Disease State Marketing & Physician Marketing Presented By: Bob Tysoe Hearing Healthcare Marketing Company Portland, Oregon Marketing Consultant & Sales Trainer robert.tysoe@netzero.net C 503 863 9250
Disease State Marketing Definition Disease state marketing is the combination of marketing strategies that: Seek to identify a disease state Identify a patient type Define the negative consequences Identify a medication, treatment plan, or surgical procedure, that when standards of care are followed will potentially result in efficacy, i.e. an improvement in the patient s symptoms
Sequence of the call strategy Identify the disease state hearing loss Identify the patient type 50 year old diabetic, blood sugar out of control, sedentary job, poor diet, not an exerciser Identify the negative consequences of untreated hearing loss marital and financial stress, recently laid off due to poor job productivity related to uncorrected hearing impairment, depressed and/or angry, non compliant with meds. Has peripheral neuropathy Identify the solution patient needs to be referred to hearing healthcare clinic for a diagnostic evaluation partner with physician to minimize impairment and maximize hearing function Identify possible quality of life improvements. Confidently ask the physician to refer this patient type, and all diabetic and pre diabetic patients to you for audiologic care
Disease State Marketing The diagnosis, prevention, and treatment of hearing loss may no longer be elective medicine it may now be thought of as sound medical care where the primary care physician is obligated to make the diagnosis, and a patient referral to the appropriate hearing care specialist is standard of care
Disease State Marketing The Hippocratic Oath In part, it states above all, do no harm The key component of an effective disease state marketing program is that we educate to obligate Therefore we are now obligated to educate our health care partners if we are to reach our mutual goals of improved patient care
Audiology and ACO s As of September 2013 370 ACO s, with 150 more being developed EMR s exist that meet certification standards and are able to participate in HIE exchanges and ACO models Audiology has no such certified EMR system If Audiology does not get such a system, it can t participate in ACO models ACO s wont include redundancy of services, especially multiple audiology practices Understand who/where are the ACO s in your community Reach out to the Health Information Exchange and ask them how you can get connected via Direct. Be part of the discussion, present your plan to the key ACO s in your community don t delay and get exempted.
Current Changes in Healthcare Delivery in the U.S. Medicare, Medicaid, and Health Plans moving from production based health care to quality care from volume based care to value based care New treatment plans focus on early diagnosis, quality treatment plan, improved patient compliance, efficacy, improved quality of life, decreased per patient cost of care A stronger emphasis on preventive care untreated hearing loss in U.S. population aged 65 and older in 2010, (7.91 million lives) is associated with approximately $3.10 billion in excess medical expenditure Hearing loss evaluation and treatment is now a part of preventive medicine
Audiology and Preventive Care The earlier we treat, the better the outcome partnering with primary may result in decreased incidence/severity of: Depression Anxiety Paranoia Social isolation and withdrawal Cognitive function decline Incident Dementia Falls Speech impediment Ischemic Heart Disease CVD events Early Mortality Unemployment/loss of income Lack of patient compliance
AUDIOLOGY DOLLAR$ & SENSE 312 Million U.S. Population $2.7 Trillion Spent on U.S. Healthcare = 19% of total GDP 260,000 Primary Care Physicians in U.S. 15,000 Audiology/HIS Specialists in U.S. 9,000 Hearing Instrument Specialists 11,000 Audiology Storefronts in U.S. 2 Million Hearing Aid Units Dispensed in U.S. $6 Billion U.S. Audiology Market 48.1 Million Persons with a Treatable Loss 12 years of age plus (20.3% of Total U.S. Population)
AUDIOLOGY DOLLAR$ & SENSE 73% Market Research Shows U.S. Population asks Primary Care Physicians about Hearing Loss First 8% Internal Medicine Physicians Test Patients 13 15% Primary Care Physicians Test Patients 15% Audiology Revenue Dollars come from Physician Referrals 67 Years Average Age of First Time Purchaser of Hearing Aids in U.S. $30,000/year Decreased Annual Earnings from Severe Untreated Loss
Physician Referral Development WHY? 48 million plus Americans have hearing loss (20.3% of people over 12 have hearing loss in one ear; while 30 million or 12.7% of the population have hearing loss in both ears.) Ref. Nov 14 2011 Arch. Int. Med. Ref. Johns Hopkins Univ. Frank Lin MD. Only 8.5 million have sought treatment or obtained hearing aids 80% of the people are untreated
AUDIOLOGY DOLLAR$ & SENSE The average number of US patients per primary care physician practice is: 2000 The percent of US patients over the age of 12 years who have a treatable loss is: 20.3 % Ref: Johns Hopkins Univ. ENT F. Lin MD. The percent of US patients who have already been treated: 20% Ref: Market Trak Data The total number of US patients who will fail a 25 decibel hearing test for every 25 primary care physicians is: 6800 Ref: R. Tysoe, HHMC, Portland OR.
Customer Pathways Physician - 15% Repeat Customer - 50% Customer Marketing - 15% Social Media Mktg %? HMO/MCO - 15% Customer ref - 10% Audiology Clinic Revenue Stream Hearing Inst. 75% Diagnostics 15% Batteries/ALD 5% Repairs 5%
The Most Critical Concept of a Physician Marketing Program Activity = Results Strategic implementation must be consistent for the ownership life of your clinic
AUDIOLOGY SERVICES MARKETING Managing Differentiation Customers who view the services of different providers as similar care less about the provider than the price The solution to price competition is to develop a differentiated offer, quality of service delivery, and image
Attributes of Importance to the Patient Purchasing a hearing aid Non Users: Nearly Invisible 81% Fitting and Follow up 79% Affordable 78% Good Reputation 74% Physician Recommended 73% Professional Staff 71% Extended Warranty 70% Take care of Insurance/Paperwork 69%
A DISEASE STATE MARKETING SCHEDULE 90 DAYS Diabetes Pre diabetes 106 MILLION LIVES 90 DAYS Smoking & Passive Smoking 48 MILLION LIVES 90 DAYS Noise Related Hearing Loss 90 DAYS 90 DAYS 30 MILLION LIVES Age 45 years Plus Ototoxicity 90 DAYS 140 MILLION LIVES CAUSAL MEDICATIONS Tinnitus 50 MILLION PATIENT LIVES 90 DAYS Cardiovascular Disease 90 MILLION LIVES
Risk Factors For Hearing Loss In Diabetics Hemorheological complications include: Loss of red cell deformability Increased red cell aggregability Increased viscosity Increased resistance to blood flow Decreased oxygen and nutrient delivery to tissues that results in ischemic conditions such as diabetic neuropathy, ischemic heart disease, nephropathy, retinopathy, and hearing loss due to impaired microcirculation
Risk Factors Hearing Loss In Diabetics Hypertension, the most common vascular disorder, may facilitate structural changes in the heart and blood vessels High pressure in the vascular system may cause inner ear hemorrhage, which is supplied by the anterior inferior cerebellar artery, which may cause progressive hearing loss This circulatory system pathology may directly affect hearing in a number of ways. One of the vascular physiopathological mechanisms described is the increase in blood viscosity, which reduces capillary blood flow and ends up reducing oxygen transport, causing tissue hypoxia, thus causing hearing complaints and hearing loss in patients. Ref: L. Marchiori, M.E et al Hypertension as a factor associated with hearing loss.rev. Bras Otorhinolaryngol 2006.
Vasculopathy & Hearing Loss
Mission with the Physician Make the diagnosis and treatment of hearing loss important to the physician. Explain the negative impacts on the patient s quality of life, the consequences of remaining untreated, and the benefits of care. Educate To Obligate the physician to diagnose hearing loss Position yourself as a trusted specialist who can be relied upon to provide the appropriate patient care that results in efficacy, minimal side effects, and fair pricing Coach all clinic staff on how to successfully refer the patient to their local Hearing Healthcare provider
Chronic Disease Management Patient Care Priorities Recognizing speech especially in difficult environments Localizing sound Communicative disability that affects family, friends and co workers Unaware of what they are missing Self isolation Reduced social activity Feelings of exclusion Increased prevalence of symptoms of depression Increased risk of falls and balance disorders Decreased cognitive function, and increase symptoms of dementia Decrease in quality of life
AUDIOLOGICAL SERVICES REFERRAL GUIDE SYMPTOMS POSSIBLE CAUSES RECOMMENDED AUDIOLOGICAL TESTS Aural Pressure/Fullness Failed Newborn Screening Hearing Loss chronic Hearing Loss poor discrimination Hearing loss sudden/fluctuating (Patient should be evaluated STAT) CALL FOR AN APPOINTMENT TODAY Eustachian tube dysfunction Hearing loss Vernix, Middle ear effusion, collapsed canal Hereditary, prenatal or perinatal hearing loss Noise exposure Heredity/Aging High frequency hearing loss Central Auditory Processing (CAP) disorder Serous Otitis Media Autoimmune disease for the inner ear Meniere s Syndrome Acoustic trauma Antibiotic/Chemotherapy Acoustic Neuroma Perilymph Fistula Oto acoustic immittance/tympanogram Comprehensive audiological evaluation OAE (OtoAcoustic Emissions) Oto acoustic immittance/tympanogram Comprehensive audiological evaluation Hearing aid evaluation Comprehensive audiological evaluation SCAN auditory processing test Comprehensive audiological evaluation Serial audiograms Tinnitus Ringing or Head noises Acoustic trauma Hearing loss (Conductive or Sensorineural) Side effect from medication Comprehensive audiological evaluation Serial audiograms Speech & Language Delay Hearing loss (Conductive or Sensorineural) Comprehensive audiological evaluation HEARING HEALTHCARE MARKETING CO 11790 SW King George Drive King City, OR 97224 Robert Tysoe PH: 503 620 3046 CELL: 503 863 9250 EMAIL: robert.tysoe@netzero.net HHMC All rights reserved
THE MOST CRITICAL CONCEPT Activity = Results
Pacific NW Marketing Trial Results Overview Program initiated in February 2004 There were seven audiology clinics which eventually expanded with acquisitions The recession began in 2007 so sales declined The program was discontinued at the end of the third quarter in 2008 due to corporate decision to convert all company owned clinics into independently owned franchises The 2011/12 results are for a half time employee only
Recorded Call Activity with Bob Tysoe Physician Liaison 2007 1194 clinic calls 2007 502 Face to Face with physicians 229 Referral Coordinators 2800 Notes with Referral Folders 88 lunch and learns 486 RN/Clinic Manager calls 321 Receptionist calls 257 Samples to clinic calls
Recorded Results from Bob Tysoe Physician Liaison 2007 909 physician referrals from doctors 870 patient appointments kept 346 opportunities created 207 people sold 334 units sold $649,809 gross revenue $715 value of each referral $1943 ASP
Commitment and Consistency Hallmarks of Integrity Cultivating physician referrals takes time, so plan long term, act long term and you will prosper! Activity = Results Reach more patients by reaching more physicians, with the right message, more frequently.
So Let s Power Up Your Priorities! First create your list of 25 primary care physicians Update your list of services Create Physician Referral Folders Copy three clinical research articles per quarter that matches the disease state marketing plan Block out two hours per week to make calls on 10 M.D. s per week if not you then delegate Your minimum additional revenue per annum goal is: $60,000 one binaural fitting per month
Activity Planning Time and Territory management Target / map clinics Two clinics/10 physicians per week 3 5 Contacts = 1 referral 3 referrals = 1 opportunities 1 opportunity = 1 unit sold = $2500.00 approx. Make Monthly calls i.e. 12 contacts per physician annually Schedule Lunch and Learns and appointments Write personal notes to Physicians with the updated referral folders Bring big chocolate cream pies!!!
Time and Territory Management Graph Week Four Itinerary #4 Week One Itinerary #1 10 Physician Calls Per Week. i.e. 10 Referral Folders distributed. 10 Physician Calls Per Week. i.e. 10 Referral Folders distributed. Up to fifteen mile radius 10 Physician Calls Per Week. i.e. 10 Referral Folders distributed. 10 Physician Calls Per Week. i.e. 10 Referral Folders distributed. Week Three Itinerary #3 Week Two Itinerary # 2
Identifying The Referral Source Primary Care Physicians (M.D., D.O.): Family/General Practice Internal Medicine Pediatrics Specialists: Geriatricians, Allergists, Rheumatologists Otolaryngology (Non dispensing) Neurologists Endocrinologists Pulmonologists Oncologists Cardiologists Nephrologists
Identifying the Referral Source (cont.) Sub specialists (Not M.D., D.O.): Diabetes Nurse Educators Podiatrists Nurse Practitioners & Physician Asst. Nurse Case Managers Other: Medical Assistants Licensed Practical Nurses Pharmacists
THANK YOU A FINAL EMPOWERING THOUGHT The audiologist should be a part of the comprehensive team of care givers striving to assist the diabetic patient to minimize impairment and achieve maximal function. Contribution of evidence based practices will add to the growing body of literature in the fields of diabetes and audiology. Ref: Pamela Parker M.D., A.T. Still University School of Osteopathic Medicine, AZ.
Disease State Marketing I sincerely appreciate your participation in this workshop I am honored by the invitation to present at this important program Should you have need for future contact, I can be reached at robert.tysoe@netzero.net and at cell phone 503 863 9250, Portland, OR.