Welcome, everyone, to the webinar, Building Relationships in the Commission. My name is Ted Annis. I'm the Senior Marketing Specialist at the International Hearing Society, and I'll be your moderator for today. Our expert presenter today is David Huxley, from the Clean Health Consulting Company. I would like to introduce Seth as a Marketing Manager, Sam Bennett, who is the Senior Presenter and Sales Representative for the Health Care Industry. He has over 25 years of experience in the pharmaceutical industry and medical device sales, as well as 11 years of experience in physician marketing for U.S. audiology companies and privately owned audiology practices. We're very excited to have Bob as our presenter today, but before we get started, we have just a few housekeeping items. Please note that we're recording today's presentation so that we may offer it on demand on the IHS website in the future. This webinar is available for one continuing education credit through the International Hearing Society. We've uploaded the CE quiz to the handout section of the webinar dashboard and can be downloaded at any time. You can also find out more about receiving continuing education credit at our website, ihso.org. Click on the webinar banner to see the upper right-hand section. Tomorrow, you'll receive a link to a survey that we asked you to take just a moment to Today, we'll be covering the following topics. Principles of Key Account Management, Relationship Marketing, Building Staff-to-Staff Relationships, and How to Get Started. At the end, we'll move on to a Q&A session. You can send us a question for any time by entering your question in the question box on your webinar dashboard. It's usually located to the right by the top of the webinar screen. Now, I'm going to turn it over to Bob. Either way, Bob. Thank you very much, Ted, and thank you very much, International Hearing Society, for inviting me to give this presentation this morning. The main goals of today's presentation are to introduce you to the concept of marketing your practice to physicians and developing partnerships in patient care. We're going to cover Principles of Key Account Management. We're going to cover Relationship Marketing, Building Staff-to-Staff Relationships in Physicians' Offices, how to get started in this process, and then we'll answer questions at the end. The first thing that you have to decide in building a partnership in patient care with primary care physicians is who is going to represent your clinic. Will that be the provider? Will that be the clinic manager? Will that be the front office manager? Or will it be somebody from outside your clinic? That's the first thing that you have to decide. Then, you have to embrace key account management strategies, similar to how the pharmaceutical companies market their drugs to doctors' offices. This is the most successful form of marketing in the history of medicine, and I would strongly encourage you to get a copy of Principles of Key Account Management from your website or from me, and begin implementing that process in marketing your practice to primary care doctors. We have to have key high-level management buy-in, which means you're the provider. Then, we have to appoint a key account management champion. That would be a representative outside your clinic. Then, we have to identify the key accounts. That would be the physician's clinics. Primary care physicians means family practice, internal medicine, and some specialists like endocrinologists, cardiologists, and pulmonologists. Then, we appoint and train this key account manager in external marketing practices. We have to set the right metrics. We have to define our target market. Usually, you can start with, say, around 25 physicians. The average number of patients in a busy physician's office is 2,000. Say you're looking at a patient population of 50,000, of which 20% cannot pass a 25 dB hearing screening in their worst year for everybody over the age of 12 years of age. You're looking at around 10,000 patients who would test with loss. Then, the next metric that you want to set is you want to be in 8 to 10 clinics per day. You should try to block yourself out of your clinic for at least two hours plus, once a week, in order to call on your target market. Now, we'll talk about benchmarking and building as we go through the presentation. This physician liaison or professional development representative needs to be familiar with science-based marketing strategies, which means they've got to be comfortable in reviewing clinical research articles, providing those to doctors, discussing the abstract, the first two paragraphs in those articles, and, of course, discussing the summary, which is where the call to action is, which we want the physician to review and make a decision as to how it's going to change the way they practice medicine related to the hearing-impaired patient. Creating a service rep model means that there's got to be somebody inside your practice who supports the person outside your practice. This inside sales representative is the one that you would direct calls to when a physician's office calls and wants to set up an appointment and has questions about hearing loss, tinnitus, or dizziness and balance disorders. Then, between the internal rep and the external rep, they can coordinate the request and get the right information back to the doctor's office. Now, information for you is that one in every four physicians' practice is owned by the hospitals or large corporations. I also want you to know that approximately three-quarters of visits to primary care doctors' offices do not result in a face-to-face meeting. You cannot make a decision about the success of a program between your practice and the doctor's office based on whether you see the doctor or not. You have to do what the pharmaceuticals do, which is implement a total office call strategy. Educate everybody in the doctor's office about the disease state of hearing loss, the negative consequences of uncorrected hearing loss, the benefits of care, and the reasons why they should refer those patients over to you. This takes a long time. You have to be patient and let relationships develop. Let's talk about that as we go through this presentation. Now, it says on this slide that you need to think about essential multi-channel marketing strategies. By that, I mean having a physician liaison in the field once a week, calling on a target market. We also want to be able to do email marketing, telemarketing, marketing through your websites, and of course with webinars where you offer CEUs to physicians to show up or to clock in and listen to a presentation by your provider. A key objective in making a call on a doctor's office is where you seek to be added to the database of specialists to whom they refer. When the doctor walks out of the exam room, he says to the medical assistant, schedule Mrs. Brown for a hearing evaluation. The medical assistant goes in the computer and looks up the choices of providers or specialists, especially the ones that are closest to where Mrs. Brown lives or closest to where the doctor practices. You need to make sure that you're in that database, and that's got to be a key objective of any marketing program between your practice and the doctor's practice. Physicians are mostly concerned about three key objectives when treating a patient. One, efficacy, two, side effects, and three, cost. It's very difficult for a doctor to get a patient efficacy if there is lack of patient engagement, which simply means that providers and patients working together to improve the patient's health. Barriers to getting patients to efficacy are patient cannot hear the doctor, there's verbal instructions, two, untreated hearing loss results in depression about 12% of the time, versus 6% of the time for people whose hearing loss has been treated or they do not have hearing loss. So depression is a barrier to getting the patient efficacy because those patients have a three-fold greater incidence of lack of patient engagement, and that frustrates the doctor. But you, working in partnership with the doctor and their staff, can help that patient hear again, so the doctor has good communication. You, by treating the hearing loss, can potentially avoid a problem with depression that interferes with the doctor's communication with the patient, and the doctor will surely appreciate what you have done for that patient and for his ability to get the patient to efficacy. Now, hearing health care providers have to develop a marketing pathway to the primary physician through their staff. You have to use your communication skills when you arrive at a doctor's office to partner with the physician's staff so that they will carry your messages back to the doctor's desk, to their own desk, and they can all work together to make sure that patients who do have hearing loss are referred to you. Relationship marketing centers around lead generation, which is the number one priority of practice, around customer experience management, and tailored access with targeted information using multi-channel marketing strategies, which we've discussed, and using customer relationship management software. But what I'm focused on today is lead generation. You have to leave your practice, so if somebody has to leave your practice and go to the doctor's offices with the goal of educating them and with the goal of establishing relationships with everybody in that practice. Relationship marketing is a facet of customer relationship management that focuses on customer loyalty and long-term customer engagement rather than shorter-term goals like customer acquisition and individual sales. Now, you can probably think of some big box retailers who are mostly focused on finding new patients and patient turnover and refitting that patient about every three years as opposed to maybe every five years like you do. The goal of relationship marketing is to create strong, even emotional customer connections to a brand that leads to an ongoing business, free word-of-mouth promotion from customers that can generate leads. In the world of marketing, the new direction that most major companies are going is figuring out how to establish an emotional connection to a brand. Now, you have to establish an emotional connection to the people who work in your practice. Your patients have to feel like they are emotionally connected to you, and you have to make an effort to be emotionally connected to your patient as does every member of your staff. Simply Google emotional marketing on your computer and you'll find all kinds of great ideas on how to accomplish this. Customer personalization is still tone-deaf in the world of audiology because we don't train our providers on establishing bonds with our patients, our customers, our clients. Establishing emotional bonds with them is what binds them to your practice. So everything that you can do, read, practice about this will only enhance your customer's loyalty to you. And it's about the customer life cycle, not just closing the deal. If a patient is diagnosed at the age of 30 and their life expectancy is 85 years of age, you have 55 years to treat that patient as your customer. So you have to do everything in your power, as do all of your staff members, do everything in their power to establish this emotional connection to that patient so they stay loyal to you. In that 55 years, you'll fit them with approximately 11 pairs of hearing aids. At a big box retailer, their goal is to replace them every three years. So they will potentially fit that patient 18 times. Now I'm going to ask you, which is better for the patient? 18 fittings or 11 fittings? Which is better financially? Well, you can price your fittings appropriately so that you can compete with any big box retailer by making 11 fittings during a patient's lifetime versus 18. So building customer loyalty with surprise and delight marketing, an example of that would be after Mrs. Brown has been successfully treated by you to give her some coupons to the movie theater so she can go see movies because she can hear those movies now. It isn't just sending a birthday card, it is doing other things that surprise and delight your customers so that they want to come and see you. You can be creative with that. Building these staff-to-staff relationships, physicians have questions on what they expect from a specialist. Harvard Medical School published an article recently called Selecting a Specialist. They ask these questions when they want to refer a patient to a cardiologist, a pulmonologist, an audiologist, or a hearing and speech specialist. Let's just go through some of these questions. Before we do, I want to just focus on internal marketing, that person that is inside your clinic who is going to support the external marketing representative. Traditional marketing communications play a relatively small role in creating customer love. Marketing isn't what marketing people say it is, marketing is what customers say it is. Every point of contact with your clinic that customers have is an opportunity to evaluate you, to decide if they're going to stay with you, to decide if they're going to refer their family, friends, and co-workers to you after you've successfully treated them. Every single person in your practice is a marketer, from a warm voice on the phone to a warm smile when they walk in, to a cup of coffee when a patient needs one, to providing understandable billing, to providing follow-up phone calls. All of that creates customer love, and that influences your reputation and your patient to patient referrals. Hearing health care clinics that practice great internal marketing recognize that the most valuable marketing media are the people who work for your clinic, and the best companies, the best hearing health care practices focus on customers both outside and inside the clinic. If you practice great internal marketing and know your brand's promise and everybody keeps it, everybody in the clinic will raise their performance to meet the standards that you expect and to meet that brand promise so that the customer's expectations are met when they walk through your door. Your external market-facing brand can never be better than your internal brand because it's the people inside your clinic or practice who create the customer experiences that make possible your external brand. So what happens inside influences everything you do on the outside, and there has to be congruency between both, and there has to be good communication between both, and good morale and good support between employees. The best measure of a strong internal brand is if everybody in your clinic has a shared belief in who you intend to be, and they can only be who you wish them to be by you articulating your message of what it is you expect them to become in order to represent that practice to your customers and patients. And that's what you want to aim for because it unifies your team in creating an overall experience of brand harmony for your patients and your customers. So being the brand is an empowering imperative. It's something that people want to do in order to improve their ability to do their job and improve the profitability of the practice. So share with people what the brand is so that everybody understands what they need to do to be the brand. Hearing health care and medicine, that's you and doctor's offices, have to be aligned in your patient care priorities. We'll talk about that as we go through this presentation. So questions that are frequently considered by physicians when making referral recommendations, this is from Harvard Medical School, are these. Does this hearing health care practice have enough expertise with the problem for which the patient requires consultation? Do other physicians also refer to this specialist? Can the patient schedule an appointment with the hearing health care provider in the appropriate time frame? Will you clear your schedule for sudden hearing loss if you're capable of doing those evaluations if it's within your scope of practice? Is the hearing health care professional's location easy to get to? I provide pads and maps to every single doctor that I call on so that people can find where you are. Findability is important. Make it easy for people to find you. Does the hearing health care professional accept the patient's insurance? You need to let doctor's offices know you do all the paperwork that you're not going to add to their workload. You'll find out if there's full or partial patient coverage and you'll provide information about other insurance plans and payment plans that customers and patients can avail themselves of. Does the hearing health care professional communicate well with patients and their families? What is the quality and promptness of the hearing health care professional support staff and the quality of the facilities? They have to be impeccable. They have to be up-to-date. They have to have the latest magazines. They have to have warm coffee. They have to have comfortable chairs. All of those things people are assessing when they walk through that door. Does the hearing health care professional have genuine concern for the well-being of his or her patients? So are you a warm, caring, empathetic person who has integrity and cares deeply about the success of the treatment plan that you provide? Does the hearing health care professional practice style match with the expectations of the patient? Some patients want to see a female provider. Some want to see a male provider. Some want to see a young provider just out of school. Some want to see an older, more experienced one. Have your receptionist have their antenna up if you have a choice of providers when the doctor's office calls and wants to make a referral to you. How well will the specialist communicate with the referring physician? Well, you've got to send a patient report for every patient, so I think that's essential. If you're not doing it now, counseleer can help you with that. That's one company that will, and you can develop other processes to make sure that every single patient that you see, that the patient report goes back to their primary care provider. Of course you've got to get permission from the patient to do that, but what happens as a result of that is you now have patients in common with that doctor. You're now partners in patient care with that patient. Does the hearing health care professional use the same electronic records as the referring physician? The answer to this is mostly no, unless you are part of a hospital-owned health system where they provide it for you. However, I recommend that you think about those systems like counseleer and other providers who can give you computerized systems that allow you to transfer information electronically over the doctor's office that may be able to be downloaded into their electronic health systems. Will this hearing health care professional provide good continuity of care and follow-up? I don't think physicians are really aware that people stay with us for the whole of their lives, and you need to articulate that to your doctors and nurses, that this isn't just a fit-them-once kind of relationship between you and their patients. This is a whole-of-life commitment, and that you're going to be there in that practice for a long time, taking good care of their patients. Does a hearing health care professional have infrastructure for communication during an emergency or after hours? I recommend that you set up a call cycle with your peers in your community or your city, minimum of four providers, so that one of you can be on call once a week to see patients after hours, on weekends, in emergencies, take care of a broken hearing aid on a Saturday, and send that information to the doctor's offices so that you can say, look, we provide 24-hour, 7-day-a-week coverage. Now, physicians do that. I think people in the hearing health care industry have got to do the same. If we want to be seen as an allied health care provider, working in the health care industry just like they do, this is one of the things that you can do that can differentiate your practice from theirs and make you look awfully good when they're thinking about who to refer to. So will a hearing health care professional return the patient to the referring physician for ongoing care? And of course you will. Will a hearing health care professional refer other patients to the referring physician in return for having referred patients to him or her or he or she? Yes. I pick up their business cards. I take them back to my clinic locations, and I let my providers know that these are physicians who they may want to refer a patient to if there's a medical condition that they uncovered during their evaluation. Now here's a graph that I want you to look at, and it basically is a new way of stocking your clinic and setting responsibilities within your own practice. And take a close look at your receptionist. I'm now recommending that you don't replace a receptionist with a receptionist. I'm recommending that you replace a receptionist with somebody who can do administrative work, who's warm and caring on the phone, but who can also do telemarketing and marketing outside your clinic. You're the revenue engine. This person can take the external marketing load off you, and I highly recommend that you write your job wanted ads or your position open in newspapers differently than you have in the past and ask for more skills so that you can be effective in developing marketing pathways to primary care positions. Now here's what I mean by the total office call. Don't expect to see the doctor because you won't 75% of the time, but do expect your representative to develop communication pathways to the nurse, the referral coordinator, the clinic manager. If I say nurse, I also mean medical assistant. If they've got a nurse case manager or a social worker there, you have to give them a package of information as well, and you have to keep an accurate record of everybody that you've communicated with in that practice so that you educate them up to the point where they're obligated to make the diagnosis and referral of hearing loss and refer those patients over the year. How do we get started? Well, we create a list of primary care doctors who are close to your practice. I did mention 25, but if you've got 50, that's 100,000 patient lives. And out of that 100,000 patient lives, 20,000 of them have a hearing loss of 25 decibels or greater. So that's a big population. It means opportunity. It means we have to educate the doctors because only 20% of those people have been treated. The 80% have not. We can provide access to care by calling on doctor's offices and letting them know who we are, bringing them the latest clinical research, educating them about the disease state of hearing loss so that they're better at risk versus benefit counseling when that patient is in that exam room and they determine that they have a hearing problem, that there are communication difficulties, and the physician thinks it's in their healthy best interest to come and see you. So we also want to choose physicians who currently refer to you, the ones who are closest to you, who are in multiple physician's offices, and those whose practices are busy and yet have a high potential to refer to you. Send a letter of introduction expressing your interest in providing quality of care for their hearing impaired patients. Focus on the needs of their practice and their patient needs. That's your priority. And promise to show up with a patient care folder that they can use to refer the patient over to you. That patient care folder should have your literature. It should have clinical research articles. It should have insurance and payment plan information in it. It should have patient education material in it. In your hands, it's a sales and marketing tool, but in the doctor's hands or the medical assistant's hands, it's a patient care management tool. So be sure that everybody in the doctor's office gets one. Now, I like the idea of collaborating, not competing, with ENT clinics that have an audiologist. They need a backup provider when the audiologist is sick, goes on vacation, his schedule is slammed, they don't take insurance plans, the audiologist resigns, and the ENT is left in the lurch. So where do they go when they're left in the lurch? Well, I suggest you go see them, just like you would see an ordinary primary care doctor, and bring a package of information and talk about the benefits of why you should be their plan B, why you should be their backup on a Friday night or a Sunday morning or seven days a week so that you can begin the process of cross-referring and relying on each other and being partners in patient care. Showing up at a doctor's office means that patients come first, park away, the closest parking spaces are for sick people, wait at the end of the receptionist line, patient care always comes first. When you do that, they recognize that you're a person of integrity, you know the rules of patient care, and you're willing to wait to talk to the receptionist in a respectful manner, and ultimately, you'll be the one they choose because they like the way you handle yourself as a person of integrity. To be respectful and quiet, people are sick there. Ask the receptionist for the rules governing the medical industry representatives, and be sure to follow them. It's okay to ask for a couple of minutes of time from the nurse, the referral coordinator, or the doctor. When you're talking to the receptionist, let them know that it'll only take a couple of minutes of their time. Stick to that promise so that you can explain the contents of that patient care folder. Physicians want more time, so respect it, don't steal it, and provide the latest clinical research, especially about comorbidities, that cause hearing loss, that allows them to get to the right outcome. If they're busy, write a personal note and attach it to your promotion literature. Nothing should go into a doctor's office unless there's a handwritten note from you, signed, that basically says, thank you. I'm sorry I missed you. We appreciate you considering our practice for the diagnosis, treatment, and prevention of hearing loss. In the diabetic patient, or the cardiovascular disease patient, in the smoking patient, or the aged patient, or the patient who works in a noisy environment, that you write a little handwritten note that demonstrates that you were there, that you cared enough to leave your practice, to go to their practice, and give them information, quality information that helps them do a better job in taking care of their patients. Thank the receptionist. Give her a Reese's Peanut Butter Cup as a nice reward, plus a pair of earplugs, and tell her to take care of the hearing. They'll remember you forever. Physicians are human just like you. Be friendly, but not informal. Be formal, and be respectful. Keep consistent contact with each member of the physician's office staff is just as important as seeing the doctor, as we've discussed in the total office call. Create a learning champion in each office so that they can represent you after you leave. My default learning champion in every doctor's office I call on is the medical assistant, but sometimes it's not. Sometimes it's the office manager. Sometimes it's the referral coordinator. Sometimes it's the receptionist. You have to find that out over time, but you have to make sure that any information that goes from your clinic to their clinic covers all of those people who work in the doctor's office because they all directly or indirectly affect the patient care outcome. They need to know how to handle a patient who has a tinnitus disorder, a hearing disorder, or may need a referral to a dizziness and balance specialist. Physicians may have preconceived ideas about hearing aids, about how well they work. I suggest you do a lunch and learn and explain these technological marvels to them. They're fascinated by the science. They're fascinated about how they work, and they're fascinated about the fact that this is an opportunity for you to be able to demonstrate the quality of these because the market is about to change. Physicians want to provide input where some patients are concerned, particularly those that are suffering from dementia and may not be able to make a good decision in their own healthy best interest. Let the doctors and nurses know that you will, upon determining that that patient type has a treatable loss, that you will contact them, advise them of your findings and your recommendations for care, and get input from the doctor. Some hearing health care specialists are not willing to do that because they think the doctor might turn the patient away from being treated. Your level of integrity in the eyes of the doctor goes up when you make that call back to them and inform them of your findings and seek their input on total patient care. Provide nurses, medical assistants, and doctors with patient education about the disease state of hearing loss. Only 12% of all the people in the United States who go into an exam room with a physician understand what the doctor is talking about. They don't know what the nurse is talking about. So bring your patient brochures, your patient education brochures. Be sure you put them in the front office and the back office. Be sure that the medical assistant has got a good supply at all times. And then that patient, once they understand the disease state, they're more likely to show up when the doctor refers them to your practice. Provide business cards, maps, provided bio cards, free screening certificates, insurance plans that you honor, and also give them a list of the ways that patients can pay for a pair of hearing aids, whether it's finance, whether it's credit card cash, whether it is through a non-profit, etc. We interfere with patient care if we stay too long, talk too long, block hallways, fail to observe patient privacy regulations. Physicians want to know, as we said before, about efficacy, side effects, and cost. And if we maintain a spirit of openness and trust and communicate with integrity, rather than avoiding guesswork, we will help that doctor get to efficacy, which is, as we said, his or her number one priority. Most of us like to be around can-do, problem-solving, upbeat people who are not greedy, who have a healthy level of compassion, efficacy, and altruism. Doctors are looking for this when they meet you. So you have to be at your best, not just the first time, but always, because of commitment and consistency, and that you care more about their patients than your own paycheck. Smile a lot. Exhibit a positive attitude, no matter what you find in each clinic. If it's chaos, leave and come back next month. You'll be welcomed and respected because you left when they were having an emergency or slammed patient waiting room. Coach all the physician staff, as we said, how to refer a patient to your practice. Don't assume they know how to refer a patient to your practice. So when you take in that patient referral folder, show them a patient referral form, explain how it all works. Patients will be more likely to show up if you take the time to educate the doctor, the nurse, the referral coordinator, the office manager, the receptionist on how to manage a patient from their practice to your practice. Now we talked a little bit earlier about a brand, a promise. We can also talk about a call message here. Do you have a call message for your practice? Here's one. Comes from the Mayo Clinic. The earlier we treat, the better the outcome. I think the way they say it is the sooner we treat, the sooner the outcome. Create a primary care physician target list by getting permission from each patient that you see in your practice to allow you to mail the audiogram to the doctor. At normal audiometric results or other findings, require a phone call, a fax, or a personal visit to the doctor's office to explain the results of your evaluation. As we said before, you're now patients in the comprehensive care of that patient and your interventional skill as a provider may do more than diagnose hearing loss. You may save a life. That's a conversation for another presentation. Inform the referral coordinator about insurance and payment plans you cover and provide a list of plans and benefits covered to the referral coordinator in the doctor's office. If they don't have a dedicated referral coordinator, then default to the medical assistant or the office manager. Let them know that you do all of the paperwork for them, that you're not going to create more work for them, that you're going to make access to hearing health care easy, and the ultimate responsibility for that patient is yours and you will return them to them potentially with the improved ability to hear and potentially with an improved quality of life. So obtain each physician's business card when you drop by, so for your direct mail campaigns. Provide the physician, as we've said, with the latest clinical research, especially about prominent comorbidities that have a direct impact on hearing loss. For example, diabetes is an independent risk factor for hearing loss. Most physicians are unaware of that. And be sure you provide the clinical research that documents that and other comorbidities. I like to give out ear anatomy posters or any other promotional literature that educates the patients about the disease state of hearing loss that doctors can put on their walls that have my name, address, logo, text number, and business address on it. Explain other professional skills you may have that will benefit the physician's practice. Update your clinic brochure, add in other services, take more courses, add in other services, learn more new things, add in other services. We're going to have to be competing like heck as the market changes. And the more you educate yourself, the more services that you provide, the more valuable you become to primary care physicians and the more effective you are at differentiating your practice from other practices in your city. I like to give out pure tone screeners. And I like to give out a patient guide that identifies the patients who are most susceptible to hearing loss. And Ted Ennis has a copy of that guide if you would like it. Schedule lunch and learns as often as your budget allows. If you want to get your face in front of that physician to develop peer to peer relationships, explain a new technology, then do a lunch and learn. That's about what it will cost for 15 attendees. I do take case presentations and an audiogram and if time allows, I do some education on the audiograms while I'm there too. Fruit baskets, Reese's Pieces are appreciated and occasionally a big fluffy chocolate cream pie to say thank you for your referrals. I like to do that. They don't forget me. They appreciate it. And everybody likes to feel appreciated. Show them that you appreciate the relationship that you have with them and their patients. Keep those patient education materials well stocked in the front office and the back office. And other samples that you can provide that will give you access to the back office in a doctor's clinic are ear plugs, pure tone screeners, ear wax removal kits, pocket talkers and any other items with your branded label on them. When you mail, hand deliver or fax a patient report to the primary care, always include a thank you card for the referral. And add in any relevant clinical research articles if the patient history allows you to conclude an association, a correlation or cause and effect between an existing comorbid condition and the hearing loss that you diagnose and want to treat. Show up once a month as we said, not every two weeks, not every two months, but once a month is normal in this industry. Keep your practice top of the mind with brand name recognition and brand name loyalty strategies that are vital in this market where space in the customer's mind is limited. Respect other providers, no put downs ever. No put downs of big box retailers by name. So what I want you to do is say I respect your choice of providers there. The reason why I came by today is to bring you some new information about some new products and services that may be appropriate for some of your patients. So bring new information and force them to make a new decision about you and your services. They want to know how much you care, not how much you know. Be interested as opposed to interesting. Here's a couple of books that I recommend to everybody, The Power of Nice. Anybody calling on a doctor's office has got to read this book because they like nice people. They like soft sell. They like solution oriented warm people who care about their patients. Read The Power of Nice. It will make you money. It will influence the psychology of persuasion if you're interested in understanding people's behavior and the reasons why they make the decisions that they do. Volunteer. provide pre-hearing screenings at local health fairs, especially if the physicians are sponsoring it, speak at diabetes support groups, speak at smoking cessation groups. Both of those lifestyle-related behaviors cause hearing loss, and physicians are mostly unaware of that, and they are very impressed when you go out in the community and educate the community on behalf of the patients. Only lunch and learns are acceptable. Invite the physicians and staff to your practice. Invite a speaker. Invite all your patients to show up. Keep an accurate record of the content of every call, every person you spoke to, and what promises were made, and any follow-up that's required for the next visit. I have an Excel spreadsheet that I'll readily make available to anybody who listens to this webinar and would like to use it to record their calls in their own target market. Every point of contact with you and all your practice is an opportunity for the physician's office to evaluate you, so you've got to be committed, you've got to be consistent, and you've got to show up once a month. We talked a little bit before about multi-channel marketing. Here are some examples of multi-channel marketing. I'll let you look at these, and if you have any questions about the success of these or how to implement them in your practice, talk to Ted, talk to me. I'll be sure to help you out. The hearing healthcare professionals should be part of the comprehensive team of caregivers striving to assist the hearing patient to minimize impairment and maximize function. You should learn this off by heart and repeat it to every doctor and every professional in every doctor's office that you call on, because that's our goal. From a marketing perspective, our goal is to educate, to obligate. The more they know, the more likely they are to make that diagnosis, make that referral, and refer that patient to you, because you're the person who brought the valuable information to them that increased what they know, that helped narrow the gap between what they know and what they need to know about the hearing impaired patient. Finally, questions for today. Ted, I'd like to open up the program to any questions from any of the attendees at this time, and I want to thank everybody for listening. Thanks, Bob. Bob, we're so excited that we've had over 200 of your fellow colleagues that have joined us today in this webinar. As Bob said, we do have some time for questions. If you have a question for Bob, please enter it in the question box on your webinar dashboard. Bob, our first question is from Kevin. Kevin asks, what should the percentage of my gross revenue be as a result of physician referrals? That's a good question. You should target 15% of your gross revenue coming from physician referrals. That's the national average. Clinics that do this well, according to the Phonak Benchmark Study, it's around 20%. I have clinics that do it really well who are at 40%. Set your goal as an attainable 15%, and once you get to that, then set it at 20%, and then move on up. If you're doing it really, really well, I think you should pat yourself on the back if 30% of your gross revenue is coming from physician referrals. Next question, Ted. Thanks, Bob. Our next question is from Ellen. Ellen asks, what is in it for the physicians to form patient care partnerships with hearing care specialists? That's a great question. What's in it for the physician if they develop a partnership with you is, as we discussed in that exam room, it's all about preventive care and getting that patient efficacy. When you help facilitate that for the doctor, you earn their respect, and they're more likely to reciprocate as a result of that by referring their patients over to you. Also, when they get that patient to efficacy, that patient is not coming back and back and back and back and incurring increased medical costs, so that the physician keeps the cost of care down. When they do that, Medicare, Medicaid, and insurance plans reward them with a bonus called a quality metric performance bonus. Those quality metric performance bonuses add up over the course of a year to the point where physicians are earning between 10 and 30% of their total revenue from quality metric performance bonuses. You can help improve the profitability and the income that comes into a doctor's office by making sure those patients adhere, and yet you're helping facilitate and get that patient efficacy. That's what's in it for the doctor, besides the doctor's satisfaction that they treated that patient well and that they have a trusted partner who can help them do so. Great. Thanks, Bob. Our next question is from David. David asks, typically how many sales connections does it take to generate a physician referral? That's a great question. Pharmaceutical companies know it takes around an average of five or six to earn that first referral. It might take you three or four months to get that first referral. They have to like you, respect you, trust you, know you, but you have to be patient and work through that process. You have to show up once a month and bring that valuable information that's going to help improve the quality of care that they provide and the quality of life of their patients. I can tell you that over time, the number of calls drops. In my experience, over a five-year period, I went from averaging six calls to get a referral down to two calls on a doctor's office to get a referral because they liked me, knew me, respected me, trusted me, and appreciated the information that I brought. Be patient. Those six calls might take you six months, but be patient. You will be rewarded because the opportunity is there. Next question, Ted. Thanks, Bob. Bob, our next question is from Linda. Linda asks, how much time should I spend on trying to build my network of physicians each week? Another good question. I would recommend that you block yourself out of your clinic two hours per week and use those two hours to call on the physician's offices that are closest to you. In those two hours, you can probably call on four, maybe five, practice locations. If you've got two doctors in each practice locations, that's 10 doctors a week. That's 40 doctors a month. That's 480 calls per year. That's approximately 80 new patients. Out of that, maybe half will test with loss. Out of that, maybe three-quarters will be fitted binaurally. That's a lot of money per year, additional revenue, for just two hours a week. But modestly, same day, either 10 to 12 or 1 to 3, on a Tuesday, Wednesday, or Thursday is best. Thanks, Ted. Thank you, Bob. Bob, our next question is from Steve. Steve asks, I'm a sole practitioner with a staff of one. This means it would pretty much be impossible for me to do everything that you are outlining. Do you have a suggestion for a truncated program? Absolutely. Ted, this morning I sent you an email, and it was called the Cliff Notes of Physician Referral Marketing. These are the essentials for getting started. These are the step-by-step process for you to implement a physician marketing program. I realize you can't do everything, but what you can do is think about this. A pharmaceutical company markets their drug for the patent life of that drug. It might be 15 years. You've got to market your practice for the ownership life of your practice to primary care doctors, because the opportunities are never going to go away. So be patient. Implement the steps that I've outlined over time in that article that I sent to you, Ted. It's called the Cliff Notes of Physician Marketing. Be patient with your implementation of the program over time. Don't give up on this, because patients need your interaction between you and that doctor's office. Thanks, Ted. Thank you, Bob. Bob, our next question is from Steve, and Steve asks, he says, will physicians really refer to hearing aid specialists? Yes, just like they refer to a podiatrist or a physical therapist or a respiratory therapist or to a chiropractor, a nurse practitioner, a physician's assistant, yes, they do refer to hearing aid specialists. And I've been doing this now for 15 years, calling on doctor's offices, representing hearing health care practices. I've only had one question in 15 years come from a doctor asking me about the qualifications of my providers. What matters most is that you show up as a person of integrity on a regular basis with valuable information that helps improve their ability to provide care for that patient. And when they do get to your practice, they do provide outstanding care so that when they go back to that office, they can go back there with a positive report about you. Sometimes, yes, our patients are outside your scope of practice. And you do have to get back in touch with the doctor and let them know that this patient will require a referral to an ENT, to a neurologist, to perhaps an audiologist or pediatric audiologist. That happens all the time with every specialty. So don't feel self-conscious about your qualifications. You know more about the treatment, diagnosis, treatment, and prevention of hearing loss than anybody in that doctor's office. So you're the specialist, so be the specialist that we talked about in that article that come from Harvard Medical School called Selecting a Specialist. And you will do very well, very nicely with this marketing program. Thanks for that question, Ted. Thanks, Bob. Bob, our next question is from Brendan. Brendan says, when you mentioned bringing gifts to a physician's office, such as a Reese's Peanut Butter Cup, Brendan says from what he has learned, it was illegal to bring such a gift, and it may affect some sort of kickback lot. Do you know anything about that, Bob? Yes, I do. Another great question. It's the stock lord that he's referring to, and you cannot give away, you're allowed to give away up to $100 in free goods. Excuse me, is it $100? I believe it's, no, wait a minute. You're allowed to give away up to $50 in free goods, and you're not allowed to give away a technical instrument like a pure tone screener that's valued at more than $100. You're not allowed to do that. The hearing healthcare industry is not governed by the same guidelines that the FDA set up for pharmaceutical representatives. Those laws mostly apply to the pharma reps, and they don't apply to you. And I try to follow them in this way. I don't like to give out pens with my logo on it. That's expensive. I'd sooner give out a pair of earplugs that generates a conversation about hearing loss. I don't like to bring lavish lunches to doctor's offices when I do a Lunch and Learn. I like to bring tasty, healthy, inexpensive lunches. They don't expect you to spend lavishly, because once you do, then you're a little bit suspect. So keep it modest. Giving somebody a Reese's Peanut Butter Cup to say thank you. Some people will say, no, I'm on a diet, and say, okay, then I'll just leave you with the earplugs. Or, feel free to give that Reese's Peanut Butter Cup to one of your co-workers. I don't like to spend a lot of money to say thank you, but I do like to say thank you. So I hope that answers your question, and you are not affected by those SPAC laws. There's nothing that you will do, as long as you follow what I said earlier. No more than $50 in free giveaways, and no more than $100 on any kind of technical device. Thanks very much for that question, Ted. By the way, Ted, I have all of the articles from the FDA, from AAA, that explain those guidelines, and I'm more than happy to share those with you, so you can provide them to your members. We can make those available. Thank you, Bob. Our next question is from Sharon. Sharon asks, do you find your program is successful for both primary care physicians, as well as private practice physicians? It's a good question. I'm not sure that you can differ. Let me answer it this way. When we say primary care physicians, I mean family practice, internal medicine. What your member's question might be related to is practices that are owned by doctor's offices, and they are, quote-unquote, no-see, no-call, and they won't refer outside this system. Those independent physicians in the community are frequently primary care doctors, as well as internal medicine physicians. It's a good idea to qualify whether your physician is an independent practice owner, because that means that they're not bound by any bureaucratic dictates that say where they can refer patients. I'm not sure I've answered that question, but when I say primary care, I am specifically referring to family practice doctors, internal medicine doctors, and there will be specialists like endocrinologists, cardiologists, who we have to call on to talk about the disease state of hearing loss. If that question needs further clarification, Ted, have them get in touch with you and me, and I'll explain it further in person if necessary. Great. Thanks, Bob. Bob, our next question is from Chris, and Chris asks, some doctors refer to Costco because they know they can get good hearing aids at a very cheap price. How do you combat this? There was a great article that was published by Dan Qual, who is an audiologist, but he's highly respected in the hearing health care industry in the United States. He said, the first thing you should do is buy a pair of inexpensive hearing aids from a manufacturer that you trust, whose technology is quality, so that you can compete with the lowest price hearing aids that are on the market. That's the first thing. As far as competing with Costco, you know it's all about service. You know it's all about that patient loyalty. Costco is interested in a marketing strategy called churning their patients, which means that patients get turned over on a regular basis to get new technology, or to replace technology that either cannot be unfixable or cannot be programmed. I'm not saying Costco is bad all the time. What I am saying is that you can compete with Costco if you wish. I don't like to refer patients to Costco because they think it costs less money. What I like to say is, let's look at the number of fittings during a patient's lifetime and you tell me, doctor, would you like to be treating a patient for hearing loss 18 times during their lifetime or 11 times during their lifetime? If my price for 11 fittings equals Costco's at 18 fittings, then advantage goes to the independent provider, like my audience this morning, because you simply can provide better quality of care without the hassles of so many repeated visits where you run into patient engagement issues. Now I'll finish up on that statement by saying I respect your choice, doctor, however I have some new services and some new products that may be appropriate for some of your patients. May I explain the contents of my folder to you? Spend more time talking about your services and your products than you do about Costco. Don't waste your valuable face time with doctors defending your practice against Costco. Talk about the benefits of your practice and you will win most of the time. Thanks for the question, Ted. Thank you, Bob. Our last question is from Emily and Emily asks, why call on a physician's office once a month? Why call on a physician's office every two weeks? It's too much. You know, the pharmaceutical industry tried that years ago. They started out making calls on doctor's offices every two months and then they figured out that where their representatives went, there would be a peak in prescriptions written wherever the representative showed up in their territory. So they said, wow, why don't we call on a doctor's office every six weeks and see if we can increase the number of prescriptions? And in actual fact, they did get a 25% increase in prescriptions written and sales without any additional investment other than changing the call cycle. So they said, oh, well, if that works, let's go to four weeks. Well, that doubled the sales of pharmaceutical products in the United States. Trust me, it did. I was there. I was part of that. And so the people in marketing said, oh, wow, maybe we can double our sales again by making a call every two weeks. No, it didn't work. They pushed back dramatically. They pushed back so strongly, they banned some pharmaceutical companies from calling on them because it was just too much. Patient care came first. Hospital-owned practices didn't want the interference with physician's time and patient's time. So the unwritten rule is every four weeks, 12 times a year. If you have 12 connections per year, and I said it takes six calls to get a referral, then there's two referrals per physician. And over time, that drops down to two calls per physician. So trust yourself, trust me, trust the industry. Once a month is just about right to make that call. Don't go every two weeks. It's too much. Don't go every two months. It's not enough. But every four weeks, just perfect. Thanks for the question, Ted. Thank you, Bob. Bob, I would like to thank you for an excellent presentation today, and I'd like to thank everyone for joining us today on the IHS webinar, Building Relationships with Physicians. If you'd like to get in contact with Bob, you may email him at robert.tysoe at netzero.net. For more information about receiving a continuing education credit for this webinar through IHS, visit the IHS website at ihsinfo.org. Click on the webinar banner or find more information on the webinar tab on the navigation menu. IHS members receive a substantial discount on CE credits, so if you're not already an IHS member, you'll find more information on our website. Please keep an eye out for the feedback survey that you will receive tomorrow via email. We ask that you take just a moment to answer a few brief questions about the quality of today's presentation. Thank you again for being with us today, and we will see you at the next IHS webinar.

physician referrals

building relationships

hearing care specialists

regular contact

marketing strategies

primary care physicians

patient care folders

professionalism in healthcare

gratitude for referrals

educating physicians