VP, Applied AI & Growth
VP of Clinical Platforms
Chris Hemphill: Good morning, or if you’re on the East Coast like me, good afternoon. Hello, Healthcare. Hello, LinkedIn. Hello, YouTube. We are excited to be back. Last week, we took a brief hiatus from LinkedIn Live and went on Zoom with Edward Marks to talk about digital transformation in healthcare. But now we’re getting back to our conversations that are more related to the physician relationship and physician experience. And we’ve brought on, she’s actually done a couple of sessions with us in the past, but Kriss Barlow. Kriss, do you want to say hello real quick? Kriss Barlow: Good morning, or afternoon. Chris Hemphill: Happy to whatever time zone that you’re in, but the exciting thing about what Kriss Barlow is focused on is if you’re not familiar with her background or haven’t seen her before, she’s one of the biggest in the physician liaison and physician outreach side of healthcare. And what that role is, we’re going to get a little bit deeper into it, but this is about, like when we talk about listening to physicians and listening to providers and understanding their needs and concerns, especially as there are so many different things that are impacting their health and wellbeing, the physician liaison relationship is critical to gathering information from physicians and maintaining a relationship that helps them understand what processes are and directing referrals and things of that sort. But Kriss works with a number of institutions across the nation with regard to this physician outreach and physician liaison program that hospitals are doing. And what that’s giving is a perspective on how the industry has changed since COVID, but now, she’s recently posted an article, Looking Into a Crystal Ball, about what’s to come, and we wanted to have a conversation where the liaison community and others that are curious about hospital physician relationships and maintaining these relationships with physicians. We wanted to have a conversation that involved Kriss to give her feedback and her perspective on the shifts and changes in the market as they come and what leaders and liaisons might want to be able to do to start focusing on the future and the changes as vaccines rollout and as the way that meetings were structured change. So to do that, to mine that information and have this conversation, I’ve brought on our VP of Clinical Platforms, Terry Tuznik. Terry Tuznik: Hi. Chris Hemphill: Terry works with some of our larger physician relationship management clients and has a clinical and nursing background, healthcare IT background as well. So I thought it’d just be a perfect marriage of conversation to discuss, Hey, what are the issues impacting the type of work that liaisons are doing right now, and ultimately, what do we need to do to better be on leadership radar? How can leadership better understand these efforts and understand the physician liaison position in their physician relationships and referral processes? And ultimately, what can we do to prepare as the future demands more data-driven work and data-driven guidance into the types of activities that are optimal for liaisons as they come. So with that, Kriss, are you ready to get into some questions and some back and forth here? Kriss Barlow: Yeah. Ask away. Chris Hemphill: Okay. Fantastic. Well, we hope that everybody watching is ready to do that as well. So we invite you to share your questions, your thoughts, your stories, any input or feedback. I know that this is oftentimes, a really emotionally trying time trying to balance these various aspects of change needed to effectively do the physician liaison job and support physician liaisons with the marketing and strategic and process support that they need as well. So let’s get down to the basics though, because it’s more than just the physician liaison audience that watches this. I’d like to just go to the very basics. Kriss, how would you define the day to day for physician liaisons? And what’s the impact that a liaison can have on a healthcare system? Kriss Barlow: Well, pre COVID, physician liaisons actively visited physicians and their practices in the office. It’s very much to build relationships, leverage education about the services that are offered, but really at the end of the day, it’s to earn referrals, it’s to support the management of issues they’ve had. And the other piece that liaisons offer such good resource for in the organization is to gather intelligence, strategic and tactical intelligence about those practices that can go back to the organization. So in that pre COVID world, most liaisons were 70 to 75% of their time in the field. Chris Hemphill: Interesting. So with the transition from 70 to 70% of time in the field, what’s been the transition since then? Kriss Barlow: And so you know it happened for most teams in a day, they were no longer doing visits. And it was a dramatic shift for many liaison teams. So there’s a portion of them in our country that were deployed to do different functions, a portion that stayed consistent with doing their outreach, a portion that were furloughed. So what we’re seeing now is that of them are getting pulled back into liaison functions, most of that’s being done virtually. And a lot of that has been historically over the last year, really around nurturing conversations, those conversations that really help our practices with, “Where are you these days? What do you need? Do you have communication and resources?” Especially for some of those independents. So that change happened so dramatically. And now most liaison teams are working via Zoom, phone calls, texts, and emails to work to connect with those practices. And we’re now hearing leaders encourage them to get back on that growth wagon. We need volume, right? In organizations. Chris Hemphill: Now that’s really interesting to hear as well. The fact that, Hey, they’re pulled off the field from being able to meet face-to-face, but there’s a shift over to virtual. I’m curious, with these post COVID changes, what’s permanent? Do you see any of these changes as lasting or once vaccines and things like that are commonplace, is it going to go back to business as usual? Kriss Barlow: Well, selfishly, I hope it never goes back to business as usual, because we should’ve learned some things and we’ve had some really good opportunity to regroup on what is best practice and what was working well. So one of the things that I think most teams are looking at is, where is the role of virtual visits in our future? And I think there’s great potential for that. Don’t you? I mean, I absolutely believe that to drive two hours to spend 15 minutes, sometimes you need to do that, sometimes you can pick up a phone or set a Zoom meeting. So I think there’s going to be a place for virtual in our future. I also think that some teams have taken the time to go back to their data, to really look at how are we targeting? What is our approach? So having used this last year to really do some good thinking about better strategic focus, better growth focus, what does our organization need? How can we bring that forward? I think we’ve got some tremendous opportunities to evolve these programs and really get more strategic in how we’re thinking about it. Terry Tuznik: Kriss, I wanted to also ask, so we know that with COVID, and we’ve had a couple different LinkedIn Lives on provider burnout, that burnout is at an all time high. And that in fact, a large number of providers plan on retiring after this is all over. So, as you mentioned focusing on growth, we also really feel like panel retention, retaining the patients of the providers leaving. What do you see the liaisons’ role in maybe helping with some of the retention and maybe some of that maybe loss of information so that they don’t lose that entire panel of patients out of the health system? Kriss Barlow: Well, Terry, great question and I think it’s twofold. The first is let’s be having good meaningful conversations with these docs. So if they are frustrated, which to me is step one before burnout, and we can have somebody counsel with them or offer some changes in their practice experience, or perhaps alignment. Let’s get the liaisons in there fast to be able to uncover this. So step one is, I don’t think we have to let them completely leave us if there’s a way to nurture those relationships or provide some other resources. The second piece that’s critically important in my mind is good succession planning, and it’s going to impact all of us, because we’ve got to know who’s leaving. For a lot of the recruitment efforts, it’s 12 to 18 months to get somebody new in. Most of the docs have stayed through COVID, but our concern is what’s going to happen in the six months post. So that opportunity, I think, for liaisons to begin to understand that and work internally with their physician recruiters and their leadership to say, “I think we need to look at some succession planning in this market, and here’s why. Here’s the indications I’ve got.” And it’s also those conversations that just don’t say, “Dr. Smith is thinking about leaving,” but, “Here’s why, here’s what here’s when,” so it’s going deeper in conversations to really uncover the tactical responses that we need to be able to make as an organization. Terry Tuznik: Yeah, that’s a very critical role and great points there, Kriss. Chris Hemphill: I appreciate that. And Kriss, it makes me curious, there was the issue of burnout, but what are some other ways that the physician liaison, physician outreach, what are some other ways that they can be partners and provide value for the clinicians that they’re serving? Kriss Barlow: The biggest is so simple and it’s recognizing that this isn’t just about the tell, I think for a long time, liaisons were so excited about what their organizations had to offer, and they felt like the job needed to be to go out and tell people about what we had. The critical piece, I think, of re-entry right now is more on the ask and it’s not asking broad, generic questions about, “How are things?” It’s specific questions that don’t make that audience think a lot, but to really help to unearth, “How are things in the practice? On a one to five, how are your clinical staff doing in the practice? Are you and your colleagues having conversations about finances? Is there any way that we could support that?” So to me, a lot of this is being proactive with good questions that open the door. It’s a tender area, so you have to go at it cautiously. You don’t want to expose them, but you certainly want to say I’m a resource that can help you with things beyond telling you about our cardiovascular program. Chris Hemphill: So with that, this also makes me curious, we talked about various types of changing types of engagement that we’re having. We’re moving more towards virtual versus physical, and you outlined maybe even a key takeaway where, Oh, I liked some of the questions that Kriss shared to open up conversations and have more authentic relationships with clinicians. But with all this change, one thing that you had highlighted in some recent publications was just around resistance to that change and people pushing back. And I’m curious, where have you seen the most resistance to this type of change that we’re talking about? Kriss Barlow: Well, I think it’s an underground thing. I don’t think most are talking about it, but in most teams, I suspect if we said to their leader, “Do you have team members that I’ve gotten really comfortable with doing this virtually and feel less inclined to want to get back in the field?” I think some team members, it’s pure the physical part of, “I’m not yet comfortable with where COVID is. I’ve got elderly parents. I don’t want to expose people.” All of the physical presence of being back in the field is some of it. But I also think there’s a percent of liaisons that have just gotten comfortable with the lifestyle of not having to be in the field or for some, have liked not having to be as proactive because their organizations have said, “I need you to do this now. Fill the gap with this now.” And so, instead of being the owners of a territory and focused on the proactive piece, I think they’ve gotten comfortable with perhaps a different lifestyle. The other piece that I think is really interesting is there are some teams that were very actively led by senior leadership prior to COVID. So senior leaders, service line leaders, I bet you’ve seen this in some of your organizations, Terry, were actively saying, “Here’s what we want you to do now. Do this next.” Those leaders have not been able to be active at the same level of detail. And so these teams have been a little paralyzed with, “I’m not exactly sure what I should do because my leaders just haven’t helped to direct and guide me.” And to that, I would say, put a plan together, figure it out, do something. You know what needs to happen, you know that voice of customer. So take that first proactive step for your organization. So those are two ways. Either liaisons are a bit reticent for a variety of reasons, some very legitimate, some, maybe not so much, or they’re waiting for leaders to say, “Here’s what I need you to do.” In both cases, I think team leaders are going to have to step up and to help their liaisons to say, “It’s go time.” Organizations right now, they need us to go now. This isn’t an ease back in time. This isn’t a, let’s just see how things flow. We got to go fast from a volume perspective, in my mind. Terry Tuznik: I think you made a key point about the leadership and I want to circle back around to something we were discussing before we got on live here. We were talking about where does the physician liaison group belong within an organization? And from your experience what’s worked best and why? Kriss Barlow: And I think the team needs to report to the person who gets it. It’s so basic, and yet it needs to be somebody who understands the importance of growth to the organization. And it’s somebody who can speak to the highest level within the organization about what that looks like. It also has to be a place within the organization that really understands the role of our physicians in our future state of referral growth. So consumer marketing is alive and well, and we all love it, but all of that marketing says, “Go see one of our doctors,” and we can’t afford right now in growing health systems to not have that doctor refer in and there’s that old leakage word again. So I think it’s wherever people get it, statistically, it’s about a third in marketing, a third in business development and a third to other places within the organization. But all three of those departments have to work together regardless of reporting structure, right? Terry Tuznik: Yes. Totally agree. Kriss Barlow: Yeah. Chris Hemphill: So it’s a given, these three parts of the organization have to work together. In reality, they might report into different places, but no matter where they’re reporting, there are still efforts and assets and resources that from a marketing perspective, benefit the outreach efforts and vice versa. I’m curious, where would you say, if we were looking at the liaison relationship, what kind of marketing assets or marketing resources or efforts would they benefit from most using? Having seen different levels of integration with marketing, I’m wondering where can marketing provide the best support for the liaison program? Kriss Barlow: Well, and what a lot of liaisons will tell you is, “I need stuff. I need marketing materials.” I’m less inclined to be a stuff person, mostly because our physicians say, “I don’t really have time to read a lot of that.” And it’s really hard to get materials written that are of interest at the physician level. So I would say step one, in terms of collaboration with marketing needs to be the strategy, what’s our marketing strategy? What are those clinical areas that we need to focus on? Are you talking to consumers and physicians at the same time? Do we have good statistical outcomes that we can showcase? Do we have good templates so that if I want to show a doc a CV of another doc, I can easily put it up on a data card or something like that. The other thing is many, many practices are heavily reliant on their office staff for making the actual appointment. So I do need good accessible referral tools about our medical staff that I can share with those referral coordinators and practices. So the biggest piece to me is the strategy, making sure we’re on the same page, we’re talking about the same benefits in that way. And then the second is what are those key pieces of materials, whether they’re electronic or print that would be assets, especially for the referral coordinator as we use them? Chris Hemphill: Terry, I was wondering your thoughts on the same question, too, just with regards to what can marketing do to be a better partner to physician liaison, or if you’re just taking a step back and you’re looking at both departments, are there ways that tweaking efforts or tweaking materials and tools can help amplify the efforts of the other? Terry Tuznik: Yeah, I do think that obviously there needs to be great communication between the two and some of the more successful marketing departments I have seen have had a lot of physician involvement in not only the strategy, but the campaigns as they roll out. And I think you need to communicate that with the physician liaison team, to make sure that everybody’s aware, this is the campaign this month, this is how we’re rolling this out so that the focus can be shared. I think there are some tools that marketing has where you almost run campaigns out to your physicians through your physician liaison team. I think it’s important because if you’re bringing on a new specialty that everyone within the physician community is aware of that, and that the liaisons can do the best job educating them. I think we need to continue from a marketing and a provider relationship management tool set to try to evolve, so there’s a little more connectedness, because I think from a reporting perspective, there’s a lot of data that could be shared. That would be again, an important tool for your liaisons. So I’m going to use that to segue Kriss, when we were talking earlier, you talked about data and about data-driven conversations and data showing, and I would love for you to dive into what data’s important for the conversation and what data is important to show the work that’s being done by the liaison team. Kriss Barlow: Well, I think all of us would agree that data tells us what, conversations tell us why. So our ability to be able to frame these programs on data is absolutely essential. Liaisons are, it’s an expensive resource for an organization, right? To have an individual calling on practices. We need to make sure first and foremost that we’re using the data for the right targeting. A ton of teams have spent time over COVID really trying to clean up their data and understand that better, but making sure that we’re calling on the right audience, step one, from a data-driven approach. The other piece with that is to be able to demonstrate how my activity is directly related to the results that we’re seeing in our program. So activity linked to results has to be a data-driven function. And I think that there were some programs pre COVID that the organizations were doing really well. The specialists were super busy, everybody was pretty happy and the liaison work was heavily focused on retention of those referrals, keeping people happy, figuring out issues or barriers to growth, bringing those back in. And I’ll tell you, as I’m talking to a lot of specialty physicians and organizations right now, everybody’s a little hungry for growth. So I think we’ve got a fabulous window of opportunity if we take advantage of it, to say, “Here’s the activity that I can provide that will correlate directly to growth. And that’s all in the tracking and reporting of what we said we were going to do and then what we demonstrated.” The other piece with that I think is that sometimes the reporting piece can get overwhelming. And we usually say to programs, “Just pick out one area, pick one something that you can start with for really good measurement, and you can grow from there. So don’t try to boil the ocean and do it all at once, pick something and start measuring.” So I think it’s a critical time for us to do that. Chris Hemphill: You took us down an exciting avenue and it’s actually really heavily related to some research that we recently did with regards to a program at Intermountain Healthcare, a physician outreach program where the question, and this was pre COVID when these questions were coming up, but it was very focused on, what’s the impact on referrals and revenues that we get from these referral relationships? So I’ve actually just dropped that case study down in the comments where if you’re interested in seeing an approach that identified the value of relationships and provides a playbook for some things around change management, you get to walk through Intermountain’s program that Robert Perkins had led, but you can use that to get a perspective on, Hey, here’s how they’ve used data. Maybe there’s some practices that you can glean and use that within your own organization. So that was an exciting way to bring it up Kriss, but it makes me wonder, part of that case study included, there was some initial resistance to starting to use data to drive these programs and things like that. So I’m curious, with the faster shift that we’re seeing towards needing to validate our efforts through data, are there some resistances to this kind of data-driven approach, and what are some thoughts on how leaders can help manage through that as well? Kriss Barlow: Well, I think the resistance is people are nervous about how much spotlight looks at them. There’s some resistance because, if only we were selling shoes, it’s cause and effect, and it’s easy to measure. It is so messy and complicated to say, “I talked to this PCP three times because of those conversations, he referred to that surgeon, that surgeon saw X number of people in the practice. And one of those ended up with surgery.” So the referral chain is messy. It’s complicated in our worlds. It’s still critically important. And so giving liaisons permission to feel comfortable with the data, I think they need to be taught about data. I mean, most of these are fabulous people with good sales skills and it doesn’t mean that they like to look at a spreadsheet all day. And so I think they need to be taught. I also think a critical piece for some of the best practices to have a data resource that can be helpful, so that liaisons understand what kind of data they need to look at. And then the liaison has to help the organization to say, “That’s not business I can move, and here’s why. You see all this business over here with Dr. Smith, but did you know his wife’s the CNO at our competitor? I’m not going to move that volume for you.” So it’s taking the data and matching it again with what you learn in the field to be able to grow business, but take the time to teach the liaisons, give them permission to learn in their way and give them enough support so that they aren’t overwhelmed with the data. Because again, eventually we’re going to want them back in the field, maybe 60% of the time with 15 to 20% of the time doing virtual visits and that other 10% of the time doing good planning and good reporting. Chris Hemphill: Any thoughts you have on that, Terry? Terry Tuznik: No. I mean, I think Kriss hit it. It’s just every time Kriss, I listen to one of these with you on it, I learn something and learn something that can help as I interact with our clients. So I really appreciate it. I loved your example there because I can think of a few where, “Why isn’t this happening?” And when you dig under the covers, “Well, there’s a relationship there we didn’t know about that maybe we should have known about. And that’s why we’re not moving that provider from referring outside.” So great point. I love this conversation. Chris Hemphill: The way you worded it too was, Hey, once things are back online, our idea is not for you to spend all your time buried under a spreadsheet, but instead to have the right level of guidance without going into an analysis paralysis phase. Kriss Barlow: No better way to burn out a good people person than to put them behind a spreadsheet. Right? Terry Tuznik: Absolutely. Chris Hemphill: We’re talking about the changing perception of data, and I considered data results, revenues, there’s different things that are part of a universal language in business and within an organization. And earlier in the conversation, you just alluded to the idea that you have to have this program run by leaders who get it, but it sounds like there’s a lot of leaders who don’t get it, or aren’t exposed, or don’t quite understand. How can folks on physician liaison leadership, or physician liaison teams start helping these leaders to understand and visualize and start really understanding what’s needed to successfully drive these efforts? Kriss Barlow: Tough question. I think what’s happened over the last year, in all fairness is, operations has owned most everybody’s brain, right? For all the right reasons. Within organizations, safety, quality and operational efficiency has been front and center. So as our leaders shift back to looking at the volume side of growing the business and financial viability moving forward, I think the biggest thing that liaisons can do is to proactively communicate what they’re hearing in the field. And we’ve had lots of conversations with liaison teams to be able to say whether it’s virtually or you’re actually in the field, face-to-face, “Let’s capture some of that voice of customer and bring it back to leadership in a meaningful way.” So if liaison teams think of one or two questions that they’re calling the practices now and saying, “I’d love to capture some information from you. Could I have Dr. Smith for two minutes?” You ask him a couple of questions. It could be related to COVID response. It could be related to, “Are your patients coming back?” One of the things we’re hearing is, patients for elective procedures are still waiting till everybody’s vaccinated. So you think about orthopedics, you think about some of those elective things that were just waiting and that patient says, “Hey, I can deal with this hip for another six months.” So getting some of that volume back, letting our leaders know that, “Here’s what we’re hearing in the practices.” That will help, number one, with our marketers, to be able to say, “Maybe we can message better to consumers about this.” It will help with leaders to be able to know it’s not that our practices aren’t sending to us, they just start seeing that volume. So it may be that we have to ratchet up some of our tools and vehicles to allow patients to come in more. So when I think about leadership, step one is let’s get them intelligence and let them hear that voice of customer, number one. Let’s communicate proactively to our leadership about, “Here’s what I’m hearing from the practices. 63% of practices indicated that, if we’re able to do this, then…” I think it’s also liaison team saying, “Because we heard this proactively, here’s some of what we’re doing.” I think we’ve got a window of opportunity to really let leaders know, “We’ve got your back. We can help with this. We can help communicate this. Are there messages? Are there different ways, like our ambulatory surgery center that we should start to promote more if patients aren’t comfortable with hospitalization?” So I think part of it is leaders are mostly operationally driven. If we want that voice, we have to get proactive and we have to actively communicate. The other thing is, I think it’s going back to reports that say, “Hey, here’s the number of virtual visits that we did last week. Half of them were to do physician introductions, but the other half were to go deeper in conversations about this and that.” So big topic. Chris Hemphill: Yeah, yeah, definitely one that’s the topic of a broader webinar, perhaps. Unfortunately, we’re a little bit past time, but I always like to leave just a little bit of space to help address. There’s a reason Terry and Kriss, that you came here and there’s a reason other people are tuning in to get this perspective. I’m just curious if there’s anything that you would hope that people would watch this and take away from it and learn, what would that final thought be? And Terry, I’ll let you start with it just [crosstalk 00:33:57] Terry Tuznik: Well, for me, it’s so clear what a critical role physician liaisons play in both, and Kriss, you hit something that really resonated with me, and getting that voice of the customer from the provider back to the health system. You can say, “Oh, we got phone calls, emails from patients,” but really that provider is out on the frontline and they’re hearing. And really having the physician liaisons understand the issues that those providers are facing both from a retention and a growth perspective. So this to me, has just been really enlightening and really just shows the value that a physician liaison team brings to a health system and how critical of a role they play. So as always, I learn so much every time you talk, so thank you so much for participating in this with us. Kriss Barlow: Yeah. Thank you. That was really well said. And the piece for me, the takeaway, is that I think liaison teams right now have a window of opportunity to be absolute rock stars for their organization. So I say, craft a plan, craft a 30 or 45 day plan, say, “Here’s what re-entry looks like for us. Here’s what we’re going to learn. Here’s what we’re going to share. And here’s how we’re going to measure.” And let’s just go and show the rock stars that we are. Chris Hemphill: I love it. I love it. And I appreciate you sharing that perspective because it just sounds like there’s so much hidden value in these relationships. There are, I’d say a growing number of data-driven leaders who would be excited to understand how you can lead a program to start getting feedback on how physicians feel about working with an organization, or feel about changes in practices and policies. And you can’t do that without some sort of data-driven collection of that voice of customer, voice of physician, voice of clinician, et cetera. So, Kriss, again, thank you for hopping on with us and sharing your perspectives. We’re going to make this conversation, the video and the transcript, for those who don’t like to sit through a whole video, you’ll be able to read it too. So we’ll make that available on our website. And in the future, we like to cover a whole range of topics. There’s B2C concepts that we cover. There’s things around the B2B relationship with physicians and things like that. But next week, we want to focus in on, there’s a whole lot of policy change that just happened. $1.9 trillion stimulus package, along with the ongoing tug of war with the Affordable Care Act and all these other different decisions that get made on a national level that impact us trying to operate and improve care for people. So Dr. Paul Keckley will be joining us. He is just fantastic, has a deep experience with the advisory board and a DC background. And is going to be talking about the policy changes that are happening at that national level. What’s going to be the impact on what we’re trying to do and patient engagement and things like that. So stay tuned for next week. We’re really excited to have that conversation and a big thanks again, Kriss, for hopping on with us today. Terry Tuznik: Thank you. Kriss Barlow: Thanks for inviting me. Chris Hemphill: Thank you.
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