Season 3, Episode 45. Chuck and Chris talk about a new HBR article by Bill Taylor, "Your Competitors Aren’t Always Who You Think They Are". We explore what this means in healthcare and how we can optimize the patient experience.
https://hbr.org/2022/11/your-competitors-arent-always-who-you-think-they-are
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As always, thanks to @iampetermartin for the amazing introduction and conclusion music.
Listings at theupperhandpodcast.wustl.edu.
Season 3, Episode 45. Chuck and Chris talk about a new HBR article by Bill Taylor, "Your Competitors Aren’t Always Who You Think They Are". We explore what this means in healthcare and how we can optimize the patient experience.
https://hbr.org/2022/11/your-competitors-arent-always-who-you-think-they-are
Subscribe to our newsletter: https://wustl.us6.list-manage.com/subscribe?u=c6fe13919f69cbe248767c4e8&id=10e0c1dd85
See http://www.practicelink.com for more information from our partner on job search and career opportunities.
Please complete NEW Survey: https://forms.office.com/Pages/ResponsePage.aspx?id=taPMTM1xbU6XS02b65bG1s4ZpoRI9wlPhXnSF2MnEXxURVRNVDNBMEVSMU1CWFpIQVA4SEtMTFcyMS4u
As always, thanks to @iampetermartin for the amazing introduction and conclusion music.
Listings at theupperhandpodcast.wustl.edu.
Welcome to the upper hand podcast where Chuck and Chris talk Hand Surgery.
Chris Dy:We are two hand surgeons at Washington University in St. Louis here to talk about all things hand surgery- related from technical to personal.
Charles Goldfarb:Please subscribe, wherever you get your podcasts.
Chris Dy:And thank you in advance for leaving a review and leaving a rating wherever you get your podcasts.
Charles Goldfarb:Oh, hey, Chris.
Chris Dy:Hey, Chuck, how are you?
Charles Goldfarb:Fantastic. How are you?
Chris Dy:It's cold. It's cold in St. Louis.
Charles Goldfarb:It is really cold. And I am not a winter guy.
Chris Dy:You know, last year when we moved into this new place, we didn't really use the fireplace function too much. But this year, last night, I fired that thing up. But it felt really good. It was nice.
Charles Goldfarb:I there's nothing Well, there are things better. I was gonna say there's nothing better. It is really relaxing to have a fire and read a book and chill with the fam, at least with my wife, because the kids don't usually join me. But I really do like that.
Chris Dy:Yes, it was relaxing in a sense that my children were asleep. Their fire was on my wife's out of town. But I was reviewing fellowship applications. That was awesome.
Charles Goldfarb:All I can say is thank you.
Chris Dy:Yeah, so many and trying, trying to make it easier. You guys don't know this yet. But we're gonna ask you this week to review a handful at least help us get to an interview list. But fantastic applicants this year? I mean, you know, as we talked about before, and I am reading more than the letters, everybody but taking a look and you know, looking at attributes, I mean, there's so many great candidates out there. The future of hand surgery continues to be right.
Charles Goldfarb:No doubt yesterday, I had the pleasure of interviewing a bunch of residency applicants, this included externs. And in our policy here at WashU, is if you do an external rotation with us, then before you depart we interview so I had five of those interviews. And then I had, I think it was 10 WashU student interviews and remarkable, but that's all I have to say.
Chris Dy:Yeah, I mean, you know, I think that the universal offer date has been a good thing. For for the residency thing. I know that hand surgery hasn't quite gotten there yet, we at least now have a universal interview deadline day or application deadline date, which took a while to get to. And then I was reviewing and I was recalling when I had to turn in my hand surgery fellowship application, it actually involves getting individual letters and things to each individual program and sending everything out and different envelopes and the whole deal. So at least now there's an online system, although I know it's not perfect. It's a lot better than where we were before.
Charles Goldfarb:Oh, for sure. I don't I don't have my fellowship application process. I'm sure it will you know that stone tablets are hard to carve for the application process. But I do know I applied to either four or five places. And thankfully, it all worked out.
Chris Dy:Well. I mean, how's your typewriter doing? Remember, we probably put it on one of those right? Oh, for
Charles Goldfarb:college applications, for sure. And it was one of the really advanced ones where you could sort of kind of correct.
Chris Dy:So what do you want to talk about today? I think you picked up a cool article for us to discuss, right? Yeah,
Charles Goldfarb:I think you know, one of my roles in the department is to think about practice growth and strategy. And I really enjoy reading about marketing, I would never claim to be a marketing expert. But there was a good article in Harvard Business Review by a gentleman named Bill Taylor, I don't know that I've read other work of his but its called 'your competitors aren't always who you think they are'. And I thought it was a really interesting read.
Chris Dy:I think it was great. I mean, you know, I think that even if you're not into marketing, in healthcare, you have to be into the experience. You know, so it's, it's the patient experience. It's not a client experience, not a, you're not trying to sell a product, but in a sense, we kind of are in charge of an experience. And if you think about it that way, I mean, I think the article is incredibly relevant.
Charles Goldfarb:For sure. Yeah. I mean, the the, when I think about the St. Louis market, you know, we think about we have a few large so you and I are, you know, Washington University, orthopedics part of the faculty practice plan, we are aligned with a large hospital system called Barnes Jewish Christian, and we compete against and we do compete against two other large systems. One is Mercy. And the other is Sisters of St. Mary's, which recently acquired the academic practices at St. Louis University. So those are our main Well, those are two of our competitors. And our third competitor without a question is the private practice orthopedic surgeon groups in the region.
Chris Dy:Right. And I think that, you know, patients I think, seek care at within different health care systems for a reason. Sometimes they appreciate the BJC brand and the WashU brand and they go with that and sometimes it's because their care providers are in within those works. And the referral patterns are key. My personal like, when I started and I was looking for a primary care doctor, I could not find one in the BJC. Washington system. So my, my primary care doctor is in the Mercy system. And interestingly enough, because of what we've talked about in during my visits and whatever, he's actually started sending me a lot of patients for a lot. Yeah, so that's, that's, it's an interesting and a nice source of referrals. When I see a patient who has the same primary care doctor that I do, but I think patients are willing across healthcare systems and, and go from private practice to the academic practices, but it really is more of a comes down to individual referral patterns.
Charles Goldfarb:Yeah, it's really interesting for the for the younger listeners, narrow networks have become increasingly prominent, and that's where you're, you're insured, and probably cost a little bit less, if you agree, or your employer agrees to just allow you to see a very narrow group of providers. And there's a number of examples of that in St. Louis, Boeing, for a while had a contract just with mercy. And if they wanted to see one of us, for example, there would have to be a strong reason for that to be approved. So narrow networks matter. And they, you know, their penetration in different parts of the country is different. And the other thing which goes, which is, you know, really can be challenging to physicians, is the fact that some systems penalize physicians for referring outside of their system. So it sounds like your provider does not have that situation.
Chris Dy:Yeah, I would hope not. Otherwise, he must really, really liked me. You know, but I think narrow networks have become a larger concern, not only through employers, as employers drive more, you know, kind of a higher volume things to certain places. But and also, as you mentioned, some of the newer insurance plans that are lower out of pocket costs, and but we'll really tailor that you can only go to certain people for certain things. You know, and even, you know, there are still some networks that will refer you somewhere, but we'll keep things broad, like even our insurance plan through WashU, they will encourage you to see somebody in Wash U and make it a lot easier to get in and much less out of pocket than if you go elsewhere. So I think that's the BlueCare component of it.
Charles Goldfarb:Yes. Which, you know, I think all of us if we have a lower out of pocket, and we appreciate it. So they're achieving their goals and keeping us herded in the right direction, I guess you could say,
Chris Dy:right, right. So hey, we before we jump into this article a bit more, we do have to talk a bit about our friends at practice, like,
Charles Goldfarb:yes, we do. Yes, we do. And it has been a relationship which you and I have enjoyed. The upper hand is sponsored by practicelink.com, the most widely used position, job search and career advancement resource. Becoming a physician is hard finding the right job doesn't have to be. So
Chris Dy:join practice link for free today at www.practicelink.com. And if there's anywhere on there to say, Chuck told me to do it.
Charles Goldfarb:Absolutely. Absolutely. Now, we've enjoyed this relationship. And hopefully, it's helpful for some of our listeners as they think about current or future jobs.
Chris Dy:So I mean, I think practice link knows all about this. And I think our listeners should know about it. But one of the quotes that they talk about in this article to start is from Bridget van Cradling in senior executive at IBM. And she says the last best experience anyone has anywhere becomes a minimum expectation for the experience they want everywhere. So they kind of talk about this quotes, transcending things like buying a car to going to the, to a hotel, to getting a mortgage to even you know, checking in for your doctor's visit. Do you think that it actually does crossover? Do you think that health care, you know, patients have a different expectation for healthcare and I know that the last healthcare experience should shade how they view the next healthcare experience. But do you even think that you know, your experience when you're going to, when you're going to a movie theater is going to carry over to when you go see a doctor?
Charles Goldfarb:You know, it's so interesting. I don't think healthcare is held to the same standard simply because the the economics of healthcare and the contracting and healthcare, all of that is different. But ultimately, patients are human beings. And if they have a great personalized experience in the classics that you can read about or hear about, or the Ritz Carlton experience or the Disney Experience, all those things that are done really well by really concierge high level providers. They do impact what patients expect when they see any anyone including their healthcare provider, I
Chris Dy:think, well, yeah, and especially if you are say, for example, you're going outside of the kind of standard American healthcare and you're doing concierge medicine or you know, the VIP medicine thing. You are going to expect a different experience. You know, and I think that I even expect something different from my dentist than I do from my primary care doctor. In terms of, you know what, what I'm going to be getting. But I think that again, it's mainly against the last experience that I had in that particular realm. You know, for sure,
Charles Goldfarb:one of the examples they give, which I thought was super interesting was around Toyota and the launch of Lexus. And prior to Lexus as a luxury brand, Toyota was widely held to be a very reliable, very uninspired choice for automobile. And the concept that a company like that could compete against the most luxury brands BMW Mercedes catalogue was really surprising. And yet, they pulled it off
Chris Dy:all those awesome Christmas commercials with the red bow and tie. If anybody still watches commercials, or they come up in your tick tock feeds now, Chuck, but
Charles Goldfarb:one sign these are getting old, is there are a few commercials that I can see 100 times every time it would bring me joy, right? What is wife hates it when I laugh out loud again, and again. And again, some of these commercials is the other
Chris Dy:one is that he went to Jared. One, so, you know, they talk about how Lexus has tried to stay on the cutting edge. And this, you know, even adapted some things that have been used in other in other spheres. And so they really were impressed well into the development of the Lexus brand and establishment of it. But they were impressed by the genius bars in an Apple store. And then they went ahead and created their own version of that. I mean, so I think it's looking for experience things that work in other industries that may or may not be close to yours, and adapting them. And can you think of any examples of that in the healthcare space? I mean, I know that we're trying to be better about the patient experience in, you know, in our clinics, but I think in healthcare, we're a little slow to adopt some of these things. Well, one that I think all of us will roll our eyes a bit, and I think it's a fine line is patient feedback reviews, you know, when you go to your car dealer, you're hit on the head with five stars or nothing, you know, gotta have five stars. And, you know, increasingly, that is important in healthcare as well, because Google reviews matter, and other reviews matter. And I'll tell you, I got a one star review from a patient and I was on my mission trip, I got a one star review, it came across my email. And I'm like, Oh, my God, because a lot of times you kind of know those patients. And I wrack my brain for who it was, I couldn't remember. And I shouldn't go into the details. But suffice it to say, I never operated on this patient, and was given a one star review, because the reviewer was talking about his daughter, and just the whole thing was crazy. But I take those things to heart. But sorry, I'm getting off, off target. Clearly you take it to heart. But I mean,
Charles Goldfarb:the review system is something we've learned, I think from others.
Chris Dy:Yeah, I think it is, I think it's really important. I think that's where, you know, you and I have talked about this in various venues. And I've actually, I think I included in some of the lectures that I give, but I mean, patients, we are people so like, even like I like when I am trying to find a healthcare provider for some sort, I will Google them. And you know, you can't help but be attracted to somebody who has all five stars, or you can't help but say, Hey, what's going on? When somebody has anything less than, you know, four point something, you know, doesn't mean I think we're a little more discerning, and we'll try to look at the backstory and understand that patients, you know, may leave lower than, you know, less than stellar reviews, because of you know, they couldn't find parking, or because the front desk staff was rude, or because we were running late. It's not a reflection of the actual care provided, it's more about the delivery of the experience. So ya know, that stuff, that stuff really matters, the online reviews, I mean, you know, I think that that's one way in which patients have been more empowered to reflect their experience where I thought you were gonna go with this was patient scheduling of appointments, direct patient scheduling.
Charles Goldfarb:Well, that is that is very interesting. And so I think what you're getting out, you know, patients want control, and especially younger patients want control and ease of access. So picking up the phone and calling our scholars no matter how wonderful they are, is not as simple as clicking a few buttons on your phone or computer. And so some of our sub specialties, now, including hand most recently, now have the ability for patients to schedule online. It's carefully curated and limited and diagnoses, etc. But it's a fantastic step forward. And so win for everyone, for you, for me, for our schedulers who are overworked and have a crazy burden. And most importantly, it's a win for the patients. So totally agree. That's a great example.
Chris Dy:Yeah, I think there are some times where there can be some patients that are scheduled and appropriately just because you know, like, they think one thing And then perhaps are with the wrong provider doctor. But largely, I think it's a step in the right direction. I, in thinking about the patient experience, I mean, I think that, you know, one of the thing that bothers people a lot is waiting. And the difficulty of I guess the term is Wayfinding, like from when you are trying to figure out where to go and where to park and your walk. And honestly, the big Academic Medical Campus is not good for that. There are things like, you know, parking valet, and all that kind of stuff that are helpful. But some people especially I think, in the Midwest, like just want to drive up like they're going to Best Buy, and drive and park in the parking lot and walk in and see the doctor and get on their way, which is why places like our outpatient centers, like the Orthopedic Center, for me, the south county facility are great. And when patients like when I see people at the main campus, and I know that they don't need any specialized stuff for follow up in our like, complex nerve clinic, I'll tell them look, I know it might be a little bit longer of a driver, your private better experience, we just do your follow up and South County
Charles Goldfarb:Totally agree better experience. And actually, it'll be it'll be a time saver. Ultimately, if I was a healthcare consumer, and had the choice of seeing any type of physician in a simple environment, versus the massive hospital complex with parking, etc, you go simple. I think that's a message from our society. So one of the examples in the article is around the Savannah Bananas. Did we talk about that? I've been fascinated by this story.
Chris Dy:No, I've actually was about to try to figure out how I can watch his five part documentary on ESPN about his son not as educated on this.
Charles Goldfarb:So it's a it for those of you who don't know what the savannah bananas are, it's a minor league baseball team is antics on the field. But strategic innovations off the field, including, as the authors of this article, say they have simplified the economics of attending a game, revolutionize the experience of being in this dance, etc, etc. What my brain leaps to with this is thinking about who's doing innovative things in healthcare. And one example is, is in Oklahoma, there's a surgery center that has published all of their fees, they've done it for 5-10 years. And it's a very simple way for the healthcare consumer to understand exactly what the carpal tunnel of ACL is going to cost. And one could argue strongly that we should all be doing this in a very coherent way. But when this Oklahoma Surgery Center did it, they were absolutely ahead of the game. And I think we're all heading in that direction.
Chris Dy:Well, and honestly, because they're the first in the space, patients search for this, and this is what they find. You know, I think that's so that's, that's important. And, you know, on a larger scale, there's been all sorts of experiments done on reference pricing for things like hip and knee replacement, particularly in California. And, you know, once patients understand a little bit more about how the sausage is made, and start to look into pricing for things that are high volume and relatively routine, like a hip and knee replacement, like a carpal tunnel. You know, I think that that empowers them. And perhaps it's it's good that you know, they it encourages more competition, more questioning about how we do things, and how we price things. So I think that that level of innovation and transparency is going to be the way to go. It's just a matter of how long it's gonna take for our monolith of the healthcare system to change. Yeah,
Charles Goldfarb:I totally agree with that. I love a couple of sentences, which I'd love to just read out loud. The problem is not that organizations are inefficient are out of touch. The problem is that they are narrow minded and narrow minded organizations don't lend themselves to break through strategy, weakness, another quote we are living in a new world he told me that he is Lior or Rusi we're living in a new world he told me customers no longer except an ok job is exceptional or nothing impress me surprise me do something I remember that's what customers want that's what organizations have to deliver. And in healthcare, it's obviously a different experience. But that holds right being fine or being okay or went to the doctor and had a good experience that doesn't lead to anything positive what we want is we want to you know, nothing impresses a patient like getting in and out having warm caring team of providers. We can do better and you know, we it's certainly a wash you are trying to but it's not easy as you said it's a big, big system and it's hard to change.
Chris Dy:I'll pull a Goldfarb, two things. So the first being that there are so many touchpoints and moments in time where the patient experience and go south that happened before they see the physician. Which, you know, in looking at our Press Ganey surveys that we get back every month when I get that email, I cringe and then I have to open it and read the comments. And usually I'm very pleasantly surprised by what people have said. But you know, I think People who are upset or more likely to leave comments, as you talked about with your Google thing, even if you've ever had surgery or only had very limited interactions, etc, they want to make sure that they are heard kind of like when somebody burns your pizza doesn't give you the drink that you wanted at the restaurant, you're more likely to, you know, say, Hey, this is my way of getting back. But I think that there's somebody points in which that experience can go south. And if we streamlining things can only get rid of some of those pain points, and revolutionising how the experience I think will help. It's just so hard to blow that up in terms of the entire healthcare experience. For me, for the plexus is where I think that I can probably make a difference in that experience, we're trying with the plexus to really re examine the whole healthcare experience for them, because it's such a it's a small definable volume of patients where we can really, you know, try to make a difference in what, what patients go through. So we're trying to do that, eventually, we're trying to get, you know, patient navigator or coach that can be their main touchpoint the entire way to help them get through the I don't know what's going on, once my nerves study, when's my MRI am having surgery and not having surgery, do I see a hand therapist now that kind of thing. And eventually, we want to continue to use that person to educate and to help get them through the entire one year, two year five year process after surgery, I don't know how well that's gonna go. But that's a small area, I think in my practice, where I think we can make a difference. And if we establish a model of how to do that, then I think we can try to disseminate that elsewhere.
Charles Goldfarb:So it's super admirable, and there is no doubt that patients would be happy with that experience, you would be happy outcomes would likely be better, etc, etc, etc. The problem, of course, is the margins and healthcare, make it hard to pay for that navigator. And that's tough. Ultimately, you know, we try to do the right thing. And if that model can be demonstrated to help, you know, we would try to find a way to make it happen.
Chris Dy:Right. And that's where, you know, we're going to be in the process of trying to apply for, you know, grant funding foundation funding to set up the model, test the model, validate and show how it works and how it improves the experience. But like you said, like, that kind of thing is not, that is an altruistic kind of thing at this point, that will not make any money Plexus already doesn't make money. At least in the US. It is one of those things where you do it because it's the right thing to do.
Charles Goldfarb:Absolutely. So as we bring this to a close, you know, we we've talked around the central premise of the article, which is that, you know, you and I and our department shouldn't just think about the quote, unquote, competition in our region. And honestly, I think the competition is not just in our region, it's across the country, as we try to attract patients across the world. But we need to look at what the best, most efficient, highest patient and customer satisfaction organization's what they do. And I think it's really good advice. And you know, don't limit yourselves to just thinking about what your competition is doing.
Chris Dy:Absolutely. Here, competition isn't always who you think it is, then we can learn a lot because I think you put yourself back into the shoes of being the patient being the consumer, and then you're like, oh, yeah, that was great, or that was not great. You know. So I think constantly having that refresher, and that reminder is going to help us improve the overall experience.
Charles Goldfarb:Absolutely. All right. This is fun. Have a good day. You too. See you later. Hey, Chris, that was fun. Let's do it again, real soon.
Chris Dy:Sounds good. Well, be sure to check us out on Twitter at hand podcast. Hey, Chuck, what's your Twitter handle?
Charles Goldfarb:Mine is@congenitalhand. What about you?
Chris Dy:Mine is at ChrisDyMD, spelled d-y. And if you'd like to email us, you can reach us at handpodcast@gmail.com.
Charles Goldfarb:And remember, please subscribe wherever you get your podcast
Chris Dy:and be sure to leave a review that helps us get the word out. Special thanks to
Charles Goldfarb:Peter Martin for the amazing music. And remember, keep the upper hand. Come back next time