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Addressing Competitive Pressures in Your Community - Office Practicum

by Dr. Sue Kressly

Addressing Competitive Pressures in Your Community

The majority of independent pediatric practices are facing increasing competitive pressures from other healthcare delivery entities in their community. In order to continue to thrive, it’s imperative to identify current competition, explore emerging disruptors that may pose additional threats, and then create strategies to meet the needs of your families and promote your practice’s value.

If you have never done a SWOT analysis for your practice, or it’s been a few years, it’s time to set aside protected time to do this important work. You need to have a clear understanding of your strengths: both what your practice team believes you do well, as well as what your community and families perceive as your unique strengths. What do you do better than anyone else? What drives new families to your practice and what makes them stay? Would your current families recommend your practice to their friends and neighbors? If so, why? This work should not be done by only one or two leaders in your practice. Take the time to involve all of your practice team members. Plus, gather feedback from your patients/families and other community organizations via surveys, focus groups, during office visits, etc.

Once you understand your strengths, it’s important to identify who you are competing against. To do this successfully, you need to clearly define the type of care that you provide: preventive care, acute care, management of chronic medical concerns, lactation consulting, asthma education, etc. Most likely there are other healthcare organizations nearby that provide this type of care as well. In order to find out who these organizations are and where they are located, do a web search of alternative medical care delivery sites within 10 miles of your office(s). The search results should include a map of these competitive locations. On the map, be sure to identify other pediatric groups, family practice groups, medical clinics, hospitals, urgent cares, retail-based clinics, school-based clinics, and other providers of ancillary services which you provide in your practice. Survey your entire practice team to identify gaps in your map. Can you pull a report from your EHR or practice management system to access some of this data and frequency of use of other healthcare organizations? Consider asking your families where else they receive care and why.

You must also consider “non-traditional” places where your patients may be receiving care. Do they have access to insurance or employer-sponsored telehealth programs? Does their daycare provide flu clinics or other services? Is there a distant healthcare system that is trying to break into your area by providing mobile health services or renting temporary space from someone else?

Once you have a reasonable picture of your competitive landscape, you need to ask yourself why are your patients accessing care outside of your medical home? Your answers will help you better understand your weaknesses, which you should view as opportunities for improvement. It’s important to not get bogged down in the “don’ts” or “can’ts” — as in “we’re losing patients because we can’t provide 24/7/365 office hours” or “we don’t have deep enough pockets to advertise and compete.” Remember to view your practice from your families’ perspective: What value do they get from your medical home and how often/easily are you meeting their needs?

Some common ways you can turn weaknesses into opportunities:

1. Your families “never see the same provider twice” so they feel like they might as well be seen at the urgent care for sports physicals or acute problems. Relationships matter to families. Consider creating team-based care where patients are assigned to a team of two providers with additional staff so that they develop a trusted relationship with their team.

2. You have mostly two-working parent families and your office hours make it hard for them to see you. Consider early morning check-ups for increased access before school, daycare, and work.

3. Your families want to know they can be seen in the early evening so if they have to take the next day or days off of work to care for an ill child, they can plan accordingly. Consider after-dinner walk-in hours to accommodate simple sick problems. Most urgent cares and retail-based clinics are not open 24/7. Extend your hours to meet theirs.

4. Your after-hours triage service isn’t meeting the needs of your families when your office is closed. Consider having your own nursing staff take after-hours first-line calls. Alternatively, give your answering service authority to schedule appointments for first thing the next morning, if a parent requests this when your office is closed. Or consider adding online scheduling functionality so parents can self-schedule tomorrow’s appointment and plan their day in advance.

5. You never seem to have “last minute” well-visit appointments available. Proactively reach out to your student-athletes in the months prior to when you know the school requires a form and invite them to schedule an appointment in advance or remind them that if their preventive visits are up to date you will be happy to complete the form without a visit. Put your school holidays in your appointment calendar and make sure you have extra providers to accommodate school-aged children when they are home from school.

6. You have college-aged patients who have chronic concerns such as ADHD or anxiety and they can’t easily get back to see you between school breaks. Consider expanding your medical home via telehealth to meet the needs of those patients.

7. Your families are all getting their annual flu shot at schools, community health centers, or retail-based clinics. Promote a family flu vaccine fun day where you can celebrate some fall fun and give parents their flu vaccine also. Consider a drive-through flu clinic where families don’t even have to get out of their car. Hold flu clinics on those fall days where school is closed to maximize your availability.

Once you have your strategy to combat threats and turn your weaknesses into opportunities, have a concerted marketing effort to make sure everyone knows the value you provide your families and community. Utilize social media to engage and attract families. Have your providers volunteer to give talks at daycares, schools, and community centers. Utilize your website and search engine optimization to have families easily find you and engage them with personalized videos and fresh content. Create a quarterly newsletter which you email to your existing families. In short, become the awesome practice that you would want for your own children and grandchildren—and make sure everyone knows your true value.


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