In-office Dispensing for Improved Patient Outcomes and Satisfaction: Part Two – Getting Started

Now that we have discussed the many benefits of in-office dispensing in Part One, how do you begin?  Many practices with very successful in-office dispensing programs employ a technique known as “passive marketing.” Patients are never told that they have to purchase a product. Instead, opportunities for product use are made available through recommendations in the treatment plan. Take for instance this scenario: “Mrs. Smith, you really need to use a skin moisturizer on your feet twice a day.” Her response is usually, “Can you recommend one for me?”  With this response, your door of product opportunity flies wide open.

Another aspect of “passive marketing” is having your patients exposed to various products in several ways throughout your office.  For example, some offices will have binders available for patients to look through. The binders contain information on the doctors, the staff, the services offered, and a section on foot care products. The section on products shows what is available through in-office dispensing and outlines some of its common uses. Another tool to introduce patients to the products offered in the office is through patient education handouts or pamphlets. Patient education handouts and pamphlets not only aid in summarizing treatment options, but also aid in reinforcing various product options as part of the treatment plan.  Take the opportunity to ensure that these handouts reflect your recommended product uses to enhance your treatment plans.  As your patients are waiting for you in the reception area, have a sign in your waiting room as an added reinforcement that states: “We carry several products such as pads, arch supports, skin moisturizers, ankle supports and healing products in our office as surveys have indicated that our patients appreciate the convenience of purchasing the products here.”

 Many offices have had success with a small display case in the reception area, which includes some of those products that are offered in the office. Some companies offer Plexiglas cases that allow products to be clearly displayed with good exposure and a professional appearance.  These can also be purchased at an inexpensive price if you choose, but try negotiating for this to be given free of charge based on high volume orders. Patients often ask at the front desk which product they should use. Your staff should be trained in “non-selling.” In our office, we do not push a product. Instead, we will show a bottle of the moisturizer that we offer. The patient is informed that similar products can be found in the pharmacy, but these are available for purchase in our office if they would like.

With the advent of digital photography, it is easy to create a collage of your products and have them enlarged and nicely framed for each treatment room. Patients’ curiosity as to the use of the products will lead to increased sales. This also increases patient satisfaction through providing solutions to their problems. Be sure to let your patients know that they can stop in at any time to purchase products. On their follow-up visits, be sure to ask whether they are using the products, whether they are using them as directed (once a day, twice a day, etc.), and whether they have run out or are running low on the product and need to purchase more. The key is the soft sell.

Convey to your patients that this is not the focus of their visits, but simply a component of the treatment plan. Acceptance of a product is greatly enhanced by conveying to a patient how popular the particular product is amongst your other patients with similar or identical conditions. Make it clear that if they want to return the product for any reason, they will be given a full refund without question. It is rare that a patient will ask for a refund or need the product to be replaced. You should consider not abiding by any time frame for this offer. For instance, if a patient comes back six months after obtaining a product, you should gladly refund their money. You can then contact the vendor and ask that they send a replacement product. This is usually not a hassle as most vendors are smaller companies that rely on their word of mouth for business.  Patient satisfaction should be held in the utmost regard.

When visiting the offices of referring physicians, bring some products that would be appealing to their staff. Simply let their staff know that you have found these products to be of great benefit to their patients, and you would like to provide these complimentary gifts for them to try. Remember to present these products simply as part of your treatment plan for the particular condition you are discussing. The holidays in December also provide a prime opportunity for you to put a basket of products together as a gift for a referring doctor and his staff. They will try the products themselves and introduce the products to their families.

So, if you find yourself in a practice rut, consider expanding the service base of your business. Start by evaluating where you are today: keep a running list for one month of all of the patients that you send out of your practice to buy goods or services from others. Go through that list and decide which of those products or services you think you could effectively bring into the practice. Approach it slowly, building one product or service expansion on top of the other. Each success will lead to greater confidence and patient satisfaction.

If you decide to begin dispensing products in the office, take your time in examining the products that are available to you. Use them yourself or ask a few patients to test them for you—patients are always willing to be involved in this type of “market research.”  Start with the products you are currently sending your patients out to buy for themselves. These probably include skin moisturizers, exfollients, antifungal preparations, sports pain relieving creams/gels, wart therapies, or pre-fabricated orthotics. You may want to visit some of the local pharmacies and supermarkets and explore their foot care areas. I think you will be amazed at the variety of products out there. Then you want to start paying close attention to the advertisements in your podiatric journals and magazines. They are full of foot care products that you can easily stock in your office. Many of them are not widely available and become even more attractive from a business standpoint. The decision in setting up a price point for these products is completely up to you. They can be sold at your cost, or you can add some profit into the price. If you do sell at cost, please be sure to factor in the cost of shipping for each product.

As mentioned discussed in Part One of this article series, do not be fooled by misconceptions that patients are turned off by the thought of “selling” products in the office. In an effort to maximize treatment, patients are willing to answer to any reasonable price, as long as it is necessary for their care. It is your job as the specialist to inform them of the products that are in fact necessary to their care. In order to convince your patients that you know what is in their best interest, you must speak in a manner that is confident. Even the patient that might appear unwilling to spend a great deal of money on orthotic devices may be willing to accept the treatment plan if he or she has faith in the physician. Your job as a physician is to gain this trust by giving the patient what they need to feel better and reinforcing the importance of your treatment plan.

Confidence makes all the difference in having in-office dispensing be an integral part of your practice. Avoidnon-definitive communication with patients regarding treatment options. Statements such as, “You may need orthotics,” or “Maybe a cortisone injection will help,” leave patients feeling apprehensive and uncertain about their treatment. Patients come to the seeking a professional opinion; as such, they expect you to take control of their treatment in the quickest, least painful, and most cost-effective manner possible. Non-definitive statements elicit non-definitive patient responses, such as “Well let’s see how things go before we try that.”  To avoid losing control of your doctor-patient interaction, be confident in your diagnosis and treatment protocols. Do not hesitate to offer your patients a product that will help!

Every practicing podiatrist today is faced with the financial stress of decreased reimbursement rates coupled with the increasing number of litigious patients. These two factors have significantly impacted the practice of podiatric medicine, causing many of us to rethink our treatment protocols. Practicing physicians are seeking alternatives to elective surgery that provide positive care for patients while maintaining the financial viability of private practices. The exploration of new sources of revenue reveals that the pendulum is beginning to swing in the opposite direction, and those practitioners who embrace this movement will be far ahead of the others. In-office dispensing has become widely accepted in podiatry and is now recognized as an important part of the treatment armamentarium.

Success and growth in a practice are closely tied to a doctor’s own perceptions…and sometimes misperceptions. In many cases we misread our patients and again, think for them about what they do and don’t want. This critical mistake frequently leads to the patient not receiving optimum care and has an adverse affect on your bottom line. It is vital not to underestimate your patient’s ability to make an informed treatment decision. A properly executed program will enhance patient satisfaction, outcome, and your bottom line.

In summary, podiatrists are beginning to place greater emphasis on non-surgical treatment modalities in the private office. Non-covered services such as in-office dispensing should be looked upon as a positive aspect of the practice. Physicians and their staff must be clear in relating the beneficial nature of a particular treatment to patients. Turn your patients into educated consumers and you will be pleasantly surprised with the results!

Hal Ornstein, DPM and Neil Baum, MD