0:00
Well, I see your maybe every year and this year as well, your pool of patients, your market size, slowly, slowly, slowly shrinking a little bit, which just means, on top of the competition that you have, you're now fighting for a, you know, a slightly smaller pool of patients every year. So

0:19
how are you going to stand out how you're going to be valuable. Welcome

0:29
to off the chart, a business and medicine podcast featuring lively and informative conversations with health care experts, opinion leaders and practicing physicians about the challenges facing doctors and medical practices. My name is Austin Luttrell. I'm the associate editor of medical economics and I'd like to thank you for joining us today before we get started. A quick note, physicians practice will be hosting a practice Academy event on March 19, offering practical guidance for physicians and practice leaders on a range of business and operational topics. More details on that will be available soon, but with that said in today's episode medical economics content, Vice President Chris mazzolini sat down with Carl white, the President and Founder of market advisory group, to talk about the marketing realities facing independent medical practices. They discuss how competition for patients has intensified, why simply providing good care is no longer enough to stand out, and what practices should focus on to stay visible and relevant. White also shares practical guidance on differentiation, patient retention and how tools like generative AI will fit and don't fit into physicians marketing strategies. Carl, thank you so much for joining us, and now let's get into the episode.

1:36
Carl, white, thank you so much for joining me on the show today. I really appreciate it. Thank you for having me. Happy New Year. Yeah, happy New Year to you too. You know, independent practices, they're fighting for attention.

1:49
They're fighting for patients. You know, there's a lot of competitors out there, whether it's urgent cares, convenient clinics, you know, hospital owned practices, there's, you know, there's the practices, and competitors arrayed against them are just growing more numerous right now. So what do you see as the biggest marketing challenges that these independent practices are facing now, as we are, you know, kick into 2026

2:14
you know, I don't see them as terribly different than before, just

2:19
maybe a little more squeeze. So if you're a marketing plan responds to a growth need. So if you need to grow a lot, all other things being equal, or you need to replace a lot of patients, you need a bigger marketing plan than if you don't. So the way I sort of framed it is, if you are a traditional insurance then it's it's the affordability of insurance. And so as an example, I was just talking to a friend yesterday, Tim and his wife, they have one child. They've decided for 2026 they're going to buy health insurance for their child, but not for them. And they've never done that before, because the premiums just the right, you know, the right to schedule appointment is well over $20,000 for the two of them, and they're healthy, you know. But, but here we are. So if you're traditional, I see your maybe every year, and this year as well, your pool of patients, your market size, slowly, slowly, slowly, shrinking a little bit, which just means, on top of the competition that you have, you're now fighting for a, you know, a slightly smaller pool of patients every year. So

3:20
how are you going to stand out? How you going to be valuable? We'll get it out of it. The other side of it is, if you're private pay. So that's growing a bit. Whether you're a traditional practice trying to add more private pay services, or your private pay from the ground up, your pool theoretically is getting bigger, you would think, but it's still. Health care is weird here in the United States. Is it a right? Is it a good people still have this sort of reflex of paying out of pocket for healthcare, so your job is to convince them that what you have is it's a very generic way of answer. It's valuable if I'm going to pay, you know, $200 for this visit, whereas last year, I paid the copay, what am I getting more? And there's, there's one thing I see, there are some parts of the, you know, the private practice world, where that makes a lot of sense, private care. We're seeing that there's nothing new about those models anymore. But I see others saying, Well, I want to do this, because they'll pay for it. Are you sure? Like, what's the unmet need? Is it really there? For example, I've heard of a couple people opining about the idea, maybe I'll do a concierge pediatrics practice. My first reaction is, we never have a hard time getting into our pediatrician. So what are you going to offer? That's that. So that's what I see, whether you're, you know, insurance based or not, at a very macro level, that's, that's kind of like, you know, they're not thought of, typically as marketing challenges, but, but that's kind of what it is, yeah, so I think, you know, in the good old days and, and maybe this is more of a story than than the truth, you know, the idea was that a physician can hang out their shingle and the patients would just come. It's like the Field of Dreams, if you've been.

5:00
So that they can come, yeah, and, and now, you know you have to, like you were saying, you have to fight for and work for and grind for every, every patient to a level where maybe you didn't before. And I think some physicians maybe still think, like, if I just practice good medicine and take care of my patients, that things will take take care of themselves like so what do you what do you say to that sort of attitude? Well,

5:26
good care is a must. It's a must. And it's actually, this is a bit overstating and saying it, but it's if it's a good theme, it's not marketing. But if your service is bad, generically speaking, no amount of marketing or promotion is going to rescue so your clinical care must be good. But that's expected. And the truth of the matter is, any patient who's sitting on the outside looking in is saying, I'm looking for we're looking for a pediatrician. Let's just pick that example, and I find five of them that all sound really good. The clinical care, I can't tell who's good or bad from the outside looking in, and it's supposed to be good anyway. I mean, that's not really. It shouldn't be much of a differentiator. The second part is to say to the one who wants to hang their shingle and do nothing else, my friend, you have competition. You just do and it's easier and easier to find them and to try them than it then it every year. And so the fundamental question is, why are patients going to choose you when they find you and your competition whenever that may be? That's kind of the way in, just like you dr X when you go to purchase something, you maybe you comparison shop. So do patients. It's a very rational behavior, and it's not based on price, if it's insurance based. So what are you going to do? You can choose to ignore that. That's your choice. But, you know, unless you've got a really good competitive,

6:51
you know, competitive position, maybe there's not that much, or you're just the name, the machine is humming. All these things count as marketing, but if that's coming up short, then

7:03
something's got to fill that gap. Yeah. And I think we'll get into that a bit later, about what are some of the things that that physicians can do. Um, yeah, but I think we have to talk about, like, the elephant in the room, which is, you know, generative, AI, chat, GPT, you know, whatever service you want to kind of discuss. But like, I think any form of content, so including marketing content, there's just a glut now, you know, there's this term of AI sloth, there's just like, you can just like, produce content on a whim, and, you know, so I guess the question is from, how does that change the playing field when it comes to marketing, the sort of the use of AI, like is, is AI something that can actually help physicians market? Or is it, is it more of a challenge that they get around? Or is it a bit of both? So what are your thoughts on AI and marketing and where we are right now? So, yeah, I mean, I break it down. I take the world view of you are a private practice in city or community x, there is some reasonable radius around your office that is your kind of, your hunting ground. And that's when, when we approach clients we say we want to win. There it is true. Some travel further. Yes, those are more the exceptions, the further will you get. We must win in our core area. If you take when somebody fires up chat GPT, and they're staring at that prompt area. There's, broadly speaking, two types of prompts. This is my own. I didn't come up with this categorization. First one is called Teach me I need to learn about something. What does this mean? What is it? Whatever it is, as a local practice, with the time and budget constraints and realities that they have, I find that difficult to win. When I say I want to win in this hunting ground, if you are able to stick on pediatricians,

8:48
is the MMR vaccine safe? You know, do you really need to be the one to answer that question? And you know, we know some of where chat GPT goes. What's interesting is Gemini, which is owned by Google.

9:00
Nobody's said this, but it sounds really logical. Is that Gemini relies more on Google's sort of database than anything else, whereas chat GPT looks around. But it's very difficult to win in the Teach Me types of prompts, if you want to, I say, enter carefully. Have a goal, like, is there one or two questions? Start, figure it out, maybe expand from there. The other type is recommendations. Who are good pediatricians in my area? Now let's try to win there. And when I run tests for my clients,

9:33
I find highly similar, not always the same, recommendations as what I'd find in Google. And why is that? Because chat GPT. Let's just pick on them not owned by Google. Smartly says, well, I need to give an answer to this question. I don't know, but I'm going to go find sources I trust, one of which is Google and the reviews and Yelp and everything else. So if you're winning on the local online game, you're probably going to do, okay, maybe the same as wherever.

10:00
You are in recommendation. So if you want to win on AI in the who are the best service providers near me, make sure you're killing it on search first, because you're not going to overcome that if you try to skip it over.

10:13
That's what I would say for that. As far as, like, the content, yeah, content. You know, if you're going to do that step one, make sure you quality control it, both from clinical accuracy as well as, does it sound like you dr X or whoever? And you know, and don't gloss over that, because, just don't gloss over it. Because there's two audiences to anything you publish online. There's the people who read it or skim it, and then there's the search engines look over it as well. They're pretty smart, do you really, you know, and if it doesn't sound like you, if it sounds like what they when it spits out, you're going to sound like everybody else. Now, for whatever reason, a lot of people discount that online. But if you were in a, if you were in a, you know, on a panel, and somebody asked, you know, an expert panel, and somebody asked the person next to you a question, and they gave an answer. Would you want to give the same answer? Say, ditto? No. I mean, unless it was you really had nothing else to say. But that doesn't that's not you. That's not what you want to be. So apply the same. Does this sound like the way I would say it?

11:18
Now that's on the content side, interesting kind of side point, if it's more internal operational, like, for example,

11:26
you got a denial of coverage letter from Aetna man, I'm meeting a lot of people who say chat GPT is awesome, and helping me craft the response to that. And so, you know what? And people who are like in billing companies, who are, you know, looking at that, going, I should be doing that. But, you know, why not? I mean, your audience is just an example, but like the publicly facing, this is the type of practice we are. This is what we stand for, things that you should be thinking about. Does this sound like you in the way you would say it? You can train an AI to learn you over time, but you got to do that. So just because it can spit it out in 10 seconds, and that's really cool, doesn't mean it's worth, you know, publishing, yeah, okay, great.

12:09
In terms of getting noticed in today's, you know, noisy, busy, sort of short attention span, information environment, what are the, what are some of the must haves? You know, what actually moves the needle for practice? What are some of those things that you work with with your clients? One of the first things we work on is trying to figure out something that is valuable to patients and different from your competition. It must be both, if it's valuable but you're the same. Who cares if you're different from your competition, and something that patients could care less about. Who cares so it's got to be both. And that could be, you know, that could be anything from you offer some treatments that somebody that none of the rest of them do. You've got a particular level of expertise, your office just runs better. You know that it can be anything. It's just got to be valuable and different. And the reason that that's put aside everything else that's useful is that it's easier to stand out when you have something valuable that's different. If you sound and look and feel the same as all of your competition, then the way you win and get noticed is you scream louder than everybody else, and that is the most expensive way to promote yourself, because the louder it is, the more pricey it is. To be louder, better to be different, you can be more surgical strike this. That's the first one. The second one is consistency. You must say this over and over again, forever. You know you're making progress when you start to get bored, or you look at you look at something from, from whoever's doing your marketing, and you're like, God, do we still have to say it this way? Do we start to say this? And the answer is, yeah, yeah, you do. Because you know that there's a reason McDonald's Golden Arches look the same, you know, from the day that they figured it out, because people recognize it. And this matters too at the at the local level. So pick a couple of things, the most important things, and say them over and over and over again for ever, forever, forever, forever. One side note is, I see this every once in a while. If you're thinking about opening up an office or opening up a new location, scout the competition. And if there are an easy example, this is like general dentists, because there's a lot of them. If there's six general dentists on that, you know, in that building, and we see this Don't be the seventh Why would you do that? I mean, and before that, check the population, like, try to get some idea, if we open there are there enough people to fill us up in a time that we can stomach. But what about the town next door? What about and there's more online considerations about how Google's algorithm works. But if you can, especially if they're entrenched competitors. I mean, you got to sort of weigh this. But if there are, I mean, our family dentist was in a building of four other dentists and, oh my god, like, you know, literally next door, small building, not hard to navigate. And so just check your Kate.

15:00
A petition we work with a client, recently, wanted to open up a pediatrics practice, six other practices of anywhere from 25 to 40 pediatricians, depending on how you count, full time equivalent, within six miles, wow, oh my god, like, you know, look, I get the hero. I won. But you know, you can make it all easier on yourself. I mean, maybe they don't need a seventh or a 22nd 42nd so valuable and different, consistently said, think about your location if you have the opportunity to do

15:43
Keith, hey there. Keith Reynolds here and welcome to the p2 management minute in just 60 seconds, we deliver proven, real world tactics you can plug into your practice today, whether that means speeding up check in, lifting staff morale or nudging patient satisfaction north. No theory, no fluff, just the kind of guidance that fits between appointments and moves the needle before lunch. But the best ideas don't all come from our newsroom. They come from you got a clever workflow. Hack an employee engagement win or a lesson learned the hard way. I want to feature it. Shoot me an email at kreynolds at mjh life sciences.com with your topic, quick outline or even a smartphone clip. We'll handle the rest and get your insights in front of your peers nationwide. Let's make every minute count together. Thanks for watching, and I'll see you in the next p2 management minute.

16:34
Speaking of advice, and you had mentioned before, you know the idea of a physician sitting on a panel, I think right now, you know,

16:43
one of the, one of the ways that's like growing in terms of marketing and promoting yourself is being a thought leader and or a content creator, I think, like whatever, whether we're talking about live events or, you know, recording yourself and putting yourself on Tiktok or whatever.

16:58
What's your advice on physician led thought leadership. How can a doctor, you know, build that credibility as somebody who knows is an expert in a space, whether it's a clinical thing or a business thing, you know, without having to become a full time, you know, content creator tied to a chair on YouTube all day or something? Yeah, I, what I, what I thought of thinking about this is I, what I wrote down is be known for what, by whom, and to accomplish what goal. Have a really good answer to those first so if thought leadership is a way where you're going to build your practice, okay, then you're thinking about like your more local area, and you're thinking about the patients who need to find you, and you're thinking about those who could refer to you. So if you are, let's imagine, in the world of cardiology, you know, a new treatment, a new surgical procedure, sort of gaining steam. And you want to be the first, okay, then everybody in the area who should know about it needs to know about it. And the way that you are in this model you're going to do it is you're going to be highly educational, highly you know, be the benevolent expert, very giving

18:06
to build trust so that people refer to you. And you have to figure a few things out if it grows beyond that, though. I mean, the marketing plan comes back to the goal. Who do you who do I need to know that I do this? What is it I want to know? Who needs to know it? And why am I doing this? What's the goal? And then kind of go from there, as far as, like, the channels, whether it's video or podcast or whatever, that can all be easily figured out. But if you're just spraying stuff out there, which is what's going to happen if you skip over what I just said, then six months a year from now, certain amount of money and time will be spent, you're going to stare at a bunch of metrics and go, Well, did we get there? And then, if you're honest, you'll say where we never figured this out. So figure that out first, like anything else,

18:51
and then it's just you can change what you figure out, sure, but have you're pointing at something. Who needs to know it? What do they need to know? What do I want them to know about me? And why? What's the goal?

19:04
So, you know, marketing, I think a lot of physicians, it's probably not 100% accurate way of thinking about it, thinking about bringing in new patients. I want to attract new patients. It's obviously, it's, that's part of it. What about retention of patients, trying to prevent them from from leaving you and going to the competition. Obviously, we talked about good care as sort of a must, so like leaving that aside, what, what are some of the high impact ways that that a physician in their practice can, can try to use that, like service marketing, to try to keep those patients, you know, reduce, you know, no shows, you know, improve that sort of internal visit efficiency and keep patients loyal, like all without not like having the patients feel like they're just being sold to all the time. Well, yeah, I mean, well, don't sell to them all the time. I mean, and if you know that's not really an issue for you, it's an issue for you, if you depending on the service.

20:00
This treatment service mix that you have,

20:03
I'll give, you know, a good example. So general dentistry actually has some good lessons to learn here. It's not a group that we work a lot with, but I can speak to my family dentist. So I have a night guard eight or nine years he's saying, you know, one day, one day very often. And then one day he said, Carl, you got to go. And he showed me a picture you're beating the hell out of this tooth. So it was my point. It's clinically appropriate, like, in my mind, if there's a legit need for you to recommend to a patient, you know you really ought to do blah, because, and here's the reasons why they might say yes or no, but that's not salesy. That's education. The difference is my, in my opinion, salesy, in the negative. You know, gross way that we all think about it is when stuff is pushed at you that you're thinking yourself. I don't know why I need this. When the need is there, then an option is this is an option. Another option is not, but this is a legit option, nobody. Salesy, I don't think in that regard, the other side. And so he didn't do that. And I, you know, eight or nine years later, I finally went, Yeah, you're right. Can I argue with that? Let's go. How fast can we get this done?

21:12
The other side, the other thing that they do really well is up like the operationally scheduling reminders.

21:20
I have become totally reliant on the text message appointment reminders that I get totally like, I'm like, a kid. I'm I know they're coming. It's in the calendar, but when I see those, I go, Okay, here we go. And then scheduling the next appointment. Rescheduling couldn't be easier. Any forms I have to fill out so that when I show up for my treatment, I sit, I'm there like, you know, 15 seconds. They call me in on time. If they're late, they tell me, it's,

21:48
it's, it's just a really, if you think about, you know, what, what upsets people, what upsets your office, and what upsets you

21:58
the patient, it's just making things obvious, things difficult, obvious things difficult. So scheduling, and there's so many services and systems out there, probably your EMR has a way to do this, and maybe it's just buried deep in the feature set that you know you just haven't found. But and then, if it's easy to schedule and reschedule, your front desk is happier because I'm not fielding as many calls, depending on so everything.

22:26
Make it easy. Just in the it is a very large two letter word here, but just take the steps. What do we ask them to do? Schedule, reschedule, fill out forms. Refill out forms. Every year, whatever it is, send your insurance card again. I mean, I've got, I go to my primary care, and I have to hand the I'm waiting 20 minutes because there's a form they can't give me, and I have to give them my new insurance card, even though nothing's changed, it's all handled by the front desk. I go to a specialist, I get the app reminder three or four days prior. It's all done. Pictures uploaded. I walk Done, done. Why can't it be that easy? It's sad. Has nothing to do with medicine, nothing to do with the practice of medicine. But again, your competition could be doing it, and it's so easy for people to switch. And if your traditional insurance base, you get like, 12 minutes with your patient, the deep relationship that you would love to have with your patients, harder and harder and harder. So make the Make, make the relationship with the practice pleasant before we before we wrap up a couple more questions, how do, how should independent medical practices measure success? You know, well, in the year, I will say, obviously, this year is 2026, so we'll say, this year, you know what? What metrics do you in your experience? And you know the clients you've worked with, you know which ones actually predict growth and success. You know what? Where are those metrics that you should really target and really pay attention to as you kind of make your way through the year and all the ups and downs and challenges of running a practice.

23:54
So I mean revenue, patient revenue is built on how many patients come in. There's a few metrics, right there. You know, there's a few variables. How many patients come in, what's the mix of of treatment? How much churn is there? There's a, you know, there's a handful of reasons why any patient's going to leave any practice. If you can affect those as you go along the way, then you know, if you can make them better, you'll end up better. If you if they end up falling off, then you know, then, then you're going to be worse. None of those change. I think in 2026 I in my industry, in the marketing industry, every year is the year of something. This is the year of video. This is year six of the video, of video. Video is 2026 and you go back and look, it was 2020, 2019 2021, maybe this will be the year. So I just, I've learned, cut out the noise, because whatever else you know, practice owner who's listening to this, you think I need to do this or that, if the revenue and profit is not there, those other things are just going to they're going to fall off your list, as they should. Patient satisfaction are you? Are you getting?

25:00
Use Are you reading and reviewing the reviews? There's gold in there. If two people, two patients, on their own, or even if you ask them, say remotely the same thing, good or bad, there's your pattern. Don't overthink it. 10 more think the same thing. Address it good and bad. If something's really good, try to make it stronger. If something is sort of even slightly negative, just have a look. See, you know, the front desk was rude. Maybe they were having a bad day. Or maybe there's something really, you know, systemic in there. I pick on them all the time because they're an easy example, but for the most part, they're wonderful.

25:36
Patient satisfaction, employee satisfaction. I mean, hiring is hard. Labor market's tight. You got a key employee and they walk out

25:44
that's going to burn, you know, make sure, at least unless you want them to go. But you know what I mean? Like these things should be, you should have your finger on the pulse of these small handful of metrics that tell you, and if you don't know what those are, take the time with your accounting firm, with your marketing agency, if you're using whoever's got the, you know, your HR, people who have those few metrics where you can look at that, you know, say, once a week, and in five minutes, go, Yep, we're good. Or red flag, let's watch it, whatever it is. Because you own the place. You and your partners are you alone. You own the place. And you need to know these things. What about no show rate? What you could bury something like, there's a bunch of them, but there's usually a subset that really predict the rest, and that can give you, you know, finger on the pulse of the overall health of the practice as you define it. So go with those. Take some time to figure out, once you get it, you know, it's, it's the first time that's a little can be a little painful to put together, not really, but if you're curious in your analytical which you know you are, then it can be done plenty. Do it.

26:53
Okay, great. Last question, is there anything that we haven't discussed that you think it's important for physicians or practice managers to consider about these topics. You know, with marketing, just don't forget about HIPAA marketing. And HIPAA and overlap. Do overlap? There's a lot of marketing agencies out there that are not HIPAA compliant. It's you don't have a choice. Of course. You all know about HIPAA, but I've just learned it's kind of a blind spot when talking about marketing. So make sure we're HIPAA compliant fully through and through. Make sure you check the right HIPAA boxes. As an example, one thing we do with a lot of clients is help them get more reviews from their happy patients. If you share with us their name and their cell phone number, their email address, which you will need to we now have just a tiny kernel of protected health information. We're in HIPAA land, as I call it. Just make sure that those checks are in place. Compliance matters, as you know,

27:48
that's not why you would choose any service provider for anything, for compliance, aside from being compliant, you you need them to do their job, but in a compliant way. So you have to, you have to do both. I would say that that's a good one. Carl white, thank you so much for sharing your insight today. I really appreciate your time and thanks again you as well. I appreciate the opportunity. Thanks.

28:22
You a conversation between medical economics content vice president Chris mazzolini and Carl white, the President and Founder of Mark advisory group. My name is Austin Latrell, and on behalf of the whole medical economics and physicians practice teams, I'd like to thank you for listening to the show and ask that you please subscribe so you don't miss the next episode. Be sure to check back on Monday and Thursday mornings for the latest conversation. Conversations with experts, showing strategies, stories and solutions for your practice. You can find us by searching off the chart wherever you get your podcasts. And don't forget, physicians, practice will be hosting a practice Academy event on March 19, offering practical guidance for physicians and practice leaders on a range of business and operational topics. More details will be available soon, plus, if you want the best stories that medical economics and physicians practice published delivered straight to your email six days of the week, subscribe to our newsletters at medical economics.com and physicians practice.com off the chart, a business of medicine. Podcast is executive produced by Chris mazzolini and Keith Reynolds and produced by Austin the trail, medical economics and physicians practice are both Members of the MGH Life Sciences family. Thank you. You.

29:40
You.