Urgent message: Changing consumer expectations have led experts to question the future viability of “traditional” doctors’ offices, but urgent care provides a model for shifting from “caregiver-focused” to “patient-centric” care.
Alan A. Ayers, MBA, MAcc is Chief Executive Officer of Velocity Urgent Care and is Practice Management Editor of The Journal of Urgent Care Medicine.
In the not-so-distant future of healthcare, the familiar query Is the doctor in? could very well be met with a resounding No! when it comes to the traditional doctor’s office setting.
Indeed, independent primary care offices—once the backbone of America’s healthcare system—remain under siege from a variety of market forces, and, as a result, are being slowly pushed toward extinction. No longer the frontline of medicine due mostly to healthcare consumerism ushering in more care choices than ever, traditional doctors’ offices have been slow to keep up with the modern consumer’s expectations for service. This has allowed new players and market entrants to enter the fray, establish a foothold with consumer-friendly platforms and models, and fiercely compete for the modern patient’s healthcare dollar.
Traditional Doctors’ Offices Struggle
According to insurance data analyzed by the Health Care Cost Institute, patient visits to primary care offices from 2012 to 2016 saw a decline of 18% and continues to trend downward.1 Contrast that with the explosive growth of urgent care: private insurance claims originating from urgent care visits between 2007 and 2016 increased by 1,725% according to FAIR Health, a data collection agency.2
Clearly, urgent care’s emphasis on on-demand, fast, low-cost, and convenient care is resonating with consumers far more than traditional doctors’ offices are. Beyond the rise of urgent care, though, are additional factors contributing to doctor office struggles, including:
- Limited office hours – Traditionally, medical offices have adhered to a “business hours”-type schedule: 9 am-5 pm in many cases, with little to no availability during late evening hours and weekends. This limited availability has always been problematic for patients who have 9-to-5 jobs and don’t want to miss work for a doctor’s visit or need to have a sick child seen by a doctor outside of normal business hours.
- Long waits for an appointment – A major contributing factor to the rise of urgent care (and convenient care in general) has been the weeks-long waits to get an appointment to see a traditional primary care physician. The long wait to see a doctor has long been a major grievance of consumers who need an appointment right way but can’t be seen by their PCP.
- Lack of digital engagement – Global IT innovator NTT DATA Services recently conducted a survey that confirms what much of the healthcare market already understands about the modern consumer: 78% of respondents stated that digital tools in healthcare—such as online scheduling, text reminders, lab updates, provider messages, and patient surveys—are severely lacking. This deficiency is acutely felt in traditional physician offices, which collectively have been notoriously slow to embrace digital innovations in patient care.3
- Poor patient throughput due to location – Many traditional medical offices are tucked away in sprawling office parks, or medical buildings with lots of floors, which can be inconvenient to access and out of the way of patients’ normal driving and shopping routes.
- Boring, uninspiring physical plant – If you’ve been to one primary care office, you’ve been to them all. There’s a counter, usually behind a wall of plexiglass where you check-in with a front desk person before being assigned a stack of forms attached to a clipboard. There may be Wi-Fi available and a TV on the wall, but it also probably has the typical old magazines and cold, sterile exam rooms found in most medical offices.
- Inefficient workflows – Independent physicians trained in clinical medicine often lack the time and expertise to efficiently manage the administrative side of the business. Hence, in the absence of a trained office manager or digital productivity tools, this can result in inefficient workflows (often built upon broken processes), which can lead to micromanaging staff and poor delegation of tasks. These factors, when they’re out of balance, negatively impact patient wait times, lower employee productivity, and lead to burnout.
The New Consumer Expectations
These struggling independent doctors’ offices are not only competing with urgent care for patients, but with large hospital systems, retail clinics, and telemedicine providers, among others. Thus, when factoring in the deficiencies that plague a traditional doctor’s office, the outlook is bleak that the status quo model has a future in the new healthcare landscape. So, can traditional doctor’s offices find a way to survive as consumer expectations and healthcare options continue to grow? Yes, but it will require a complete paradigm shift in how they do business.
Indeed, there must be a reckoning that the modern patient has options and will no longer accept the status quo. They’ve come to expect convenience, digital channels, competitive and transparent pricing, great customer service, and a retail-like experience from every company and brand they do business with—including their healthcare providers. So, there is an opportunity for physician offices to remake themselves and integrate what they excel at—patient─provider relationships and continuity of care—with the success principles of strong consumer brands that have mastered the capabilities that allow consumers to experience exceptional service delivery.
Shift from Caregiver-Focused to Patient-Centric Care
The paradigm shift that a doctor’s offices must undergo to thrive must begin with their fundamental approach to delivering care. It requires a shift from the traditional, caregiver-focused model, to being patient-centric in everything they do. The old, ineffective way of delivering healthcare in an inconvenient, impersonal, commoditized manner must give way to a fully differentiated patient experience that delights patients and engenders brand loyalty. Thus, it’s time to start reimagining your practice model from the perspective of the brands with the strongest customer loyalty.
In other words, you must think like innovators and disrupters such as Amazon, Apple, Tesla, and Starbucks rather than the old guard of Chevrolet and Sears when evaluating your practice. To win and retain patients today, your practice must embody, embrace, and integrate retail principles and digital experiences, and deliver them in the most consumer-friendly way possible. To that end, here are several principles that should form the bedrock of your differentiation strategy to delight patients and build loyalty:
- Improved access – Traditional doctors’ offices, in order to compete with urgent care, retail clinics, and telemedicine providers, must offer some level of on-demand, same-day service. This may require a radical restructuring of the practice model, but it’s a necessity for patients who won’t wait a week to be seen in your office when they can pop in at the local urgent care and be in and out in under an hour. Also, your practice should offer evening and weekend hours more in line with the urgent care and retail clinics vying for the same patients.
- Inviting waiting room. Taking a cue from urgent care, your waiting room should be a pleasant place to wait. Wi-Fi is standard nowadays, but there should also be at the very least a free coffee machine, complimentary bottled water, and light snacks. Additionally, the waiting area should be redesigned to remove unnecessary physical barriers in favor of a more inviting and modern open concept.
- Digital check-in. Clipboards with paper forms must become a thing of the past. They should be replaced with digital check-in capabilities, either from an in-office kiosk or through online apps. Digital check-ins will help to alleviate much of your staff’s administrative burden, freeing them up to focus more time on patient care.
- Opportune locations. Doctors’ offices should leave the sprawling office parks and six-story office buildings for more prime locations. Urgent care rightly builds their centers in high-traffic areas where big box retailers, grocery stores, banks, and the McDonalds are. These are the places patients frequent, so you want to make it easy for them to meet you where they are.
- Premium, responsive website. If your current website is clunky, poorly organized, and full of text, it’s overdue for an overhaul. The vast majority of internet users search online to locate local businesses, so you want visitors to your website to have a seamless and streamlined experience. Ensure that your web designer utilizes hi-res images that showcase your office, highlights your amenities, and lists your providers (with their portraits) and their education and clinical backgrounds. In addition, include a section or page with online reviews and/or patient testimonials for social proof.
- Online scheduling. The last thing a patient inquiring about your services wants to do is navigate a complicated phone tree. By offering online scheduling, patients have a no-friction way to set an appointment day and time that fits their schedule. As an added bonus, online scheduling flattens demand, and frees up your staff to handle fewer administrative tasks.
- Text/email communication. Modern consumers expect text messages from the brands they do business with. For a medical office, this will likely require upgrading to a software system that facilitates and manages the text messaging system. Medical offices should therefore send patients text messages with appointment and payment reminders, lab results, provider messages, and patient surveys. The patient survey should take place right after the office visit, however, so that if the patient provides negative feedback, the office staff can attempt to remedy the situation right away.
- Self-pay pricing. Especially for those patients who are paying out of pocket, there should be a clear and easy-to-read menu of prices for services posted in the lobby of the office. Affordable and transparent pricing—a hallmark of urgent care centers—builds trust with patients, such that it’s a convenience every doctor’s office should offer.
- A welcoming, cheerful staff. When you think through your lifetime of doctor’s visits, aren’t you more likely to recall harried and impersonal staffers rather than charming brand ambassadors? Indeed, the demeanor of your staff is a huge differentiator and can be the difference in whether your patient returns to your office or seeks out another provider. Your care team should be trained to be cheerful, greet patients by name, explain each step of the process, and to intervene if there is a wait of longer than 5 minutes at any point of the visit. In short, they should take on the role of concierges of your practice, and really make an impression on your patients.
Traditional doctor’s offices can compete for patients and thrive in the new healthcare landscape, but they must evolve to accommodate the modern patient. No longer willing to deal with inconveniences and unresponsiveness, the consumer of today has learned to expect the same speedy, digitally based, low-cost, and friendly service they receive from Starbucks and Amazon. These power brands have engendered consumer loyalty through differentiation, personality, and the experience they deliver, which is the same route doctors’ offices must take to achieve similar results.
The path to this differentiation is to adopt the patient-centric principles of urgent care—fast service, convenient locations, digital tools, and affordable prices—and meld them with primary care core competencies of provider-patient relationships and continuity of care. Only then can traditional doctor’s offices thrive once again and become the modern patient’s provider of choice.
- Health Care Cost Institute. HCCI’s Health Care Cost and Utilization Reports. Available at: http://www.healthcostinstitute.org/report/2016-health-care-cost-utilization-report/. Accessed September 13, 2018.
- Managed Health Care Connect. Urgent care utilization spiked over the last decade. Available at: https://www.managedhealthcareconnect.com/content/urgent-care-utilization-spiked-over-last-decade?page=5,0). Accessed September 13, 2018.
- NTT DATA Services. Consumers want simple and reliable digital interactions for routine transactions. Available at: https://us.nttdata.com/en/news/press-release/2018/march/ntt-data-study-finds-consumers-expect-their-healthcare-digital-experience-to-be-like-retail. Accessed September 13, 2018.
- Blumenthal D. Do small physician practices have a future? HuffPost. Available at: https://www.huffingtonpost.com/david-blumenthal/do-small-physician-practi_b_10150100.html. Accessed September 13, 2018.
- Anderson LV. Why are doctors’ offices so badly run? Slate. Available at: http://www.slate.com/articles/business/the_ladder/2016/01/doctors_need_to_learn_to_be_better_managers_to_run_their_practices.html. Accessed September 13, 2018.