1. Growing Markets by Knowing
Referring Physicians
Key Concepts and Tools You Can Use

2. PAGE 2
Agenda
1. Situation Overview
2. Key Trends
3. The Physician Experience
4. Segmentation and Prioritization Principles
5. Taking Action
6. Additional Resources / Handout Outline

3. SITUATION OVERVIEW
1

4. PAGE 4
Pressure…By the Numbers

5. PAGE 5
Physicians Today ...
77% are pessimistic about the future of medicine.
82% percent believe they have little ability to change the healthcare
system.
Factors driving widespread feelings of discontent
• Liability / defensive medicine pressures
• Medicare / Medicaid / government regulations
• Reimbursement issues
• Uncertainty/ changes of health reform
Source: Physician Foundation Survey, 2012
Size = 13,575 physicians

6. PAGE 6
Communications Environment
Channel/Message
overload
• Anxiety
• Irrelevancy
• Overlooked
Audience confusion
(physician)
• Economic
• Regulatory
• Cultural

7. PAGE 7
Good Old Days of Physician Practice
• Physician-based
• Solitary
• Focused
• Controlled
• Work on hook

8. PAGE 8
New Way: Collaborate to Win
• Care continuum
accountability
• Emphasis on
relationships
• Team dependent
• Constant
communication

9. PAGE 9
What Credentials Do Doctors Find Most Important in a
Physician Relations Rep?

10. PAGE 10
What Really Hasn’t Changed
Focus on clinical quality
Customer experience is a differentiator
Brand management matters
Market expansion requires insight

11. KEY TRENDS
2

12. PAGE 12
Internal vs. External Challenges
• Consolidation is hitting many healthcare systems
• Specialists who were competitors are now partnering
• Unresolved political issues
• Divided loyalties in referring clinicians
• Adapting to new governance
• Where does a liaison go with internal barriers to
business development?

13. PAGE 13
Internal vs. External Challenges
• Moving from “baby-boomer” clinicians to younger
groups
• Differing definitions of “great practice”
• Program builders (baby boomers)
• Quality of life with my “job” (gen X-ers)
• Limited training hour challenges (gen X and Y)
• How do you communicate with clinicians in each
group?

14. PAGE 14
Internal vs. External Challenges
• Clinician turnover in healthcare systems is much
faster than in prior eras
• How well do you know the providers in your
system?
• Are you keeping up with changes in the medical
staff at your organization?

15. THE PHYSICIAN EXPERIENCE
3

16. PAGE 16
Physician Experience Benchmarking
Source: Gelb Consulting Benchmarking survey

17. PAGE 17
Experience Management Best Practices
Patients ReferrersInternal
• Conducting weekly meetings between faculty
and service staff
• Enhancing the role of volunteers, including
recruitment & their role in the patient
experience
• Offering amenities to paramedics
• Sharing best practices across multiple
departments
• Including front-line staff in operational
redesign, particularly for call center and
scheduling
• Implementing real-time organizational
effectiveness feedback system
• Developing uniform customer service
standards across roles
• Providing scripting for organizations,
especially front line staff
• Implementing weekly progress meetings
• Creating non-traditional support groups
• Improving waiting areas by providing laptops for
checkout, pagers for patients and separate areas for
adults and children
• Customizing welcome packets based on geography
and personal preferences
• Offering patient advocates, particularly for destination
and international patients
• Screening interviewees to share their story for
inclusion in marketing materials
• Implementing real-time feedback system for patients
and referring physicians
• Mapping out the experience by setting expectations
for every step and reiterating during steps
• Including referrers on advisory boards
• Sending “thank you” notes and/or calling to
thank them for every referral
• Adding photos and sub-specialty focus to faculty
directory
• Promoting availability of diagnostic center for
undiagnosed patients
• Revamping follow-up notes to include a concise
summary upfront
• Creating opportunities for on-site CME,
backstage tours, and meet and greet with faculty
• Courtesy calls for a personal touch and rapport
with physicians

18. PAGE 18
Customer Enchantment

19. PAGE 19
Recognize Needs
Functional Emotional

20. PAGE 20
Relationships Matter
Source: Cleveland Clinic / Gelb Presentation

21. PAGE 21
Channels Matter, too
Source: Cleveland Clinic / Gelb Presentation

22. PAGE 22
Engagement Process

23. PAGE 23
Video / Audio Recordings
Physical
Environment
Communication
s
From Data…
1.
Interview
Transcripts
2.

24. PAGE 24
…to Insights
Detailed Findings:
• Key themes
• Verbatim comments
• Strengths and barriers
Day in the Life
Touchpoint Assessment:
• Key Recommendations
• Illustrate with pictures
• Enrich with clips
3.
4.

25. Experience Map
Awareness
• Perceptions /
knowledge of
facility
• Choice of hospitals
for delivery /
practice
• Ideal relationship
Need
• Evaluation and
selection of
treatment providers
• Discussion with
patients (diagnosis,
referral options)
• Preparing patients
for what to expect
Scheduling
• Initial contact
• Timing and ease of
process
• Resources for
patients and their
families
Treatment
• Coordination of care
with specialist
• Progress notes and
methods of
communication
• Family feedback
about their clinical
experience
Transition of
Care
• Discharge summary
• Coordination of
on-going care
• Ongoing patient
care/support
• Call-backs for
assistance
Primary Experience Stewards
• Physician Liaisons
• Faculty/Staff
• Front Desk Staff
• Faculty/Medical Staff
• Faculty/Medical Staff
• Support Staff
• Faculty/Medical Staff
• Support Staff
• Faculty/Medical
Staff
• Support Staff
Key Touchpoints

26. PAGE 26
What are your key challenges?

27. PAGE 27
Ways to Engage: Sample Discussion Areas
Patients / Families
• Current Perceptions
• Decision Criteria
• Sources of Frustration
• Areas of Praise
• Usefulness of Touchpoints
• Likelihood to Recommend and
How
Physicians
•Referral Roles / Process
•Ideal Relationship
•Self / Patient Experience
Assessment
•Recommendations
•Likelihood to Refer and
Why
Staff / Executives
• Vision of Ideal
• Current Barriers
• Patient Dissatisfiers
• Opportunities for Improvement
• Model Employee
• Likelihood to Recruit and Why

28. PAGE 28
Ways to Engage: Advisory Boards
Keys:
Set a Clear Vision
Recruit Thought Leaders
True Collaboration
Recognition, Exchange Value
Right Mixture of Participants
Use for:
Industry Trends
Organizational Strategy
Outreach Planning
Service Line Development
Experience Enhancement / Concept Testing

29. PAGE 29
Internal Processes
Key Activities
Scheduling First Visit Treatment Follow-upNeed
Physician contracts call
center for additional
information
Pain Points
• Calls not returned
• Provided incorrect information
• Need to repeat their “story”
How can CRM support/improve process? Are we improving?
Information Needs
• What is currently collected, needs migrated
• What needs to be collected
• How should that information be organized
Assessing, Monitoring and Tracking
• Surveys
• Key Metrics
• Reports and Trends
Liaison Pain Points
• Incomplete records
• Information needs
• High volume of calls

30. PAGE 30
Service Recovery

31. PAGE 31
Real-time Insights

32. PAGE 32
Interested in growing practice Anxious about competitiveness
PCPs and Specialists
are different
Concerned about staff
Wants a seamless
experience
Uncertain about future
Physician Partners and Personality Traits
Wants to be a partner,
know individuals to
whom he refers
Requires respect

33. PAGE 33
Action Planning
Communication Coordination Care
Awareness Need Scheduling Treatment
Transition of
Care

34. PAGE 34
Incorporating into Lean Work

35. SEGMENTATION AND
PRIORITIZATION PRINCIPLES
4

36. PAGE 36
FY14
Plan
Can We
Grow It?
Where?
Who
Controls
Referrals?
Sales-
Verified
Volume
EBITDA
Growth
Opportunity
Mapping Precision
Targeting
Revenue
Sustained
Growth
Building “Right” Volume

37. PAGE 37
Service
Quality &
Outcomes
Value &
Opportunity Context
System /
Med Policy
How We Make Your
Practice Life Easier
Why We are Best for
Your Patient
How Misunderstood
Elements Fit In
Benefits of Aligning
with Us
What You Need to
Know to Practice Here
GRAND NARRATIVE STORY
Assets & Attributes
Differentiator Strengths
Programs & Initiatives
Shared Goals
Collaboration & Enrollment
Mutually Beneficial Outcomes
MESSAGE
Desired Perception
Source: SVP Strategies LLC
Communications Engagement

38. PAGE 38
• Drive “Ease of Practice Life” Strategic Engagement with Physicians
• Adapt Professional Sales Practices to Physician Relations
• Physician Field Team Call Strategies are Aligned to FY14 System Strategies
• Data-driven Field Activity Strategies
• 40 “Quality” Calls to Physicians per Week w/ Incremental Volume Expectations
• Systematic Surfacing of Barriers to Growth (Tickets)
• Field Team Intelligence Puts Pressure on Operations for Timely Responsiveness
• Sales Field Team Seen by Physicians as Relevant Advocate for Physicians
• Hospital CEOs and A-Teams Have Specific Sales Call Expectations
The Culture of Growth: Physicians

39. PAGE 39
Pre-Call Plan
• Review Field Intelligence
• Purpose for My Call
• Define an Objective / Outcome
• Prepare Message / Questions
• Set Specific Volume Targets
Create Relevance
• Establish Rapport & listen
• Relevant Information Exchange
• Surface Needs / Growth Barriers
• Ask and Answer Questions
Offer Solutions
• Understand Customer Needs
• Address Objections
• Facilitate Issues Management
• Create Connections
Gain Commitment
• Negotiate
• Set Follow Up
• Close on Action
Profile & Strategy Open the Call/Create Relevance
Advocacy for Customer Close
Professional Relationship Model

40. PAGE 40
Persona: Primary Care Providers
Primary Care Provider
GOALS
• Grow their patient base
• Strengthen reputation through
excellent care for their patients
• Build lasting relationships with their
patients
BEHAVIORS
• Employed or affiliated PCPs refer
to their institution
• Refer locally for less complicated
cases, believing their patients want
convenience
• Refer to The James for many
types of cancer and to other areas
of The OSU
“My patient’s satisfaction with care directly impacts the
success of my practice. When my patients are happy,
they stay with me and refer me to their friends and family.
When I refer a patient, my reputation is at stake.”
NEEDS
• Know what their patients can
expect at The James so they can
prepare them in advance
• Secure timely appointments
• Referral process that does not tax
their resources and staff
• Stay informed about their patient’s
treatment and care
• Have their patients perceive them
as being engaged and involved in
their careSource: OSUMC / Gelb Presentation

41. PAGE 41
Persona: Specialists
GOALS
• Grow their patient base
• Strengthen reputation through
excellent care for their patients
• Building lasting relationships with
Primary Care Physicians
BEHAVIORS
• Refers to sub-specialist at The
James for complex cases
• Manages more common cancer-
related issues and screenings
“I am an expert in my specialty. Almost every case I refer is
complex. For rare cases or those that require special
technology, I need a physician at the top of their field with
very specific expertise- distance to travel is less important.”
NEEDS
• Ability to identify oncologists at
The James based on expertise
• Knowledge of
technique/technology available
• Have the patient referred back for
specialist-level care when possible
(such as common surgeries)
Specialist
Source: OSUMC / Gelb Presentation

42. TAKING ACTION
5

43. PAGE 43
Impact of Transformational Leaders
Leaders translate customer
expectations to the organization
and reinforce desired employee
behaviors. They also set strategies
such as value equation, culture
alignment and patient enchantment.
Culture and your brand promise are
linked through the experience
delivered.
This alignment creates an
exceptional experience and a
sustainable competitive advantage.
EXPERIENCE
STRATEGY
Culture Leadership Brand
Ensures
alignment and
sustainment
RTB-CTB
Impacts
Culture
Envisions
Future
Motivates
Individuals
Manages Red
Zones

44. PAGE 44
Aligns the culture Creates a shared vision
Builds trust on all levels
Models moral behavior
Advocates for the
customer
Motivates the heart
Where It Begins - Transformational Leader
Transformational leadership is the process whereby a person engages others
and creates a connection that raises the level of motivation and morality in
both the leader and the follower (Northouse).
Challenges the status quo
Develops and enables
others to act

45. PAGE 45
Establishing a Dual Agenda
The Red Zone
As you progress with dual agenda, conflicts appear
between them. You must look for opportunities in
current operations to make changes.
Use the momentum of
Run the Business to
sustain the Change
agenda.
The Red Zone
Employees
Transformational
Leaders
Managers
Future
Business Model
Today’s
Business Model

46. PAGE 46
Ensuring Commitment
The Red Zone
Your employees will travel up a commitment curve.
While the speed with which this
journey can vary, the steps are
always the same. Our practices
accelerate the timing.
The Red Zone
Acceptance
• Rational
• Emotional
Enable
T I M E
COMMITMENT
High
Low
Envision
Engage
Energize

47. PAGE 47
Prioritization
Quality
The Kano model shows how tangible
customer needs, wants, and
suggestions can be segregated into 3
separate requirement categories:
Basic Requirements
Meet these requirements quickly and
with the lowest cost possible
Performance Requirements
Selectively meet these requirements to
achieve highest ROI
Enchantment Requirements
Meet these requirements to achieve
elite status
Competitive
Pressure
Satisfied
Performance
Needs
Enchanted
High
Satisfaction
Dissatisfaction
Enchantment Needs
Unexpected and unspoken,
adds value but not required
Basic Needs
Expected, minimum
requirements

48. PAGE 48
Action Prioritization
Basic
Requirements
Performance
Requirements
Enchantment
Requirements
C o m m u n i c a t i o n
Awareness of
Services
Self-Service for Referrals
Creative, Value-Added,
Patient Education for Docs
Accessible,
Responsive
Personnel
Single Point of Contact
Engage Physicians in
Developing Services
C o o r d i n a t i o n
Improved
Scheduling
Coordination of Referrals
Outside of Original Intent
Real-time Status Updates
Internal
Coordination
Web-Enabled Scheduling
and Lab Results
Nurse Navigators
C a r e
Consistent Quality
and Quality
Control Process
Dedicated Physician
Access
Concierge Service
Respect for
Referrers
Physician Sat
Measurement
Share Performance
Results
O v e r a l l
E x p e r i e n c e
Presenting a
Clear Brand
Promise
Ownership Culture
Engage Physicians
Strategically

49. PAGE 49
Run the Business, Change the Business
• Identify the RTB/CTB activities you engage in today:
RTB CTB
_________________ __________________
_________________ __________________
_________________ __________________
_________________ __________________
_________________ __________________
_________________ __________________
_________________ __________________
• How would you change this ratio to be a more effective
transformational leader?
• Discussion with table partner

50. PAGE 50
RTB/CTB worksheet
Takeaways
1
2
3
How would you
change your ratio
of RTB/CTB
activities?
1
2
3
Call to Action
1
2
3

51. PAGE 51
Personal Action Plan
What is now clear to you
that was not clear to you
prior to this workshop?
1
2
3
What has been most
valuable for you?
1
2
3
What are the top 3
commitments you will
make to improve your
effectiveness as a
transformational leader?
1
2
3

52. PAGE 52
Managing the Transition
The Business must be prepared
for each step on the way to the
Future Operating Model
FOM
Marketing
Front Office
Planning Trading
Moving and
Tracking
Settling
Controlling
Trading
Controlling the
Business
Managing the
Business
Mid Office
Back Office
2014
Marketing
Front Office
Planning Trading
Moving and
Tracking
Settling
Controlling
Trading
Controlling the
Business
Managing the
Business
Mid Office
Back Office
2013Marketing
Front Office
Planning Trading
Moving and
Tracking
Settling
Controlling
Trading
Controlling the
Business
Managing the
Business
Mid Office
Back Office
2012Marketing
Front Office
Planning Trading
Moving and
Tracking
Settling
Controlling
Trading
Controlling the
Business
Managing the
Business
Mid Office
Back Office
COM
Marketing
Front Office
Planning Trading
Moving and
Tracking
Settling
Controlling
Trading
Controlling the
Business
Managing the
Business
Mid Office
Back Office
COM = Current Operating Model
FOM = Future Operating Model

53. PAGE 53
Q&A

54. ADDITIONAL RESOURCES
6

55. PAGE 55
Session Leader Contact Information
Doug Backous, MD, Douglas.Backous@swedish.org
Shannon Frazier, sfrazier@endeavormgmt.com
Jeff Cowart, jcowart@barlowmccarthy.com

56. PAGE 56
Handout
Key Challenges
Discussion Guide
Experience Map
RTB/CTB Activities, Agenda
Personal Action Plan

57. PAGE 57
Selected Physician Experience Resources
Gelb referring physician experience
management overview
Ohio State University Medical Center
Cleveland Clinic
MD Anderson
Texas Children’s
University of Michigan Health System
Experience Mapping Workshops
Building Enduring Relationships
with Referring Physicians
Healthcare Growth Playbook
Marketing in the Era of Health Reform
Message Mapping – Creating a
Communication Roadmap

58. PAGE 58
About Gelb Consulting
We understand the nuances of healthcare having worked
with some of the largest and most respected organizations
in the country.
Our healthcare professionals lead stakeholders to make
best use of market information to build and execute sound
strategies.
We uncover attitudes and expectations to form consensus
around which transformational strategy to pursue.
We then provide recommendations, based on our
knowledge of the market segments, as to how to best
achieve real business value.
Selected Clients
Barnes-Jewish Hospital
Boston Children’s Hospital
Cleveland Clinic
Cincinnati Children’s Hospital
Duke Medicine
Froedtert Health
Mayo Clinic
MDAndersonCancer Center
Memorial Sloan Kettering
Menninger Clinic
TexasChildren’s Hospital
TheOhio State University MedicalCenter
University of Chicago Medicine
University of Colorado Health
University of Michigan Health System
www.endeavormgmt.com/healthcare

59. PAGE 59
About Barlow/McCarthy
Recognized as one of the nation’s top healthcare consulting firms, Barlow/McCarthy provides
community hospitals, academic medical centers, systems and specialty providers with forward-
thinking physician relationship strategies and solutions:
• Physician relations/sales programs
• Physician recruitment and onboarding
• Engagement communications for physicians
• Practice marketing strategy, design and implementation
• Alignment and leakage; business strategy and model development
• Retention, loyalty and physician leadership development
• Medical staff development and community health needs assessments
Barlow/McCarthy provides insightful and practical advice in physician relationships. We succeed
because we listen and work systematically through hospital/physician challenges. We do the careful
and detailed work it takes to inspire positive change and achieve lasting results.