As Corporate Entities Enter Healthcare, Practices Can Respond via Patient-Centered Care

Richard E. Anderson, MD, FACP, Chairman and Chief Executive Officer, The Doctors Company and TDC Group

Retail medicine and private equity are important drivers of primary care delivery in the U.S., and they are poised to become even more so. Corporate entities have always been involved in healthcare, but now mega corporations—from outside the medical space—are entering the field. The involvement of these large non-legacy corporate entities in healthcare is growing and is challenging—and while this trend brings some benefits, it will also impact how all clinicians provide healthcare.

In a single quarter of 2021, private equity firms acquired $126 billion in medical practices. And these private equity firms, formerly mostly interested in specialty practices, have now set their sights on primary care. Similarly, the expansion of retail medicine into traditional areas of physician practice has been massive. For context, here’s a quick snapshot of the retail medicine landscape:

Let’s focus on several of these.

Amazon Brings Credibility to Claims of Service

As Amazon continues their push into the healthcare space, they have several advantages. One is their remarkable reputation for customer service. As they move into healthcare, they will have significant credibility in claims they make about providing better service, better access, better prices, and better convenience. Traditional healthcare will struggle to match them.

We clinicians are aware of the distinction between medicine’s definition of “patient-centered care” and retail’s perspective on “customer service.” Yet despite the profession’s emphasis on patient-centered care for several decades, we haven’t fully achieved it. That’s one reason that these new healthcare entities will exert broad downward economic pressure on primary care practices.

But Amazon’s expanding influence goes beyond drawing patients away from individual small practices. Nobody has more data than Amazon—between Whole Foods, Alexa, and Prime members—and this data can be used to shape healthcare delivery. Moreover, Amazon is in the process of developing nationwide pharmacy availability, a hospital at home partnership with leading healthcare providers, and an accelerator for healthcare startups. Clearly, Amazon plans to develop into a major player in healthcare delivery.

Walmart Brings Experience as an Insurer—Plus Affordable Prescriptions

Walmart seems to be one company that is able to compete, at least along some metrics, head to head to head with Amazon. Though Walmart once had a terrible reputation for not providing healthcare insurance for their own employees, they now provide substantial coverage. And they already have more than a million people in their own insurance plan. It may not be long before Walmart starts providing a health insurance plan for non-employees.

In addition, Walmart has done some very commendable things in the realm of pharmaceutical pricing. Walmart provides most of the most common generic drugs for a flat $4 per prescription, which is a true blessing for many people. In addition, while the cost of some proprietary insulins runs to thousands of dollars a month, Walmart has its own private-label version of analogue insulin, which it makes available at very nominal cost. That’s not only an important service, but a visionary one.

We’ll see how the healthcare competition between Walmart and Amazon shapes up over time, but the outcome is likely to have a major impact on pricing and service in many areas of clinical practice.

Health Insurers Bring Their Ambition to Become Healthcare Providers—At Scale

Health insurers are not just financing care. They’re providing care. Optum, working under its parent company, UnitedHealth Group, purchased its first medical practice 15 years ago. Today, they own the practices of 56,000 physicians in 1,600 clinics, representing $40 billion a year of revenue. By 2028, their expressed goal is to reach $100 billion in revenue. Optum is far from the only player in this space, but it is the biggest.

This is a different model of healthcare delivery, with a real potential for conflicts of interest. As this trend accelerates, it is conceivable that health insurance will come to cover an increasingly limited range of clinical options.

Private Equity Brings Ongoing Disruption

The model of private equity—invest, disrupt, exit— wouldn’t seem to fit healthcare. Nonetheless, as the first wave of private equity investments matures, we’ll see what those exits look like. Who will buy these companies and practices? They will be sold, presumably, at much higher valuations than before. This means that revenue and operational efficiencies will become more important than ever, and the management agreements that may have been attractive in the initial partnership may or may not be continued into the new partnership. Regardless, when we see that private equity firms acquired $126 billion in medical practices in a single quarter of 2021, we must expect that pressure will increase on physician-owned practices to compete with the challenges presented by private equity investment.

Can Medicine Compete Through Patient-Centered Care?

If we want to continue to be the driving force in our healthcare system, when medical professionals say “patient-centered care,” we’re really going to have to mean it. We’re going to have to mean it in the customer-service-forward way practiced by corporations like Amazon or Nordstrom or FedEx. After a decade of talking about “patient-centered care,” although we know what it should mean, it isn’t what we typically offer. We need to stop requiring outpatients to see multiple doctors, labs, and imaging centers in different locations at different times, and then to hope that someone thoughtfully acts on the results. That isn’t how we access services anywhere else in the economy. Retail medicine is making significant inroads into primary care by providing rapid access at convenient locations at lower cost.

We should recognize that some of the disruption in healthcare today is actually healthy, because it is based on the pressing need for improved healthcare access, healthcare equity, and healthcare literacy. That said, as these new forces in healthcare compete to recruit new medical school graduates, they will also disrupt the day-to-day operations of many existing physician practices. Instead of reacting in surprise when these forces reach the door of our practice or our healthcare system—if they haven’t already—we would be wise to think now about how we should respond.

We would like to know what steps your practice or medical system has already taken in response to large non-legacy corporate entities delivering healthcare. Please answer this poll, and we will provide an update with your responses.

To discover more about upcoming changes, read our whitepaper, What U.S. Healthcare Will Look Like in 2032.

Begin the Poll

The guidelines suggested here are not rules, do not constitute legal advice, and do not ensure a successful outcome. The ultimate decision regarding the appropriateness of any treatment must be made by each healthcare provider considering the circumstances of the individual situation and in accordance with the laws of the jurisdiction in which the care is rendered.

Poll: Majority of Virginians only want eye surgeon to perform eye surgery

FOR IMMEDIATE RELEASE
Contact: Jeff Kelley for VSEPS
(804) 397-9700
[email protected]

80% of respondents would not trust primary vision care doctors with eye surgery

RICHMOND, VA (JANUARY 20, 2022) — A new poll released today by the Virginia Society of Eye Physicians & Surgeons found an overwhelming majority of Virginians — 80 percent — would only trust a trained eye surgeon to perform eye surgery. Just 10 percent said they would allow an optometrist, whose role is to provide primary vision care, to perform surgery on their eyes.

The poll is released as Virginia legislators review two bills in the General Assembly that would allow optometrists to perform laser-eye surgery if certified by the Virginia Board of Optometry. The bills are Senate Bill 375 (J. Chapman Petersen, D-Fairfax City) and House Bill 213 (Roxann L. Robinson, R-Chesterfield).

Laser-eye surgery procedures are common to treat cataracts, glaucoma, and related conditions. They are advanced eye surgeries requiring careful placement of laser energy into the eye. The procedures are never without risk, which is heavily minimized when performed by a medically trained surgeon: an ophthalmologist.

“Eye surgery should be performed by eye surgeons, who have experience and proficiency that only comes with years of education and training supervised by other surgeons, and participating in hundreds of surgeries on real live people,” said Michael Keverline, M.D., President of the Virginia Society of Eye Physicians & Surgeons. “Optometrists play a key role in eye and vision care, but it is important to understand where their scope of practice should end, and that is with surgery. Ophthalmologists are the only physicians qualified to perform eye surgery and prepared to manage surgical complications that can and do occur.”

  • Ophthalmologists (eye physicians and surgeons) are medical doctors (who can treat the entire body and specialize in eyes) and complete between 12-13 years of total higher education — which include 4-5 years of intensive surgery training. They typically have 17,000+ hours of surgical training before certification.
  • Optometrists (vision care experts) can practice after 7-8 years of higher education and diagnose eye conditions and treat vision problems. Optometric surgical training is generally didactic or simulated and does not include surgical experience involving patients under the supervision of a trained eye surgeon. They do not attend medical school.

The vast majority of states — 43 — prohibit laser surgery by optometrists, as does the U.S. Department of Veterans Affairs. Even in those states where laser surgery is allowed for optometrists, few optometrists provide the services and typically not in any rural or underserved areas. Eye surgeons are widely available statewide, even in rural areas. There is no evidence that allowing optometrists to perform laser eye surgery would increase access to care or reduce costs — reimbursement is the same regardless of specialty. Expanding scope of practice for optometrists may lead to over-utilization of these procedures and drive up costs and health insurance premiums and the need for corrective medical care.

“No need has been demonstrated to change Virginia’s standard for eye surgery. Not on access to care, cost, or other patient need,” Keverline said. “The only thing we know is that if this legislation passes, inadequately trained practitioners will be performing surgery on people’s eyes.”

About the Virginia Society of Eye Physicians & Surgeons

As the “Eye MDs” of Virginia, The Virginia Society of Eye Physicians & Surgeons is a statewide, non-profit organization comprised of medical doctors and doctors of osteopathy. The VSEPS mission is to advocate for the best quality eye care through education, legislative efforts and community service. Members are committed to heightening public awareness that eye disease and blindness can be reduced through prevention, and early detection and treatment. Member physicians are dedicated to the public’s direct access to ophthalmic care. The organization was chartered in 1920.

About the Poll

The poll was commissioned by the Virginia Society of Eye Physicians and Surgeons and conducted by Mason-Dixon Polling & Strategy from January 13 to 17, 2022 with 625 registered voters statewide. The margin for error is no more than +/- 4 percentage points. For questions on the poll, contact Brad Coker with Mason-Dixon at [email protected] or call (904) 261-2444.

Bills being considered by the General Assembly may remove safeguards to protect the health of Virginians

Wider health care access
Letter from Dr. Mohit Nanda, President of the Medical Society of Virginia, to the Richmond Times-Dispatch Editor

Editor, Times-Dispatch:

Enhancing access to medical care in underserved and rural communities is an important priority for Virginia’s health care system, and there are many possible solutions. Currently, three bills being considered by the General Assembly are not likely to help and may remove important safeguards to protect the health of Virginians…

Read the Full Letter Here

Federal Public Health Emergency Extended Until April 16, 2022; New State Public Health Emergency

TO: All Providers Participating in the Virginia Medicaid and FAMIS Programs

The federal public health emergency (PHE) was extended on January 14, 2022, and will now last until April 16, 2022. In addition, Executive Order 84 allowed for certain additional state flexibilities under a new, temporary state PHE…

Read the Full Bulletin

Birth Defects Have a Lifelong Impact for Physicians, PAs, and their Patients

Every 4-1/2 minutes in the U.S., a baby is born with a birth defect.

Birth defects affect 1 in 33 babies in the U.S. each year. That means about 120,000 babies born every year have a defect that affects how their body looks or works, or both. Those defects can range from mild to severe and can be fatal. Birth defects cause 20 percent of all infant deaths.

While some birth defects can be corrected in utero or in infancy, many birth defects have a lifelong impact for patients and physicians — who will treat patients with birth defects not only during pregnancy and childhood but throughout adolescence and into adulthood.

This month, during National Birth Defects Awareness Month, we will provide you with information about birth defect prevention and considerations for lifelong care.

Birth Defect Prevention

Unfortunately, not all birth defects can be prevented, but risks can be mitigated. Evidence points to many factors that cause them, from genetics and the environment to behaviors, medications, medical conditions, and maternal age.

Having one or more of these risk factors may result in a birth defect, or it may not. There’s no exact formula — or fail-safe. That’s why it’s important for physicians and PAs to work closely with patients who are or may become pregnant to help them understand how to lower their risks. Though most birth defects occur in the first 3 months of a baby’s development, they can occur later, so prevention efforts are important throughout pregnancy.

Three prevention strategies to advise patients include:

1. Be cognizant about what you’re putting in your body. Pregnant women should avoid smoking, drinking alcohol, and using marijuana and illegal drugs, as well as taking certain prescription and OTC medications and some dietary and herbal supplements.

2. Communicate with your physician to monitor and manage your overall health, not just your pregnancy. Close management of medical conditions like diabetes, infections like the Zika virus, and medical situations like a high fever are critical, as all can contribute to increased risk for birth defects.

3. Learn as much as you can about your medical history. For patients with personal or family histories of birth defects, which includes the baby’s father, genetic counseling is also an option to understand and evaluate risks.

For more prevention strategies, visit The American College of Obstetricians and Gynecologists’ FAQ page on “Reducing Risks of Birth Defects” or the Centers for Disease Control and Prevention’s web page titled “Commit to Healthy Choices to Help Prevent Birth Defects.”

Lifelong Care of Patients with Birth Defects

Infants and children with birth defects often require specialized treatment and care, especially those with physical and intellectual disabilities. Early recognition and early intervention and supports are integral to their health, well-being, and quality of life as they grow up.

But what happens next?

To help physicians and PAs understand how best to help your patients with birth defects throughout their lives, here’s a list of challenges they may experience as adults and as they transition from adolescence to adulthood:

  • Navigating changes in insurance providers and coverage
  • Switching from familiar, trusted pediatric specialists to new specialists who treat adults
  • Adapting to new lifestyle situations related to increased independence, like becoming responsible for managing their own care and skill development required to effectively address their daily needs
  • Mental health issues resulting from managing their condition, treatments, transitions, and other circumstances
  • Requirement of additional surgeries, medications, or other procedures to maintain or improve health
  • Increased health risk factors related to their birth defect, like an increased risk of cancer later in life
  • New or ongoing health complications related to their birth defect, like heart defect patients who may develop trouble breathing
  • Loss of family relationships and support on which they depend, such as the death of a parent
  • Developing new social relationships, including dating and marriage
  • Entering the workplace, which may require new skill development and managing needs for adaptation
  • Exposure to discrimination
  • Planning for parenthood, including understanding risks to their own health as well as to their baby
  • Planning for long-term care as their healthcare needs may evolve and change over time

Birth defects have a lifelong impact on patients. With increased awareness and focus, physicians and PAs can help empower their patients with birth defects to live healthier, longer, happier lives.

Sharon Sheffield, MD, FACOG
Obstetrician-Gynecologist

Telephone Communication for Healthcare Providers: Strategies to Mitigate Malpractice Claims

Nicole Franklin, MS, CPHRM, Patient Safety Risk Manager II, The Doctors Company

The way we communicate has changed dramatically over the years. Even with the introduction of technology-based communications, such as social networking sites, telemedicine, and texting, the telephone call is still the most widely used communication tool between healthcare providers and patients. Telephone conversations can, however, present difficulties and may be inherently deceptive if both parties lack the ability to observe nonverbal communication (for example, facial expressions, eye contact, and gestures) that clarify and qualify what the voice is expressing.

When casually or carelessly conducted, telephone communications can lead to diagnostic errors and misunderstandings that may culminate in professional malpractice claims.

Mitigate Risk in Telephone Communication with Patients

Creating comprehensive, clear guidelines for telephone encounters with patients is critical in mitigating risk. Establish practice guidelines and ensure that all office and clinical staff are trained on their roles in communicating with patients by telephone. Protect yourself from potential liability by following these general practices:

  • Smile when greeting patients. Research has shown that people are able to tell if you are smiling by the tone of your voice. Warmly express to patients that you are happy to speak with them today. This interaction may be the first impression that a patient has of the practice or the staff, and it is a factor in patient satisfaction.
  • Triage and refer all critical calls to emergency services. Examples of critical calls include abdominal or chest pain, fever of unknown origin, high fever lasting more than 48 hours, convulsion, vaginal bleeding, head injury, dyspnea, casts that are too tight, visual alterations, and the onset of labor. For more information on this topic, read our article, Telephone Triage and Medical Advice Protocols.
  • Obtain as much information as possible about the patient’s presenting complaint, medical and surgical history, current medications, and allergies to help you arrive at an accurate appraisal of the patient’s condition. Listen carefully and allow the caller both the time and opportunity to ask questions.
  • Speak to patients clearly and slowly, and enunciate carefully. Use easy-to-understand language that avoids medical terminology.
  • Obtain the services of an interpreter if you encounter a language difficulty. Follow the Americans with Disabilities Act (ADA) requirements for patients using telephone auxiliary aids or services, including interpreters. For more information, see ADA Requirements: Effective Communication.
  • Avoid distractions, such as checking email or attending to other duties, when speaking with patients. Drowsiness, fatigue, or distraction on the part of either party can affect the ability to communicate effectively.
  • Adhere to HIPAA rules and regulations to maintain patient privacy when communicating over the telephone, both inside and outside the office. Use a low voice when discussing protected health information, and implement reasonable safeguards to avoid disclosing information to others not involved in the patient’s care.
  • Develop written protocols for front office/unlicensed personnel to help them respond to patient questions and concerns. An unlicensed individual cannot provide medical or dental advice. Clinical/licensed individuals answering patient calls cannot exceed their scope of practice.
  • Prescribe or advise by telephone only when you have reviewed the patient’s allergies, medications, and medical and surgical history. If providing new instructions to the patient, such as changing a medication dosage, ensure understanding by asking the patient to repeat back the instructions to you. Document the patient’s understanding in the medical or dental record. For more information on this topic, read our article Rx for Patient Safety: Use Ask Me 3 to Improve Patient Engagement and Communication.
  • Accept a third party’s description of a medical or dental condition only when you have confidence in that person’s competence to describe what he or she sees. If descriptions are unclear, the patient may require an office visit.
  • Make prompt referrals if the patient’s call concerns a medical or dental problem that is outside your expertise. Proactively track the consultation and expected report, and follow up with the referred provider and patient.
  • Confirm that pharmacists understand all dosages and instructions for drug prescriptions given by telephone. Spell out any similar drug names and use individual numbers for dosages, such as “five zero” for 50. Include the reason for the use of the drug. Insist that pharmacists repeat information back to you. Do the same with facility personnel who take your telephone orders. A safer approach is to use electronic prescribing or fax the medication order.
  • Verify and document the patient’s adherence with telephone advice through a follow-up contact to ensure continuity of care.

Mitigate Risk During Provider Cross-Coverage

When you will be away from your own practice or covering for another provider, these additional strategies can help you avoid problems:

  • Implement a communication process between cross-coverage providers. In several instances, a covering provider has been held completely responsible for damages resulting from a telephone misdiagnosis while the original provider was exonerated.
  • Give a brief status report on your acute patients with notice of any anticipated patient calls when handing off care.
  • Document all calls in the patient record. Brief the primary provider on all calls during your coverage period.
  • Prescribe only the amount of medication the patient requires during the period you are covering for another provider. Pain medications and narcotics should be refilled or ordered only in small amounts and per state regulations.

Document Thoroughly to Mitigate Risk

Disagreements about what was said during telephone conversations can be a major problem in professional malpractice cases. Follow these documentation processes to mitigate this risk:

  • Document all patient telephone conversations in the medical or dental record—including those received and returned after hours. Include the date and time of each contact and when follow-up is completed.
  • Record all details immediately about the information you received, what you advised, and the orders you gave. This action is especially important when a telephone call occurs after office hours or on a weekend.
  • Implement an office process for calls received during office hours. Office staff should tell the caller when the provider is most likely to return the call. Include tracking and follow-up to ensure that the caller’s questions and problems are resolved and documented.
  • Document a patient’s hospital medical record with telephone conversations about the hospitalized patient—including any conversations with nurses or other providers.

Effective telephone communication and its documentation are vitally important in preventing and defending litigation.

For further assistance, contact the Department of Patient Safety and Risk Management at (800) 421-2368 or by email.

Physician Self-Care Is Mission-Critical Today

There’s no question COVID-19 has up-leveled physician stress and burnout — which you know all too well was already a challenge for medical professionals. Quarantines. Increased patient loads. Staff absences and shortages. Fear of exposure. Supply anxiety. New PPE protocols. Vaccinations and vaccination status concerns. Decreased practice revenue and increased costs. Patient fear. Misinformation. Telehealth visits and their related technology demands. Delayed patient health screenings and treatment.

The list goes on. And that’s all on top of issues already facing physicians and PAs every day before the pandemic.

We’ve all felt it.  We’ve all worried about this.  And we will all need to come together to approach and help solve these issues!

The results from the American Medical Association’s 2020-21 “Coping with COVID-19 for Caregivers Survey” paint a troubling picture for physicians, nurses and other medical professionals:

  • 6 out of 10 reported high fear of COVID-19 exposure for themselves and their families
  • 50% reported symptoms of burnout — including 16% who indicated their symptoms were persistent
  • Over 3 in 10 reported experiencing symptoms of anxiety and depression as a result of COVID-19

While nearly half of the survey respondents indicated being part of the COVID-19 response has increased their sense of meaning and purpose, that bright spot just isn’t enough to counterbalance the stress, anxiety, and increasingly real risk of burnout faced by physicians, PAs, and other members of the healthcare team.

So, what’s the solution? One part of reducing the impacts of COVID-19 stress and anxiety is self-care, and right now it’s mission-critical for us and other healthcare professionals.  Look into this today!

What is Self-care?

Self-care is the modern buzzword encompassing both ongoing and episodic self-help, wellness and coping mechanisms that empower you to live a healthier, more productive life.

The World Health Organization defines self-care as a broad concept, specifically “the ability of individuals, families and communities to promote health, prevent disease, maintain health, and to cope with illness and disability with or without the support of a healthcare provider.”

What does self-care mean for physicians and PAs? It means taking care of yourself so you can take care of others. The American Society of Addiction Medicine (ASAM) likens self-care to putting an in-flight oxygen mask on yourself first, so you can then help others.

Let’s look at how you can put self-care into practice.

Self-care for Physicians and PAs

How can you address your self-care needs?

One great place to start is with MSV’s own confidential clinician well-being program, SafeHavenTM, which is focused on addressing and maintaining the mental health and well-being of clinicians. Its customized services for healthcare professionals include 24/7 professional support, time-of-need counseling, and peer coaching for everything from stress and burnout to workplace anxiety to developing healthy habits.

You can also try stress first aid for medical professionals. It’s the framework for identifying stress injury — including irritability, decreased impulse control and withdrawal from friends and family — removing a stressor, preventing further harm, and promoting recovery.

In fact, the AMA recently published an entire article focused on how physicians can cope with COVID-19: “With pandemic’s end not in sight, 8 ways to deal with the stress” that’s well worth checking out.

Taking time for yourself is another top recommendation for physician and PA self-care, especially now during the pandemic. It can include everything from using your vacation days to practicing yoga to getting in touch with your creative side through art or music. This can feel like an impossible task with our current workloads, but it is so critical that we all find a way, even if it’s just for 5 minutes a day.  Schedule this time if it helps you.  Don’t schedule it if that feels more spontaneous.  But make yourself accountable.  Recruit friends and family to let you know how you are doing at finding time for yourself!

Finally, the American Psychological Association recommends several self-care strategies for healthcare providers during COVID-19, including maintaining good health habits in areas like diet and sleep, getting regular aerobic exercise, and just taking the time to breathe — literally by pausing to take deep breaths several times a day.

Whether you add breathing, exercise and other healthy habits to your daily routines, or you seek assistance from professional resources that can help you mitigate your stress and anxiety, the important thing is to take action now.

There is strength in deciding to care for yourself.  It’s the right thing to do for yourself, those you love and your own patients.  It is the greatest gift you give others.

Art P. Saavedra, MD, PhD, MBA, FAAD
UVA School of Medicine
Chief of Population Health & Health Policy

Cancer Screenings Are More Important Now Than Ever

Do you know when your patients had their last recommended cancer screenings?

At its outset, the COVID-19 pandemic unfortunately resulted in the delay of many scheduled health procedures — including cancer screenings. While a recent Dana Farber Cancer Institute study reported cancer screenings rebounded sharply in late 2020 it also indicated racial disparities in the return to screenings, particularly with mammography and with Non-Hispanic Black and Hispanic patients. It’s also worth noting colonoscopy screenings did not return to pre-pandemic levels, although that could result from the use of home-based methods.

Missed or delayed screenings can, of course, lead to delayed diagnoses as well as adverse oncologic outcomes and increased mortality rates. The Dana Farber Cancer Institute study, which was released in July 2021, suggests that, although the late 2020 rebound of screenings helped make up for some “missed” screenings from earlier in the pandemic, a significant number of cancers still remain undiagnosed — making promotion of screenings more important now than ever.

As we know, for patients, there are two key messages to communicate to help get them back on track with their recommended screenings:

  1. Emphasizing the positive impact early detection and treatment can have on their long-term health. Simply put, early detection leads to the likelihood the cancer will be easier to treat and they will be less likely to die.
  2. Reassuring them of COVID-19 safety protocols that will help protect them in a healthcare setting.

Breast Cancer Screenings

Considering October is Breast Cancer Awareness Month, now is the perfect time to discuss the importance of breast cancer screenings with your patients. Check in with them about when they had their last mammogram, or whether now is the time to get started with annual screenings based on their age or history.

As a helpful reminder, the American Cancer Society’s current guidelines for breast cancer screenings are as follows:

  • Age 40–44: Women have the option to start annual mammography screenings
  • Age 45–54: Women should get an annual mammogram
  • Age 55+: Women may choose annual mammograms or go every other year

Due to family history or genetic tendencies, some women with a higher-than-average risk of breast cancer may need to start annual mammography screenings at an earlier age or should be screened with MRIs in combination with mammograms.

Colon and Rectal Cancer and Polyps

It’s all too easy for patients to put off colonoscopy screenings. The idea just makes people uncomfortable. Talk to your patients about whether a stool-based test may be an alternative to colonoscopy — or why it’s not. The critical thing is to help your patients understand why screening is important.

The American Cancer Society’s current guidelines for colon and rectal cancer and polyps screenings are as follows:

  • Age 45–75: Patients should get regular screenings
  • Age 76–85: Screenings are optional based on health and screening history
  • Age 85+: Screenings are no longer recommended

Patients with a higher-than-average risk of these cancers may require screening at an earlier age.

Additional Cancer Screenings

Based on age, gender, genetics, and history, your patients may need regular screenings for other cancers as well, including:

For your convenience, you can click on the links above to get information about screening guidelines for each so you can best inform your patients about what’s recommended to help keep them healthy today and tomorrow.

Robert Winn, MD
Internal Medicine
Richmond, VA

Why Online Medical Marketing is a Must-Have

Thanks to the digital revolution, word-of-mouth referrals and directory listings are no longer enough to bring in new patients. More and more, consumers are doing it all online, and this trend shows no sign of stopping – as COVID-19 accelerated the drive to digital.

The modern consumer expects to do everything online, and there is heavy competition for their attention. For this reason, the modern medical practice must be proactive in meeting people where they are: online. Strategic digital marketing increases the chances of introducing your practice to prospective patients while they are looking for answers and to book services.

Medical Advantage and iHealthSpot recently joined forces to provide a powerful digital marketing package with everything the modern practice needs to remain competitive and bring in new patients. In this article, we’ll introduce five essential components of an effective digital marketing strategy.

Be Found When People Search Through SEO Implementation

When considering medical care, over 70% of consumers use a search engine. Consider that when someone is searching for solutions to a problem, it is highly likely that they are ready to do something about it. When people are searching, SEO tactics help your practice be presented as a solution.

When anyone conducts a search on Google, they are presented with a results page. This page displays various sections of media including links to the most relevant content. When a website earns placement on the first page of Google results rather than pays for it (PPC) this is called organic search.

Google rewards websites with quality content and high relevance with high rankings – the pursuit of this merit is known as search engine optimization (SEO). The goal of SEO is to make your page show up toward the top of an organic google search – where your competitors are. SEO is essential but also complex, so it’s best to partner with experts who understand how to best position your web properties for the greatest chance of success in organic search.

Increase Search Visibility with PPC Campaigns

PPC (or Pay Per Click) is the Google Ads bidding space and is yet another opportunity to be found in search. Advertisers earn preference from Google based on the quality of their ads (relevance to user search) and what maximum spend is set (CPC).

Just be aware that ad campaigns for medical entities must be carefully communicated, lest they violate any healthcare regulations. With that said, some practices cannot afford to not have PPC in their budget because the competition lures away too many leads through PPC campaigns. PPC is a full-time effort, so when you recruit help to manage your campaigns, you need experts who are skilled at getting the most for your ad spend.

Take Control of the Conversation with Reputation Management

Around 70% of prospective patients read patient reviews as a first step in finding a new provider. When it comes to your online reputation, it pays to be proactive and pursue any recourse for remediation.

No establishment can control what is said about it online, but this doesn’t mean practice managers should be passive about what is being said. By moderating what is said about your practice online, you mitigate the influential power of negative reviews. Your practice should be represented fairly, with only legitimate reviews displayed and an overwhelming number of positive reviews.

When you’re running a medical practice, you don’t have time to be reading every review posted and responding to every patient complaint. A team of review platform moderators dedicated to managing your reputation takes proactive measures while you give full attention to your operations and to encourage satisfied patients to leave positive reviews.

Leverage Social Media Tools for Brand Building and Laser-Focused Target Marketing

We think of social media as being all about entertainment, but these platforms are built for business advertising. According to Statista, Facebook generated close to 84.2 billion U.S. dollars in ad revenues in 2020. But a medical practice is not a typical business, so why bother with social media?

Why a medical practice should have active social media campaigns:

  • PR value – With your social media presence, you have control over how your brand is presented to the public. Business page visitors will become acquainted with who you are, learn more about what you do, discover what differentiates your practice, and see the quality of your public outreach.
  • Social media platforms are search engines – Like Google, Facebook provides a search bar for users to enter what they are looking for and specify a location when they seek goods and services.
  • Patient engagement opportunity – Patients can post a check-in on Facebook or tag your practice in a praise post which is effectively influencer marketing. We recommend encouraging your patients to connect with your practice’s social media channels by posting promotional signage in the waiting areas, exam rooms, restrooms, etc.
  • Sophisticated ad targeting – Facebook has comprehensive knowledge of each user including their demographics, specific interests, search history, website visits, and more. This means you can be extremely specific in who you market to. For example, run a sports physical campaign targeted only to parents of middle school students who are in groups or like pages about competitive sports in your local community.

With the assistance of healthcare social media marketing experts, a team dedicated to crafting social media marketing copy and assisting with laser-focused campaigns can help your practice reach its revenue goals.

Get the Most of Online Medical Marketing by Tracking ROI

The big question is – are you gaining enough leads and conversions to make the marketing spend worth it?  No one should continue pouring money into marketing activities that are not attracting and converting qualified leads. With any marketing budget, you should know exactly what you are gaining from your investment. Ideally, marketing should pay for itself.

If one or more aspects of your marketing plan are not generating leads, something needs to change. A marketing plan must be organized. Every digital marketing service used and campaign executed must be accounted for, so you don’t lose track of expenditures and end up wasting resources.

Better yet, partner with an all-in-one medical marketing service. Our clients are given full transparency and input into marketing activities for their practice.

Get the All-In-One Online Medical Marketing Package

Every facet of online marketing strategy is best handled by a professional who gives their full attention and expertise to a specialty. It would take months to recruit all the talent needed to run comprehensive digital marketing operations – but the good news is you don’t have to.

With our monthly marketing services — including search engine optimization, digital advertising, online reputation management, social media marketing and more — our clients have seen tangible results that boost online presence, increase patient and visit volume, and improve ROI for their medical practice marketing. Our clients have reported:

  • 47% boost in website visits.
  • 58% increase in appointment requests.
  • 160% gain in online reviews.
  • 2,645% growth in Facebook followers.

To find out how well your digital presence is performing, fill out our FREE Website Analysis. Those who submit an analysis will hear from a Medical Advantage Practice Marketing consultant to discuss the results and how Medical Advantage Practice Marketing can help you expand your patient population!

Plus as an MSV member you can take advantage of NO UPFRONT FEES and YOUR FIRST MONTH FREE on any of Medical Advantage’s Practice Marketing Packages!

Back to School with COVID-19

Virginia’s students head back to school during COVID-19 for the second year in a row. Variants like delta, lambda, and now mu continue making news. With mask protocols in place for students and vaccine availability evolving for children, it’s a lot for parents and students to keep up with.

This blog is for you to share with your pediatric patients and their families to help them navigate the current COVID-19 landscape.

COVID-19 VACCINE

VACCINE EFFECTIVENESS: The Centers for Disease Control and Prevention (CDC) advises COVID-19 vaccines are highly effective at preventing serious outcomes for those who get sick with the virus, including severe disease, hospitalization, and even death.

AGES 12 & UP: The CDC recommends all children ages 12 and older get the COVID-19 vaccine. The American Academy of Pediatrics (AAP) also recommends all children ages 12 and older without contraindications get the COVID-19 vaccine. In mid-August, the Pfizer COVID-19 vaccine was fully approved by the Food and Drug Administration (FDA) for all people ages 16 and up. Its brand name is now COMIRNATY. Children ages 12 to 15 may still be vaccinated under the FDA’s emergency use authorization of the Pfizer vaccine. The Moderna and Johnson & Johnson COVID-19 vaccines are currently restricted to ages 18 and older under the FDA’s emergency use authorization.

UNDER AGE 12: The AAP recommends against giving the COVID-19 vaccine to children under age 12 until it is authorized by the FDA. No COVID-19 vaccine has currently been FDA approved for use in children under age 12. Clinical trials for COVID-19 vaccine use in children under age 12 are ongoing, with the goal of securing the FDA’s emergency use authorization and eventually full approval. Pfizer is reporting it expects to complete studies on children ages 5 to 11 in September, and studies on children up to age 4 shortly afterward. Moderna’s clinical trial data for COVID-19 vaccine use in children is tracking for late fall or early winter. And Johnson & Johnson will begin clinical trials on children ages 12-17 this fall, followed by trials for ages 2 to 11. After the FDA receives clinical trial data, it could take as long as 4 to 6 months to review.

COVID-19 VACCINE WITH ROUTINE IMMUNIZATIONS: According to the AAP and the Advisory Committee on Immunization Practices (ACIP), the COVID-19 vaccine may be given along with a child’s routine immunizations including the flu vaccine.

COVID-19 SCHOOL ENVIRONMENT

MASKS INDOORS & ON TRANSPORTATION: Due to the COVID-19 delta variant, the CDC is currently recommending universal indoor masking for all students age 2 and older, in addition to staff, teachers, and visitors to K-12 schools, regardless of vaccination status. Masks are also recommended during school transportation, whether public transportation or on school buses.

MASKS OUTDOORS: Masks should be worn by unvaccinated children and adults when in crowded settings or during activities with prolonged close contact with others. Fully vaccinated people might choose to wear a mask in crowded outdoor settings if they or someone in their household is immunocompromised.

SOCIAL DISTANCING: Current CDC guidelines recommend schools maintain 3 feet of distance between students in classrooms to reduce the risk of COVID-19 transmission. If the 3-foot minimum is not possible, layering other prevention strategies such as screening testing and improving ventilation is advised. A distance of 6 feet is recommended between students and teachers or other school staff.  Social distancing should be maximized, ideally 6 feet or more, when masks are taken off during lunch. Strategies should be employed to minimize the time with the mask off.

HANDWASHING

BENEFITS: Regular handwashing with soap and water continues to be important in keeping children safe from COVID-19 at school and at home — and it protects against other germs as well.

TECHNIQUE: Handwashing with soap and water for at least 20 seconds is recommended by the CDC, and especially in these situations that particularly apply to kids: after being in a public place, after blowing your nose, after coughing or sneezing, before eating or preparing food, before touching your face, after handling your mask, and after using the restroom.

HAND SANITIZER OPTION: Soap and water is the preferred handwashing technique, according to the CDC. If soap and water are not readily available, the CDC recommends using a hand sanitizer that contains at least 60% alcohol. All surfaces of the hands should be covered with the sanitizer and rubbed until dry. Children under age 6 should use hand sanitizer only with adult supervision.

To learn more about vaccine myths such as “I don’t need the vaccine if I already had COVID-19” or “The COVID-19 vaccine will disrupt puberty,” see our August 16, 2021 blog, Busting Common COVID-19 Myths.

Michael Martin, MD FAAP
Pediatrician
President, Virginia Chapter, American Academy of Pediatrics