Patient Acquisition Starts With Operations

Speaker: Welcome to the Ignite Podcast, the only healthcare marketing podcast that digs into the digital strategies and tactics that help you accelerate growth. Each week, Cardinal’s experts explore innovative ways to build your digital presence and attract more patients. Buckle up for another episode of Ignite.

Ashley Petrochenko: Hey, guys. Welcome back to another episode of the Ignite Healthcare Marketing Podcast. A little welcome back to me, your host, Ashley Petrochenko. I’ve been away for the last few weeks on a short medical leave, but I’m really excited to get back to the podcast. I think that time is always a good reminder of what patients are going through, we’re all a patient, what’s the care journey look like? I’m really excited to bring those thoughts to these conversations and to welcome our guest today. Joining us is Colleen Mulder. She’s a fractional CMO helping multi-site, PE-backed healthcare organizations accelerate growth, which is what this whole podcast is about. Welcome, Colleen, to Ignite.

Colleen Mulder: Thanks, Ashley. Welcome back to reality after all this time.

Ashley: Welcome back to you. I know you’re getting back from a vacation, as most of our listeners are this time of year, everyone’s off, out of office, on vacation. Where’d you go?

Colleen: We live in Michigan, so we went to Northern Michigan and spent a week.

Ashley: Oh, it’s beautiful. I love the UP. Welcome back. This is going to be a good conversation. Before we dig in, let’s give a little context to our listeners about your background, the type of work you do, organizations that you help.

Colleen: Sure. I have held senior marketing leadership roles and now work as a fractional executive and consultant with PE-backed multi-site healthcare organizations. My focus is building the marketing foundation and scalable growth engines to support patient acquisition, to drive provider growth, service line expansion, and practice integration. What I do is help organizations move from a fragmented marketing activity to a connected growth platform. We do that aligning marketing operations, finance, providers, and financial performance.

Ashley: That’s ultimately what matters to PE-backed healthcare organizations. You have to connect marketing’s impact to revenue, to business outcomes. That’s what we’re going to dig into today. You’ve worked with a range of organizations, from lower acuity to more specialty care. In the specialty care space, something that I think we’re going to dig into first is how has the patient acquisition strategies evolved? Historically, those types of organizations have really relied on physician referrals. Patients are taking control. They are looking for their own providers. They are trying to find the doctor that best fits their needs. How do you think about patient acquisition for specialty groups in this new world?

Colleen: Patient acquisition was primarily referral-driven. Now, physician referrals are still really important, but patients aren’t passively accepting the first referral that they receive. We know they’re going online. They’re evaluating physicians. They’re reading reviews. They’re comparing locations, availability, and really trying to decide if an organization or the doctor is credible. Most recently, is it easy to navigate? Is it easy to get an appointment? Is it easy to be their patient?

I always say we should be making it an easy button, like staples, to become one of our patients. Healthcare groups have to perform well at two different moments. They have to be visible when they’re referred by a provider. Then when they call the practice or the practice reaches out to the patient, the practice has to be persuasive. Patient acquisition isn’t really just about generating demand. It’s making sure the doctor and the practice are local, that they’re differentiated, that they’re credible, and that patients can find them.

That really requires strong local search visibility, and especially in multi-site. The provider information has to be accurate. We have to have online reputation management, useful content. Many of the groups I start working with don’t have intuitive websites. We have to make sure that the service line positioning is clear, and, again, that it’s easy for a patient to make an appointment. I don’t look, Ashley, as referrals and patient marketing as competing strategies. They’re part of the same patient journey.

Ashley: Yes, definitely. You get that recommendation from your trusted doctor, but then that continues on after that. You have to be appearing on search. You have to be appearing on the local maps. If not, you almost don’t exist in many ways. When you’re going into a new organization, how are you auditing or evaluating? Are they over-invested maybe in the referral relationship, or do they need to do work on another side? Is that kind of conversation that you have when you go into an organization we need to reset? How do you think about that?

Colleen: I look at referral development and direct-to-patient marketing complementing each other. The relationships are critical when you’re thinking about a patient being referred for something that’s complex. You want to look at the physician reputation and the coordination between the referring doctor and the provider. Direct patient demand really becomes important when patients are actively researching their own options, like elective surgery, plastic surgery, or hearing pain, allergy, or elective vision correction. The right balance depends on the specialty, it depends on the market, it depends on the provider, the service line, and stage of development. Those are conversations that I have with leadership and with the physicians.

Ashley: There’s no one-size answer. It depends. A lot of people, when they work with marketing, are like, yes, just in general. It depends. It truly does based on the type of care and the market. In my own instance recently, I had it taken into my own hands to find a specialist out of state, very far away. That was independently driven. It’s balancing the very unique needs of that type of care, and like you said, the doctors and the market. When you’re going in, do you ever find that there’s a pushback from any of the organizational leaders, or how do you make the case for direct-to-consumer if they’re thinking, no, no, no, that’s not important? Is that an obstacle that you often face in those leadership conversations?

Colleen: I don’t face that obstacle, I think, because when a fractional person is brought in, they’re being brought in for their expertise. I’m not brought in without trust. I’ve always had great relationships with physicians. We start with, okay, what is the strategy from leadership? That should always involve the physicians. Physician-led organizations are critical because without the buy-in from the physicians, we’re not going to make any progress.

Ashley: Yes, that’s great. That’s the stage that you’re walking onto. When you’re in an organization, what foundational capabilities need to be in place before you can actually start growing? You’re going in, what are you auditing? What are you really thinking about needs to be there for an organization to grow?

Colleen: A lot of organizations just say, “I want to grow,” and they want to accelerate growth. It’s really critical to have the operating system to support that, and then the foundation. When I go in, it begins with strategy and ownership. Leadership needs agreement on, okay, where’s the growth going to come from? The question I always ask is, what are your main EBITDA drivers for that specialty? That’s where you want to focus. I have a three-part framework that I work with for marketing. It’s, number one, awareness, making sure our local patients know the doctors, know that they’re credible, they’re visible, they’re validated.

We do that through the consistent and cohesive websites, Google Business Profiles, SEO, and reputation management. Then number two is acquisition because not all patients are created equal. We want to capture more high-value patients. We do that through the referral growth program that we just talked about, and new provider launch programs, paid search. We want to target those high-value patients that are EBITDA drivers, especially in PE.

Then number three is patient reactivation. Activating our existing patients who know and love us and trust us and focusing on high-value patients is critical. It’s interesting because I’ll go into many practices and they don’t have some of the basics. It’s important to have recall and reminder platforms in place. It seems so simple, but many practices don’t have formal programs in place. If they do have a program, it’s often set it and forget it.

Ashley: That leaves the patients getting multiple messages and things that are completely outdated or confusing, which you can’t set and forget that type of thing.

Colleen: Yes. You just went through an experience. You were a patient. You understand getting multiple messages or the reverse, which is you don’t show for an appointment you get one reminder and then no one thinks about you again. Time goes by so quickly. Your doctor may have said, come back in a year. All of a sudden, it’s two years and three years and it seems like it was just a year ago. I always tell people we need to inspect what we expect.

Ashley: I feel there’s so much money left on the table for that very reason. Especially when you’re in a post-care setting, you’re trying to get back to it. You’re like, oh, I know I need to do that, but you forget or you’re busy or whatever. Or you’re in pain and you’re like, “I don’t have time for this right now.” I think there’s a lot that could be improved. That’s a whole other sob story right there. That is a whole thing.

Colleen: You could do a whole segment, Ashley, on no-shows and cancellations. The reality is some specialties have high no-show rates. Some are low, but many have high no-show rates and cancellations. If patients trust you, they’re already your patients. It’s much less expensive to get an existing patient back than to get a new patient.

Ashley: Yes, absolutely. Thinking about what you said, working with the operational team, executive team, on finding that alignment around goals, growth targets, you mentioned what are the real EBITDA drivers. That is part of that analysis. How do you focus and align your marketing strategy against identifying and finding those drivers of growth? Is that something you can speak to? How do you really align marketing’s activities to those actual EBITDA drivers? Is there any advice or things that you could really share with our listeners that would help them?

Colleen: Yes. I am a big proponent of marketing can’t be a silo. To be successful, you have to be aligned with finance, with operations, with IT, and everybody has to be focused on the same growth goals. When I initially start working with a group and an organizational platform, I’ll ask the CEO and the CFO, what are your main EBITDA drivers? Then we look at do they have capacity or do we need to optimize the schedule? We really focus our marketing on those high-value patients.

Ashley: I love that. Marketing can only do so much if they’re kept out of the loop of those conversations, and then they only have visibility into that capacity piece. Then they’re just wasting money, maybe against doctors, schedules that can’t expect anyone new, even if they are the highest revenue line item. Thinking about marketing, you have that alignment piece. How do you think about actually improving performance, the whole marketing measurement component when you’re going in? What are those non-negotiables or how are you building that foundation?

Colleen: Especially in PE-backed environments. I don’t think this is just PE. It should be across all healthcare marketing. In PE, I think we look at three things: the impact, the economics, and the scalability. When we think about impact, marketing really has to demonstrate it, create an incremental business growth, not just activity like clicks, calls, and leads, which are useful metrics. Leadership really needs to see additional completed visits, procedures, treatments, revenue, contribution margin that marketing help generate. Then second, I would say economics. The growth has to be financially attractive.

An organization should understand how much does it cost me to acquire a new patient, and what are my conversion rates, and what is the contribution margin and the payback period? That’ll differ by service lines when you think about, okay, a general ENT visit is very different from a hearing aid visit, or facial plastics, a facelift, or an elective vision procedure. Performance really has to be evaluated within the right business context. Then third, I would say scalability.

Can the model be repeated across additional practices with doctors and different markets and service lines? Sometimes the program works because you have an exceptional doctor or one very highly engaged local team member, but is it a scalable platform capability? You don’t say, did that campaign work? Did it create incremental impact? Were the unit economics attractive? Then can we repeat it across the platform?

Ashley: Now, part of scaling growth is really understanding, where can you scale growth? Not all locations are the same, and it’s really important to understand capacity across your platform before you start investing marketing dollars into ads for a location that has a three-month, six-month wait time. How are you really thinking about building that knowledge base and understanding capacity across your system?

Colleen: We have to make sure that we have capacity, and that has to be part of the growth strategy. Then we have to make sure providers have availability. Sometimes we go into practices and they say, I want more patients, more patients, but we’ll look at their schedule, and we may need to optimize their schedules. We look at, oh, they’re booking out six months. Well, maybe we need to shift some of those patients to a different provider, a newer provider, a different location that’s 20 minutes away. Sometimes the answer is really to increase demand. It becomes really important in multi-site organizations because across different practices, capacity levels vary a lot.

Sometimes even the internal doctors aren’t aware of that. They may think, okay, I need more patients, I need more patients. Then again, we have to say, what kind of patients should we be creating demand around? Ashley, I would say the number one issue I see across healthcare organizations is marketing driving demand, but the phones aren’t being answered or online scheduling isn’t available, and so the conversions aren’t happening. I’ve had contact centers or call centers roll up to me in the past.

When that alignment with marketing occurs, magic is made because if marketing is generating demand and marketing falls under the contact center, we’re paying very close attention to conversion rates. Then we can actually, because it rolls up to marketing, we can make sure that the call center reps are trained appropriately, that they’re taught how to answer these elective surgery questions when patients are shopping around for a LASIK procedure or a facelift.

Ashley: That’s the dream scenario. I’ve heard of some healthcare marketers actually reporting up into the operational roles, and in many ways that really gets that really tight alignment because everyone is reporting up and has the same source of truth. If that’s not the reality, if you really are two different functions in silos, how have you been able to get closer and closer to operations? One thing that’s really worked in your career that has enabled you to get that kind of collaboration from that team.

Colleen: I think it’s tricky. My advice would be for healthcare marketers, as they’re looking for positions, to make that part of the interview process. When you’re being interviewed for a position, but you’re also interviewing a company to find out, is this an organization where I can be successful? Those are questions that should be asked. Is marketing a silo or is the team working together? Is finance involved, operations involved? Without that teamwork, it’s very difficult to be successful.

Ashley: Do you have any advice for people who don’t have that reality, unfortunately? If most people are in an organization and they’re already there, anything that you would recommend to really help gain that alignment?

Colleen: I am a big proponent of communication, and so starting out with the person that marketing reports to and having a conversation about the success being critical as a team-driven goal. The strongest results come when we’re all working together and we have the same growth objectives, the same performance measures, and service levels. You know that alignment really reduces friction. When you think about operations, they’re trying to increase revenue and grow the business. If the conversation is with operations and maybe approaching it from revenue leakage, we’re driving leads, but they’re not being followed up on.

Really, then you look at it and say, we don’t have these individual silos. We’re all working together to grow this practice. Some PE groups are very involved with the platforms and others aren’t on it. It’s trying to figure out who to talk to, and I would start with the person that they report to, just to get that conversation going. Often, it’s going to be leadership-driven, whether that’s successful or not.

Ashley: Yes, so much, like you said before, is finding that alignment around what is the goals, what are the revenue targets, and then having those conversations. You have to have those honest, hard conversations sometimes where there is leakage, maybe where there’s opportunity to improve the patient experience and getting people access. Let’s take a pivot here and maybe do a little hard lesson truth from your career. If there’s a marketing bet that you made that didn’t pay off, or maybe it did, if there’s something that you learned from that situation, you want to walk us through that story?

Colleen: Oh, yes, three questions. One lesson I learned very early is that even when you have a well-designed initiative, that doesn’t necessarily produce consistent results across every market. You can have a sound strategy, you can have strong creative, and you can generate leads. If local practices have different capacity levels, member engagement, lead follow-up, doctor participation, if they’re not operationally ready, my biggest mistake was not the concept, but it was assuming that, oh, we can launch this same program across every location and it’s going to be successful. What I’ve done is really change how I approach platform-wide initiatives. I spend more time assessing, is the practice ready?

Is there somebody who’s going to own this? Does everyone on the team understand the program? Is the doctor participating? Can the practice accommodate additional volume? Is the follow-up plan clear? Then do we have a way to measure completed appointments and revenue and ROI? I often will run pilots whenever possible because a well-structured pilot is going to allow us to test both the marketing hypotheses and the operating model before scaling it. Then you’re proving the complete model and then building the conditions needed to repeat it.

Ashley: Testing those pilots and new markets, especially, is such a way to– Every region is different. Doctors, providers are different. You have to sometimes test the waters. Something we share with our clients is this marketing readiness checklist. You touched on it. Is marketing even ready to handle this influx of new leads? That’s something you really have to be- before you just do a blanket everyone, go, go, go, really testing and assessing those individual markets and locations. Then the pressure often is on to just go, go, go. It’s always that delicate balance of we do need to move and drive growth, but are we actually ready? That’s our hard conversations to have.

Colleen: It is a hard conversation to have. It is.

Ashley: Looking ahead, if an organization is thinking about where I am today and where I want to go, when would it make the most sense to bring on a fractional CMO, or when do you build an in-house team? Your advice on navigating that conversation and building that marketing and demand-gen arm?

Colleen: I think a fractional CMO or a senior marketing advisor consultant is really valuable when the organization has significant growth goals, but they don’t have leadership structure for the marketing position. The best-case scenario is at the beginning. I often step in at the start of brand development after the sponsor has the platform practice in place. That’s an excellent time to bring someone in to begin building the foundation before they’re ready to hire a permanent person. There are times when I’m brought in when there’s a leadership transition or a group decides to develop a new service line.

The role really is to, let’s assess the business, determine the priorities, which are probably already set, align all of the executives. I often go in and improve or vet current vendor partners and their performance, mentor the internal team. Then making sure, as we just discussed a few minutes ago, connecting marketing with operations and finance and building a repeatable process. Bringing someone in when you said, well, what would your advice be to somebody who’s struggling with that? Bringing in a senior consultant will help that and point out the obvious. Really, the goal is to build a strong brand and an organizational structure that has really clear direction and capabilities that drive growth.

Ashley: I love it. Earlier, the better. As you said in the beginning, work needs to be aligned with the operators. We’re already halfway through 2026 somehow. Not quite sure how that happened, but looking forward to the rest of the year and to next, what is one thing that’s changing in patient acquisition that you’re watching and you want people to pay attention to?

Colleen: Patient acquisition is really becoming less linear. It’s becoming more dependent on trust. People want convenience and they want speed, like the rest of the things that people do. When we’re out in retail, we want it fast and convenient. Patients, really, they might discover a doctor or practice through a referral from a doctor, a Google search, an online review, an AI-generated answer, maybe social, and our number one referral source, which is always a recommendation from someone they know and trust. Patients right now are moving between a number of those sources before they make a decision.

As a marketer, we have to be okay with knowing attribution is going to continue to be imperfect. We all want that one system that’s going to provide the perfect answer that says, your patients are coming from X. We need to triangulate the performance using multiple data sources and then trying to understand how the different channels contribute across the patient decision journey.

More and more, we talked about the easy button, if we can respond quickly and be convenient, just like other industries, we’re going to be farther ahead than most healthcare organizations. I would challenge marketers to try to make sure that they’re involved with I can generate leads, but what’s happening after? I need to make this easy for patients because it’s becoming, in many markets, much more competitive.

Ashley: I like that advice. That’s a good closing sentiment. We can invest so much into marketing, but if it’s not easy for the patient, if you’re not making it a phone call that’s going to get answered, then you’re going to lose. The marketing investment is going to be wasted. That close collaboration that you spoke to, that’s really important. Acting as a patient, going through the actual patient journey that you’re working through, what is it like?

I feel that’s something that doing Secret Shopper almost. That’s something that they do in retail, but maybe healthcare can do a little bit more of that Secret Shopping to fully understand that patient experience. That’s good advice. Thank you so much, Colleen, for joining Ignite Healthcare Marketing Podcast. If anyone wants to connect with you, where can they find you? On LinkedIn? Share any destination if the people want to connect with you.

Colleen: Sure. You can find me on LinkedIn or my email is [email protected].

Ashley: Great. Thank you again for joining us. We’ll be back next week with another episode of Ignite Healthcare Marketing Podcast. Thanks.

Colleen: Thanks, Ashley.

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