Episode 89: What Word of Mouth Looks Like for Today’s Practices

Word of mouth is still a key referral engine for any practice, but it happens differently than in the past. If doctors aren’t careful, they might ignore some of the most important parts that drive their practice’s reputation. There’s a false belief that just because you’re doing a great job with your patients, everyone will understand that. But doing a great job in a patient’s mind is more than the surgery, and their experience is more than their interactions with the doctor.

In this episode, Michael and Scott discuss key considerations including bio pages, web content, online reviews, and differentiation – what sets you apart compared to other doctors?

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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 here today with my co-host, Scott Zeitzer. This show is focused on the many ways that healthcare is changing and how the consumerization of healthcare is affecting practices. We talk about this topic on a regular basis over at p3practicemarketing.com, and we invite you to be a part of that conversation. Today, let’s talk about word of mouth and what it looks like for today’s practices.

Scott: Yeah. We talk about this quite a bit, internally. To the point where I think we make fun of each other about it. This whole concept of word of mouth, it’s typically used to describe a recommendation from a friend, a family member, or, you know, another practitioner. If you talk about orthopods, you talk about primary care practice, primary care physicians, you talk about rheumatologists, etc.

And it’s an interaction that generally takes place offline. You could be in the ER, you could be doing rounds, etc, and it’s just commonplace. Most doctors, surgeons, etc, are very familiar with it. They’re trying to take care of one of their patients, they know somebody who’s good at this, who’s taking care of other patients for them. And they, you know, just trying to help the patient out and move them along to the right place. All good.

The interesting thing is that since most of these things happen offline, most of these conversations are happening offline, a lot of practices just assume they don’t need “Marketing.” It’s almost like marketing is a dirty word. I don’t do marketing. That’s what lawyers do at 3:00 in the morning. It’s like rip this check up. And no, I don’t think it’s a dirty word, of course, because part of what we do. Right, Michael? But the other part of it is, is like, it’s actually can be helpful.

I mean, when you’re a young surgeon and you’re just getting started, your number one thing is I just want to be busy. I want to get people in, you know, into the office. So a lot of those clinic visits could be, I don’t want to call them wasted, but there are a lot of clinic visits where if you’re a hip surgeon and you’re seeing somebody who has hip sciatica, you kind of tell them like, hey man, I’m not the right person. You got to go see the neurologist.

And that’s not good for the orthopod and it’s not good for the patient. So, you know, setting good expectations, getting the right referral certainly makes sense, and online marketing can certainly help with that.

And if there’s this question of like, why the heck would I pay for it? Michael, we get that a lot. You know, why would I pay for online marketing when I’m just walking around and doing my business, and I can get that done. And the answer to that is, I really do wonder if enough surgeons out there realize how much business they’re missing? Yes, you will fill up some seats by just being there, but you’re gonna miss a lot.

And Michael, you know, you and I talk about this all the time. It’s a misnomer to think that all practice, all incoming traffic is just, you know, coming from family and friends or a primary care doc or other referring doc. There are a lot of people who get referred to you that don’t go to you. You know, Michael?

Michael: Yeah. I think a lot of this has to do with those ways of referring patients. That’s still happening.

Scott: Yep. You bet.

Michael: So that’s definitely a part of the process. I think the thing that’s probably the biggest change in all of this is what the patient is doing with that information. So you just talked about like, yeah, I got the referral, but I didn’t go to that doctor.

Scott: Sure.

Michael: That’s probably the point that we’re most interested in here, is what does that leakage look like? I got the recommendation to go to them, but why didn’t they follow through? What led that person to not make that decision to follow through with that? And it’s one of those things that can just, it’s easy to discount because it’s just like, well, I can’t know. Right? I can’t know what the patients are deciding, I can’t get in their minds. So like, I guess there’s just nothing I can do about it.

Scott: Or I’m too busy.

Michael: I’ve got so many people coming through, you know, all that kind of stuff. So it does come down to, you know, I think it’s a good thing to think about. Like, when should you care about this? Right? Like, we’re into marketing so, of course, we’re going to say that marketing is a good idea. But if you’re busy all the time and you’re not seeing the patients that are right for you, this is a time when you should care. If you don’t have enough business, if you don’t have enough patients coming in the door, this is a time when you should care.

It’s looking for those different opportunities to say like, you know what, like word of mouth may not be working as well as I hoped right now, or word of mouth isn’t really doing everything I hoped it would do. Because there’s such a false belief that if you’re just a good surgeon, if you’re doing a great job with your patients, that everybody will understand that and that you’ll keep getting more patients. Just the quality of the work will speak for itself and there’s no need to do anything more than that.

Scott: Let me jump in on that. So as a surgeon, Marshall Steele, he’s made a very good living over the years of being a very good orthopedic surgeon and also kind of delving into this, getting the word out by doing a great job. And I think I want to warn all the practitioners out there, doing a great job does not mean simply having a good surgery. It really doesn’t.

So Marshall Steele actually had a quick little article in the Journal of Orthopedic Excellence and Innovation. And he basically said like, hey, I had this specific issue that required a neurosurgeon. Okay. And he found out through friends who the best neurosurgeon was for that specific surgery. Remember this is a guy who’s in the business, right? So he called that practice and before he could even get to the surgeon, his interactions were so poor that he decided, you know what, I got to go find somebody else. And he dug deeper to find another practitioner. So I’d go back who thankfully did a great job and took good care of him.

When I talk about this, I always tell surgeons and anybody in the practice, call the front desk, don’t call your back line every now and then. See what happens? You know, it’s so important. And I think I brought this up in another meeting, in another radio show, excuse me. And you know, it’s very, very important that it’s the entire conversation that’s occurring. So now I go back to this whole thing about, you know, leakage that you just brought up, Michael. You assume that every time the rheumatologist says you should go see Dr. X, that Dr. X gets the call. That is not the case, man. It really isn’t. Yes. A lot do, but not as many as you think, right?

Michael: Sure.

Scott: I spoke to a surgeon who wasn’t getting any more referrals from a couple of primary care docs that always used to refer to him. And they got bought out by a hospital system and the hospital system basically politely told the docs like, hey, if you think there’s a medical reason why our orthopedic surgeons are not up to snuff to take care of particular case, well, that’s fine. You send them out. But if you don’t, what are you doing? Sometimes that’s blatantly said, sometimes that’s, you know, quietly said or whatever.

Michael: Inferred.

Scott: And so all of a sudden that conversation about controlling your own destiny comes into place. So I do think from the perspective of word of mouth, first of all, I think we need to reset what that means. That’s paradigm shift, right? Word of mouth. It’s like, it’s not just gonna be the old school of like, well, my mom went to you, so I’m going. I do think that people are going to look you up no matter what. You remember in the old days would be like, you need to take these two blue pills. Now we got people going online going, what’s the blue pill and should I take it?

By the way, if I see one more pill commercial where you can die or something’s going to come off of you, but don’t worry about it, while they’re fly fishing, I don’t know what I’m going to do. Different conversation we can have for a different day. But I do think that there’s a couple of things. When you talk about extending your practice’s reach word of mouth, it really is about getting the right information about who you are and what you’re about, both old school and online. New school.

Michael: Let’s talk about the patient side of this, right? Like we’re talking a lot about, like, the practice referral. But also just let’s talk about like the ways that these referrals can happen. A lot of interactions are happening on social media, they’re happening through email, they’re happening through a lot of digital channels and they’re not things that you can easily observe and control.

Scott: No doubt.

Michael: Also that there’s a whole component. When they look at, you know, trying to attribute traffic and trying to attribute different pieces of information, that this is a dark network. And it sounds so mysterious and so exciting, but it’s just like, hey, it was Facebook Messenger. I can’t tell you what happened in Facebook Messenger, but it happened.

Scott: It happened.

Michael: Facebook can tell you because they’re watching everything, but I can’t tell you. But here are these conversations that are happening. And, you know, I watch how my wife interacts with what I call the mommy mafia. If you’re in new Orleans and you’re a part of these different mom boards, it’s like things happen. I don’t know how they happen, but they happen because somebody knows somebody.

Those types of networks, that’s the same thing as what the old school way of communicating used to be. The moms, I’m sure, 50 years ago had their own way of communicating like that, different gathering points, that sort of stuff. Now it’s online. So yes, there’s a lot that’s happening in person, but there’s a lot that’s happening as well online. And then all of the time that conversation leads to, I know this doctor here, here’s the site. Here, here’s the review site that reflects that doctor. Here’s the, you know, information about how that doctor provides this kind of service.

So all of this stuff that used to be just like in-person or whatever, now it is happening and that next step, it’s so easy. The easiest way to get across that information is to…

Scott: There you go.

Michael: …go, here, see. Here’s Dr. Smith. I loved Dr. Smith. He was so great, and here’s a site. Here’s his, you know, whatever it is that you’re using to point. I mean, it could be as simple as just saying, like, here’s the map listing that can tell you how to get there, but all of those map listings have reviews on them.

Scott: They do.

Michael: Every step of the way you’re getting some sort of reinforcement of this is a good process, or maybe you should reconsider. And it’s all those like, maybe you should reconsider points that practices should really be on lookout for.

Scott: No doubt about it. And, you know, and I’ve had conversations with a lot of practices over the years where they pooh-pooh the reputation scores, where they pooh-pooh what other people are saying. And I’m like, look, man, I get it. You should be proud of the work that you do, but you also should listen. That’s one part of it. And the second part of it is, I think the days of pooh-poohing any of these other resources, like, hey man, they’re there and they’re not going away.

So, you know, there’s a couple of factors that come into play here in my mind. It’s like, don’t give up on being a good person, doing a good job and talking to people and making sure people come to visit you. That old school word of mouth, definitely don’t stop. That being said, if you really do want to extend your practice’s reach, right? Hey, you would be foolish to ignore the online marketplace. It doesn’t make sense to me.

Also, a big part of this conversation when I talked to a lot of my docs, as they start to mature in their practice, most surgeons that I speak with, they start getting more focused on what they want to do and what they don’t want to do.

The young orthopedic surgeon will see anybody, right? It’s like, hey, I’m a sports medicine guy, but I’m taking care of his little trauma because I know over time, blah-blah-blah, it’s quite standard. But as you get further away from that point, you’d prefer not to be spending your nights in an ER fixing risk fractures, and really focusing on what you trained and what you were excited to train to do, whatever that fellowship happened to be.

And then I get into this conversation with these guys about value versus volume. That’s a big deal, Michael. You know what I mean? Like you could be seeing 80 guys in a clinic and be mentally and physically exhausted because you did surgery beforehand. You still have to round. But half the people that they saw weren’t people that they really…like, hey, they took the Hippocratic oath, they’re going to take care of them but weren’t really people that, you know, they thought that they went to fellowship for. Does that make sense?

Michael: Yeah, exactly.

So listen, if you’re just joining us, this is the “Paradigm Shift of Healthcare,”. I’m Michael Roberts with Scott Zeitzer today, and we’re looking through what word of mouth looks like for today’s practice. And we’re talking some about if you’re not finding the right fit, sometimes you’re just getting the wrong patients. And that’s definitely a good time to be reevaluating that word of mouth. And then looking at how that old school, you know, “old school” approach combines with how people are communicating today.

And part of what it looks like to be in that discussion is using online channels, is using various, whether you call them marketing tools or communication tools, there are digital tools that are available to help you be a part of that conversation. So, you know, Scott as we’re talking about this, like what should practices be focusing on? We’re saying we’re kind of flirting with the ideas and we’re kind of talking kind of all around some of the things that they should be looking at to really make this work. Where should they start?

Scott: Yeah. So I always go back to the ABCs. Airway, breathing, and circulation. I managed to get undergrad and grad school by working as an EMT and they hammered airway, breathing, and circulation into your head over and over and over, for good reason, and good way to keep a patient alive.

But the ABCs for online marketing, online word of mouth, would be number one, a website. You need a modern, accessible website that has all the information that you want to give to your patients on there. About you, about your practice, forms, FAQ’s, all of that good basic stuff. It’s such a win for everybody, for yourself, for the patient. So that’s your central spot, so to speak.

On that website, I kind of touched on it quickly. You need good content. So I don’t think your bio should be I went to school at X.,I love my kids, I play golf. In reality, it’s like, well, give me a little bit more about what you’re about, what you’re good at. What you’re experienced at. It’s the kind of conversation you have with your patient all the time. When the patient finally comes in, they’re going well, I’m a total knee replacement surgeon and I’ve done lots and lots of them. And you can get into what the specifics are. And I was trained by blah, blah, blah, who was, you know, at his time was one of the great, you know, total knee replacement surgeons.

Michael: It’s amazing how hard it is to write your own bio page.

Scott: I’m telling you, you’re so right about that.

Michael: Like, I hate writing my own types of bios for that kind of stuff. So, like, whether it’s somebody else in the practice or whomever, like getting somebody else to go like, well, don’t you want to talk about this?

Scott: There’s some surgeons who have no problem with it, but most of them that we talked to it’s like, please help me. And then, you know, the other thing too, this inferred knowledge thing. So, you know, I get a surgeon who says, you know, I went to Rothman and it’s like, well, I know Rothman is a great institution and I know that total joint replacement surgeons trained at Rothman are very well-trained, plainly put. But the general public really doesn’t know that. They’re not supposed to know that. And you’ve got to explain that, you know, in the bio. So, that inferred knowledge.

But getting back to the content. So we have a good website. We have good content. It’s just not about a bio. Michael, it’s about, well, what do you want to do? I always say to the surgeon, like if you could sprinkle magic pixie dust, what three or four things would you want to be found for? And I always get, Michael, I can’t tell you how many times I get, well, I want to be found for everything. I said, really? No. They want to get found for those kinds of things that they got taught to be great at, and that they want to get even better at. And so talking about those things and writing good content about those things and highlighting your expertise, and what sets you apart from others, that could be so many different things, Michael, but that’s critical as well.

Michael: I think that like differentiation, what sets you apart component? Like, I can’t emphasize how important that is. Because not long ago, you know, I had to have just a medical procedure done, but that one piece of it was what I felt like was missing from so many places. You’d go and you’d look and it says, I do excellent at this procedure. Like, cool, man, I’m happy for you, but there’s six other doctors.

Scott: What do you mean by that?

Michael: Right. There’s six other doctors saying the exact same thing. So nobody came out and just said, like I do an okay job at this particular procedure, you know, like I could squeeze you in and it would be fine. They’re all excellent at it, supposedly. They’re all trained at it, that’s fantastic. But what is it that’s going to make this doctor’s approach different from this doctor’s approach? What are the details that are going to help me make a decision?

I do this approach and I do this because of this. It’s very quick to lose a patient in that conversation so I don’t want to like get into, like, this is exactly the way that I make the incision, this is…but what are the benefits of the approach that you’re using? Why should I care about this doctor versus this doctor? Because look, we talked about it, we mentioned it a couple of times, like. the consumerization of healthcare.

My experience when I go online is to compare features and benefits now. I have the Amazon pages, I have the whatever else, you know, site. Docker’s website or whatever, and I’m looking back and forth with like, which vendor I’m going to use to get a shirt. Well, if I can get enough information…so this is our decision-making process that’s happening. Again, if we’re thinking from the patient’s side of things, I’m shopping back and forth and that can be like, I’m sure, a gross thought for doctors to think of being shopped for, you know, one versus the other.

Scott: But you are.

Michael: But this is some of what’s happening.

Scott: That’s what’s happening. I agree with you, and, you know, telling people that, like you mentioned. Like, hey, I’m, good at whatever. I’ll be silly, jumping jacks, I’m expert at it. It’s like, okay, why? Because there are four people online doing it. And again, I go back to, like, so there are some people in that word of mouth conversation where they said, you should go see Dr. X for jumping jacks. And that’s it, they’re done. They’re going to Dr. X for jumping jacks. But more and more, they’re going online going, well, I know you said Dr X is good or Michael, like you said, there’s an institution where they mentioned three or four, but I really like Bob. No one said anything, right?

But that being said, people are still going to go online now. It’s almost matter of fact. So I think it’s critical that you realize that. If you’re a practice listening and it’s critical that you realize that there is a new modality for that. And content and having good information in there about what you do, what sets you apart, etc. Michael, that makes a big point.

Michael: And just at a very simple level on how you can check with how well you’re doing on that differentiation. Go look at three other surgeons in your area. You know, pull up. Don’t worry about all the other things that we could talk about from design and accessibility and all those other kinds of things. That’s for another time. But just when you look at their bio page or their page where they’re talking about that procedure that you do, could you see why a patient would choose that doctor or you? Is there enough of a distinction between the two of you other than what school you went to?

Scott: Right. Or I’m just “Better than that guy.” It’s like, all right. Why? What is it that you do that, you know, you wish more patients knew? I mean, that conversation, like, I wish more people knew. When you talk about extending your practice’s reach, it really is. I wish more people knew that I was really one of the top rotator cuff repair surgeons in this area. I was trained by one of the best. You start going into the conversation.

You know, when we write content, we literally interview almost like it’s a school newspaper thing, and our people are very well-trained at pulling out the specific details. Because getting the right balance is always important and writing it in such a way that a patient’s going to understand it, Google’s going to index it. That’s a whole different conversation. Like we can have a whole show just on how to write good content, but good content’s important.

And I think the other part of it is online reviews. So I always shift the conversation when I talk to practices about online reviews, I always say like, look, you go online and you find out that a particular hotel looks great. You go to their website. Man, does that hotel look great. What beautiful rooms. And they say they have good food. Well, what do we all do? We go online and look it up. What are the Yelp reviews like?

And every surgeon just kind of cringed when I say Yelp reviews, because, ugh, Yelp reviews. It’s like, well, people reading them. Doctor.com reviews, Healthgrades, Google reviews. I mean, Google’s making a lot of money with their reviews because they combine it with their ads. Right, Michael? I mean, so, you know, they’re going to move it up. So online reviews become so important. They’re prevalent, they’re out there, people are looking at it. Whether you like it or not, they’re looking at it, and it’s important.

Michael: Yeah. We’ve talked with people that, you know, compare the experience to feeling like they’re being rated as an Uber driver, you know, like this, like, man. Yeah. It does matter. It does factor into decision making processes.

Again, we go back to the example of, you know, hey, go see Dr. Smith and go to the website. Hey, Dr. Smith looks like he knows what he’s doing. And I see, you know, this looks like an interesting surgical approach. And then I go look at the scores. Oof. And let’s, you know, like you could have one site even that that has a negative score, but you’ve got seven others that have great scores. Again, people are used to seeing these kinds of things and they know to, you know, make decisions around, well, hey, not, everybody’s going to be happy all the time. I get it. Some people get negative scores sometimes because they’re just angry that day or whatever.

There are a lot of different ways to approach how you improve your scores and all of that good stuff, but I think looking at it as the whole, right? Looking at it in terms of when I look at this doctor’s reviews and I see overall a trend towards the positive, that’s very reassuring to me.

Scott: Absolutely. You know, you’re talking about surgery here. So for the practice that does surgery all the time, you know, of course we’re gonna take great care of you. This is what we do. But for the patient, they’re nervous, and rightfully so. And so of course, they’re going to look up everything about you. And so if you do have a particular procedure and you’ve written about that procedure and you’re telling a story. You know, you’re setting good expectations. Like you were very well-trained, this is what you can expect. This is how our team takes care of you. Again, the reinforcement on team. If you are a surgeon, please stop thinking that it’s only your interaction or your surgery that makes up the patient experience. It is not, it’s your practice as a whole.

And that’s the big part of reputation marketing. It’s like, it’s not just about “Getting good grades,” so to speak. It’s also about, you know, listening. If, you know, your billing person is always mean and nasty, well, maybe you need to have a conversation with a billing person and just say, “You don’t need to be mean and nasty.” So all of that is important. And so when you combine website, content, online reviews, that’s the overall SEO search engine optimization. Because it’s like, I’ll talk to people and be like, yeah, but how do I do better with SEO? And I’m like, that is SEO. That is search engine optimization.

All those things combined that come together. For sure, for sure. And search engine optimization is a thing that we can go way down a very nerdy pathway, and I’m very happy to go down that pathway with people if they’re interested in that conversation. But…I will say that if you’re a marketer and helping out a practice, I can’t tell you how many times we’ve had great geek to geek, fun conversations about what you’re doing, how you’re doing it.

Michael: And so the word of mouth process like definitely exists today. I think all of these different ways that we’re talking about…moving this process online is essentially augmenting what was there before.

Scott: That’s right.

Michael: Word of mouth didn’t die, it’s just that it looks a little different now. And when they do go looking for your name, when they do go looking for your practice, what kind of information are they going to find? It’s not just your website. It’s not just the hospital’s website, depending on what your scenario is. So, you know, look for that. The way that these pieces all interact together. That’s going to teach you a lot about where any potential drop off points could be, and also how you can improve, how you can grow, how you can extend the reach of your practice. There’s a lot of different tools that are available to you. Guys, thank you so much for joining today. I really do appreciate the time for listening in.

If you’d like to learn more, please feel free to visit our website at P3 Practice Marketing. We’ve actually set up a short quiz to help practices go through this thought process and think through their approach to word of mouth and what your next steps might be. So you can find that quiz on our homepage again as p3practicemarketing.com. Again, thank you so much and have a great week everyone.

Scott: Have a great week.

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 MedTech and pharma. Subscribe on Apple Podcasts, Google Play, or anywhere you listen to podcasts.