So, hi, everybody. My name is Taylor. I'm the marketing manager for Rater8. I'm super excited to welcome you to today's webinar, When Patient Review Sting, Navigating Negative Feedback. I'm just here to quickly let you know that the Q&A is open. It should be in the controls toward the bottom of your Zoom screen. And you guys are welcome to ask questions, make comments at any time throughout the webinar. If we don't get to your question or comment in the moment, we will get to them at the end. So, with that, take it away, Al. Taylor, thanks so much for setting us up today. Hello and welcome, everybody, to our session. If you're joining us live or if you're listening here after the fact, we're very glad to have you here. Thanks for joining. My name is Al Norweb. I am the chief growth officer for Surgeomate. If you don't know Surgeomate, we are an all-in-one surgical coordination software solution. Our vision is pretty simple. We want to make surgical coordination easy and not a burden, and we have some pretty cool tools to do that. I feel pretty privileged because I get to moderate today's panel in collaboration with our friends at Rater8. Rater8 is the leader in healthcare reputation management. It automatically cultivates patient reviews when and where you need them so you can outshine the competition and attract more patients online. So, that's our shameless plug, but we're all here really today because we wanted to have a conversation with our friends Kemuel Carey and Jonathan Dunford. Kemuel, I've had a chance to get to know you over the last couple of years and the many innovative ways you run your practice, and Jonathan, just getting a chance to get to know you more recently. I know you're pretty new to your role. For those that don't know you here in the audience, could you both give us maybe a 20-second bio on yourself and a little bit about your organizations? Yeah, I guess I can start. Kemuel Carey, I practice in Salisbury, Maryland over near the beach. We're about a 34-provider practice, orthopedic surgery practice. I've been with the practice for about 18 years. The majority of that is actually as a practicing PA before I moved back and getting my MBA and then transitioning into the operations role of the practice and then took over the CEO role this past January. We do have four office locations, a surgery center, as well as two physical therapy locations. Very nice. Yeah, my name is Jonathan Dunford. I'm the new COO at Michigan Orthopedic Surgeons. MOS is a 51-physician orthopedic practice located in the greater Detroit area. We've got two surgery centers that we align with. We've got 10 locations. I've been in my role for about six months. Prior to this, I was working in the surgical operations room, doing that for about 10 years and excited to be a part of the practice space now. I'm actually learning just along with many of the other people who are on this call related to what's taking place on the clinic and how we can support better operations on the clinic end. Looking forward to the conversation today. Likewise, I'm so grateful to have a chance to speak with you both. I know we did a little bit of pre-wiring and some of your insights, I think the audience is really going to enjoy today. This conversation, the idea for this actually was a brainchild of a conversation I had with Evan Steele, who's the CEO of Raider 8. I asked him to pull some reviews around surgery, negative reviews around surgery. He pulled up an astonishingly long list from his solutions in Raider 8. We were looking through them and reading them. We were kind of joking, what would it be like if we had practice managers read these in the spirit of the mean tweets, the way that Jimmy Kimmel does on the late night show? That is going to be your job today. One of your jobs today is we selected a handful of these types of negative reviews from real reviews out on the web. The idea is let's use these to launch off a conversation. What would be the causes of a review like this? What are the ways to recover from it? How do you work with your organization to improve from them? Ultimately, how do you manage that online reputation when some of these things do happen? That will be how we jump in today. I do want to let the audience know that while these are all real reviews, they have been anonymized. We've taken out any specific information about our practice. These are actually not from Michigan orthopedic surgeons or from Peninsula Orthopedics. You guys are a little bit off the hot seat here. I'm sure you've gotten some like this before in the past. If that sounds good, let's dive in. Jonathan, I'll have you read our first one here, which is already on the screen. Then we'll talk about it. All right. Sounds good. First one. I didn't know where or when my surgery would be until about 8 PM the night before. I was moved and squeezed in a different hospital. I woke up on the table, which was terrifying. Because that was the last surgery, I was rushed out of the recovery room. It's been nine months, and I'm still not happy with the results. I'm afraid I'll have to have another surgery. One star. Yeah. This sounds like an overall tough situation, clinical impact, administrative impact, site of care. Camilo, as you read this, what's your first go-to? What's your first action when you get a review like this online? How do you diagnose and deal with it? Yeah. Obviously, I wish I could say we'd never seen anything like this, but I think anytime you see a volume of activity, you can certainly see this occurring on rare occasions for us. Really, it's a breakdown in communication. From my perspective, it's likely associated with an issue with insurance authorization to the surgical coordination process. It's something that we try our best to mitigate through the tools that particularly Surgeon Mate has offered us in terms of transparency around the surgical coordination process. But in the feedback loop and patient experience, it also allows us to reach out to that patient, talk about their experience, provide some coaching maybe to our staff on how we could have better communicated with the patient in a more efficient and effective manner. I see this as an opportunity more than a frustrating experience, although certainly the patient was frustrated through the experience. Yeah. My only comment, I agree with what Camille had mentioned. My only other additional comment is this happens as a result of issues where to your point, Camille, communication isn't happening. There are issues sometimes with authorizations or with other needs for information where a patient might not get information to the last minute. It's so important for us to be able to communicate with our patients so they understand what the status of their surgery is and so they're not blindsided last minute about a case that might either be canceled or delayed or put on at the last minute as a result of figuring all of this information out prior to surgery. What tools do you use to communicate with patients and keep this sort of regular communication going when you're like, hey, this is a fluid situation. There might be some things not entirely in your control. You need to stay in touch with the patient. What do you guys like to use? What do you do? We use our EMR platform. We use Athena Health for EMR and we use some patient text communication or email communication. The benefit of using Athena is that we're able to communicate with those patients in the preferred way that they like to be communicated. So it allows for us to be able to communicate in a way that the patient prefers. For things that are time sensitive, we try and go to that either text or calling them so that we can communicate with them as quickly as possible so we can make sure that they have as much time to reflect and know what's happening with their surgery as possible. Yeah, for us it's very similar. We use a product called Well, which is now our Terra for our bidirectional HIPAA-compliant secure text messaging. And then we also communicate obviously with these types of situations more so over the phone, utilizing phone communication. Okay. Do either of you measure generally the response rates between phone and text and asynchronous models to see like which ones tend to be more, you get better response rates? I don't think we have specific metrics related to the response rates for them. We obviously tend to get better response rates when we call. One of the things that in my prior role that we were very cognizant of was the title of the caller when we sent that out, making sure that the title of our practice or the title of the surgery center that I was affiliated with was there at the front because if they see it's from a random number, they're much less likely to pick up any type of those calls. We've been doing bidirectional text messaging for several years now. So our community is sort of aware of it. And so we haven't really had that particular concern, but it works both ways. You know, sometimes our patients won't pick up the phone for a variety of reasons. And so we'll hit them secondarily with a text to say, Hey, we need to get ahold of you on some sort of basis. So I would likewise say, I don't know that we have a KPI for which communication methodology is preferred. And it comes down to an individual basis and how that patient receives it. What we try to do is provide access and provide that communication in a fluid environment and not requiring one versus the other. Yeah. And I'm curious, Camille, in the case of the bidirectional, do you, what parts of the staff do you provide access to that kind of communication tool and how do you train them to make sure that they're, you know, they're giving tight communication, the right information, it's not conflicting, HIPAA compliant, et cetera. What kind of, what kind of strategies do you use to manage that? Our primary space is really in our patient access, which is our call center. But we've extended that into our diagnostic coordination, our surgical coordination, even our surgery center now uses it as part of the PAT process as well. If they're having a trouble getting a hold via phone, as many people are aware, sometimes you call a phone number and their voicemail is full and you can never leave a message. And so in those instances, we found particularly helpful and be able to send a text message in a HIPAA way, HIPAA compliant way. Just out of curiosity, do any of those members on the team who might have access to this, can they see all the same communication channel with that patient? Or is it only between that one individual and the patient? The entire thread. Okay. That makes sense. Current and past communication. Okay. Yeah. We make sure that that communication takes place within our Athena Health portal. It's HIPAA compliant. And so much the same way, it keeps track of what the communication thread is between us and the patient so that at any point in time, another individual within our team can be able to go and know what's happening with the communication. Camille, you mentioned at the top that you use this as an opportunity to learn and educate. So when you're reaching out to that patient, what are usually your strategies to do that? Are you doing it via the online reputation tooling itself, wherever you got that review? Are you calling them directly? Are you emailing them? What's the method to reach out and try to gather that feedback? Yeah. We have a patient experience person, so to speak, within our organization who reaches out directly to the patient via phone. Because oftentimes these patients have an opportunity to express their frustrations and we want to hear that and then be able to take that information back to our team and say, hey, here's where we could have done a little better. So we actually use that tool very frequently to improve internal operations. All right. So you guys want to move on to the next mean tweet? All right. Camille, you're up on this one a little shorter. Why don't you read this out for us? Sure. I would give zero stars if I could. The doctor saw me for like five minutes, no tests, no exams, zero attentiveness, and I was billed like $3,000. What gives? That's definitely a one star. Nice. I like the radio voice there. A lot going on there. What would have been zero stars, by the way, but it sounds like some issues with doctor bedside manner or attention, the sense of not getting adequate care, and then this whole billing question. Jonathan, I'll turn this one over to you. What's your diagnosis here? What's your plan of action when you see something like this? Sure. So I take a look at this and it looks like a breakdown in expectations, right? So you know, they expected the doctor to see them for longer than five minutes. The patient came in with an expectation that there would be tests, that there would be exams. Obviously, that there would be attentiveness through this communication and that they would be billed much less than what they got the bill for $3,000. And so a couple of things here. Number one, you know, there are instances where doctors do spend five minutes with the patient and it's appropriate care for the five minutes. It's important that we make sure that, well, number one, that doctors are aware of the importance of listening to patients' concerns, that they get those concerns addressed. And when patients have this communication, that they know what the outcome of that communication is. So that if there's no tests or no exams, they're aware of why there's no tests needed or no exams needed. I also see the point at which to say that they were billed $3,000. Oftentimes within medicine, you see these enormous bills that are very large and a lot of our patients just don't understand what billed amount means. And so it doesn't necessarily mean that that's what they're being or the out of pocket that they need to pay or that what their patient responsibility is. And so there's some education that needs to take place on it to make sure that they're informed about what that actually means in terms of billed amount, that that's not necessarily reflective of what they're actually going to be paying. And so there's some back-end recovery, some patient recovery that we need to have with these patients to inform them about what this is happening, what's taking place. That's helpful. Camille, what do you see? Anything you'd add to that? Yeah, I think things very similar to what John had to say. It's about patient education for us. You know, healthcare, I think, is such a unique environment where you send out these outrageous bills and you get paid a fraction of what the bill actually states. And sometimes it's really hard for the patients to understand that because nowhere else in America do we sort of have that environment. So we spend a lot of time educating our patients. But again, we take this as an opportunity to educate both internally and externally because sometimes your own staff don't even understand it, right? They're removed from the billing cycle. They don't understand any of that information as well. So we try our best to educate our internal staff as well as the patients who raise those frustrations and concerns. Regarding the amount of time spent with the patient, we always say we take as much time as necessary to make sure the needs of the patient are met. And so while we may have spent five minutes with you today, it doesn't mean we didn't spend two hours with you last visit. And so I certainly understand the concern here, but we try our best to meet the needs of every patient throughout the day. Is there anything you guys do in advance, in anticipation, especially let's say the billing question, to acclimate patients in their intake process or as part of a review of systems or whatever you're doing with them, you sort of let them know what to expect in terms of how billing is going to be managed based on their insurance? Yeah. So we currently use a platform that lets them know their copay and deductibles so they can be able to pay that prior to surgery. So they can see what that looks like. And so they're not surprised when they come to the day of service and they actually need to pay a certain amount. And so that helps break down the questioning of what financial impact am I going to have when I end up going to either have the surgery or go and have this office visit. It helps ease concerns of our patients in that way. Yeah. I think on the surgical side, we do a fairly good job. It's on our day-to-day E&M. I think there's a potential for us to do better. We use a platform called Health iPass, which has the capability. I just haven't turned it on yet, which basically projects sort of what the patient's out-of-pocket would be for that particular visit. I'm not exactly sure why I'm hesitant about it, but at some point they'll probably invoke that at some time here in the near future. But we don't currently do it. But I think it's a great opportunity for patients to understand what they're going to pay when they receive the service, right? The hard part for us is we do a little bit in our DME space through a product through MotionMD and VeraPro, and it actually pulls up what the allowable is for the patients or what they've already participated in terms of the insurance plan and gives them what they owe. The hard part of predicting or showing patients what they owe today is that claim may not have been adjudicated that they saw somebody yesterday for, had an MRI yesterday or had something done yesterday. That claim hasn't been adjudicated, and so I have a hesitancy to showing information that may not be fully accurate on the date of service provided. And again, that's a nuance of the healthcare system where I really don't see that in the rest of America. Yeah, you trade one problem for another. Maybe you gave them some transparency in advance, maybe avoid this kind of review, but then when it's different than what you initially said, then it looks, then you have a different credibility problem. I've also heard even when you can explain the nuances of the healthcare system and how payments work, especially with commercials, the idea that somebody charged $3,000 for something, even though that's before some contracted rate and certainly before what actually the patient's gonna pay out of pocket after co-insurances or deductibles and et cetera. There's just this pervading sense that it's all rip off, right? So I don't know if you do have any tactics, anything you guys like to do to help patients feel like they're getting the right value for the services you're providing. I don't know that we've missed. Yeah, yeah, that's a tough one. I'm fortunate enough to have a team that has those conversations with patients. I don't have anything specifically off the top of my head other than really around education for the patients around the healthcare system and how it works. At the end of the day, our hands are a little bit tied by the way the system is. I would say at the same time, it's not necessarily our responsibility to teach patients. It's our responsibility to inform patients of everything that's happening within the health system. If we were here to teach all the patients everything that happened within the health billing space, we could be on the phone for hours with each of these patients. And so to be able to do that effectively, we just wouldn't be able to do that. But at the same time, it's important for us to inform patients. We need to inform patients of what their deductibles are, co-pays, what their ultimate financial responsibilities are and help them get to the point where they understand what they're ultimately responsible for and the benefit that comes from being part of their insurance plan as well. And as Kimmy all said, we have some fantastic members of our billing team who have those types of conversations with patients on a regular basis and do a very good job at managing that communication. All right, so you've got people who do that with the patient. Who's got the job of telling the doctor when you've got a bedside manner issue or some tact issue with a patient and you have the responsibility trying to give that feedback like maybe we saw in this last review, you wanna sit down with that doctor, who gets that job and how do you manage it? Just for us, we're fortunate enough to be able to recover a lot of these communications that we received through our patient satisfaction surveys. For us, it's anything that's a three-star below, we wanna review. And oftentimes if there's some sort of direct message that we can assist with, particularly on the physician or the PA or MP side, we take that message back. And in fact, every month we send all of our physicians, PAs and MPs, physical therapists, a report where they get to read all of their own reviews. But if they don't catch it in the monthly, we try to react to those opportunities where we can improve and provide that feedback in a timely fashion. And there's always more sides to the story, right? Oftentimes we go down and talk to a surgeon or a PA or MP and you hear a different side of the conversation. And so we have the responsibility of putting the two pieces together and say what makes sense for us and how we react to it. I did see someone typed in a question related to how do you respond to online reviews? We do. Oftentimes the frustrating reviews, we ask them to call us if we haven't had an opportunity to connect with them and provide them an access point to us. We're pretty proficient in responding to those reviews. So, and just like Kimuel, we too are able to send monthly reports to our physicians, letting them know the feedback that they're receiving from their patients. And so it's provided a great tool for them to hear it directly from their patients and see the responses that they're getting, not just from a comments perspective, from a ratings perspective as well. And so, we've used that as a tool to communicate with our physicians to help them understand how they're doing in relation to various components of the service that they're providing. And so we unfortunately haven't gotten to a point where we're actively responding to our negative reviews, but it's one of the areas that we're looking to implement within our Rater8 platform. One of the neat things about Rater8 is that they have the capability of providing responses within the Rater8 platform to Google reviews and to the patient feedback that we're getting as well directly from Rater8. And so, it's one of these tools that we're looking to implement here shortly within our organization to respond to online reviews, because it not only gives better ratings within the Google platform, but it also makes sure that our patients are being responded to, that we're listening to them and that they know that we're taking these responses seriously, and we're always aiming to improve the service that we're providing to our patients. Yeah, and I think, Kemo, you sort of said a little bit earlier, sometimes half the battle is just making sure that the patient feels heard. So that reach back out, say, hello, I'm hearing your issue, can go a long way to resolving that concern, even if there's something that physically or something about the service that you can't correct, at least they know, like, hey, I was heard. Okay, well, that's all very interesting. And one thing I learned from Evan when I was talking about that recovery and online reviews that I had never thought about before is, I'm sure you guys are well aware of this in every practice manager, you have to be really careful around HIPAA compliance too. So you can't just go back into these reviews and respond, you have to, because then you're identifying somebody potentially and certainly can't say anything related to their service. So it seemed like a method to get them back on the phone is often a preferred approach, because that way, you avoid some of those concerns. All right, we're ready for the next one? Sure. Yep, mean review, mean tweet number three. I'm gonna take this one back over to you, Jonathan, go for it. Give us your best radio voice. That's right. If I could give negative stars, I would wait two hours and 37 minutes to see a doctor. I was ignored by four people that walked by when I was trying to get an update, awful. Yeah, probably been there. Yeah, yeah. For us, I certainly hear the frustration of the patient, you know, particularly around being ignored by four people that walk by. We try our best to educate our team to make sure that we're in the right business, which is taking care of people. At the end of the day, we are in a service business and we try our best to make sure people feel a little bit loved while they're coming to see us for their ailment. Regarding the wait, one thing that we implemented, I guess a couple of years ago now, is we actually display in our waiting areas the time in which a provider is running behind. And what we found is the response from the patients is when they look up and sort of see that's one of our physicians or mainly our physicians are behind, gives them the idea of, hey, do I wanna reschedule or do I wanna spend a little bit of time here waiting for them to be seen? And I found that just the education to the patient in terms of that knowledge was very, very helpful. And it is a fluid situation for our schedules and we communicate that to the patients that while they may be behind 45 minutes at this point, they could easily catch up in the next 10 to 15 minutes depending upon the complexity of the patients in front of you. So we found that to be very helpful. But do we still get frustrating reviews associated with wait times? We do. So I haven't solved the problem completely, but at least we're providing that information to the patients so they can make an informed decision about how they want their day to go as well. Yeah, one of the things that we started implementing within our system has been a framework called AIDET. It's A-I-D-E-T. It's a tool that was provided by a student group and it stands for Acknowledge, Introduce, Duration, Explanation, and Thank You. And the duration piece of that is an explanation of the patient, where we're at and how long they expect to be waiting until they're able to see the provider. And I think it comes down to being able to set what the expectation is. So if they know coming into this, that this is gonna be a 30 minute wait or an hour long wait or whatever the case may be, that that's communicated to them so they can know to prepare for that. And they're not thinking the entire time that they're sitting down there, all right, I'm gonna be the next one or it's gonna be only two more minutes because if you have that two minutes and then it's another two minutes and then another five minutes, it can be very, very frustrating as a patient to be waiting that long. And so as long as we can be able to help as much as we can, provide that communication to patients, let them know what the expectation is around the duration. Patients tend to obviously appreciate when they're given that information. I know practice that sort of implemented something a little bit the other way around, Camille, where they created a pretty effective rooming solution to clock people in and out of rooms and had a whole internal dashboard. So they were using it in with the providers and the staff to see how long every step was taking, when things were over and who was most behind schedule, but only they kept it really on the provider side. And that actually created a lot of interesting incentives because providers got really frustrated when they felt like they were falling behind and it actually would help them take actions and change things up so that they could streamline their day and make sure that they're staying tighter on schedule. And they saw some big improvement that way too. So that visibility seems to be like a big key of this whole thing, right? Either for the patient or internally to people knowing. Camille, that tool you described, is that something that's available in the market? How do you get that wait time displayed in the wait room? Yeah, sure. That's actually, we have an open database in our EHR system which gave us the opportunity to do some coding and calculating that we did internally. So it's an internal product for us. But you brought up a good point about the providers. Interesting in our EHR system as well, if a provider is taking longer than I think I have it set for 20 minutes, it actually turns red. So they know how far behind they are running as well. So they're in the EMR and they'll see that too? That's correct. So they actually see that on their half. Because when I took over operations as a clinician, I used to get frustrated when I didn't have the ability to get patients into my exam rooms to take care of it. And so when I helped out with the operations side of the house, I said, team, we wanna make sure that the provider is always the one who's holding the flow down, right? And so that's what I worked extensively with to make sure that patients are efficiently brought back into our system, evaluated by the physician on PAs and PEs, and then exited for the next visit. So part of that process is really to make sure that providers are engaged as well. Al, do you know what system that was that was doing that or that was communicating? I believe it was relatively homegrown. I believe it was a group called Health Spaces that helped them build it. But they did do something relatively custom for the practice around that. That's cool. Yeah. And then anything you do inside the weight room itself that you find helps with helping people feel more comfortable or anything you've seen other practices do that you think is pretty innovative? I think something that's just important to think about is finding ways to distract patients, right? So whether it be some type of TV on the wall or pamphlets, they can be able to read some way, just like when they go to a amusement park or some other place where there's a long line, you obviously know that there's things to distract people who are in the line along the way. And the more that we can help individuals be distracted until they finally are able to see their doctor, I think it helps improve that patient experience. Yeah, the thing that we introduced a couple of years ago was actually music into our waiting areas, which seemed to help tremendously because I don't have that dead space and people are getting frustrated because nothing's moving. But quite honestly, when I implemented these sort of tools to help improve the efficiency throughout the practice, that really limited the time spent in the waiting area, believe it or not. So we've seen a huge improvement in that. And we get out of here most days at five o'clock instead of 6.30 and seven o'clock. And so we saw the end of the day. And then through that, your staff morale improves because people are getting home on time. So a lot of advantages we saw over the last five years. Yeah, I believe, being with our friends at Rader, the number one biggest issue that the practice faces around wait room time. So this is the topic. How did you decide, Camille, that that was gonna be the thing that you were gonna try to resolve through all this process redesign? I just saw it as an opportunity. Because as a clinician, as I expressed before, I used to get so frustrated when I'm sitting on my stool waiting for the next patient to come in. And I used to say, how do we fix this? And so then when I got on the operation side, I had the opportunity to do it. And so I started looking at the process from prior to check-in, which we now do mobile checking before they arrive, to the check-in desk, to our registration process, to our history intake process, to our x-ray process, to their DME. And I took it all down. And then I sort of revamped us sort of every step along the way. Meanwhile, keeping the providers engaged with their part of the responsibility, which is to not get lost, not go see your friends for a little while, don't grab food from upstairs for a while. So I put the pressure sort of on them as well to be part of the responsible solution here. Okay. We have a couple more here, and then we're gonna turn to Q&A. And I think I wanna keep on track. So let's head to our next one here. Camille, you're up to read this one. Yeah, they have bad reviews for a reason. They don't do anything to help you. And the receptionist is a dog. Pretty frustrating. That's not very PC. I was just about to say, what does that even mean? Like you get to a point where you, like, I don't know about you guys, but sometimes I look at reviews and ask myself, all right, well, what can I do? What can I do to help support? You know, what change can I be able to make? And I look at this and think to myself, like what positive things can I take away from this? Or what can I take back to my team? Or what can we do differently from an operations perspective to change the perspective of this patient? And it's really challenging. I don't know, you know, what I could be able to do to really take something positive away from this. And I think that's something that we need to keep in mind as administrators is, you know, there may be ones that we come back with and say that person might've had a tough day. This person might have just been experiencing some really tough challenges. Patients come to our staff not because they're doing great usually, it's obviously because they're in pain or because they've had challenges for one reason or another. And so I take something like this and think to myself, I'll read it, but let's go to the next one because I think it's important to look at this, look at this feedback as a tool, as a pulse on how we're doing it. If there's not really anything that we can take away that's positive or that we can do to improve, then let's go to the next one so we can, you know, look at that one. Yeah, I'm so interested in how these reviews actually affect your teams and the employee morale. You know, a couple of months ago, I was sitting in with a coordinator team and a patient who had had care and had worked with this coordinator came in and it was a room full of, there were like seven other coordinators in the room and he just gave, this patient gave props to this coordinator for how she helped him along the way and was so patient, et cetera. And like everybody in the room clapped when he left and it was like this really cool, touching moment. You could tell like they thrive off of that. That positive feedback is really good. And it made me feel like if you see a review like this, you might have the same negative reaction, right? That just feels like very demoralizing. So what do you guys like to do to make sure to balance that with the team I think you described that well, Jonathan, like next person up, let's keep moving and learning. What else do you like to do and how much do you find that this affects the team? Yeah, I can share a little bit from my side because obviously we see some of these frustrating reviews and what I tell my leadership team and we talk about it on occasion is listen, we saw 10,000 patients last month and we've got one review. And so I think it's helpful to keep that in perspective because sometimes in leadership all you do is take care of the problem, so to speak. And then sometimes it can be frustrating and maybe not as rewarding as it was as a clinician when people actually walk out the door and say, thank you. But I try to put it in perspective. In this example that was provided, I don't know that anyone could have made that patient happy or that person or whatever matter that may be. But the other thing I do for our staff is I try to send out a Friday feedback, I call it about every two to three weeks where I pull out our positive reviews from our patients that really recognize our staff for going above and beyond. And I usually provide, I don't know, anywhere between five and maybe nine of those in a given feedback Friday. And I found that to be very helpful for the staff to recognize them for the efforts that they put in on a daily basis. And it is being recognized not only by us in the leadership world, but also the patients that we serve on a daily basis. And so I really enjoyed sharing those positive experiences with our patients, sorry, with our employees. One of the things that I try to be conscious of is also providing actual thank you notes, written thank you notes that go to our teammates to let them know how appreciative I am of the great things that they're doing. And that's been a very positive and well appreciated method of recognizing the great work that they're doing. And I've seen them put them on their cubicles or put them on their desk or somewhere else. And it means something to teammates to be recognized, to be able to especially be recognized by their executive or senior leadership. And so through those methods, I found that the morale changes, it shifts, it lets them see that when we have the onesie twosies that, you know, we might not have done so well at, there are some fantastic things that we're doing within the organization. And when we see the aggregate, when we see as a whole, that we're getting positive, positive, positive, positive, positive, it helps put one negative piece of negative feedback in perspective. Yeah, appreciate that, Jonathan, because actually, we just started doing that as a leadership team as well. I've encouraged our leadership, senior leadership to send a thank you card to one of our staff members to their home address, and it's been received extremely well by our team. And so we look forward to continuing that pathway as well. You know, as we, it's just struggling. I've been practicing for 18 years. And so I was a small mom and pop practice. And now we have, I don't know, north of 175 employees. And so as we grow, we're trying to figure out how do we stay small at the same time. Because at the end of the day, if we have a great team, which we do, and we're very fortunate and blessed to have a great team here. But that has such a huge influence on the patient experience. When people enjoy working and doing the work that they do, they tend to take better care of the people that they serve. At least I do. That's so retro. But I mean, it makes a big difference. Those little personal touches. Well, here's the thing that was it, it brings it home. And so, you know, not only do they receive thank you notes, but then their spouse or their loved ones also have an opportunity to have a conversation about what's happening at work and allows them to be able to see the positive effect that they're having. And so, you know, it's validation, not just for the individual, but for the family that they interact with at home, and they see those things, I'm sure. We haven't done that. But I think that's a great idea. Again, curious for, you know, this type of review here that we just we just saw, we all kind of agreed, hey, there's not a lot I can do with this. Do you still attempt recovery with with this specific individual? Or will you actually selectively say in certain cases, this is one I will not engage with further? For us, we reach out to them, give them an opportunity to respond. If they don't call us back, then we're certainly not going to expend a lot of energy trying to listen for this particular one. Because quite honestly, there wasn't much there to go on. Validating their comments is important, but also at the same time, and giving them an opportunity to provide feedback, additional feedback, if they'd like to. But if not, move on. We got a great comment here from the audience. From Tracy, she mentioned that one thing that you can do as well as in those online reviews, provide a compliant but compliant response form, that those individuals can go in and actually provide a more detailed response in a compliant way. That way, their identity isn't going to be exposed in any way, and you still get the feedback, and they feel like, hey, potentially being heard. And then depending on what that feedback indicates, of course, then you have a better, easier way of what's my course of action to follow up with that patient if I call them back or whatnot. That's something I know Rater8 can do in terms of providing that sort of feedback, and I think other solutions as well. That's certainly one route that is a little less directly invasive, but gives you a chance to hear back from them. All right. Should we move on to our last mean review? Last mean review here. All right. Waited for over 30 minutes for someone to pick up the phone and then ended up hanging up. Nothing positive to say about this place. They clearly don't want my business. Yeah, for us, we're actually in the in the midst of this Yeah, for us, we're actually in the in the midst of this frustration right now with our patient access system. For me, it appears to be a bit of a technology issue on our side, but also a performance related issue from our staff. And we're actively working through this piece now. So we have received these type of responses. And certainly, we work with the patients to hear what they have to say and try to do our best to meet their needs. But we're actually working towards putting a new phone system in place, which I hope to have in place by the beginning of the year, maybe by the end of the year, which will help bring us some additional metrics that we're not capable of seeing at this present time. We have some rather rudimentary metrics that we have available to us currently in our current system, but we're hoping to improve that and provide specific feedback to the patient access team members so they can actually see the activity that they have throughout a given day or given week. But I certainly understand this is a frustration for us. That's also why we've implemented the text messaging a few years ago, which was an alternative means to communicating with us by directional text messaging for creating appointments. And then about a year and a half ago, I guess at this point, we've actually introduced online scheduling as well, which has been received very well by our patients. Roughly, I'm going to say 90, sorry, about 70 to 100 patients per week do their online scheduling through us. But certainly not a unique comment here that we haven't heard before. No, and I can resonate exactly with what Kim was saying as well. I too have been working with our team in relation to what our wait times on our phone. And what I found as we dig into the details are Mondays and Tuesdays tend to be very high volume days as compared to the later days in the week. And so that requires that we find some form of staffing to allow us to be able to manage what the need is to manage those phone calls with the actual individuals who are able to take care of those phone calls. And so we're to working through some technology solutions as well as some personnel solutions to ensure that these types of responses don't occur as frequently as they have historically. What are some of those key metrics you're you're looking to track on on the inbound calling the call center and managing this? Well, for us, it's number of calls, outbound and inbound calls, average wait times. And we have a tool right now that allows us to call patients back, so they don't have to wait on hold. But it's still important for us to be able to track how long they're having to wait until we finally give them a call back, right. And so, you know, those are just a smattering of the tools that we're currently using to evaluate how the utilization of our call center teammates and making sure that they're being utilized appropriately. Yeah, for me, the same as Jonathan, but also a median call time. So we want to have a better understanding how much time we're actually spending on the phone with each call. And then we also likewise have that callback functionality. I try to keep that under 10 minutes for a callback. But oftentimes, we see that creeping well above that, which makes for difficult days, particularly on Mondays and Tuesdays, Jonathan already alluded to. But the other piece I'm working on with a reason for a new phone system is I want to be able to score calls from a quality in terms of communication quality. So we're working with a company right now to build that out before we go live with a phone system. So we're looking forward to having that. So not only do we judge in terms of the objective metrics, number of calls, meeting call time, all that fun stuff, but also have a be able to supervise or be able to listen to the phone calls and score them from a patient service quality perspective. And that scoring is that being done through AI and language processing? Or is somebody actually going to do like some sampling and provide? It's going to be sampling, we actually looked at a platform that does AI for that, but it's picking up keywords. And so I think the validity of that's not quite there yet. Yeah. Not to mention, you introduce a new security risk to in terms of now, PHI and sensitive content is now in another place that is potentially at risk. All right, well, that, I guess concludes our first portion of the day, which was to go through those and hear all of your input. I love the discussion. Thank you, Camilla and Jonathan. We have some time now for a q&a. We have a couple of questions here and encourage anybody else in the audience who wants to toss out ideas or questions, please do. First one, easy one. Will we be providing this recording after? And the answer is yes. So this will be available. I'm sure we'll post it on our social media and via email to those who participated in today's webinar, or discussion. I hate the word webinar. I really meant not to use that word. I feel like that's a relic of COVID. I don't ever want to hear it again. So sorry about that. But yeah, we'll definitely make this available. And thank you for your interest. We've got an interesting question here from Austin. Do you track or, I love this, do you have any idea if online reviews are influencing patient returns, or new patient decisions? So you have a way of knowing like, hey, every time I have a negative review, does that patient actually come back? Do we see that they definitely fall off? Do new patient volume get influenced by this, etc? Like any way that you can measure that? For us, we sort of try to gain an understanding of where our patients are coming from. And so one of the options is online reputation, so to speak. I would certainly say that most of us, when we're choosing a restaurant in an unknown area, we tend to go to Google or Yelp and sort of look at their star reviews and their most recent reviews. And so I can share that I think we're somewhere around 2000 reviews and 4.8 stars or something like that. And so I would definitely believe that influences. Do I have any direct evidence of it? I don't, can't say that, other than my own personal behavior and how we tend to value services in other industries. Yeah, I too am not familiar with any specific metrics or specific statistics that are around that. But I too follow exactly what you're saying, Ken, well, in terms of the way that I go about finding my favorite restaurant, finding other things, and other things in my life that I want to go to. And obviously, Google and online reviews are a major source of information for potential or for current patients. And so, yes, we too have an online reputation score that we track and, and look to on a regular basis. So from the time that we started ours, about a year ago with Raider 8, it was about 4.3. And we've steadily increased that to about 4.8 now. And so it's been great to see the impact of using a platform for our organization to see the progress that we're making in that area. It's indispensable. I agree. I mean, everybody's going to use online reviews are going to be your front plate. And it will be something almost everyone will check. So anything you can do to optimize that makes a ton of sense. And have you, Jonathan, I know, maybe you weren't there since that 4.3 to 4.8 progression, but is there any, any notable impact on your patient volume, new patient volume, returning patients, anything that you could quantify to say, yeah, that actually, you know, I wish I could, I wish I had a pulse on exactly what the secret sauce was to that, you know, I think that there have been a couple of things that have significantly changed over the past year, we've had a change in our CEO about a year ago. And she's been a great impactor of the culture that we're looking to continue to build here within the organization. And so I think that her her example in our leadership has a significant impact on the overall organization. I think it's part of the feedback loop that we're getting from our, our, our physicians who are getting feedback from this, these surveys, and are hopefully using these to influence the way that they interact with our patients. But they're also giving us some direction on areas that we need to be focused on when it comes to either looking at our waiting room time, the ease of scheduling interactions, the friendliness with our staff, you know, these are things that we're using, as we have our leadership team meetings, and focusing on to see where we've been doing well, and what opportunities we have to improve in the areas where we have opportunities for improvement. Those are the areas we focus on from a leadership perspective. Yeah, I definitely agree. And what we know from patients is they want primarily access, you know, access when they want access, and then quality of service. And believe it or not, it appears as if the quality of outcomes is the third entry into that decision making access, how well they feel loved and taken care of, and then the quality of their outcomes. And so we really try to increase that, particularly with our patient experience, ratings or surveys that we do. We've been using it for several years now, we don't as a disclosure, we don't use rate rate, but very similar platform, and we've been using it. And so the conversation for us came up around, it's a spend, and are we getting a return on investment? At the end of the day, we sat back and said, the value that we get from it is that continual feedback, that we're able to provide both the clinicians and our team members, as well as able to recover frustrations that we may not have been aware of, and that frustrations that we may not have been aware of otherwise. And so that's why we continue to place an emphasis on, on the opportunity to collect that information. Yeah, it can be very hard to quantify the impact of culture, but you guys know it, because you live it, and you see it, and you see that you see how that those changes influence how the team feels, and how your patients end up feeling. So without about it. I don't see any other questions. Well, let me see what maybe came in here. I have a question from an anonymous attendee. Do you prefer to pull insights to improve your patient from external reviews, internal reviews, such as form surveys, or a combination of the two? I guess this decides, internal or external reviews you find are, are more important. Yeah, I can share from our side. It's actually both. We do an annual survey internally for all of our staff, looking at sort of the organization as a whole, not so necessarily on the patient care perspective, but really, as we as an organization, how do we care, right? But then we also do the patient survey information as well, and combine the two of them. So we like to use both opportunities. And so for us, we currently, I know, since I've been with the organization, we haven't performed a teammate engagement or a patient or patient or a teammate satisfaction survey. But at the same time, we value feedback from our patients, both on the Google end, where it is visible externally, and from our Raider 8 surveys, which are only seen internally. And so, you know, independent of whether or not it comes from Google or Raider 8, that feedback is really important for us, and we can be able to improve. And so, to me, it doesn't matter where that comes from Google, Raider 8, another source, that's feedback that we can use to improve. Yeah, one part of the thought here is we actually have something called a Bones Program, where our employees can give kudos to one another, in terms of excellent service that they provided. And oftentimes, we'll have patients who come in to our front desk area and say, hey, I just wanted to give a shout out to X, Y, and Z, because of this, that or the other thing. And oftentimes, that gets converted into a bone that gets thrown into the pot. And then on a monthly basis, we have an Employee of the Month. That's selected. That's great. And then, I guess one last question I have, probably from this last one is, do you have any process for collecting feedback at steps within the office itself? Like, I'm happy with my service, push a button here or there, or points to make sure you're kind of digging in to the whole process step itself to get that feedback? We actually, we don't have any staple easy buttons anywhere in the organization, or on Amazon, whatever the button was called. But prior to the current patient satisfaction engine we had, we had a rather detailed survey that would mark through the different, march a patient through the different departments. And what we found is a low response rate because of the volume of survey questions that really broke down into the individual departments. And so now, it's more of a global, we can sort of understand where the success was and where the opportunity for improvement is, through the basis of questions. So no, we don't have anything specifically throughout the organization. And we don't have anything stepwise, but we do ask questions related to various steps of the process in our patient satisfaction surveys. And so when it comes to friendliness of staff, when it comes to the outcome, other steps along the process, they can provide their feedback. And in addition to that, they can provide specific comments related to each one of those areas. And so if it's related to the front desk, it actually has a section for front desk, and then they say, you know, what their experience was like with the front desk or with the provider that they saw. And so we can provide more detailed feedback to the individuals at the location who are at the front desk or to the providers that provides a bit more information to them than if it had been just a global, had a great experience. Well, I think with that, we'll wrap up today's session. Camille and Jonathan, I really want to thank you for a really fun discussion and for taking some of your precious time to spend with us. And I hope everybody that joined us in the audience today or after really, really enjoys the discussion, takes away a few great nuggets. You both have some really interesting processes, some tools and frameworks that I think any practice could benefit from. And so I'm sure that you'll be getting some follow up questions. Here's some information about RaterAid and SurgeonMate. You can find us on LinkedIn, social media. You can, of course, email us with questions. And on LinkedIn, I'm sure you can find Jonathan and Camille for your follow up questions as well. But I won't publish your cell phone numbers here just in case. Hey, thanks so much, Al. It was a great experience. Appreciate the opportunity to be with you. Yeah, I agree. Jonathan, Al, thanks for having us, as well as the RaterAid team. Just great opportunity for us to talk about this, which I think is a quintessential part of patient care. And it really takes a practice from average to great. And so I think if you focus on excellent service, that's where the future is for all of us. So I appreciate the

negative feedback

patient reviews

communication breakdowns

staff training

online scheduling

patient satisfaction

reputation management

healthcare organizations

bidirectional messaging