started recording today a newsletter…

Scott: I’m impressed that you’re reading. It’s great.

Michael: Thank you. Thank you. I’ve been working on that. So there’s a guy named Scott Monty who sends out a weekly newsletter, I think, several newsletters. But one of the things that he talked about was this trend that some companies are moving away from having chief marketing officers, and they’re moving just towards chief revenue officers. And so it’s this whole…this is a battle that’s happening, again, across industries. It’s not just healthcare.

Scott: Right. Not just healthcare.

Michael: All these different kind of stuff. But so here are some companies saying, “I don’t think that the long-term plan is worth it. Let’s just focus on, ‘Show me the money. Show me exactly what transactions we can improve, exactly how we can line this all up.'” And there are, you know, things like doing a podcast, things like doing, you know, these kind of bigger branding efforts that we’re doing.

Scott: Right. Of course.

Michael: That’s why we’re here, you know, that’s part of it. Part of it, we are fascinated to see where healthcare is going. We are a business. You know, we have objectives that we’re trying to match, too. But all of this is definitely like on a softer level when you’re talking about branding exercises. You’re trying to tie things together and you’re trying to be a part of conversations that are going to improve the overall environment of what you’re doing. And so there are metrics that you can start putting together around very specific scenarios for that. But it’s a battle, again, that I think that everybody is having to go through right now. And everybody is having to try to figure out, where do we land in this space?

Scott: Sure. And you know, when it comes to healthcare, it really is higher stakes. We’re not talking about whether company X or company Y makes it or how much profit they make. Ultimately, what we’re talking about here is how do we take better care of patients? That’s the win. Now, again, the hospital, the provider, the insurer in our current state here in the United States has to make money while we do this. That’s the way it is right now. And what I’m seeing is the win is whether it’s a short-term or the long-term play is more communication, right?

Michael: I’m interested also in the flip side of it, because, you know, the three of us, we all work in healthcare to some degree. But also, like all of us are patients.

Scott: Absolutely.

Michael: All of us are family members of patients. And so this concept of the patient that’s able to engage a patient advocate, the patient that’s able to…you know, thinking all the way back to when we had Robin come on the show, and talking about these sort of larger groups of patient advocates that are out there that are helping make people more aware of their conditions, that sort of thing, there’s a sort of level of communication where we’re all trying to become more proactive patients as well. We’re trying to do what we can.

Scott: And we need to be, so I agree with you.

Michael: And we need to be. So I’ve got a family member, an elderly family member that is not capable of managing this information on her own. And so it’s that side of things where I’m very encouraged to see that we’re coming at that problem in a number of ways. Because whether it’s because of age, whether it’s because of just the ability to comprehend the materials, even if we do right for, you know, an easier audience, even if we do make it simpler, it’s still a very complicated decision.

And then there may just be people that we can’t reach with good communication tools. They don’t have access to internet as easily. They don’t have access to…maybe they’re not coming across the commercial that the drug company put on TV or whatever that messaging is that’s trying to be more proactive.

Scott: It’s a very valid point. You know, first of all, so Bonnie Sheeren, who the patient advocacy, who’s private, will we start to see this because it is so helpful, where they’re actually hired by the complex medical systems to say, “Hey, it’s actually smarter to have somebody hold your hand as you walk in the door to this large hospital.”

When I came back from the…that day, I came home, and I said, “You know, your mom and my mom both are stubborn in their own ways.” You know, because as you get older, and I am getting older, I’m becoming more stubborn and I know my parents are more stubborn. I remember having a conversation, it was a simple problem, where somebody might have had gout. And I’m remote, and I’m asking questions, and they’re getting very combative like, “I do not drink too much wine.”

I’m like, “I didn’t say that you did drink too much wine. I’m just wondering whether or not you have gout?” “Well, I don’t think that it is.” It’s like, “Well, why don’t we go see someone and you can take tests?” And I said, “We have to hire somebody.” Because I love my parents, and by the way, they didn’t have gout and they were correct. But I was just asking questions. And wouldn’t it be great to just have good information, and how do we empower people?

So here are these generations that, you know, there’s a generational thing happening where certain levels of acceptance, you know, are here. To your point about the demographics, Ira Kirschenbaum, an orthopedic surgeon in the poorest congressional district in the United States. The conversations that he has and has to have, and what he needs to do to provide excellent orthopedic care is very different than somebody at a suburb in Cleveland for the Cleveland Clinic, say, in Beachwood, which is a very nice suburb of Cleveland. I know that because my wife is from Cleveland and her family is from Cleveland. It’s beautiful out there. The Cleveland Clinic is great. But that’s a different conversation occurring in Beachwood, Ohio versus what’s happening in New York City. You’re right about those demographics changing.

And that’s what I found interesting about Dan, and how he’s getting different groups together. You know, so in a very rural community, it’s like, how do you even get the word out over thousands and thousands of miles, right? And it’s gonna take more people communicating, more people talking to each other, and more people thinking long term. I’ll say it over and over, you gotta think more long term than short term. And that’s coming from Scott Zeitzer the salesperson, who only was, you know, coming into your office going, “How do we get more sales tomorrow?” And you’d be like, “You gotta calm down, man.” Right?

Michael: Absolutely. Activate it now.

Scott: Yes, that is Michael’s thing, that I am the activator. There’s no doubt about it. I get that a lot, Jared, I get bothered a lot about wanting to fix it now.

Jared: Hard to imagine, but I think I can picture that.

Michael: Guys, we’ve covered a lot in today’s episode. Thank you so much. I really am through all of these conversations that we’re having, very encouraged by the direction. I think that there are…there’s definitely challenges that we’re facing. There’s definitely a lot of I think new things that we’re highlighting that have to be resolved. There are new challenges that have to be solved in order for all of these models to kind of come to fruition, but people are solving them. It is happening in different pockets in different ways. You know, there’s only…I can’t remember the number of ACOs that are out there that are kind of on this newer model. It was a relatively small number.

So this isn’t everywhere. There isn’t one solution that I think is going to fit for every single market or anything like that. And I think that that’s a lot of opportunity for that. I don’t think there’s like any, you know, inevitable model that we’re just all gonna have to submit it to, you know? But I think that there’s a lot of different possibilities that are out there in the current paradigm. You know, throw that word around a little bit. Within the way that healthcare is set up right now, there are tons of opportunities. People are doing things right now. So that’s really exciting. I think.

Scott: I agree.

Michael: So, guys, thank you so much, and thank you again for listening.

Announcer: Thanks again for tuning in to “The Paradigm Shift of Healthcare.” This program is brought to you by P3 Inbound, marketing for ortho, spine, and neuro practices. Subscribe on iTunes, Google Play, or anywhere you listen to podcasts.