From the Files of SOS...



The story that you are about to read is true…the names have been changed to protect the guilty…

The city is Scranton Pennsylvania, population 74,320. This city made the successful transition from a steel and coal producing enclave of a bygone era to a growing middle class suburb. And with this economically viable population growth came a plethora of small businesses, professionals and of course healthcare providers. While this story has a happy ending for the people who call Scranton their home, for one podiatry practice, this economic expansion almost caused his practice to go the way of the old steel mill.

Like many podiatrists in small communities across America, our Scranton podiatrist had decided to start his practice here because of his roots to the area. Demographics and economic expansion played no role. Twenty three years ago he hung out his shingle and carved a secure, successful place for his practice and his family. Things went very well for our local boy. There were only two other podiatric practices within a 15 mile range and there was plenty of work to go around for everyone. Marketing for this successful practice consisted of a Yellow Pages listing and some birthday and thank you cards for patients and referrers. If it sounds simple, it was. But simple worked well and our doctor managed a full schedule for many years.

We live in a rapidly changing world, and Scranton is not immune from its effects. As the economic base of the community began to change and grow, it began to draw the notice of “outsiders”. Physicians of all types began to consider this small city an ideal location to establish a practice. Our podiatrist found that in a period of just seven years he saw the number of podiatric practices increase from 4 to 16; and during that same time he began to notice a drop off of patient volume. His appointment wait times went from one week down to three days and the number of surgical cases dropped by almost 30%.

Like many in his position, the doctor decided he was not going to take this lying down. He had a plan, albeit not a very good one. He decided to increase his commitment to Yellow Page advertising from a 1/8 page to a ½ page ad and to develop a tasteful advertisement that he placed in the local community newspaper. His marketing expenses increased by almost $15000 per year. According to a recent FBI Crime Index, there have been a total of 2,549 crimes in Scranton.  Our doctor just rounded out the number to 2550. Disappointingly, this did not come even remotely close to stemming the tide of patient defections and lost revenue. Desperate, he made the most important call of his professional life…..the call to SOS.

The trip to Scranton took several hours and brought us through farmland, small one street towns and past 100 car Lackawanna freight trains. Upon arriving in town we stopped for a quick breakfast and began our normal reconnoitering process. Mel’s Diner turned out to be a great choice. The buttermilk pancakes were fluffy not stuffy and the coffee didn’t have any fancy names. But even more valuable was what we learned about the city itself. Although it was a small growing city, it seemed that it hadn’t lost its small town appeal. People seemed to gather and interact there, a community bulletin board was filled with events, and the community newspaper was read by all.

Upon arriving at the podiatric crime scene, a forensic review began immediately. The practice was located in a free standing building on a busy street. It was easy to see that this building was at least thirty years old….not just because if the architecture, but also the age of some of the weeds growing on the property. Although there was adequate parking, the driveway was in disrepair and the original “shingle” that was hung 23 years earlier, was still there. The reception room also turned out to be a hotbed of evidence. The paneling which covered the walls was dark and last saw the light of day when Neil Young released his Harvest album. Although the magazines were from the current millennia, the overall look and feel of the practice was tired.

After two grueling hours of interrogation, these facts were deemed most germane:

1. Scranton was a close knit community
2. Our perpetrator could never hope to out-spend the competition
3. The location of the practice was an asset
4. The reputation of the podiatrist was positive and he was viewed as a caring and capable caregiver
5. This practice had a home field advantage that was not being leveraged.

SOS developed a marketing strategy that was built on two pillars. The first is the belief that patient loyalty could be created by the making the overall experience of patients exemplary and by regularly exceeding their expectations. The second is that word-of-mouth marketing would be effective. It seemed to us, that people in Scranton “talked”. Our tour of the city uncovered many examples of highly successful small businesses that grew as a result of their own excellence rather than by more traditional marketing and advertising techniques.

A practice face lift was underway. This included both the exterior and interior of the building. New paint, new furniture, uniforms for staff and a brand new shingle gave the practice a completely different look and feel. And people talked. Almost immediately following the renovations, the doctor was engaged by patients who complimented him on the physical changes to the practice. While important, this was only a first step and a superficial one at that. The backbone of the strategy was to vastly change the overall patient experience. In order to be effective, a comprehensive patient survey was developed to determine what mattered most to the patients.

The staff played a very important role in this transformation. Convincing them that the needs of the patients were to take priority over all others, sounds simple but for many people is actually counterintuitive. New scheduling protocols, office hours and recall procedures were established. Great efforts were made by all staff to learn personal information about patients. Armed with cheat sheets in the patient charts, the doctor began engaging patients about their personal lives remembering seeming arcane details. Patients were amazed and flattered by this. Simple…but effective. Every surgical patient received a personal phone call from the doctor during the evening of the procedure in order to make sure the pain was tolerable and that the overall condition of the patient was satisfactory.

The dimension of patient interaction was noticeably enhanced as a result of these and other changes in the office. The doctor was no longer timid is his outreach for new patient referrals. His comfort in doing so was buoyed by the frequency of compliments that he and his staff received. Their first breakthrough was a noticeable increase in current patients referring their friends and family to the practice.

Although a life long resident, the doctor was not very connected to community events. SOS performed an initial review of school, church and other civic functions. From there the staff was asked to make suggestions regarding organizations that they had interests in. The list was narrowed and the doctor began to get involved by volunteering his time and expertise. Additionally, $5000 per year was allocated for sponsorships and charitable giving. You would be surprised how meaningful even small contributions can be. Not surprisingly, new patients began to populate his reception room once again as a result of the community networking. The doctor made sure that the recommendations made by the staff received proper allocation of his charitable budget. The pride and loyalty that this created was considerable.

The result of improving the overall practice environment and patient experience combined with a sincere effort to become more civically involved proved successful in ending the patient declines that the practice had experienced during the previous three years. The podiatrist and his staff have been re-energized by these activities and have decided to host a grand re-opening of their practice catered by none other than Mel’s Diner.  Of course, we were invited. Unfortunately, we didn’t have time to stay for the “Radio on Whiskey Down” blackboard special, so we grabbed a “Shimmy and a Shake in the Alley” and boarded the next train home. We’re SOS. We carry a computer.