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Patient retention is a crucial part to the success of any clinic. While good success rates and pleasant staff can get patients to continue treatment with you, there are other ways that your clinic can help. On this episode of Inside Reproductive Health, Griffin talks to Connie Stark of A.R.T. of Wellness. Their discussion uncovers a new way to help retain patients. Learn about the five aspects of life Connie focuses on in her coaching services and how integrative care can keep your patients all in on their fertility journey.
Learn about Connie Stark and A.R.T. of Wellness at www.artofwellnesscoach.com.
To get started on a marketing plan for your company, complete the Goal and Competitive Diagnostic at FertilityBridge.com.
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Welcome to Inside Reproductive Health, the shoptalk of the fertility field. Here, you'll hear authentic and unscripted conversations about practice management, patient relations, and business development from the most forward-thinking experts in our field.
Wall Street and Silicon Valley both want your patients, but there is a plan if you're willing to take action. Visit fertilitybridge.com to learn about the first piece of building a Fertility Marketing System--The Goal and Competitive Diagnostic. Now, here's the founder of Fertility Bridge and the host of Inside Reproductive Health, Griffin Jones.
GRIFFIN JONES 0:58
Today on Inside Reproductive Health, I'm joined by Connie Stark. Connie is the founder and president of A.R.T.--Art of Wellness. She's an award-winning registered nurse certified in Reproductive Medicine and is a certified fertility coach. With 30 years of fertility nursing experience, Connie knows the science, she understands the emotions the process that each person experiences when they're faced with fertility hurdles, and her services reflect that by supporting patients and promoting preconception health and wellness to complement scientific protocols that are recommended to achieve pregnancy and increase positive patient experience. We're going to talk about how that interfaces with the rest of the patient experience today. Ms. Stark, Connie, welcome to Inside Reproductive Health.
CONNIE STARK 1:43
Hi Griff, how are you?
JONES 1:46
I'm doing well. One of the things that we want to talk about was how you chose this avenue within the field. I want to zoom in--not before that, but a little bit after--of the coaching side because I think often when we think of someone in coaching we think of someone working in public health or in social work. You came from the nursing side. How did you make that transition?
STARK 2:09
Yeah, it's a really crazy story. So just a tiny bit of background--I was kind of evolved into it from over 30 years ago. I had an accident and it landed me in a wheelchair. And I remember sitting in an exam room after three months of treatment, trying to get back on my feet, the physician told me that he wasn't quite sure if I'd ever walk again. And I remember the moment I sat on the exam table, on the crunchy white paper, all alone, and I felt like the room was black, and I felt so isolated, and I walked out of that room as though no one cared. And I didn't realize that that core feeling that I was going to have was actually going to move me into where I'm at today, aligned with working with fertility patients that have that same experience. When they're faced with--in front of a physician, and a fertility center trying to conceive. And so I really can connect with that couple or that person who's pursuing the path of parenthood, what that isolated feeling feels like. And so my role that I feel that I've evolved into as a nurse, working in a center since 1990--once I learned the protocols and once I learned how to manage all the science, I realized there was an important piece that patients were missing--that piece of wholeness of all aspects of their lives that they can truly live life while they're in crisis and enjoy it while going through treatments during this temporary stage of life.
JONES 3:48
Were you already a nurse at that point, when you had the accident?
STARK 3:53
Yeah, so I worked at Northwestern in Chicago, which is an academic teaching hospital and I worked in the OR and prior to that I was in high risk labor and delivery. And as I reflect back, I still always have seen this need of this attention, this added need for patients beyond their protocol of attention that they need to grow wherever they're at that stage of life. So yeah, so I took my health and wellness, understanding what I'd went through personally, connected it with my labor and delivery, and then evolved into infertility nursing, which I just kind of landed because I was looking for a job while I was on crutches and couldn’t go back to an OR which I was working at. And Dr. Anne Wentz was the physician who hired me without any fertility knowledge and said, “You know what, you're going to make a difference in the world.” And I just kind of stayed with that and grew with it--back in the early 90s when there really wasn't any fertility nursing around.
JONES 4:54
And so this career transition is happening right after you have the accident--you’re in the doctor’s office, you're sitting on the table, feeling very alone. At this point, I don't think we're talking a lot about patient experience, as you know, as operations or as something that every system needs to have, right? There's always been great providers who provide excellent care, but the way we talk about it today, I don't think we're talking about it 30 years ago, am I correct?
STARK 5:25
You're absolutely right. It was really all about the black and white of medical care for sure.
JONES 5:31
So you had been a nurse. You're someone that works within healthcare. You're experiencing this yourself that there's a deficiency in--there's some sort of deficiency in the delivery of care, then you transition over to fertility?
STARK 5:50
Yeah.
JONES 5:51
How did you bring that experience, that foresight, that there's something that else that needs to be filled into fertility and where do you think our field specifically could use more of it?
STARK 6:05
Yeah, so working in different clinics, from academia to private practice to corporate practice and fertility management for our patients, I realized, as a nurse, whether you're doing IVF coordination, third-party coordination, or whatever your role is within a clinic, there's never enough time to really pay attention to the patient beyond their protocol. You're doing your specialty to the best of your ability from, you know, calling back results, calling back outcomes, educating patients, but never really going past that protocol. And patients feel left behind or not connected to a bigger picture. And when that happens, they're so focused in on just going from an estradiol level to a negative beta to injections, and they're not really connecting it all in with themselves and what they can do, because patients always ask, what else can I be doing? And no one's paying attention to that question.
JONES 7:07
Do you think that that's part of the reason why they don't always make it from step to step? Because there is so much and there's so many different crevices to fall off during the journey. And how does that baseline help whether it's checking in with self or having other resources? Is that all part of the reason why people fall off the journey sometimes?
STARK 7:36
It is, you know, I think Fertility and Sterility wrote an article a couple years ago, that even in mandated states like Illinois, 30 to 40% of all patients stop treatment. Some of it’s due to financial, but the bigger percentage of it is because it's so stressful, and patients have a hard time seeking out psychological appointments, the psychological consult because it's just an added step. And they feel like I just don't need that. I just need to get pregnant and I'll be fine. And the bottom line is, is that that's not necessarily true. What I've seen in the clinics and through my business is that there is so much more to be done that all these patients need. And I hear it every day in coaching all these patients through it, and aligning with them. And having the knowledge that I have as a nurse, I don't necessarily have to talk about their protocols, but I understand their protocols, so they don't have to explain it to me. I understand the science behind it, I understand the science behind PGT from as simple as from going to that extreme to even a negative beta. I get that piece so they don't have to explain it so we can go more to their core and where they're at and their stage of life, to have them grow and prepare them for their next stage, for their next month of treatment, whatever that be.
JONES 8:58
I had someone comment about the show recently that some of the people that I'm bringing on--or some of the topics I should say--to talk about mental health or talk about the patient experience and talk about coaching isn't as heavy, isn't as business heavy, and I just disagree with that. The reason why I'm bringing these people, these experts and talking about these topics on the show is because I think it's part and parcel with the delivery of care and consequently, the business of the field. And one of the biggest challenges that centers face is patient retention and conversion to treatment and losing people that are about to start treatment, but decided they're not going to, that never come in after their second consult, that do a failed IVF cycle, but then don't come back in for their other FETs or they don't come back in for another retrieval. And that's one of the biggest challenges that we're facing. Right now, it's not so difficult to attract new patients, we can do that with a new center within just a couple months. We can get their marketing and their new patients back up. There's a lot more to be said about conversion. To the extent that we can systematize it, we can one, have a lot healthier businesses, ourselves, and more importantly, we can serve the patients in a better way, because we can't help them if we can't treat them and if they're not feeling like they have ownership of the experience, or at the very least, that they can follow it, then we'll lose them and won't be able to get the results. So talk about what you do just to help people through the process that either helps them stay in treatment, or maybe they decide this isn't for me, and I'm done. What does that process look like?
STARK 10:53
Yeah, so I work with several patients that are in clinics all over the area and the bottom line of what I hear is that if they have complaints, or if they have issues with not being paid attention to, just kind of bring it back to themselves, and focus more in on themselves than blaming. And so when people get frustrated, they doctor jump, and they think they're not getting pregnant or someone is not treating them well or somebody, you know, they're not getting the attention they need. And that's why they doctor jump because they think somebody else can do it better. When I work with a lot of these clients, I kind of defocus that focus and look at more of what they're doing for themselves because doctor jumping isn't the answer. And they think that if we can put that next level of business in the clinics or have the clinics use these resources like A.R.T. of Wellness or all these other centers that are businesses that are out there to help the patients defocus from the service they're receiving and more focus on themselves. Because a lot of the clinics serve the science equally, pretty much, and it's really--you know, when someone doesn't get pregnant, it's not necessarily the clinic, it's basically focused on themselves. They're just looking for attention and someone to pay attention to more than their needs in the protocol.
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JONES 14:18
So what are these resources? What do these services entail?
STARK 14:21
So, for example, if someone--when a client calls me at the A.R.T. of Wellness, we basically just kind of talk through a five point system with them. I really make it about themselves so they can find out more about themselves while they're in crisis. Once they identify, and I help them identify that they're in this crisis of fertility, it's a temporary stage of life, that they start to learn how to cope with crisis, whether it be through with their financial crisis, their social crisis, personal crisis, with their thought processes, or their physical state. What is it about themselves that they need to evolve into their best self while they're in crisis? And teaching them those skills and strategies to do that. And when you can get their mindset straight, and not stay in that “I'm never going to get pregnant” mode and get them out of that and think more of living in the fertility instead of living an infertility life, it changes them. It gives them some power and empowerment, to make choices for themselves, to grow into a better self so when they go to the center, they're not so defeated. They're not so angry. And taking a different scope of how they're pursuing their treatment and preparing them better with education, with support and understanding so when they go back to the center with a cycle start or for treatment, they feel empowered. They feel like they're healing themselves and they're not looking for it and searching for it in a place that they may not be getting that.
JONES 16:01
What's the summary of those five points? What are the five bullet points?
STARK 16:06
Yeah. So it's the five points of struggle where they evaluate themselves. It's the mindset, the thoughts, the emotional aspect, the physical aspect, the social, and the financial. So it encompasses not just the time of their fertility stage of life, but it evolves into all stages of life of things that we all have to pay attention to. It specifically, because it’s fertility-focused--it is fertility focused--but it's focused on outside of their protocols that we focus in on and what they feel within themselves they can do better. So they can understand their mindset better, where it’s at, or they can understand what all their financial options are, or what they're doing in isolation on their social part of their life. Or where they're at just in their whole physicalness, whether it be their BMIs, or whether it be PCOS, or whether it be just someone helping them through how to be a healthier eater, or where to fit in fitness, or where to fit all this in while they're going through this stage of life that hopefully will prepare them and start living more of a preconception lifestyle to prepare them for parenthood.
JONES 17:24
Imagine if every clinic had that data about each of their patients from beginning to end that they could reference the benchmark, that they could check in, almost like a Press Ganey, but very specific to the way we deliver treatment and what that might do for their insights. I very often have clinics tell me that cost is the number one barrier to care and that is often the case, but there's also data that shows that it often isn't or just isn't the monopoly on the number one spot like we sometimes think it is. And to the extent that you could measure five different indices and see, okay, if we invest in one of them, and we put patients into pathways that help them where they're struggling most or where they perceive as the highest priority, and then looking at how that improves IVF conversion or conversion to treatment, that would be super useful. So how do you work with clinics?
STARK 18:40
Yeah, so it's hard at this point to put all my energy into it. I wish I could develop a format to study this because I know it's real. I know it changes. I know it is part of the retention. I work with a clinic right now that I've had the honor to work with for many years as an IVF coordinator, and I use all my coaching strategies with all the patients as I also journey with them as an IVF coordinator. And I will tell you the retention--I wish I could do a study on this--is very high. The patients do not leave the center because they feel they’re cared for. Not just from a physician standpoint or a laboratory standpoint of the nurses, but aligning myself in the skills and strategies that I bring in in addition to a protocol, patients just cry for that, thirst for that need for someone to pay attention to that to that piece. Whether it's talking about their weight, where their TSHs are, or what's going on with their job, or what's going on with their social aspect, or what's just going on with their mindset, with their thoughts. I don't know what the answer is on how to do the study for that, but I definitely know just living in it for 30 years that this is something that's a necessity for all people going through the journey of with or without medical treatment.
JONES 20:07
Well, some of the statisticians or systems engineers are listening, you might have a partner and Connie, you should get ahold of her. Because I think this is something that a lot of us in the field are working on. There's just so many pieces of it. You know, it's, there is an--
STARK 20:20
Griff, I hear it all the time. Every time I talk to clients, patients, members, all they say is that they're so glad that they have an opportunity to go past what they're going through, where they can find themselves, and they're actually better prepared and stay connected to the clinic. And they don't--the clinics don't lose these patients anymore. They stay right where they're at, because this member, or this patient, is actually staying connected because they feel they're healing. They have a different outlook. They're changing.
JONES 20:57
I'll ask two different questions. One is, what are a couple things that clinics that are doing a good job of keeping patients connected to them and supported throughout the journey so that they complete it? What are the good things that some people are doing? And what are the things that others might be doing that cause patients to fall off the journey? Or at the very least just don't give them the support that they need to stay with the clinic? What are the good things that you see clinics doing and what are the non-helpful things?
STARK 21:28
Yeah, I think everyone's doing a really good job in the clinics as far as taking care of the scientific needs of the patient. I think their protocols, their attention to detail when it comes to making sure patients have their next step plans to go forward. I think every clinic has different ways of communicating to patients, whether it be voicemails, or automated calls, or follow-ups. I think that clinics do want to take care of these patients. I think they take care of them for each individual protocols. I think all clinics probably do a pretty good job with that. And patients are demanding more and above their protocol, though. And this is where a lot of turnover in clinics because nurses get burned out, techs get burned out, people get burned out. And some clinics have a lot of turnover, so it's really hard to get nurses trained, techs trained, people trained to really pay attention to the high needs of what that patient needs. Whether they're the beginning stage of their journey, or the end stage of resolution, who's there evolving and growing that patient from one month to another month to another month? And that's where the fallout is--where it's really hard when you've got 25 patients to call or more to spend time with that one patient that needs to talk about where she's at and managing her thought process, or her physical place, or her financial place, or her social place of feeling, feeling isolated. Where does she go with that support? And she doesn't want to go to another appointment at times to go for emotional support, to go see a psychologist or psychiatrist--where they're all good things to support them, but it's just another added place. And I don't know, I feel like this combined nurse experience that I have and the coaching strategies, the combination of those, help the patient evolve and retain until they achieve their end goal which hopefully is parenthood, but if not, transition them into their next stage of life.
JONES 23:39
You have so many years of experience as a nurse in the field, of being a coach, of owning your own company. You help direct care coordinators with companies that serve the field. Our audience is mostly practice owners, it’s physicians, and some other executives in managers in the field, how would you want to conclude with our audience of what they should be doing for patient support, how that impacts their business, and what you want to see for the field?
STARK 24:11
I think it's really important that when couples come in or a person comes in for pregnancy, that we look at them more than just an infertility patient. And we change the language from infertility to fertility, and help evolve that practice--that it's not always about the infertility process, but it's about the preconception health and their thoughts, their body, all aspects of their life as they live life. And I think connecting with clinics and working within a clinic, whether it be my business or other businesses, that patient needs the additional support outside their scientific protocol. As working as a team, aligning together as support systems for nurses, support system for techs, and for physicians, that we all work together, not in competition, but in alignment and the better being for the patient. Which is the business! You know, people who bring in the business.
JONES 25:13
And you've done a good job of helping a lot of people in a lot of different areas, both on the clinic side and the patient side. And I hope that our audience looks into A.R.T. of Wellness and Connie Stark. Connie, thank you for coming on Inside Reproductive Health.
STARK 25:30
Thanks, Griff.
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You’ve been listening to the Inside Reproductive Health Podcast with Griffin Jones. If you're ready to take action to make sure that your practice drives beyond the revolutionary changes that are happening in our field and in society, visit fertiltybridge.com to begin the first piece of the Fertility Marketing System, the Goal and Competitive Diagnostic. Thank you for listening to Inside Reproductive Health.