Chris Hemphill (00:00):
Physician burnout reached an all time high. Even before the pandemic, Harvard’s global health institute declared burnout to be a full fledged crisis in healthcare with nearly half of physicians reporting depression, exhaustion and an overall sense of failure. Many people focus on addressing this problem. We hear tech companies touting voice-based order entry and we hear administrators reflecting on their own policies. However, one critical voice is missing from these conversations. Let’s dig in.
Chris Hemphill (00:30):
Consumer experiences, major disruptors and AI tech are shaping healthcare for years to come on. On Hello Healthcare, we dive deep on these issues with leaders who are driving change. I’m Chris Hemphill, VP of Applied AI at Actium Health, and we hope that these stories will help you to create or demand better future in healthcare. Hello Healthcare, we’ll be talking about physician relations today, but let’s define what we’re up against. To quote Harvard’s study on burnout, the prevalence of physician burnout has reached critical levels. Recent evidence indicates that nearly half of all physicians face burnout in some form reporting depression, exhaustion, dissatisfaction and a sense of failure, and it appears to be getting worse.
Chris Hemphill (01:17):
[Gallup 00:01:17] did a study on this, which we’re going to link in the show notes. And in an example in that study, they found that fully engaged physicians gave the hospital an average of 3% more outpatient referrals and 51% more inpatient referrals than did physicians who were not engaged or even actively disengaged. Engaged physicians don’t necessarily work longer hours than other doctors, but they tend to be more productive. And the healthcare system mentioned previously, fully engaged physicians were 26% more productive than their less engaged counterparts.
Chris Hemphill (01:55):
And that amounted to an additional $460,000 on average inpatient revenue per physician per year. This begs a question, how do we ensure that our physicians are engaged? Well, we can put out a survey, or we can send them an email offering a free yoga session, but something tells me that won’t solve the problem long term. So many health systems hire and work with physician relations professionals. In a nutshell, physician engagement programs have a clear purpose, ensuring that physicians needs are met in order to improve relationships and facilitate referrals. When a health system keeps referrals within their network, that may mean better care for patients as data sharing within that network reduces duplicate tests and procedures. This improves the patient experience and helps drive more revenue to fund the health system’s mission. As easy as that goal is to define, measuring it is not. Anyone who’s attempted to discuss a physician engagement team’s impact has probably had a difficult job.
Chris Hemphill (02:58):
There are all kinds of investments and practice purchases and even the time of year that might be influencing those referral volumes. To get to the bottom of what these are actually worth, we conducted a study with Intermountain Healthcare. That’s a leading health system in Utah with over 6,000 affiliated and employed doctors. In the study, we analyzed over 17,000 physician liaison meetings and over 10 million referrals. You’ll hear more from Intermountain a little bit later, but what did that study actually produce? Well, we found that a meeting between a physician liaison and a physician was worth about 45 referrals or about $4,200 in value. If you’d like to learn more about the study and the data science behind it, check it out in the show notes. Up to now, we’ve established that the physician relations team is a missing voice in the overall burnout and engagement conversation. They’re also a major revenue driver. So how should we think about them strategically?
Kriss Barlow (03:57):
Physician relations is always, but I got to say never more so than today.
Chris Hemphill (04:02):
That’s Kriss Barlow who runs a physician relations consulting firm; Barlow/McCarthy. She can honestly also say that she wrote the book on physician relations and it’s called Physician Relations: The Model, The Method and The Impact.
Kriss Barlow (04:17):
In its simplest form, physician outreach or physician relations continues to be the best way we have available right now to keep connected with the voice of referring physicians to understand their needs and their expectations, and also to ensure that they have a really good awareness of the services and offerings of the organization. So it’s connectivity, it’s conversation, it’s communication, but it really brings that voice of customer forward and keeps it very present in the minds of leadership every day. It’s not only what’s the potential value, what’s the harm if we don’t? And I think we have to look at that from both sides. So it’s what’s the value, and if COVID hasn’t taught us anything else internally, it’s taught us a whole lot about this, that ability to say, here’s why we need to invest in this relationship with our physicians, but here’s what it’s going to cost us, if we don’t have their voice present and with us as we move forward.
Kriss Barlow (05:18):
There is so much being written right now about the fragile nature of recovery. Obviously implications for that, for the hospital, certainly for our doctors, and of course for the strategy for physician relations. Today is about our ability, number one, to tell the story with a physician perceptions internally. I think it’s about our ability to fine tune those relationships and to begin planning to support the organization’s growth needs. The growth piece is going to be more important than ever in my mind. So, first I want to call out those elements that are vital today, then we can circle back a little bit on that future state planning, which of course is way more fun than this gap period we’re in.
Chris Hemphill (06:01):
So, how are they doing given the impact on face to face meetings?
Kriss Barlow (06:05):
Most teams, I think, did an excellent job with that crisis launch phase. That time when there was immediate practice shutdowns. We needed to shift to virtual care. There were tremendous demands for timely and accurate information. I think we’ve moved beyond that gap now. And so practices are marginally functioning. The immediate needs were met and we’re pretty eager for what’s next.
Chris Hemphill (06:31):
Awesome. So we now have an idea how we should be looking at physician relations from a strategy level. Let’s dig in a little bit more on how the world actually works and how it’s been impacted by the pandemic. To help us with that, we met with Kelley Knott who founded the Physician Liaison University.
Kelley Knott (06:50):
So this is about building communications, building relationships. With physicians, as they focus on patient care and things get crazier and busier, they still need those solid physician referral relationships, where they get to meet with their referring physicians, discuss mutual patients, patient care needs and wants. And a physician liaison is there to help facilitate that relationship, so they don’t replace the physician in any way. There’s no sales involved, they’re not selling a service. They’re not selling a treatment. They’re just there to help the physicians connect, so that they can build a relationship to discuss this patient care relationship, the referral relationship, and how they can better help and serve one another and their patients.
Kelley Knott (07:33):
So, a liaison can be responsible for identifying possible referring physicians, practices, or physicians in the area that your specialist may want to work with. They’re there to help with communication, they’re there to help set up appointments and events and meetings, and also there to learn and provide resources, which is huge, because as a physician or specialist is focusing on patients and that referring physician is focusing on patients, the liaison actually has the time and the ability to help streamline things, get things done, provide resources for the patient and really learn more about other practices in their healthcare community, what they’re going through and how you can better enhance your patient centric marketing or resources.
Kelley Knott (08:17):
So kind of a lot, but a lot of physician bring on liaisons when they’re looking to grow their physician referrals, which can be the heart of a practice.
Chris Hemphill (08:26):
Kelley, you’re right. That is a lot. How do we know when these types of efforts [turn 00:08:30] successful?
Kelley Knott (08:31):
There’s a lot of ways you can measure success. One of the biggest ones is you want to dive into data and analytics. We are about building relationships and we’re also there to increase referrals, which should increase revenue. And one of the things you want to identify to make sure your program is successful is you want to follow the numbers, the analytics. You want to see, is my referring physician base growing? Are we producing more of an increase in certain high revenue procedures? Are we increasing the amount of patient referrals? Are we increasing the amount of physicians in our referral base? Those are just three easy metrics that you can see if the relationship is working. And then there’s existing patient referrals. A lot of the time I’ve had clients that have existing physician referrals, but then when you take the six month comparison once they implemented a physician liaison program, maybe they had a physician that was referring one or two times a month, and now they’re referring 25 times a month.
Kelley Knott (09:23):
So things like that, and those are ways you can find in the data, and it does come down to numbers. You want to see the growth and it also can show you weak areas. And that’s a huge part too. Sometimes you don’t know what you don’t know. And if you’re struggling or things are weak, you want to figure that out because it can be really insightful on maybe some of how your organization is working that isn’t necessarily meeting the needs and wants of you’re referring providers.
Chris Hemphill (09:47):
Would you say that the pandemic has changed the way that physician relation teams operate?
Kelley Knott (09:52):
I think with any industry, it’s felt a huge impact. There’s a lot of liaisons like who have been furloughed, who have lost their position and a lot of liaisons that are just transitioning. So there’s like the actual impact of employment, but I have always, I get this question a lot from my students and from other liaisons is, what can I do during COVID to still be effective and engaged and work with my team? Well, liaisons are changing right now during in COVID, because I think they’re starting to embrace the same role they had in the field doesn’t necessarily have to change now that it’s digital. Sometimes we get really caught up in our actual visits, but it’s not about the visit as much as it is the authentic relationship building. And we’re going to take that and we’re going to go virtual. So a lot of my liaisons and liaisons I work with, we work on ways that we connect virtually and we support other practices.
Kelley Knott (10:41):
We stay engaged, and most importantly, we get resources. And that’s a really big thing for liaisons right now. [inaudible 00:10:48] even think personally during COVID, you feel differently when you feel supported by people and individuals. And you feel better when people are willing to spend that extra time to give you extra resources for either work or personal; hey, I thought you could use this. It’s really helped me out. Or, are you doing okay? And support tends to be one of the biggest values right now during COVID. So I think liaisons are trying to figure out, in this new world, and we’re not asking some of the questions we ask before, is trying to identify with each particular referring physician relationship, as well as the specialist we represent, what is the new value? What is the new needs and wants from both the doctors we represent and the physicians we have these relationships.
Kelley Knott (11:27):
So I’ve used tools like LinkedIn. I’ve taken field work all the way on to LinkedIn. And I’ve used LinkedIn admittedly way before COVID in part of my physician liaison marketing strategy. And it’s not just LinkedIn and social media that you can use, but there’s ways to support your physicians with tech issues, chatbots, telemedicine, telehealth, social media, and ways to support your referring physicians. You’re getting creative about providing resources. So, we’re doing continuing education, medical education classes. We’re doing webinar series. So it’s really created this structure that we’re creating a lot of content that’s patient centric, and it’s also great ways for liaisons to continue education.
Kelley Knott (12:08):
I’ve never seen so many specialists do these webinars that are so in depth about their procedures and their patients. How much would I have loved that when I was in the field as a liaison that I could log in and hear from my referring physicians [inaudible 00:12:22] from them directly about the buzzwords, what they’re looking for, the types of patients they see, the symptoms, the relationship to the patient, and when they refer over. And now there’s these webinar series. So I think liaisons are evolving by adapting more marketing and digital marketing strategies to take those relationships from in the field now to online using [Vidyard 00:12:45], LinkedIn, social media, webinars, continuing education classes and other tools and resources that are out there.
Chris Hemphill (12:51):
So it sounds like there’s a variety of ways to meet and interact even when face to face meetings aren’t available or possible. What are some of the ways that teams measure the impact?
Kelley Knott (13:02):
One thing people don’t argue with is ROI. You have to be willing to show them the numbers. And I do think that’s a common issue liaisons face is I would have to say like a certain percentage, I don’t know exactly, are not even privy to that information. For some reason, programs, physicians or practices in hospitals are not allowing some of their liaisons to have access to important data that would help shape how the marketing goes. ROI is the first way you can show how you’ve improved a program, but there’s a lot of other ways. Sometimes territories are suffering, and you have different locations and different territories, and you’re noticing that this territory is underperforming against another, and it may not be a huge increase in revenue, but able to increase that in a certain time period based on a strategy that you used off your data and analytics to show you’ve grown by 15% in the last two months is huge.
Kelley Knott (13:55):
And so you can show territory. You can show, like I mentioned before, I’ve had a conversation with one physician and he said, well, he was already referring. Yeah, but based off the last five years of data, that physician only referred X amount of patients with an X amount of revenue, and now that’s 10 times the revenue and 10 times the patient in just the first six months. So those are ways you can show… even getting really granular with existing referral relationships. You can also show an increase in high revenue procedures. A lot of the times we get really focused on we’ve grown so many referrals, but maybe they’re not the type of referrals that we were looking for as far as in a revenue growth. So with some high revenue procedures growth, sometimes it just takes a few referrals to make a big difference in the program.
Kelley Knott (14:42):
A lot of liaisons show their worth by scheduling meetings. Like all these mini goals, I’ve worked with physicians who may not always be on board with the liaison, but once that liaison was able to get them face to face with a practice or a provider or a healthcare admin that they were struggling to get in front of, and they were able to open a conversation once they met that person, they start to see the value pretty immediately like, oh, that was pretty great. So those are little ways I encourage liaisons. It’s not always about numbers too. If you’re finding that you’re having a lack of support or struggling to get some transparency from the physicians you represent, maybe spend some time uncovering some of their mini goals.
Kelley Knott (15:21):
Sometimes they’ll open up and say, oh, I know that doctor is seeing X, Y and Z, and he won’t take any of my calls and I haven’t met with him. And that’s a great opportunity for you to really quickly show how liaison can get them in front of each other, and then of course open that conversation. And that’s a great way to show value too, because the physicians both appreciate it, but they’re able to see how you can utilize your times and resources and skills as a liaison, so that they can focus on other things and of course get them in front of patients.
Chris Hemphill (15:50):
So, we started with some ROI metrics, but Kelley also highlighted milestones, goals and intelligence that don’t have numbers directly attached. Still, all of this helps us understand the quality of our relationships with physicians. The next layer then is proving that impact to leadership teams. How do we prove it?
Kriss Barlow (16:09):
Don’t we all appreciate that word prove in your question.
Chris Hemphill (16:13):
That’s Kriss Barlow again.
Kriss Barlow (16:15):
The proof in this is I think really one of the challenges for not just physician relations programs, but the marketers, the strategists and a whole lot of that. So I really think that impact has to be an organization-defined expectation. I will tell you that every leader I’ve talked with in the last six months, number one on their impact is they’re looking at growth. They may define growth a bit differently, but it’s all about growth. I need more volume. I need more volume in those revenue generating clinical areas. I need you to help me with alignment of more practices for acquisition. So I think our proofs really needs to start and our impact really needs to start with that organization-defined expectations.
Kriss Barlow (17:04):
And I also suspect that it goes without saying, but nobody sees impact as just having a relationship. So it’s having a relationship with a measurable outcome. And I think that’s an essential piece for organizations as they’re looking to the rest of this year. And how do we tighten that up? And as you look to 2021, it’s not just relationships, it’s relationships with intent and what’s the intentionality of this and accountability to get there?
Chris Hemphill (17:37):
So that all sounds good. But what if our peers in leadership don’t believe us?
Kriss Barlow (17:41):
It has to start with data because that’s the common language of our leadership, right? And I’ll tell you, if you say, when is it questionable? I think there’s a couple of reasons that will generally surface for that. Number one, it’s the lack of ability for field teams to be able to prove what they claim. So, for example, or when I say that the impact that we say we’re having doesn’t match with the data they trust. So, first and foremost, for all leaders, it has to be a trusted and reliable data source that we’re talking from. And then secondly, it’s this obligation to tie our activity with the results. So an example, you asked about that, if surgery is [flat 00:18:26] in the organization and a physician relations team steps forward and says, we’ve grown surgery by 12% this quarter. We’re not aligned.
Kriss Barlow (18:35):
So it’s clarity about what we’re looking at, how we’re measuring it, aligning it with what our leaders want and making sure that we’re using data sources that they trust. One of the big pieces to that with, for me, when you look at physician relations programs, is making sure that they have tools that are tracking and aligning their activity to those results. So it’s not the ability to say, well, I think we would’ve gotten that anyway. Well, have you met that cardiologist? I think he’s getting the business just because he’s great. So it’s our obligation to keep track of our activity and align that when we’re putting our results forward. So, some of that credit falls to us to have good tracking, good tools and good matching of activity with results.
Chris Hemphill (19:24):
Excellent. We have to be able to prove the impact of these relationships, but on the other hand, we also have to make sure that there’s an impact to be able to approve. We’re talking about the impact and value to the healthcare system, but it begs the question, how do we bring impact and value to our clinician and physician counterparts?
Kriss Barlow (19:44):
The biggest is so simple and it’s recognizing that this isn’t just about the tell. I think for a long time liaisons were so excited about what their organizations had to offer and they felt like the job needed to be to go out and tell people about what we had. The critical piece, I think, of reentry right now is more on the ask, and it’s not asking broad, generic questions about how are things, it’s specific questions that don’t make that audience think a lot, but to really help to unearth, how are things in the practice? On a one to five, how are your clinical staff doing in the practice? Are you and your colleagues having conversations about finances? Is there any way that we could support that? So, to me, a lot of this is being proactive with good questions that open the door. It’s a tender area, so you have to go at it cautiously. You don’t want to expose them, but you certainly want to say I’m a resource that can help you with things beyond telling you about our cardiovascular program.
Chris Hemphill (20:50):
Earlier, Kelley mentioned that the intelligence gathering that outreach teams can do is critical. Being valuable to our clinical partners means collecting the right kind of intelligence for leaders to make better decisions. Let’s hear from Kriss on what types of data these teams should be focused on collecting.
Kriss Barlow (21:06):
I think all of us would agree that data tells us what, conversations tell us why. So our ability to be able to frame these programs on data is absolutely essential. Liaisons, it’s an expensive resource for an organization, right? To have an in individual calling on practices. We need to make sure, first and foremost, that we’re using the data for the right targeting. A ton of teams have spent time over COVID really trying to clean up their data and understand that better, but making sure that we’re calling on the right audience; step one, from a data driven approach. The other piece with that is to be able to demonstrate how my activity is directly related to the results that we’re seeing in our programs. So activity-linked results has to be a data driven function. And I think that there were some programs pre COVID that the organizations were doing really well.
Kriss Barlow (22:08):
The specialists were super busy, everybody was pretty happy and the liaison work was heavily focused on retention of those referrals. Keeping people happy, figuring out issues or barriers to growth, bringing those back in. And I’ll tell you, as I’m talking to a lot of specialty physicians and organizations right now, everybody’s a little hungry for growth. So I think we’re going to have, we’ve got a fabulous window of opportunity if we take advantage of it to say, here’s the activity that I can provide that will correlate directly to growth. And that’s all in the tracking and reporting of what we said we were going to do and then what we demonstrated. The other piece with that I think is that sometimes the reporting piece can get overwhelming.
Kriss Barlow (22:57):
And we usually say to programs, just pick out one area, pick one something that you can start with for really good measurement and you can grow from there. So don’t try to boil the ocean and do it all at once. Pick something and start measuring. So I think it’s a critical time for us to do that.
Chris Hemphill (23:16):
Was it Batman or was it Spiderman that said, with great data comes great visibility? I’ll have our fact checkers look into it. But it leaves us with the question, with the data and intelligence we’re asking physician relations to collect, how can we do this without causing a mutiny?
Kriss Barlow (23:32):
I think the resistance is people are nervous about how much spotlight looks at them. There’s some resistance because if only we were selling shoes, it’s cause and effect and it’s easy to measure. It is so messy and complicated to say, I talked to this PCP three times. Because of those conversations, he referred to that surgeon. That surgeon saw X number of people in the practice and one of those ended up with surgery. So the referral chain is messy. It’s complicated in our worlds. It’s still critically important. And so giving liaisons permission to feel comfortable with the data, I think they need to be taught about data. Most of these are fabulous people with good sales skills. And it doesn’t mean that they like to look at a spreadsheet all day. And so I think they need to be taught. I also think a critical piece for some of best practices to have a data resource that can be helpful, so that liaisons understand what kind of data they need to look at.
Kriss Barlow (24:37):
And then the liaison has to help the organization to say, that’s not business I can move and here’s why. You see all this business over here with Dr. Smith, but did you know his wife’s the CNO at our competitor. I’m not going to move that volume for you. So it’s taking the data and matching it again with what you learn in the field to be able to grow business, but take the time to teach the liaisons, give them permission to learn in their way and give them enough support, so that they aren’t overwhelmed with the data, because again, eventually we’re going to want them back in the field maybe 60% of the time with 15 to 20% of the time doing virtual visits, and that other 10% of the time doing good planning and good reporting.
Chris Hemphill (25:27):
That’s a really powerful view of the type of intelligence available, if we just ask our teams nicely enough. In the meantime, physicians are suffering from disengagement and burnout that’s often related to health system technologies and policies. Are there tips to make sure that this voice of physician intelligence that our relations team is gathering is actually heard by the folks who can drive change?
Kriss Barlow (25:51):
Tough question. I think what’s happened over the last year, in all fairness, is operations has owned most everybody’s brain, right? For all the right reasons. Within organizations, safety, quality and operational efficiency has been front and center. So as our leaders shift back to looking at the volume side of growing the business and financial viability moving forward, I think the biggest thing that liaisons can do is to proactively communicate what they’re hearing in the field. And we’ve had lots of conversations with liaison teams to be able to say, whether it’s virtually or you’re actually in the field face to face, let’s capture some of that voice of customer and bring it back to leadership in a meaningful way. So if liaison teams think of one or two questions that they’re calling the practices now and saying, I’d love to capture some information from you. Could I have Dr. Smith for two minutes? You ask him a couple of questions. It could be related to COVID response. It could be related to, are your patients coming back?
Kriss Barlow (27:00):
So you think about orthopedics, you think about some of those elective things that were just waiting, and that patient said, hey, I can deal with this hip for another six months. So getting some of that volume back, letting our leaders know that here’s what we’re hearing in the practices, that will help number one with our marketers, to be able to say, maybe we can message better to consumers about this. It will help with leaders to be able to know it’s not that our practices aren’t sending to us. They just start seeing that volume. So it may be that we have to ratchet up some of our tools and vehicles to allow patients to come in more. So when I think about leadership, step one is, let’s get them intelligence and let them hear that voice of customer number one.
Kriss Barlow (27:53):
And let’s communicate proactively to our leadership about here’s what I’m hearing from the practices. 63% of practices indicated that if we’re able to do this then. I think it’s also liaison team saying, because we heard this proactively, here’s some of what we’re doing. I think we’ve got a window of opportunity to really let leaders know we’ve got your back. We can help with this. We can help communicate this. Are there messages, are there different ways like our ambulatory surgery center that we should start to promote more if patients aren’t comfortable with hospitalization? So I think part of it is leaders are mostly operationally driven. If we want that voice, we have to get proactive and we have to actively communicate. The other thing is I think it’s going back to reports that say, Hey, here’s the number of virtual visits that we did last week. Half of them were to do physician introductions, but the other half were to go deeper in conversations about this and that.
Chris Hemphill (28:58):
So, as we’re exploring the physician relations role, we’re finding more and more that things like collecting intelligence and communicating impact, all that relies heavily on data. Further than that, driving these decisions that ultimately help our clinician counterparts requires data, too. Great. So we can keep track of all these notes and results across our team with Excel, right? Put the key Dean back, I was just kidding. Susan Boydell, who works with Kriss Barlow and has previously led outreach efforts at BayCare Health and Texas Health Resources share some light on how teams can collect this much needed data.
Susan Boydell (29:35):
Think about it. If we change what we’re doing, how we do our jobs, then that changes how we document our activity and all of that. So sometimes it’s just as simple as well, now I need a dropdown that says it was a virtual conversation where before, I probably wasn’t paying too much attention to those, because we would say the most important was, we want you to be face-to-face. But when you don’t have that option, then you need that piece of it. The interesting part that I think with all of it too, is I think COVID has allowed us because we have to think differently about how we do our jobs, which means we have to track it differently. And in some ways it might open our eyes to, maybe this isn’t just something because of COVID I should continue to do.
Susan Boydell (30:23):
So it really allows us to look into that data and go, am I getting better results from some of these meetings that maybe were virtual? Can I get more physicians to have conversations with referring physicians? Because I don’t have to put them in my car. They don’t have to drive as far. I know that to try to schedule them, all those things like that. I think, Hmm, let’s just track that. But the only way I can do it is if I have it in my PRM tool and I can go back to that and link it to maybe what the results are getting. So all of it’s connected. Yeah. It’s really important.
Chris Hemphill (30:56):
And what about reporting? With new data comes new reports. How are the expectations changing from a reporting perspective?
Susan Boydell (31:03):
Oh. Absolutely, absolutely. Well, in some ways, it’s exactly what I just said. It’s understanding how we do our jobs different in the results that we’re getting. Volume is always going to be important, but voice of customer right now has probably really risen to the top. And I would say the field teams have been really, really an important piece of that, especially with those independent physicians that perhaps just don’t have those internal connections, this end communication connections that say our employee groups do, or even those that are a part of our network, but we rely on those referrals from those independent positions. It’s being able to then, how do I document that? And then how do I report that back to my leadership team that gives them an idea of what’s really going on out there. This is a simple story that probably everyone on the phone is going to go yep, been there.
Susan Boydell (31:54):
If volume wasn’t hitting the expectation we thought it was going to hit once we reopened up our elective surgeries, sometimes the answer to that question was, well, my patients are still not comfortable going in the office. So we’re out talking to physicians and we get to learn that piece of information that not only tells us well, do we need to dig a little bit deeper? Do we need to provide those offices and communication to help their patients feel more comfortable? Maybe not so much with their offices, but with the hospital. So all of that somehow has to sit somewhere and I need to be able to package that up, to report that back. So, still important.
Chris Hemphill (32:31):
So, all this talk about reporting and data collection makes me wonder, should physician relation teams be calling their universities, seeking a master’s in data science? Okay. So I’m being a bit facetious with that question, but Susan has great thoughts on how we should think about data as the physician liaison and physician relations roles evolve.
Susan Boydell (32:53):
Data is more important than it ever was before. And here’s the great thing about why data is more important than it ever was before, because we have more. That doesn’t mean we know what to do with it and all of those pieces, but we have more data that helps us figure out what we need to be doing and what works out there in the field. I’m old. So I can tell you that when I started out in physician relations, there was no data. So that’s why we put liaisons in the field to go figure out who’s referring to whom and what do those relationships look like? Nobody told me that in a report. We had to go out, ask the questions and we had Excel spreadsheets that show this what those connections are. We now have data that sets that up for us. It tells us the, what’s happening on there, teams always have to go out and figure out the why it’s happening.
Susan Boydell (33:40):
And I would say that’s one of their most important pieces of it. But I really think we’ve been probably talking about this for several years now. And I think if we want to say, COVID did shine a light, it did do this. It is a little like the title. You do need to be more of a data scientist than you used to be. It’s not all up to, oh, I need my strategy books or my daily analysts within my strategy team or my decision support team to feed it to me. Not so much. I got to be able to analyze it. And here’s what I’ll say, why we need to be able to analyze it. I want teams to be able to look at it and analyze what they’re going to do with it from a referring physician perspective. You could probably sit in any strategy department and there’s a million different ways they’re going to take the same data and slice and dice it depending on what they’re trying to do or understand.
Susan Boydell (34:29):
It’s the same for us. Then we’re usually the ones in the organization that understand that best and can provide that intelligence back after you look at, what’s the story that the data is telling you? I would say what COVID gave us was a little bit of a reprieve in the early days. So I think about when we were all pulled out of the field in March and most of us were out of the field, most folks were out of the field until maybe, probably May and teams were like, okay, what am I going to do? How do I rethink my time? And almost everybody said, let’s do some of this data work. And some of the sales planning work through the data that perhaps we just never had the time to do before.
Susan Boydell (35:12):
And so I think it really opens a lot of eyes. I think it also helped teams create what that process was or even determine, oh, my team needs a little more training or a little more education on how to use the data. And this allowed them to look at that and say, oh, let’s help them with this piece. Let’s help them understand this piece better. So that as they move through the data scientist piece, they get better at it. But no matter what, it’s still a balance. So just like you gave away Kriss, at the very beginning, this is not about spending the majority of your time with your nose in the data. You still need to spend the majority of your time having conversations with those physicians, but can you be smarter about it because of the data? Absolutely.
Chris Hemphill (35:55):
What about an example? Is there a particular story where all these pieces came together? It would be interesting to bridge the gap from liaison data collection to leadership action.
Susan Boydell (36:05):
Here’s the first thing that comes to mind, it’s how we package that up and how we provide context to it. It’s thinking the same way as when we talk about issues and barriers. If I talk about every single issue and barrier as a one-off, even though I’ve had multiple physicians or I’ve had multiple offices talk about it, but I talk about each one of those independently, they don’t get the picture of the whole thing. It’s really a little the same from this perspective too. How many offices did you speak to that were frustrated by the fact that they, I’m going to use an early one, that they had no PPE and where could they get it? That was the early one, was, can the hospital provide me PPE? And we heard from so many liaisons, like we’re not able to do that.
Susan Boydell (36:51):
How do I communicate that piece? And how many offices are asking for that, et cetera. It’s probably the same thing. And I used the example earlier with the patients that are still not comfortable with either going into a doctor’s office, whether it’s going in to get an imaging procedure, or it’s going into the hospital in general. If I’ve talked to 20 offices and 18 of those offices said, yes, the majority of my patients have expressed this, think of the power of that versus, every day, I said, oh man, we’re just getting hit up because the patients aren’t comfortable coming in. What’s the patients? So it’s really getting into quantifying some of that.
Susan Boydell (37:30):
And sometimes then I would say, add a story. If you can talk about, I had this conversation in Dr. X’s office, here’s the words he used to express what he was feeling and what he was going through. I want my leadership team to feel the same thing I felt when I was standing either in front of, or on a zoom call or on the phone. I want them to hear it in the same way. And that’s my job when the leadership team can’t be sitting there with us.
Chris Hemphill (37:55):
Up to this point, we’ve established that successful physician relations strategy means driving value for clinicians and communicating impact to leadership. Cool. But one voice still has been missing. It would be good to hear from a physician liaison who embodied some of the change that we’ve been talking about. Right? Well, we spoke with Darren Burch who is in physician outreach at Legacy Health, as well as a frequent speaker with the AAPL, which is the American Association of Physician Liaisons. Here he is with thoughts on the changing role for physician liaisons and outreach leaders.
Darren Burch (38:31):
I think the biggest thing about our role in particular as physician liaisons is to really make yourself essential. And there’s an idea around this, is don’t react to change, but lead and be the change. Be involved in the change. There’s been massive and rapid, rapid changes in the market. CMS, the Center for Medicaid and Medicare Services has streamlined and approved many things and lifted regulations so quickly. And I’m going to rifle through just a few of these that I think that are important to us moving forward. Number one, approval of telemedicine video visits and paying for 80 additional services in telemedicine. That’s huge. That’s going to change the way that we practice. They’re more frequent. Telemedicine visits are going to be approved. CMS is approving healthcare beyond hospital walls. Hospital-based services, which are typically known as hospital-based services could be provided elsewhere.
Darren Burch (39:38):
And I’ll talk about this a little bit more in a second. Ambulatory surgery centers can now contract with local healthcare systems to provide hospital services such as cancer procedures or trauma surgeries, and other essential surgeries. So think of it this way, you break your tibia fibula by playing underdog volleyball, you could be transferred to an outpatient surgery center and not a hospital. Interesting, huh? So what goes along with this, is ambulances now have been approved to transport patients to a wider range of locations like physicians’ offices, urgent care facilities, ambulatory surgery centers. That’s a game changer. One of the biggest changes of course is in hospitals and healthcare systems. Hospitals are really quickly learning how to become nimble and they’re learning how to quickly make decisions. I know in Legacy Health, we are making decisions that would normally take a year of planning to make, and we’re making them in a day or two days.
Darren Burch (40:38):
We’re streamlining policies, procedures and processes. We’re focusing on productivity of our staff, of our physical plants, office space and essential operations. We’re looking at supplies and how we utilize them and how we’re reusing them, right, to save dollars. So from an organizational perspective, this is a perfect time for a healthcare organization to restructure and retool what you’re doing. This is where liaisons really need to find an essential place. There’s been a huge buildup of elective surgeries. So what’s going to happen when we start doing more elective surgeries? What’s going to happen after that? After we’ve worked through that backlog? Strategic planning has been in hyperdrive. What will that look like moving forward? Strategic implementation, implementing those strategic plans has also been in warp speed. Are we going to continue this? This is a very lean structure that we’re working at. What’s important in the future for liaisons is strategic service line planning.
Chris Hemphill (41:43):
And what about the intelligence on physician needs? Should that drive a focus on physician relations?
Darren Burch (41:49):
Get yourself involved in that, supporting and executing those strategic plans. We are the people to help do that. Population health, one thing to think about. It’s going to change. How might that change? Are there going to be alternate payment strategies? Healthcare delivery is already looking different, is going to more virtual, more outpatient and we’re triaging critical care and emergent patients in a different way. All through this, data analytics is going to be so important. So important in identifying patients for population health, what strategies we can use for them and also, how we look back and where we’re getting our business and how we’re planning to grow. Lastly, we have to, as liaisons, think across the continuum, we can’t think about sales and strategy anymore, just sales and strategy and we’re trying to grow a business. We have to think about operations. We have to think about population health. We have to think about payment strategies. We are going to have to learn more about our organizations and how we do business.
Chris Hemphill (42:55):
When we think about Darren’s point, that changing business models and payment strategies impact physician relations, no one is better poised to discuss that than Intermountain Healthcare. They’re a leader at straddling the line between fee for service and fee for value. Robert Perkins, who directs their physician relations program, discussed how leaders should prepare their physician liaison teams for this kind of change.
Robert Perkins (43:20):
As we move more quickly into a population health or an at-risk environment for those patient types, volume becomes secondary to utilization management. And if the outreach department is seen solely as volume generating experts, then as volume becomes less important for certain patient populations, the department may become less important to the C-suite and more irrelevant at least in overall strategy. So by positioning the department as a value generating, it doesn’t matter what the value is. It certainly includes driving volumes, but it also includes driving appropriate utilization and appropriate utilization management can drive all sorts of other things that the C-suite sees as value drivers for the organization. And as we’ve done that over the last few years, the outreach department has been included on many key initiatives that our senior leadership sees as value drivers for our organization. Things that outreach may not typically be included in.
Robert Perkins (44:41):
Those are some operational things, that’s certainly tele-health population health, other things, they see us as a value driver for the organization. And it’s been key in getting us involved and included and a seat at the table in those meetings. We didn’t foresee this pandemic coming. We didn’t have our crystal ball out, but we didn’t anticipate what kind of value our C-suite would need right now during the pandemic in the short term, but also in the long-term what’s coming and what our leadership as they re-strategize and rethink about things in this new world.
Chris Hemphill (45:23):
It’s interesting to note that this strategic approach has earned them a seat at the executive table.
Robert Perkins (45:29):
What’s valuable to them in, again, we’re being brought to the table on that. A few things that we’ve done here, and that I think are key, not just during the pandemic, but as we move forward afterwards, some things that we’re doing and that are bringing value to our C-suite short-term and long-term, we’re providing insight and information on the referring market to the C-suite. Many clinics and referral sources are really struggling and furloughing staff and decreasing the size of their staff. They’re laying people off and they’re in great distress themselves. They’re going to be looking for resources. Right now they may be looking for information, but they’re going to be looking for resources to help them be more efficient in the long-term. And they’re going to need to partner with facilities, hospitals that can really help them be efficient. It may include things like online scheduling or patient self-scheduling, pre-authorization services for service lines that may not be offering pre-authorization services now.
Robert Perkins (46:47):
Extended hours of operation, anything related to access may be that extended surgical suite hours, whatever that may be. They’re going to look to partner with hospitals that can ramp up the way that the referring sources need to ramp up. C-suite leaders are probably going to need to invest in some of these resources. They may not know what they need to invest in. And right now, especially with cashflow the way it is, it’s going to be difficult to get some commitment from the executive team on investments. But helping them understand the opportunities and what the referring community is going to need here in the short term may help them realize that this is an opportunity to really step up to the game, invest where needed if that’s in online scheduling tools or whatever that may be, invest appropriately to make sure that we come out of this strong and capitalize on opportunities in the referring market.
Chris Hemphill (47:51):
Robert focused on some really powerful, yet really simple ways to answer questions the health system C-suite may ask.
Robert Perkins (48:00):
I think the opportunity to provide insight to the C-suite and help them commit can’t be underestimated. A way that they may want to consider looking at this is taking your credentialed provider lists and comparing that to volumes over the past year, year and a half, two years, to see what credentialed providers are highly aligned with you and what credential providers aren’t. And take that to the C-suite and say, this is a great opportunity to increase alignment with providers that at one time may have been aligned, but they haven’t been recently, really reach out to those providers and see if you can capitalize on this opportunity. I think there’s also going to be some real strong opportunities coming out of this for some joint ventures, some partnerships, affiliations, and even acquisitions in helping the C-suite understand those opportunities. Not just that there will be the opportunities that you may be able to bring a lot of insight into what practices or entities would be strong opportunities for an affiliation or partnership or joint venture, or even in an acquisition.
Robert Perkins (49:13):
So looking at those opportunities and determining what’s most valuable, bringing that to the C-suite, I think is a great opportunity right now. I think we can also increase alignment with referring practices and facilities. There’s a strong likelihood that referral patterns are going to change and probably change significantly in the near future with coming out of the pandemic. So, are out of the quarantine and habits are going to be broken, referral habits, those kinds of things. So we can jump in and provide high levels of service and really step up the game there and increase that alignment with referring practices. I also think developing a really focused outreach strategy is key right now.
Robert Perkins (49:58):
Darren mentioned this as well as stepping in and making sure that you’re not relying on the C-suite to develop that strategy, but you develop it and get their support and buy-in, and you can be seen as a real resource and an asset and get your seat at the table if needed. The executive leaders are trying to stop the bleed right now with cash flow. And they’re focused on so many operational things that they can even be paralyzed. And I think if you can step up the game with some strategy, it will be highly advantageous for you.
Chris Hemphill (50:30):
We started with the quiet, underrated voice in physician relations. We finished with how it’s blossomed to major strategic impact at one of the leading health systems in the nation. Physician relations teams are increasingly getting the spotlight. We believe that they’re driving measurable impact, again, study in the show notes, and that executives are increasingly asking for their field intelligence. So, we have a call to action on multiple sides, for outreach teams to prepare to be more data-driven and for executive leaders in healthcare systems to listen to their liaisons. Thanks again for tuning into Hello Healthcare. If you like what you heard, we appreciate a review on Apple, Spotify, or wherever you’re listening. You and your feedback fuel us. This conversation is brought to you by Actium Health, to get the latest on what these healthcare leaders are saying. Subscribe to our newsletter on hellohealthcare.com or join us for our weekly sessions on LinkedIn. Thanks, and when we see you next time, hello.