And we'll get right into it, is to, he set the stage, but I want to tell you that you need to now get emotionally charged, and I'm going to do that for you this morning, and get you where I think you have to be. So if I may, no disclosures. My goal is I want you to essentially avoid hiring and wasting money on a professional that knows less than you, and I just need you to be able to talk to them in the same terminology in the business world, and I'm going to increase your notoriety by the time we're done, whether you're an employed physician or a private practitioner. You have to start, as Brian said, with the value-based healthcare, and at the end of the day, it is going to be about quality and patient safety, and it wins the day every time if you remember that. So if I maintain the function, I minimize morbidity, I avoid death, so to speak, and you stay as the captain of the ship, I promise you, you'll see what I show you in the marketing. This talk is going to be about marketing yourself. You have to realize that Dr. Porter, when Michael said value is outcome over cost, it's very problematic for you, and all these slides are available for you. So the question is, whose value is it? Is this idiot who's going down the hill, okay? Is it a value for the taxpayer? Is it a value for your group? Is it a short-term gain? Is it a long-term gain? And what's the economic impact you're going to see? He's gone. So I want you, the movie is unrolling, and I want you to focus on the quality and the plot is unwinding. Don't fall asleep, don't accept things, question them politely, but when you have decrease in reimbursement, as Brian's saying, and this is so wonderful that he set it up, are we next? And the question is, if you want to live that life, that's fine, otherwise, I say to you, get out and do something different. Because even Dr. Porter said, we are, and I love it that we're a noble physician and a noble profession, but we actively seek our own demise, and I'm not upset that it is, because we work against each other just the fact that we share information. No one in the business world shares information with each other, yet I'm delighted that we do, but together, if we're there, we can help each other to build ourselves up, not individually. And so is it worth it? Yes, it's worth it to be that noble profession, but we have to figure out how to be smarter. Brian said it, the world is upside down right now, and I don't want to be eaten, and I don't want any of you to be eaten, which is what's happening. Because during COVID-19, the insurance companies loved COVID-19. They made more money than ever. You can look at how much they did, and they're holding onto that money, and they're not going to give it back. They love what they hit as their new high bars. So given that, let's go through what a normal market does. You go to the supermarket, the consumer, you want to pay and buy value. So competition, as it says, drives improvements, theoretically, in quality and cost. We have rapid innovation, all the companies that come. The excellent competitors prosper, but the weaker ones go out of business. So it's not so bad if something goes out of business. You're not going to like that for me saying that here. But that's what a marketplace should do. So the question is, can we figure out ourselves how to be more important in that marketplace? That's not what happens in the medical world at all. So here's where we are at the inflection point of private practice, value-based healthcare, and you're seeing fee-for-service. So let's talk about what the business people do. They plan, they make, they price it, they promote it, they distribute it, and they find new customers, and they satisfy what's called unfulfilling needs. If you have a phone system that says dial one for this, dial two for this, dial three for that, you're already losing. You need to change your phone system. Someone has to answer that phone, because that first interaction says that doctor cares about me. Otherwise, he or she really doesn't care about me, okay, whether you're in a hospital system or private practice. And I'm going to get you upset with things that exist, because I want you upset by the end of this. And you need to know that it's rare to have MDs in admin positions. The younger groups, I applaud you, are getting their MBAs or MPHs and going MHAs now, more so than in my time. And all that marketing is, you build the reputation, you maintain the image, you develop more patients therefore, you generate new income, and you protect yourselves when it's crisis management. That's what the MBA whole course that I went back to taught you. That's it, if you can do it. So understand the emotion of it. Patients have needs, you have needs. The customer was wants, and the question is, can you differentiate your service from someone else, not being the same orthopod? And then they have demands which satisfy their needs. And so constantly, you have to push into the customer's mind, you exist, CVS. How many times do they call, your pharmacy prescription is ready. You didn't get a new renewal, they figured out how to give you a new renewal, so CVS is important, so the person says, I'm gonna go to CVS to buy other things. Because they're in your mind. You need, we need, patients to know we are that important in their lives. And the basic difference between wants and demands is desire. And insurance companies have pit us against the patient, they have, they're brilliant. You can listen to the CEOs. The public really demands but doesn't pay for the skin in the game. So we have to figure out how to change the system, move it a little, to our benefit, which we can, because we are a lot smarter, you'll see. It's all about psychology. We are the only ones that can build the trust and form that relationship, that professionalism. And unfortunately, most customers, when you go to a business, you buy a car, you've been burned, you've thawed, you've swindled. But we leave ourselves at a higher level. So always build that level of trust with that patient, that they know that you're there, that you're thinking of them, and it's in your quality of service. And that's hard when you're churning and you're thinking about volume. So the difference, how can you get notoriety, there's a difference between advertising and public relations. Understand advertising, you control the space and time, you do a journal ad, you do something in a magazine, it's really non-personal. But if you invest in public relations, they watch out for you, they provide credibility, they deal with crisis management when you have it. And the message is predetermined. Why do I want hospitals, why do hospitals do it? Because they know it's credible, and they can take care of negative news, and they can build this relationship so that people are aware. In my city, in New York City, there's a hospital that did an amazing job, but they spent $100,000 a month. That's not tenable for me outside of a hospital. And that's why they got notoriety, and now they say, if I'm in New York, I've gotta go to that. And people don't even know who the physician is, so you've lost who that identity is. So Empire Blue Cross Blue Shield said, I'm gonna make it even worse for you. I'm gonna figure out that I'm gonna hire doctors, we always kill our noble profession, smart doctors, and their job is to say, you have to go through me to decide if your procedure's okay. Pre-certification. You know that we're fighting it thanks to the academy and others, but here you go. You know you've done the right thing, but the problem is they say, yes, but I'm gonna slow you down, because I'm gonna hold on to that money, because I can invest it, a billion of dollars. So understand the landscape and the purpose, don't get frustrated, move through it, try to figure it out, how to work with each other, and they sometimes will want it. Marketing with branding, here it is, you know, hospitals do it really great, we have to do it, it's 20% increase in most hospitals. If we sat on this stage 20 years ago, I don't think you'd see anyone marketing with a twist. So it's about telling a story. Whether you're in private practice or in a hospital, I will tell you, reaching another patient and finding it is about storytelling. Please follow the rules, if you're going to tell a story about a patient, you have to sign and know about HIPAA, you have to get written consent, and patients can opt out, but if you have success, flaunt it, it's terrific. Tell them, tell the story, this is from an MBA, that's what people do in business. Why do you go to Solomon, why do you go to this investment banker? And so I'll tell you anything's possible, you know, I said to you, I come from New York. In New York, we have the sickness that if you're in insurance, you couldn't possibly be a good physician. I'll say it again, you couldn't possibly be a good physician. After 10 years of being a physician or 20 years with me, I'm out. Yet people pay and when they can't afford it, they're free. I'm delighted to give a percentage of my care all the time, it's about 16% is free because I can make it on the other end. And so I really feel great about it. It's your product, it's your price, it's your place, production and promotion. You're going to see, we're crazy in New York City. And you say, well, I can't do it in my community. We could figure out new ways to find ways to do it. It's the peas that tell the story, what your product is, what your price is, what your place is, and picking your color. If you think about it, pediatrician's office use blues and greens for the children. It's calming. There's a fish tank. They don't use reds. Red is angry. There's a whole industry on what you should have in your office in color. There are people that really know how to design it that the patient comes in nervous or anxious and it's diffused right away because of the color that's chosen in your office, believe it or not. It's psychology. But this is what doctors do. We have committees, we zoom until we die, we have no results, we argue about the minutiae, we vote to decide, we implement, it happens one year later, it implodes, things change, we blame each other, success. I'd like you to reconsider how to do things. I want you to think about your mission. I want you to think about your goal. Why are you doing it? What do you want? I want you to be strategic. And how you do that, you'll see once you get the mission and all these slides are available, you have to have that strategy and your values. And what you do is you meet over food. Believe it or not, meeting over food, Schnecken is food, changes the whole environment. So there are practices now that provide food. That was hard during COVID-19. You walk into the office and there's food they're providing. Look at AOSSM, how wonderful. They give us a little something as you're coming before in a meeting. It changes the whole emotional outlook. Believe it or not, it's a psychological thing that's been studied. You want to treat the patients as you would care about them. It builds a team as you're sitting and learning about each other. And that's the time you have to spend. It's worth it. Think it. Don't attack your own customer, okay? Don't attack that it was a different way of doing the science. You want to be in a science meeting and say, I don't like double bundle, I like single bundle, that's fine. But don't let the rest of the world know about that because they'll view it as that's an unacceptable way to do things. We know in medicine, there's so many ways to get success in our own hands. Think about your own first appointment. Who's seeing the patient? PA? An MP? Are you? Are you calling them that night? Are you doing all those things to build that trust and that relationship? You'll see it will go better for you. Understand what's called, they talk about something in business called the value proposition. It's making the stakeholder, the patient feel that they're a part of you, rather than just pushing through. And that's how you do it. You do the surveys. You do need, even if you get 19% results, you need to analyze what your patients want in your community. What do they want? And do you know the facts of why you lose patients? Here's the truth, 14% complaints are never handled in your office. Sometimes patients just leave, but 68% of the time, they go to a different practice simply because you didn't engage. You didn't follow up the day after day surgery. They didn't know that their first follow-up was at this point. That's a lot of work, emotional work on you, I agree. But since I think all of us love what we do, if you think about it, you can really make a change to understand why you lose patients. Easy slide to say, I want to show you, people buy things either to meet their needs, wants, and desires, and we need to avoid their demands. Think about perfume, it's a good example. Do you realize why people are buying perfume? They're not buying it for the scent, even though they've done these studies. They're buying it for the romance. The new exercise machine, it's not because of the gadget, it's because the person wants to get thinner. The end result, as it says, is everyone wants to fit in. So convince our customers they can live longer and be happier by coming to you. Believe it, sell it, tell it, not with, well, I think I'll try the best I can. Baloney, say it, I'm okay, and I'm going to make you better, and I'm so excited to know you, and we're going to build a relationship, not a one-time thing. In the end, you'll gain their trust. So try an email survey, try personalized service. Get your results. I started with quality at the end of the day, a pleasant office environment. Pick the right color. If you're in a red office, get rid of it tomorrow. It's not going to help you. Learn from hotel management. Take a trip one day to a Four Seasons, I'm not involved with them, or a Ritz Carlton. Walk in and see, I learned my lesson from shopping at Nordstrom's once. The person at Nordstrom's, I accepted, I bought something, they walked around the counter to hand it to me, rather than handing me over the counter. That slight difference has been studied. You have to extend yourself, and hotel management does it great. We are in the hotel management business, whether you like it or not, but we do a little science. And so take a trip sometimes, see what they do. You do it, it will increase your patience, believe me. So the modern physician must take control. We can win. We have to be innovative disruptors. You're about to hear social media and ASCs, we're moving. We have to do registries. We have to be innovative together, but together we can win. It's emotional. I hope I got you emotional. It's financial. It's political. And the only thing great about COVID-19 is, he brought us to this tipping point a little earlier, and I think we're smarter than all the rest, and we can figure it out together. You know I leave you with this slide, as I have Al come up. This was my daughter when she was young. She didn't know this other child. I don't know why she hugged this child. Did you see something common in a bathing suit, common in whatever it was? But she was kinder to this child. We need to be kinder to each other and work together. And if we work together to do it, not in silos, we will win and help. I'm not worried about the brain trust, because this is the group of the engineers. It took them this long to figure out the two sides of this bridge will never meet, and I think we have much better answers. Thank you. I'll bring Al up. Thank you.

value-based healthcare system

building reputation

customer service

medical field marketing strategies

collaboration among physicians