Why patient acquisition isn’t enough anymore

Announcer: 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, Cardinals experts explore innovative ways to build your digital presence and attract more patients. Buckle up for another episode of Ignite.

Ashley Petrochenko: Hey everybody, welcome back for another episode of the Ignite Healthcare Marketing Podcast. Ashley here and joining me today is Hannah Twinem, the Director of Marketing at OrthoCarolina. Welcome to Ignite, Hannah.

Hannah Twinem: Thank you so much. Thanks for having me.

Ashley: Great. And I’m really excited for this conversation. You know, I was looking back, the podcast has been in production for many years and we actually had someone from OrthoCarolina, Blair Primis, on the podcast seven years ago in 2019, which is kind of wild that we’ve been having these conversations. So it’s really going to be exciting to kind of check back in, see what’s happening, how growth is being generated at OrthoCarolina. So before we jump into that conversation, let’s just get a little bit of background, who you are, where you’ve been, and then we’ll go from there.

Hannah: Awesome. Yeah. It’s funny you mentioned Blair. So he’s, he’s my boss. He’s our Chief Growth Officer. I’ve actually known Blair for about 10 years and we kept in contact. I am newer to the OrthoCarolina team than with Ortho, about four months, but not new to healthcare and not new to the physician-led, physician-owned, you know, healthcare specialty space. …career with, actually, Tenet Healthcare on the hospital side on the West Coast on 29 Palms. My husband was a Marine and we got stationed out in the Mojave Desert. So that was a fun experience, but really got me integrated into healthcare and marketing. And I really, I really don’t see myself, you know, going in any other industry. I think I really feel very fulfilled in this industry and marketing is something that I really enjoy.

From a career perspective, this role is a little shifted from true like black and white marketing to more of a growth function. And I think that’s something we’re going to talk about today, but Blair certainly has pioneered a lot of that for me and what I’ve learned in my career too. So excited that there’s a connection there too.

Ashley: Awesome. I love that. And I think marketing’s role is like not black and white anymore. The way that you achieve growth is not just one channel, one responsibility. It’s really starting to become more cross-functional need for it to be orchestrated that way. So I think this is going to be a good conversation. And you mentioned that you’ve been in the physician-owned space for many years. And I think let’s kick off the conversation with that. In physician-owned practices, marketing’s budget is typically at the mercy of the partners. It’s money that the partners, the physicians are investing. So how does that reality shape the way that you build the case for marketing? How does that shape the way that you approach budget conversations and getting their buy-in?

Hannah: Yeah, that’s, that’s a really good question. When I think about answering that question, I think there’s, there’s a lot of pros to that, right? I will say when you’re asking physician partners of a physician-owned, physician-led practice, you’re actually asking them for money that’s going to come directly from their paychecks. So I say their back pocket. So it’s, it’s more of a personal budget conversation than it would be if, if this group was PSA’d or you know, had been acquired by a, you know, very sustained longstanding health system or a PE-backed firm was funding the marketing efforts.

So I think because that changes the ask and what it means for that doctor, if they say yes to X campaign, to X net, you know, increase in budget for the next year, I think it’s important to translate how that money will be shown valuable in the near future, but also the longterm because, you know, it will be an investment. I know we always say, you know, like you have to spend money to make money. Well, this is their money, right? Like this is not like some arbitrary budget that they’re not connected to. They are seeing it, they’re experiencing it in their quality of life and their salary. So I think that kind of adds a level of responsibility for me as a leader and, and obviously like my boss Blair.

So when we think about going to the doctors with these net new asks or, or increases or just, you know, really expanding the way that we serve the community in a marketing or advertising capacity, it’s, it’s making sure they see the value near, near and, and future. And I think that helps. But the other part of that is that because it is their money, I enjoy and have enjoyed working for physician owned groups because they have more skin in the game. Like they, they really, they do care about the marketing. Like it’s not just like what’s happening on the sidelines. They go into the OR, they come out, they go home. Like they actually care that they see a billboard that has their brand on it. They care that when they search their brand shows up in a positive way. So it just, it, it makes me work harder to be honest because I feel like it means more to them.

Ashley: I love that they have skin in the game. Like you said, they want the results that marketing is, is going to be delivering to them and they’re going to be more, more oftentimes you’d find collaborative partners. I think sometimes another organization’s getting maybe some of the collaboration from physicians. It’s, it can be hard and we know you need that expertise. You need that clinical expertise in marketing now for credibility. And if you don’t have that, like it’s kind of that push and pull. And these relationships, what are you finding is helping you kind of get that buy-in? Is there advice you could give to listeners? Like what’s working? Like, because it is that personal connection relationship. What has worked in your career in terms of like really getting that early buy-in so that they’re on board and you’re all like marching towards the same goal?

Hannah: I mean, I think there’s like some really simple principles that I’ve seen that, that make a difference. Like I, one of the things I’m really, really specific on with myself and my team is like closing a loop. Right? like physicians. We have so many inbound requests, right? Like we have an event, they ask about what we’re doing with social or, you know, they have a patient come in, they want to translate it into patient story. We have so many of these inbound requests and just for a volume standpoint, OrthoCarolina has 150 physicians and my team is me and then two, we have a specialist and a manager.

So you can imagine the inbound outweighs the manpower and so sometimes it’s really just like communication and maybe it’s something that like we aren’t doing today, we’re not going to do next week, but just them knowing that it’s still on our radar, we still value their opinion and their suggestions and also just like not shying away from, you know, just candidly a complaining physician because they care. Like I will say someone that’s not complaining is apathetic, like they don’t care. Like if the event didn’t go very well and they don’t send you an email about it, then they probably won’t really care to be involved in another one and maybe they didn’t really value the opportunity. So I like to take any feedback we get from physicians and turn it into a positive thing and just not get it personally, right?

So like they care enough to give us feedback and so really like internalizing that, not taking it personal, but internalizing it in my team to see like what could we do better because we can always do something better. So that follow through, the close the loop is a really big piece and then I think just like listening to them and educating yourselves on their business. So like the more tables I sit at that I get to learn, the better and like my ears don’t shut off when the topic is not about marketing or advertising. My ears actually probably perk up because I’m like, okay, what did they care about that I can show value towards or shed some light to support what they care about? So it’s really like being a partner.

I’ll say like in my last job, one of the surgeons said I wasn’t like the typical annoying marketing girl and that was like the best compliment literally ever because I’m not just like with my iPhone, like let me get a social post. Like they really see that I like care about their business. I care about what matters to them and I’m going to follow through and I’ll be dependable. And I think that, you know, those are really like basic principles of like being an executive or being on a team. But I think in the physician space, they themselves have so much pressure on them. And so when they’re kind of admin counterparts or, or, you know, administrators don’t have that same dedication, I think, you know, you lose some of that trust.

Ashley: Absolutely. You are really understanding the business. And, and I think that is a good segue to kind of how does marketing work across, you know, you mentioned prioritization, 150 doctors, small team, how do you then prioritize, you know, the locations, the service lines, the surgical centers that need marketing support more than others? Is this a conversation? Maybe just walk through kind of how you, that thought process of you prioritize, where do you spend your effort?

Hannah: So I think like earlier in my career, I kind of looked at it like a game of whack-a-mole. And while we still kind of feel like that is what we’re playing, it becomes a little bit different when you look at it from a specialty, like I work for a specialty, you know, we’re not primary care. So our strategy is more of like a specialty and subspecialty strategy versus like zip codes and locations. And so, I mean, quality for us, we have 43 access points, about 33, like different brick and mortar, you know, access points. So for us, I want to advertise that we have hand and wrist expertise at any of those access points versus come see Dr. X at our Ballantyne location because he’s really great at hand and wrist. So it just kind of like flips that on its head.

And I think that is an education piece, right? So we do have in our center city in Charlotte, we’re Charlotte Metro-based, North and South Carolina, we do have a lot of research that’s being done that is more centered around our hub, right? Like our Charlotte center, like spine center, hand center, you know, knee and hip. So I think it’s looking at those centers as more of a hub and spoke as we market. So like if you enter our system and you see a doctor that’s been here for a year, you’re not only getting his expertise, but you’re also getting access to what he has at his disposal, which is peer-to-peer colleague investment and training and research and, you know, decades of experience at the top of their skillset. So I think it’s really about marketing of this specialty versus the location.

Now, my caveat to that is that when we do know that we have an access either issue or opportunity at one of our locations, that we know that we kind of have a toolkit of levers that we can, you know, pull up or pull down in those scenarios. So it’s really not starting with the location, but it’s starting with the specialty and then adjusting the strategy depending on access.

Ashley: And I think that, you know, focusing not, like you said, it’s not on individual physician. You do have to like build on that relationship, but then there’s that education. You are part of this greater service line. You are one of a team. And I think that helps, you know, I think something I want to talk a little bit, it’s like the capacity and management, like it’s not just focusing on one doctor’s schedule. You really have that entire footprint across that region to move your demand that you’re generating to the soonest available appointment. Is that correct? Like how you guys kind of manage your inventory of appointment spots.

Hannah: Yes. And, and like now that we’ve kind of shifted into this growth team versus like a true black and white marketing team, we have my counterpart is Catherine Anderson, she’s our director of user experience. And then we also have really, really close cross-functional relationships with our, you know, director of access, our VP of operations and all of her directors on her team. And so I think, well, and Epic, we’re on Epic, our EMR team, that’s incredible technicians and they have this like level of detail and analytics that we absolutely need in order to be successful. So I think it’s no longer we just creating demand, but we actually are learning and educating ourselves about how that demand is being used. Because if we’re driving demand and there’s not a place for it, it’s actually hurting the system, not, not helping it.

Ashley: Absolutely. It’s going to frustrate patients. You’re going to lose them in that moment. I like that. And I wouldn’t think going back to like this whole, you know, this growth function is new and the idea of like how you’re collaborating with physicians, what’s going to gain their buy-in you mentioned is, you know, is the data helping them understand the impact of marketing short-term and long-term. So what kind of growth numbers are you reporting to them? How are you kind of communicating marketing’s impact in those conversations?

Hannah: Yeah. So I think there’s definitely like return on advertising spend like ROAS. So that’s something that we normalize with them, the customer acquisition cost (CAC). And so I think obviously new patient volume, but then we also have visibility to that user experience side, which is after the demand actually enters the system. So like what is, what are the wait times? What is the call wait times to schedule an appointment? You know, like there’s just efficiency numbers that we can share with them. I think when you’re thinking about growth, there’s obviously like the immediate return, but then there’s also metrics or sentiment metrics that share like how our brand is being perceived in the community and even nationally.

And so we use a couple of vendors that help us kind of aggregate all of those loose words out in the, in the ecosphere, like, you know, Reddit, Nextdoor, Facebook, Google, like there’s a million of them. Right. So we use a company that gives us a quarterly report and it’s basically saying like, what are people talking about you and what are they saying? And what are things that are like neutral? What are things that really stand out as a differentiator or what are things that are creeping up as a risk that we need to like get the attention of different cross-functional teams and share that with them so they have visibility to some of those risks that could maybe become more of a, of a threat over time.

Ashley: Great. And I’m, I’m imagining that probably resonates really strongly with some of the partners, like just kind of hearing what is the community saying? What is the sentiment? I feel like that is probably like that paired with the data is probably pretty powerful.

Hannah: It’s definitely like that, that feedback report that we use, I mean, it’s an investment, right? So like that, that is also difficult to convince, you know, a C-suite team or like an executive committee that like, hey, we want to spend this money, but like you said, when you have the data and analytics and you also have that like brand voice tone and, and, you know, pulse, I think together it tells like, you know, the full story.

Ashley: And thinking about that full story and like how being able to actually report on those numbers. Let’s talk a little bit about the tech side, because I think that is something, you know, this is obviously the holy grail when people want to be able to report on, you know, cost per booking and actual kept appointments. That is, that’s the dream. A lot of listeners here are working towards that sophistication. What did it take to kind of get that foundation in place so you could do this work?

Hannah: So I would say, you know, Freshpaint is our CDP, it is way more than CDP. I feel like that’s a very like loose term because the way that they’re building their platform for marketers like myself, I mean, they’re really just attacking every new need. So my second week I was on a call with Blair and some of their technicians or engineers and we were doing product testing and it was just so cool to be like, okay, they just are wanting to know, like, what are, what are you wanting to solve for? And like, let’s get ahead of that as a company. Finding those companies that really see you as like a partner in helping, there’s definitely like it’s a win-win. So Freshpaint is huge for us. We use Liine for call tracking. Those are like the two main ones that we use and drive metrics from and make different decisions.

You know, Freshpaint has a lot more capability now than it did when we first started or when they, you know, first started coming onto the scene with all the, you know, HIPAA compliance issues with marketing advertising. So we really are just continuing to kind of build on what we can see. They have multi-touch attribution models that we can see within the platform. We just, you know, we have CTV and, and we have, you know, search or pay-per-click and like meta. So how do all those things work together and kind of seeing that full picture. But yeah, so that, that’s pretty foundational for us to be able to do what we do and see how it works.

Ashley: Awesome. Yeah. Having the right tech in place, you know, and then not just shelfware, but having the partners who are working with you to kind of actually implement it in a way that’s, you know, aligned with your, your organizational goals like that. Let’s maybe pivot now to continuing to put, you know, marketing and the growth team owns a portion of driving patient volume, but that isn’t where the only place that growth can come from. So let’s talk about how you’re working across the organization to drive growth beyond marketing and maybe talking about the operationals, like where do you think you have been able to find opportunities to keep growth, keep patients within OrthoCarolina?

Hannah: So I feel like when we look, when we think about growth, there’s so many different teams that we have to work collaboratively with and they see that we value them in order to have like the full story to share, you know, with the owners of the company, like the physicians that are partners. So I think it’s also like showing that my department, the growth team is actually wanting to solve for their problems as well. So it’s not just like us entering every room looking for them to do something for us, but we’re entering those rooms to also learn from them. And I think that posture has really helped like build those like trust and rapport between the teams.

I don’t speak their language and they don’t speak mine, but if I can show an interest and show that I do, I want to, I want to get to a point where I understand, you know, enough to be dangerous, right? Like the technical speak and like, you know, when we’re talking to one of our epic engineers, like they understand that we value the work that they do and, and we can’t do what we do without, without them and vice versa. And then I also think just like looking at the different departments that make up growth, I think obviously patient access, you know, you have referral management, you have business intelligence, you know, data, HIM, data analytics, patient experience. Like I mentioned, like our, our organization has invested in that, right?

Like you’d be hard pressed to find many physician owned practices that have hired a user experience director and have a full team focused on that. So there’s just a lot of different moving parts. I think as the growth function in OrthoCarolina, one thing that, you know, Blair does really well that I I’m learning from him is that there’s a foundational piece of like what we are committed to do and like provide success and demand and value for the company. And then there’s also like us kind of pushing the boundaries a lot of times, right? So like in a way that we say, we come to them and say, it would be wrong for us to not show you what else we could do.

Because if we just kind of do the status quo and you know, we don’t push the envelope or even ask to push the envelope, that’s not really growth. It’s, it’s more, you know, you’re staying stagnant. You might be trying different things. Like obviously this isn’t, there’s a lot of marketing and you know, our strategy that’s foundational, right? Like you don’t put up a billboard if you don’t have a good, you know, PPC campaign, right? Like that, that doesn’t make sense. So it’s like, yes, we’re doing the foundational pieces, but we also are coming to them continually saying what else we could do is this, and this is what it would do in three to five years.

Like we know that you care about year over year growth, but like we are actually, we’re charged to look at, you know, five, 10 years down the road, where do we see ourselves and what does that growth look like? What seeds do we have to plant now in order to accomplish the future goals of the practice? Because you have younger doctors and then you have, you know, doctors that are more senior that are like looking towards, you know, the end of their career. So it’s really our responsibility as the growth team to take that seriously and know that we have to prepare for the future to, you know, uphold the same level of complexity and success that the current, you know, senior partners have.

Ashley: I think that’s a good segue kind of to the future state of, like, OrthoCarolina. What does that look like? I know maybe you can tell listeners a little bit about the recent partnership with Atrium Health and how does that kind of set the stage for the future?

Hannah: So I think a really interesting distinction is it’s really about maintaining your independence while having partners. And so the clinical affiliation with Atrium, that was a decision made and it benefits both organizations. So, you know, we are still competitors, but it means that we are coordinating our approach to how we meet the needs in the community and the, you know, the neighborhoods that we serve. Perfect example is, you know, we both sponsor different, you know, sports groups in the community. But it’s like if we are lockstep with them, now we say, okay, they are good at this and we are good at that. So let’s both like stack hands and let’s do what we’re both good at. You know, my doctor is on the sidelines, like that he’s the team doctor, right? Like Atrium Health is not like their own employed physician is not that team doctor, but ours is.

But they also have all these resources and different, you know, avenues that we don’t have. And so I think it’s just important to look at that type of partnership as complementary and not that we lose our autonomy or we lose like who we are as a brand. We’re actually, you know, leveraging the best of us and the best of them. One distinction I’ll say is that like, you know, we’re on our own EMR. We’re on our own instance of Epic. And so the clinical affiliation is not, it’s not something that we did to gain like those types of resources, but we’re really looking at it as a growth function because Atrium and Advocate is their parent brand, you know, they’re very successful just doing so much for the community. And then we want to be a part of that and vice versa.

It is hard when you’re a, you know, independent practice to not do those types of partnerships because it’s just, it’s a part of the makeup of healthcare and, you know, it waxes and wanes and right now it’s a way that we can kind of make sure that we’re growing together with the major health systems in our community.

Ashley: Let’s talk a little bit about how you approach marketing and relationships based on the physician’s career. How do you approach marketing and building those relationships based on the career stage of the physician, thinking that OrthoCarolina is both welcoming new fresh graduates, younger physicians who are entering the career as well as the whole spectrum up to people who are the experts in their field. What’s your approach for marketing across that spectrum?

Hannah: So the incoming physicians, they are, you know, they go through a process. So, you know, we have a certain path for them if they are interested in being a partner of the group. But our newer physicians, honestly, like each physician group, there’s really three, right? Like you have the brand new docs that like are eager and hungry and will do anything and are maybe a little more tech savvy. Like their LinkedIn is up to date, you know, like they’re aware of what’s on social, have a more awareness of like the current kind of market as they look to try and like ramp up their practice or their clinic. Then you have your middle staged, middle career physicians or surgeons for us. So, I mean, those have a good established referral network, right? But they also are very busy.

Like they’re very involved in like research and they’re very like, you know, usually have growing families. And so just life stages are different too for these different groups. And then you have, you know, your more senior physicians that, you know, have seen so much change in the practice over, you know, decades. And they are, you know, it’s their responsibility also to mentor these younger physicians that are coming up and make important decisions. A lot of times those older physicians are in, you know, positions of leadership, but they’re making decisions that aren’t necessarily going to affect them long-term. They’ll really affect these newer mid-career physicians. And so I think it’s important to see like for each group, like what’s important for them and then use that to basically like help them market themselves. So like for new doctors, I would say like we want to humanize them. Like who are they?

What is their personality? How do they interact with patients? Like what are they excited about? What are they geek out about? Like get content, like work with them on that. Mid-career, I would say like consistency is important, making sure that they’re not apathetic and don’t get a little stagnant. Like I helped one of our physicians create his own LinkedIn page yesterday and I, it made me so happy. Like 45 minutes, he’s like sitting in his hotel room, like, and I think he was in Vancouver, like for a shoulder and elbow, like it was like this meeting of the minds, like 60 countries, like incredible opportunity. And he’s like, okay, wait. So like, how do I click that? Like I click the button. Okay. So I did that. But like, he, he is coming to me because he’s like, someone just printed out my face from ChatGPT.

And I’m realizing that like, they’re asking ChatGPT who to come see. And if I don’t have my LinkedIn up, if I’m not on being talked about in Reddit, if I’m not being like, you know, featured on different, you know, communication channels, like I might kind of, you know, slip through the cracks. So it’s those that you want to encourage to not be apathetic. And then your senior doctors, it’s like, they are the pillar of reputation. Like that’s our referral brand. If these young doctors want to come to our practice because of these, you know, men or women that have like gone before them and really like pioneered such amazing techniques and things that have like changed patients’ lives. We have a research institute, it’s called OCRI. And so I’m heavily involved in helping them market that. And it’s just really encouraging to see all three of those groups of physicians really take ownership in the work that we’re doing there too.

Ashley: I love that. And marketing is nurturing those relationships and customizing it to where they are in their career journey. I think that really speaks to what marketers or listeners have to do if they want to drive change in an organization. If they want to earn that seat, they really have to approach those stakeholders and understand their different objectives, place in their life, if you want to be part of that conversation. I think to wrap this up, you know, we talked a lot about marketing and the growth function is starting to incorporate a lot of different functions. Looking ahead in the future, two years from now, maybe five, you tell me, but where do you think a marketing leader is going to own something that they don’t own today?

Hannah: Yeah. I mean, I think I mentioned this earlier in the podcast. I think like the user experience piece is pretty big. And I wouldn’t say in my experience with specialty or like independent physician groups, typically they don’t have a user experience group or have invested in those, you know, people collateral or people, you know, investment. So I would say owning that. slash building it will become a necessity because demand is no longer the end of the road. Like, it’s how did we utilize the demand? And did the demand that we generated actually translate into revenue that is felt at the bottom line of the company? Also, the experience side of that is, what is that demand? What are those people saying about our brand after they experienced the patient journey? And so I think it’s both, right? Like we have to, we have to sustain the practice financially.

That’s one part. But the other part is like, our reputation is on the line if we don’t also pay attention to that user experience. And so that’s honestly one of the reasons I accepted this role because I knew that like they had already invested in user experience. And so it was like, you have the whole, you have the whole picture when you have those two teams working together.

Ashley: I hope that is part of marketing’s purview in the future, because I 100% agree that marketing can drive all the demand and capture it. But if they, the patients are experiencing a poor experience, you’re not getting this word of mouth recommendations, your social proof is going to be destroyed, Reddit, you’re going to be trashed everywhere. And it’s just going to make marketers jobs a lot harder. So marketing needs to have patient experience as part of their, their team. I’m really excited to hear that you guys are doing that there. This has been a really great conversation, Hannah, and you’ve given some really fabulous advice on how marketers can earn that seat at the table. I think if you had one nugget of advice that you wanted listeners to walk away with, what would it be for them to earn that seat at the table?

Hannah: Yeah. I mean, again, it’s like, I think just be authentic. Like people don’t want to be bullshitted. Like they, they want to know like who you really are and like, what’s important to you. And they want, they want to know that at the end of the day, like you are a learner of their craft as well. So I would say like, I always in any room want people to know that like, at the end of the day, like I’m still a student of what they’re good at. Right. So like, I always tell these doctors, I’m like, you don’t want me in the OR room. Like you do not want me there. Right. When I was helping that guy with the surgeon for the LinkedIn, he was like, I just can’t believe I don’t know how to do this. And I was like, well, I don’t know how to do surgery.

So, you know, build a mutual respect. And I think that’s like where the sweet spot is. I think, again, when you’re in healthcare, like these people are so dedicated, their patients and stuff. And so if you can just show yourself a student of their, of their work and of their craft, I think that’ll go a long way in just getting a seat at the table and joining in those conversations. Whereas maybe, maybe before you weren’t invited.

Ashley: Be curious, be a student, ask those questions, and that’s going to get you closer to the leadership and across the organization. Hannah, thank you so much for joining the Ignite Healthcare Marketing Podcast. This has been a great conversation and I want to do a small little plug. I think this is going to actually launch in November, which after scaling up, but anyone who missed scaling up, which we will have Blair Primis at and speaking at the conference with Freshpaint, which is one of our wonderful sponsors, which we love and wonderful partners. You can still register and you still get access to the event platform. So if you missed it, it’s not too late. And thanks again, Hannah, for joining and sharing about what’s working for you at OrthoCarolina.

Hannah: Thanks so much.

Ashley: Thank you so much.