Although O&P companies large and small agree that focusing on
patient care is the best way to keep the customer happy, the methods and
philosophies in how businesses apply that care are different. In the O&P
industry – as in any health-related industry – companies can not
properly focus on the patient if they only care about making a profit. In the
past, sacrificing your balance sheet for the greater good of the patient was
the noble thing to do. Over time more and more business owners have come to the
realization that they can only help their patients by maintaining a healthy and
profitable business.
Focus on care
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| © 2010 iStockphoto.com/Jacob Wackerhausen |
What caused this fundamental shift? Perhaps it was the country’s
recession and economic uncertainty forcing businesses to reassess their
processes from the ground up. If a process or product was of no economic value
for the company, owners omitted that process and moved on without it. They
became leaner and more efficient. Industry leaders point out that the O&P
field all but escaped the financial downfall. Despite those claims, business
owners alleviated their own financial burdens and made difficult decisions and
sacrifices. The economic culture changed and small businesses promoted more
forward-thinking, bottom-line approaches in order to survive.
“I do believe that more companies big and small are focusing more
on the bottom line than quality of patient care,” Joel J. Kempfer, CP,
FAAOP, president of Kempfer Prosthetics and Orthotics, told O&P Business
News. “I opened my own practice so I could focus my attention more
toward patient care rather than making revenue goals. Practitioners should ask
themselves, ‘What was the impetus to enter this profession? Was it to help
others or help the bottom line?’”
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| Joel J. Kempfer |
But is this really an either/or scenario? Can a company run a focused,
economically sound business while also maintaining the highest quality patient
care?
“I do not worry about the bottom line,” Kempfer, also an
O&P Business News Practitioner Advisory Council member, said.
“It has always been my philosophy for my practice that if I do a good
enough job for my patients, everything will work itself out. Whereas the larger
companies are always looking at the bottom line and they have to have enough
sales. To me, the patient should be the primary focus and how I can help them,
not necessarily how I can help [the company’s] bottom line.”
Focus on profit
Like Kempfer, Joe Sansone, chief executive officer for TMC Orthopedic,
agreed that the industry is changing. Sansone knows this because he has not
been shy in admitting his desire for a profitable business in the past.
“In the past, I was lambasted for being a ‘businessman’
and unabashedly saying I want profit,” Sansone explained. “What I am
seeing now is that … the eyes of the industry have opened. We have
speakers standing on the podiums at the American Orthotic and Prosthetic
National Assembly and other meetings saying, ‘You have to increase your
profit. Without profit your practice will not be able to survive in
today’s economy. I am seeing a transition in the industry — an
awakening of sorts. Regardless of the care a practitioner gives a patient,
without profit you can not take care of the patient.”
Kempfer valued Sansone’s point of view, but ultimately disagreed.
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| Joe Sansone |
“I understand the concept that being profitable will allow the
doors to remain open and therefore enable more patients to be serviced,”
he said. “I also believe that this philosophy is flawed in that the focus
changes from, ‘How may I service this individual and their needs?’ to
‘How will the device I provide afford me or my company more
profit?’”
Response to patient frustration
In 2004, Sansone put together several focus groups of amputee patients.
He asked them what they liked and did not like about his and other O&P
companies. Through these focus groups, Sansone discovered that patients were
overwhelmingly unhappy with their care. They felt they were being passed around
from practitioner to practitioner as if on an assembly line of care. They did
not get the sense that anyone seemed to truly care about them. In response to
these patient complaints, Sansone formed the Amputee and Prosthetic Center, a
branch of TMC Orthopedic that focuses on the processes of patient care.
“He created this philosophy of assigning each patient a patient
advocate,” Leslie O’Donnell, public relations director for TMC
Orthopedic said. “Patient advocates guide the patient from the beginning
of the process to the end — from the first peer visit to scheduling their
appointments to dealing with their insurance company. The patient advocate is
this caretaker that helps get the patient through this process.”
The focus group also revealed that many of the patients felt lonely
during the entire process. In response, Sansone asked former patients if they
were willing to visit new patients dealing with limb loss.
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| Jason Pawelsky |
“They’ll go in the hospital room and sit down with the
patient,” O’Donnell said. “They’ll talk to them about what
life will be like as an amputee and by that time, probably five other people
have already talked to the patient about the loss of a limb. Then about halfway
through, the peer visitor will take off their prosthesis and tell them
‘I’ve been through it. I did it.’ The peer visiting has been
huge as far as allowing us to not only offer assistance to amputees but also in
retaining our patients.”
Strategies for all businesses
Assigning a patient advocate would seem to be a great way for companies
to guide their patients through the difficult and sometimes frustrating
processes of the health care industry, while also keeping the lines of
communication open. For the small O&P business, patient advocates are
simply unrealistic in a business sense. Companies with one practitioner can not
afford to hire a patient advocate, nor is one necessary for a small-sized
practice. Still, a business owner of any size must prove to their customers
that they are focused and dedicated to patient care. An O&P company with
one practitioner must go about showing that care in a different and affordable
way.
“We try to primarily keep the patients in the fold,” Kempfer
said. “We see them when they are in their temporary and when they are on
their new prosthesis every month for rechecks and then every 6 months after
that.”
Once a year, Kempfer sends out a customer service survey through the
mail, asking his customers about the company’s services and patient
satisfaction. Kempfer estimated that he receives far more than 50% of responses
from these surveys.
“We almost always get responses from customers saying they want to
make an appointment,” Kempfer said. “That tells us that the patients
are still interested.”
As a single practitioner company, Kempfer feels as though he recieves
positive feedback from the patients because they are not seeing multiple
practitioners.
O’Donnell acknowledges the advantages of a company with multiple
locations in that they will reach more patients. With a small patient
population, this provides a significant advantage in terms of dollars and
cents.
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“I do think there are services a company can do, that are
relatively inexpensive to keep the level of patient care high,”
O’Donnell said. “Complete follow-up care, as well as providing
educational materials can be an effective way of servicing your patients.”
She believes that no matter the size, it is the company’s
responsibility from the practitioner to the front desk to make the patient feel
like they are the only patient in the office that day.
“What I found is that most patients just want to be heard,”
O’Donnell explained. “Whether you are one practitioner or you are a
company with several practitioners, I think listening is how you succeed in
keeping the patient for the long term. Any company of any size can offer caring
services to their patients.”
Social media
Perhaps it is no coincidence that as the O&P industry focused on
their financial situations, they also began changing the way they were
communicating with their patients and customers. According to a 2009 Nielsen
Global Online Consumer Survey of more than 25,000 Internet consumers from more
than 50 countries, recommendations from people they know and consumer opinions
posted online are the most trusted forms of advertising. According to the
study, 90% of internet consumers trust recommendations from people they know,
while 70% trust consumer opinions posted online.
“The way we jumped on the social media bandwagon was that we
developed a new website 2 years ago and then to help draw traffic to the site,
we started using Facebook, Twitter, our blog and LinkedIn to inform people
about the resources and educational materials on the website,” Jason
Pawelsky, sales and marketing manager at Tamarack Habilitation Technologies
Inc., explained. “We have put a lot of effort into providing really good
content in our blog. We try not to promote our products too much through the
socia media sites. The blog was established to support our distributors,
O&P practitioners, technicians and their patients.”
O’Donnell agrees that it is important to get your information
online because word of mouth is crucial to retaining and even adding customers
to your business. Using social media is just one way to promote word-of-mouth
advertising.
Reach the patients
TMC Orthopedic and the Amputee and Prosthetic Center run events for all
amputees, not just their own patients. This is a great way for patients to
mingle with other amputees and learn from other amputees firsthand about the
issues they are facing,” O’Donnell said.
“I think smaller businesses can do this on a smaller scale,”
O’Donnell said. “It’s a matter of knowing how to reach your
patients. If you have that connection with your patients you are able to get
their e-mail address or phone numbers if they are not computer savvy. We have a
Facebook page that is a great word-of-mouth tool. Reach out; plan a small
event. Events do wonders … and I think any size company can do that.”
One of the advantages for the O&P practitioner is his or her ability
to be less formal with patients, as opposed to a physician. O&P
practitioners can build a better relationship with patients. Working in a
single practitioner office, Kempfer has the advantage of building close
relationships with each of his patients. Taking the time to ask the patient
about family members or just listening to what he or she has to say can go a
long way in turning one appointment into a long-term relationship.
“I think it is important to maintain a close relationship with the
patient,” Kempfer explained. “If there is a distance between the two,
patients may not open up about how they feel or what is bothering them.
Ultimately, it comes down to patient satisfaction. If they are not happy, then
I am not happy.”
Approaches to losing a patient
Companies can employ social media, plan events, e-mail or call to check
up on patients and sometimes it is just not enough to keep them. When Kempfer
found out he was losing a patient to a different facility, he used to take the
losses personally.
“I thought I did my best for them,” Kempfer said. “I have
been in practice now for 27 years and I have come to the realization that there
are some people that you can not make happy regardless of how hard you try. The
patients who have a realistic view of what we are doing for them and for their
prosthesis and who understand what it takes for them to utilize a prosthesis,
those are the more satisfied patients.”
Sansone takes a more business-like approach to losing a patient. If a
patient is lost, he conducts a meeting with his staff and practitioners.
“We discuss each of our lost patients in a monthly meeting,”
Sansone explained. “We try to determine what it was that caused this to
happen. It is important that we take the excuses away from the employees who
say, ‘that patient had unrealistic expectations,’ or ‘that
patient had issues.’ While some of those reasons may be true, oftentimes
there is still something that we could have done that would have prevented us
from losing this patient.”
Business metrics
Sansone uses business metrics during these meetings to illustrate or
back up his points. Business metrics are any graph or chart that informs the
owner about his or her business, according to Sansone.
He gathers key information from practitioner punctuality to the loss of
a patient and enters that information into an excel spreadsheet. He then
publishes that information for all of his employees to see.
“It’s not enough to run and analyze the metrics. You have to
be willing to act on what the metrics are showing you,” he said. “We
are afforded the luxury of having 12 practitioners so we can compare them to
ow for your business and
simply doing everything you can to earn a profit.
“Patients are your income,” O’Donnell said. “There
is no way around that. It is making sure that your mindset does not become
looking at these patients and only seeing dollar signs. It just takes those in
leadership positions to remind everyone, just what our mission is, and
that’s patient care. If you take care of them, the patient will take care
of you. It is amazing.” — by Anthony Calabro
for more information
The Nielsen Company. July 2009 Nielsen Global Online Consumer Survey:
Trust value and engagement in advertising. Available at:
http://blog.nielsen.com/nielsenwire/wp-content/uploads/2009/07/trustinadvertising0709.pdf.
Accessed: Oct. 14, 2010.
