Episode 95: How COVID-19 Is Continuing to Change Patient Behavior

The recent surges in COVID cases and new variants mean that we aren’t moving to a “post-COVID” existence just yet. Patients feel more uncertainty than ever, and they want to be able to look to their providers for guidance. Join Michael and Scott as they share tips for practices to make convenience a priority, proactively get information to patients, and help them feel safe.

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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 healthcare is changing and how the consumerization of healthcare is affecting practices. We talk about this topic on a regular basis at P3 Practice Marketing, and we invite you to be a part of that conversation. Toda, we’re looking at the ways COVID-19 is affecting patient behavior, particularly when it comes to communication needs between practices and patients.

Scott: Yeah, there is a lot of recent searches going throughout the entire United States with the new variants. And this particularly is Delta. And I think everybody’s realizing that we aren’t moving to a post-COVID existence just yet. It might even just be an endemic, you know, and part of our lives for some time. So, you know, really things are so varied at this point, depending on, um, where your practice is located. Some states and regions are putting more restrictions back in place and other places, maybe those safety measures never stopped. It’s just a lot of different rules depending on where your locality is. And I know certain areas of the countries are, they haven’t changed anyway in way where they manage it. It’s still pretty relaxed. And we can all argue that some other day. The main takeaway that I’m thinking about from all this is that patient behavior is continuing to change as a result of COVID. And many of those changes, Michael, I think, are going to become the norm.

Michael: For sure. I actually just saw an article this morning that was talking about even just like the shopping changes that we’ve all made. You know, like how many people have made some sort of change in their behavior and how many of those people are likely to keep that behavior on through like, whatever happens next. And that’s the thing, what happens next? Like there’s still so much that’s up in the air around all this kind of stuff that like, there’s no easy end in sight. Last year, we were on the show and we’re talking about like, “Yeah, man, like in the fall,” you know, “That’s it, like everything is getting there.” All those patients that sat on the sidelines, they’re going to be able to come back in and get all those procedures done. And, and there is some pent up demand and, and, you know, orthopedic practices, like the ones that we work with so much, like they are seeing some of that, but it’s very uneven. And then depending on which state you’re in, have they had to shut down again, have they had to deal with any of those kinds of things? So there’s just so much going on there. So you’ve got

Scott: So you’ve got this different set ofboundary conditions, depending on your locality. Some have relaxed rules, some are more restrictive, et cetera. But I really do think this is critical, no matter what the “mandates” are, rules are, et cetera, patient behavior is still changing. So a couple of things along those lines, number one, hey, there are some patients who are essentially going to require that they go to a place where there are mandates of some sort in place. Whether that’s like, “Hey, is everybody vaccinated at your, your shop?” Or whether that’s, “I really need to make sure everybody’s wearing a mask,” or whether that’s, “I don’t even want to come in. I just want telehealth options.” Um, I think that being very upfront about what you’re doing and what you’re not doing and what those options are on your call tree, on your website, et cetera, are going to be critical to setting the appropriate expectations for your practice.

Michael: Yeah. And let’s dig into some data around that. Cause you know, over the past year and a half, there’s been a lot of different studies that have been done around patient behavior change. And it’s interesting because you know, as we’re recording this, we are very much in the throes of Delta and dealing with all the things that are going on there. Some of the data that we have to talk about is sort of that first wave of it. And the reason that we have this and not the Delta stuff is because we don’t have the updated information yet, right? Like so much of this stuff is still evolving. We’re figuring this stuff out day by day, but let’s talk about some of the initial waves, some of that information to come out that came out. So from an SPH Analytics study, this is like a division out of Press Ganey.

They did a study and of the 2000 respondents surveyed between May 5th and May 11th of last year of 2020, only 29% of their doctor, said that their doctor had reached out to them with information about the virus. So this is right in the middle of everything’s like completely blowing up, only less than 30% say that their doctor reached out to them about something there. And then from a McKinsey study, “How COVID-19 has changed the way us consumers think about healthcare.” This is also data that came from last year, but among the 80% of respondents who reported having a primary care physician, 11% were considering changing their PCP, their primary care physician, primarily because of dissatisfaction with their physician’s response to the pandemic, a lack of telemedicine appointments, and a lack of communication related to the, the entire, you know, the whole mess of it.

Scott: Yeah, this goes back to my statement about like look, if you’re an orthopedic surgeon, you’re not going to get into a long conversation about the epidemiology of COVID. You’re not getting into a conversation about, you know, the variants, et cetera. But darn it, you’ve got to set standards for your practice. You’ve got to let your patients know what to expect. Things are changing. And I really mean this. Like, especially when you talk about ortho, orthopedic surgeons who deal with older patients, like the total joint side of things, it’s like, hey, there are a lot of scared people out there still. Set what you want it to be. I’m not a medical doctor. So I’m certainly not going to tell you what to do, but if you believe that masks and or the fact that you’re all vaccinated or whatever, the 180 degrees from that, like you don’t believe in it and whatever, put it up there, right?

You want to set good expectations. We talk about this all the time with just general patient education, about the tons of procedures and pathologies we talk about when we talk about content marketing. You know, you want happier patients, set good expectations. Same thing goes with COVID and, you know, that’s where our website quite frankly, is really helpful. Updating your call tree? Yeah. That’s hard. You know, you might even have to actually hire somebody, hopefully, you know, when it comes to your, your website, you’ve got some sort of content management system. If you don’t, you’ve got a good relationship with your developer and, you know, you’re taking a look at what your COVID protocols are. And they should be up there, man. They’ve gotta be up there, because you’re gonna lose patients without even knowing you lost them.

Michael: Yeah. The opportunity costs on those kinds of things is always so hard to like really truly know. It’s interesting because like, as we’re having these conversations, we’ve been having a lot of conversations with clients recently about things like opportunity costs and things like communicating clearly. So that for a number of reasons, right? To help the patient feel more confident about booking an appointment to start going through that process. But you know, you do have those patients that will cross state lines to be able to come and get care, you know, with the best surgeon, with the best physician in this type of area. And so, of that specialty, but do they know what to expect when they get there? I mean, when I was, we had a business trip not too long ago, and you know, I fly Delta and Delta is like, “Hey, make sure you’re checking all the things that you need to have when you land, because what it’s going to be in that state is probably not what it is in your state. So make sure that you have this kind of information.” So, you know, other places are at least raising awareness of travelers, of consumers, and they’re doing what they can to start bringing those health concerns to the forefront. There was this odd lull where we got through, we got through the first wave.

Scott: We kind of did. If Delta wasn’t around, man, you know, the Delta variant, not Delta, the airline, maybe we’d all still be a little flippant about being able to go wherever we’re going.

Michael: So some of that information that we were really hammering last year about making sure that you’re communicating. I think people started, yeah, people started feeling like, “Well, maybe I can pull that off my site. Maybe, you know, telemedicine isn’t as important anymore. Maybe some of these kinds of things aren’t as, as big a deal.” But we’re in Louisiana recording this and it’s an awfully big deal down here. And in a lot of other parts of the United States as well. So this is something that keeps getting attention. That’s going to keep coming back up.

Scott: And I think, Michael, for me, the takeaway from this whole conversation is, and I think everybody’s kind of wired similarly. It’s like, “Hey man, I made it!” You know, if you’ve got your vaccine and all that. Or if you’re worried about it and got your vaccine, I should say. And I think you should be, and I think you should get your vaccine. That’s my big statement of the day. That being said, I think that all the practices, to your point, Michael, were taking a step back and going, “Okay, I think we’re done now. You can pull the COVID stuff down.” It’s like, don’t pull the COVID stuff down. The COVID stuff’s going to be with us for awhile. Make sure you’ve got your COVID page. Now the takeaway should be,  “Don’t pull it down.” Rather, what, like maybe make it once a month, once a week, depending on what, where we are in the surge and your beliefs and how you’re managing your practice, but hey man, regularly take a look at what you got up there, so that you don’t have a lot of angry patients. Or you have patients leaving you and you don’t even know it.

That’s that opportunity cost thing, where you have no idea that they left, because you have no information. I think the telehealth part, right, Michael? We were talking about this, the telehealth part. I think it’s going to be here to stay. Now how you integrate that into your practice, we’re going to set that aside for another podcast, but heads up everybody, we’re going to be talking a little bit about that.

Michael: Yeah, that’s definitely coming. Yeah. Yeah, and you know, going along those lines of like where practices can and should be communicating that. Like, you know, what else are you advising practices on right now? Like, what are those conversations like?

Scott: Big picture, it’s like “Set expectations well.” Whether it’s about COVID, whether it’s about what pathologies you treat and don’t, what procedures you want to do and don’t. It’s kind of along the same lines, the same big picture. And we work with a lot of practices on their website, on their content on the website, on reputation marketing, and then, you know, a lot of Facebook, where that can be changed as well. So when I talk to them, it’s always about like, “What’s going on on your site? What’s your front desk talking about? Have you trained them, when they’re coming in the door to back up what you have on the site? What are you putting online? Like, are you on Facebook? Are you on Twitter? Well, put some information there as well.” And I want to circle back very quickly to that front desk, that’s got to suck up all of this.

Do you have a mask requirement? Well, they’re the ones who are enforcing it, everybody. Walk them through it. Make sure they know it’s on the site. Walk through the philosophy. Get everybody on the same page. Take the time to train your staff. I think that’s really, really critical, because there’s a wide range, to put it mildly, of opinions out there about the virus, about what to do about the virus, et cetera, et cetera. And that’s up to your practice to go figure out. But that’s what I really tell them. It’s like getting back to basics. What should they be prepared for?

Michael: You know, talking about like, um, there was a boss that I used to work under that would have the line of, he loved slogans, loved all the different phrases that you could throw out there. You know, “You can’t expect what you don’t inspect.” So like what’s that, that sort of like review process that you have in place? But you know, if there are things like, you know, call recordings, that sort of stuff, to be able to review, how are, how is your front desk doing at getting across some of this, this kind of information? We have conversations that I have definitely been a part of recently where it was, “Hey, the expectation was this, but the reality was this and it was not the same thing.” And it wasn’t necessarily like, it didn’t result in terrible patient care or anything like that. But it was definitely, definitely a miss in terms of what could have happened. And in really helping that patient feel comfortable with the process, be able to get to results faster, to be able to get where they needed to go.

Scott: You know, Michael, we talked about this when COVID first came out, how, “Hey, the paradigm shift of healthcare is about the consumerization of healthcare.” It’s a big part of it. And how COVID has exacerbated this consumerization. It’s here. So along those lines, you know, when you’re scared, and a lot of patients are. Like, “I don’t want to go in.” Somebody that I know very well basically dropped their dentist cause the dentist kind of pooh-poohed COVID and was like “Whatever.” And the guy was basically like, “So I’m going to have my mouth wide open for a half hour, 45 minutes. And you don’t believe in the virus? I’m out!” Moved all the records–done, gone, bye. And you know, I’m telling you, I understand that.

And in your own practice, this is happening with ortho, spine. You know, like remember the old days, like it was like, “Well, I’m the orthopedic surgeon, I’m the spine surgeon.They’re lucky to come to me. I’m so busy. I’m so good at what I do.” And it’s like, probably true. You probably a very good orthopod, a very good spine guy, whatever. But with COVID, now people are asking a lot of questions. And one of those questions is, I don’t know if I want to come visit you. Maybe I’ll go travel somewhere. Maybe I’ll go where COVID’s less. Maybe I’ll go with it as an ambulatory surgical center. “But I have one.” Yeah, I don’t see it on your site. I don’t see any conversation about it.

So look, if you’re just joining us, this is the Paradigm Shift of Healthcare. I’m Michael Roberts joined here by Scott Zeitzer, and we’re talking about the ways that COVID-19 is continuing to change patient behavior. One of the things that we’re talking about here is how practices are communicating with patients. And Scott, it doesn’t necessarily have to be, we were talking to someone about the front desk already, about how that process is looking. There’s part about how the physician himself or herself communicates. Who, who else can, and should be a part of that process?

Scott: It’s interesting. And again, this is about that change, about what’s happening in practices where any medical question had to be handled by the surgeon, by the doctor. And that’s just not the case, especially if you think about it at larger institutions, that’s certainly not the case. And I think a lot of the smaller practices out there and need to start thinking in a similar manner. So, hey, at a minimum you should be training your staff to have better conversations with your patients about who you are, what you’re about, and of course about COVID. Maybe now’s the time to start hiring, uh, thinking about hiring a physician’s assistant who might be able to take care of a lot of phone calls, a lot of patient information, a lot of expectations-setting, even reviewing some of the work, so that your, you as the surgeon, you as the doctor, can really focus on what you want to focus the most, and not yet another conversation about the difference between, say, sciatica and the need for a hip replacement. Perfect example of one.

And again, you really gotta train that, that PA to work well as a team, and it can work very, very well. I think that if you do a good job of training your staff and you’ve got the right staff in place, you’re really setting yourself up for not only keeping your patients, attracting potential patients. And this is a big thing, it’s like, listen, I don’t know what the hourly rate, and you guys can all figure that out. You know, just, just figure out what your salary was last year and, you know, divided by whatever 40 times 52, blah, blah, blah is. And I, I get that you work more hours than that, but whatever your hourly rate is, do you really want to spend an hour having a conversation about sciatica?I’m just asking. I don’t think so.

And this is where like, hey, if you trained your staff better, whether it’s your nurse, your front desk, your PA, et cetera, my goodness, not only are you taking better care of your patients, I think you’ll end up being more profitable. Failing to inform the patients on how you are keeping them safe could result in patient leakage, delay in care. Michael, I think that McKinsey study more than one in three consumers have demonstrated that they are willing to delay healthcare if they do not feel that physical locations are safe. So I go back to like, how’s your office set up? How are you taking care of them? Remember like at the height of COVID, everybody was like waiting in the car before they came in? Are we going to go back to that? Because you know, I get it, man.You may not be that worried about it. You may be double vaccinated wearing a mask, whatever, but you really got to put yourself in your patient’s shoes. Especially like, hey, they’re 80 and they might need a hip replacement. You really want them sitting in there? And frankly, it doesn’t matter as much about what you think, it matters more about what that patient thinks. Maybe you need to go back to that, but you need to set expectations correctly. And if you don’t, man, you’re going to be wondering like, what happened? If you’ve got info, if you’ve got an ambulatory center, now’s the time to highlight it.

Michael: Yeah, I think that just because there’s like a sign on the door, you know, that people are driving past that location, they’re not going to put that together necessarily, right? Like, “Oh, is there a new ASC over there? I bet Dr. Smith is, you know, operating there too.” Like, people aren’t making that leap in, in the conversation, so like really being able to draw that out. And I think so much of this past couple of years, the need to over-communicate has just become more and more apparent. And I’ll even go back to this, you know, consumer survey that, that I read from this morning, like talking about like how much like people are making, they’re making decisions kind of on the whim, you know, like, hey, I saw this information and now I made a change in my purchase behavior. I made a change in my decisions because of what I saw.

So, so much of what we were doing in terms of online communication, so much of like of my training, has been around “What are people searching for? What are people showing interest in? What are they, like, what are they raising their hand and saying, you know, I’m interested in this thing?” This is the thing that I want to be focusing on, but we’ve got so many decisions that are happening today based on just pure exposure. Like, I had to put this on like advertising terms, right? Like we were completely like “Paid search, pay-per-click kind of advertising on Google. That’s where you need to go all the time.” But decisions are being made with display ads. And probably not display ads, cause nobody actually clicks on those and they get a terrible return. But you know, if they’re done really well, it is possible. And Facebook ads and those kinds of things, like, those kinds of things can get that sort of interaction, and it is starting to affect people more and more.

And I think that, it’s interesting because it’s not just about, you know, we’re talking a lot about safety and we’re talking a lot about like, what the patient needs in this situation, but there is a lot where people are now just starting to go like, “Hey, wait, health care can be convenient? Holy crap, holy crap. This is amazing.” You know, and people are really starting to look for that. Going back to the same McKinsey study, and just in case you’re joining us later on in the show here, we’re talking about the study “How COVID 19 has changed the way US consumers think about healthcare.” This came out last year from McKinsey. They found that more than one in four survey respondents highlighted frustrations of not feeling listened to. Never in healthcare! I don’t know, you know. Not feeling listened to or not being able to meet administrative needs such as scheduling appointments at convenient times.

So again, this is something that, it’s not necessarily new that I would say, it’s kind of surprising that it’s only one in four, actually this study, but maybe this is still under that mindset of like, “Well for healthcare, it’s not that bad.” There’s so many things that are, that are changing from expectations. You know, you think about how like, one click shopping, you know, from, from Amazon, like how easy that is, and this is such a first world problem, but how frustrated do you get when you have to fill out the whole form? And you’re like, ugh, and it’s so silly because I have to put my credit card information. And again, you know, and I use OnePassword to save some of that kind of stuff so it still makes it faster. But sometimes when it doesn’t happen seamlessly, you know, I’m just like, “Ugh, I just can’t believe it.”

But this is what we’re talking about, right? This is the consumerization. This is that need to over-communicate to make the process as seamless as possible, to start reducing the friction that people are dealing with over this kind of stuff. So yes, practices are going through a lot. Practices have been through like a major hit last year. They’re going through ups and downs this year, but it’s still, still so important to focus on making sure that patients have what they need. And this, again, this affects like your patient attraction, your ability to bring in new patients, but your ability to retain them as well. Having decent scheduling tools, if it’s possible, depending on what type of practice you’re in, if you have any kind of weekend appointment times or anything like that, and it’s definitely going to depend practice by practice, right? So we’ve talked some about telemedicine, the fact that we will be talking about that more, but so there definitely continues to be a demand for telemedicine beyond just that initial surge. Like we are seeing that again, from a convenience standpoint, if I can get away, “get away” with being able to do a telemedicine appointment set up, than having to go in, man, I’d much rather be able to do that right?

Scott: With, without a doubt that over-communicate part–it’s so critical. So there are some surgeons out there that may or may not have an ASC, that may be part of the answer to how they’re keeping people safer. There are some hospital systems where they basically designated building X as being like, “This is where we do all of our surgeries now. There is nobody with COVID. We have extra steps that we’re taking.” I smile when I say “there’s nobody with COVID.” What I mean by that is you’re tested before you come in, you’re coming back negative. We’re allowing you to have your surgery, whatever that is. But over-communicate what that is so you can reassure patients. You know, there’s a book out there called “The Power of Habit.” It’s one of those business books, you know, that you buy and you go like, “Ooh!” And habits are being reformed right now.This major change is reforming habits.

And so all those people that just picked up the phone and called you before, because their primary care provider said, so are now going online. And they’re like, “Hey man, before I even go, I want to know how they’re going to protect me.” What? You know, that’s why we’re going back and harping on, on this. Why it’s critical that you set good expectations, because patients are changing that the way they pick, and part of the conversation and who they opt to go see is what your thoughts are on managing your practice during COVID. And telehealth, I think, is definitely here to stay. How you involve that in your surgical practice, wow man, that’s a lot different than, say, the pediatrician, don’t get me wrong, but certainly telemedicine is here to stay.

Michael: Let me go back and, um, just kind of give like a little bit more detail here on, on this, on another study that I’ve been mentioning. So the article that I read this morning was called “Five Dramatic Post-Pandemic Consumer Buying Behaviors.” I’m a big fan of Mark Schaefer. I’ve definitely talked about him on the show before, some of the content that he’s shared, but this is an article that came out today. So just a few of the facts that really kind of stuck with me. And I’m reading these, so I’m, I’m not that good at remembering, but I can find it quickly. A staggering 81% of consumers admit they have changed their shopping habits since the start of the pandemic. 81% have changed their shopping. You talk about habits–81% have changed in that, in that particular way. 92% say they will continue their new behavior in the long term, and 66% of consumers say their mobile phone is their most favored shopping tool.

So again, let’s, let’s just kind of connect the industries here, right? Like you’ve got your purchasing habits that you’re now forming. You’ve got these new ways of, of, you know, showing your behavior all of a sudden. And now you’re just going to completely abandon that when it comes to healthcare? No way! Here, this is definitely like the, the thing that you’re going to be using more and more. So like just a personal, like in our house, we, you know, we order our groceries online a little bit, and we order our groceries online, and my wife does the whole order on her phone. And it just like that process of doing such an engaged thing, but just on a small device, like blows my mind as I I’d hate to do that, I would hate to have to choose it that much.

So all this to say, there’s a whole lot that has gone on, that’s changed, that hasn’t gone away. Right? And I think we were all hoping mid-summer last year, that by this point, we’d be talking about how this was in the past, and how we’ve recovered, and all of those kinds of things. COVID is continuing to foster a lot of uncertainty around patients and drive behavioral change. They want to be able to look to their providers for guidance. So it’s just so critical for practices to keep over-communicating, to keep looking for all the channels, to be over, to, to be able to over communicate on and remove those obstacles that are preventing patients from getting care. That’s a lot to cover today. Thank you so much for everybody that listening. Thank you, Scott, for your time today. And everybody be well out there.

Scott: Yeah man. Stay safe. Everybody get your vaccine.

Announcer: Thanks again for tuning into 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.