The Fertility Website Rip Off: 6 Tips to Protect Doctors

By Shaina Vojtko and Griffin Jones

Let’s just hope fertility doctors aren’t paying attention

Most fertility practice owners redesigned or built a new website in the last decade, and they might be getting hosed.

The website development-marketing problem isn’t unique to fertility doctors. If you’re the executive of a fertility company or any business for that matter, these tips are equally relevant to you. There’s just an established category of marketing companies that takes advantage of physicians and some of them have concentrations of fertility doctors.

The problem: paying for website maintenance with a big marketing markup

Your new website project is finally complete and search engines are starting to reap the fruits of your labor.

Now, regular updates and maintenance are crucial to keeping your site running at full capacity. In most cases, the first touchpoint a prospective fertility patient has with their provider is their website.

Security is the primary reason that website maintenance is so important. When you don’t make website maintenance a priority, it’s easy for hackers to find vulnerabilities. With a few clicks, they can easily target an outdated site.

As a marketing tool, your website was designed to provide information and turn visitors into new fertility patient inquiries. An up-to-date site and content management system (CMS) demonstrates credibility and communicates that it is safe for visitors to submit their information to you.

And because security and maintenance are such a need, some marketing companies take advantage. They bundle in low return marketing services and mark up what should be a low cost expense.

We’re not talking about small firms with good hearts that struggle with keeping the mission (scope) from drifting, while not being so rigid that they fail to help the client when they could meaningfully do so. That’s a natural tension that all client services firms face.

No, we’re talking about large medical marketing agencies whose business model is undeserving doctors by scaling their overpriced packages, including arbitrary blog and social posts, or ambiguous ongoing Search Engine Optimization (SEO).

Make investments, pay expenses, and know which is which.

Remember a $10,000 expense that generates nothing is more expensive than a $2 million investment that generates $5 million. Return is more important than cost, though the higher cost the bigger the problem if there’s no return.

The best way to keep your fertility company’s website updated and protected from hackers, while not overpaying for it, is to have a website maintenance package that is separate from hosting and from your marketing investment.

Here are six tips to help you:

1. Your marketing agency can hire a developer, but don’t hire a development agency to do your marketing

Digital marketing agencies and website development agencies were usually one in the same in the early days of the internet. Because each has become so specialized, it’s far more effective for them to partner than to try to do it all.

Fertility Bridge, for example, has done, and will do, plenty of website builds and redesigns…but we are not a dev firm.

For the convenience of our clients and for the continuity of branding and messaging, we have preferred developers on our contract team with whom we’ve partnered on many successful fertility websites. We can use them and include the cost of development in a one time project. Or we can use the client’s developer while we provide project management and design.

2. Quote maintenance separate from build

Ask for the cost of ongoing website maintenance, including security and routine updates to be quoted separately from the site build.

You may need continuous improvement in marketing and business development but keep those separate from the maintenance of a new site. Again using Fertility Bridge as an example, after we redesign or build a new website, the minimal maintenance agreement is between the developer and the client, completely untethered from the client’s engagement with us.

3. Budget for both website hosting and website maintenance

While both have associated costs, web hosting and web maintenance are two separate functions. Both are necessary for the health and existence of your website. The main purpose of web hosting is to get your website live on the internet so people can access it.

4. Keep the hosting cost the smallest

When budgeting annually for maintenance fees, don’t forget to budget for hosting costs, too. You can expect to pay anywhere from $25-75 per month for hosting with an annual contract from WP Engine.

In order to keep your website online, you’ll need a reliable web host. While there are plenty of options for hosting providers, make sure to pick one that is designed for speed. A fast loading website is key to a strong user experience and good Google rankings. We recommend WP Engine or DreamHost but strongly encourage you to take the advice of your developer as they are well versed in the specific needs of your website.

5. Use this checklist to select a good maintenance plan

A good maintenance plan covers security but should also take into consideration routine content updates and changes to website pages.

• WordPress Core Updates

• Theme and Plugin Updates

• Security, Uptime Monitoring, and Hack Clean-up

• Regular Back-ups

• Access to Support Resources

• Content Management*

• Performance Optimizations

While package costs can vary significantly based on the level of customization and care needed to handle your individual site, it is reasonable and typical to see costs that range from $500 annually for lean updates to $5,000 or more annually for robust updates.

6. *Have someone on your team that can update content

Minor content updates are a tension point between fertility companies and their agencies. Minor updates are those like

• Adding office hours for satellite office on location page

• Removing staff member from about us page

• Changing PGD to PGT-M on old blog post

• Deleting Zika pregnancy warning from home page

Sporadic requests like these are not a good use of the developer’s time to receive, nor yours to send.

You don’t need an employee to create major pieces of content, a marketing agency can do that. You need someone inside your organization who can make content updates to your website. If you’re a giant fertility company you may have a whole team, but even a small REI practice needs at least one person who can access your website’s CMS.

*Being able to make content updates is not the same as having the relevant skills to properly maintain a website. If your team member causes an error while updating a page, you need to have someone retained that can fix it.

INVEST FOR RETURN, KEEP FEES SEPARATE

Sometimes fertility companies have to invest a lot in marketing, but it should be for the return of future value. Don’t buy services you don’t need because they’re bundled with something you do need. Keep website maintenance separate from build, hosting, and marketing. Train someone in your organization to make minor updates to your website. Follow these six tips instead.

If you think your fertility website is preventing you from reaching your business goals, consider Fertility Bridge’s strategic guidance to determine how it plays into a greater market or brand strategy.

Start your business assessment with our Goal and Competitive Diagnostic for just $597 here.

5 Steps To Improving Your Fertility Clinic’s Online Reputation

By Griffin Jones

Yikes.

It’s no different than what many of us do when choosing a new hair salon or restaurant, they search online. 

Years ago online reviews of doctors were scarce, and even fewer considered trustworthy, but times have changed.  

 According to a survey from MobiHealthNews, 95% of U.S. adults believed online ratings and reviews to be reliable.  Even more interesting, 70% of those surveyed said online ratings influenced their choice of doctor. 

With the increase in prevalence and weight of online reviews, today it’s more important than ever to take action and proactively manage your clinic’s reputation by following the 5 steps to improving your fertility clinic’s online reputation.

1. Provide Concierge Service

2. Claim & Maintain Listings

3. Request Reviews

4. Manage Reviews

5. Market Reviews

Let’s break down each component. 

1). Provide Concierge Level of Service 100% of the time

While putting systems and services in place to improve and maintain an online reputation is necessary, your clinic must first have a concierge level of service written into the fabric of its DNA.  The clinic leadership team must have an unwavering commitment to offering a concierge-level of service at every turn, and mandating its employees to do the same. 

Offering concierge-level service is thinking about the small things and asking yourself, What Can I Do To Remove The Patient’s Pain In This Moment? Examples include, but are not limited to: 

• Using the patient’s name during conversation 

• Having call center / new patient coordinators use the patient’s name immediately 

• Always remaining calm and using a pleasant tone of voice

• Providing patients with support/messages of hope during the two-week wait.

 If this belief and level of customer service is not woven into the fabric of your culture or expressed within you as a physician, it will affect how your staff treats their patients.  

2). Claim & Maintain Listings 

Once offering the concierge level of service has been addressed, the next step is to organize your listings.  Local Listings are a directory with your business's key information. When people search for your business (or the service you provide), your listing is usually displayed in the search results.  The most important listings are:

• Google My Business (GMB)

  • Physicians should be tied to the clinic listing, but owned by the physician 

  • Each clinic location should have a listing, including satellites so reviews can be left

• Facebook

• Yelp

  • Yelp is important because it is also integrated with other listings sites, like Bing and Apple Maps 

• Fertility IQ

  • Fertility IQ has skyrocketed as an influencer platform over the last few years, and the length, depth, and detail of the reviews have it becoming a recognized source of patients’ trust. 

Once Google & Facebook are at a minimum of 4.5 and 60+ reviews, begin to focus on Yelp & FertilityIQ

3). Request Reviews 

Patients will always leave reviews when left up to their own devices, but if you want to achieve and maintain a rating of 4.5 and above, you need to be proactive about asking and automating review requests.  

Asking 

When you’ve treated patients right, they want to help you.  Therefore, ask the right patient for a review and give yourself and your staff permission to do it.  While verbal requests are necessary, asking also includes creating marketing materials that advertise where to leave reviews and post the requests on social media.  Bottom line: Don’t be afraid to ask with the right patient!  In your waiting room, use video to ask satisfied patients to like you on Facebook, rate you on Yelp, or fill out a patient satisfaction survey.  Seek patients who give your practice high marks and ask them if they’d be willing to give you a testimonial. 

Automation 

Using a service that automates repeat requests to reviews and pushes them to the four most important platforms in Reproductive Medicine (Google, Facebook, Yelp, FertilityIQ).  The software element helps ensure the patient is reminded and the review is pushed to the platform where you need it most.

4). Manage Reviews 

It’s critical to respond to 100% of reviews - both positive and negative.  While it’s also helpful to have a foundation of scripts to utilize so that responding on every platform is not tedious, slight customization is necessary to ensure the consumer’s needs are being addressed.  Something as simple as “Thank you for your feedback. We’re committed to a better patient experience and are in the process of reevaluating all staff communication” will show the patient you take their feedback seriously.  And to the prospective patient who hasn’t yet chosen your practice, it lessens the harshness of the review.

5). Market Reviews 

You’re collecting the reviews, now it’s critical to share the positive patient feedback with other prospective patients still in the decision-making phases.  Our internal data shows that at least 50% of patients will conduct an online search of the clinic, often landing on your website, to evaluate a practice.  Highlight positive reviews and testimonials right on your home page so they aren’t missed. And if your center does not have amazing, professional patient testimonials that blow folks away, it’s time to get that changed right now by consulting with the creative team at Fertility Bridge.  

By taking charge of your online reputation, you will impact the number of new patient appointments, retrievals and ultimately, revenue.  

If you’d like Fertility Bridge’s help in improving your online reputation, we can assess your situation in the Goal and Competitive Diagnostic.

Brand vs Reputation: 4 Competitive Disadvantages for Fertility Business Owners

By Griffin Jones

“Our reputation speaks for itself,”

Does it?

Young, massively funded companies are entering the reproductive health space and developing widely recognizable brands to a population that had been generally unfamiliar with the field.

Established fertility companies often attempt to counter these branding advantages with their reputation. 

Reputation is extremely valuable for all of us business owners in the reproductive health space, but especially for fertility specialists. Even when process complaints and negative outcomes make an REI’s rating less than five stars, you still have a proud reputation. You’ve dedicated your career--one which very few other people can do--to help people have families. Your reputation deserves respect.

Still, reproductive health companies that make little distinction between brand and reputation are at a competitive disadvantage.

Brand and reputation overlap. They can work with or against each other. But they are not the same.

In the absence of the intentional formula ‘reputation plus brand’, a fertility business suffers from the default equations of ‘reputation minus brand’ or ‘brand minus reputation’.

“Brand is about relevance and differentiation. Reputation is about legitimacy” 

“A strong brand helps communicate that the company and its offerings are relevant and uniquely able to meet customer needs. A solid reputation is desirable because all businesses ultimately depend (either directly or indirectly) on the goodwill of the governments and communities in which they operate”. From 'Don’t Confuse Reputation With Brand' by Richard Ettenson and Jonathan Knowles

In the case of your fertility practice or reproductive health company, your reputation amounts to what is said about you by these five groups

1. Patients/clients

2. Peers

3. Employees

4. People you do business with

5. Media
   

Patients

On social media, on online review sites like Google and FertilityIQ, in patient support groups like RESOLVE and Fertility Matters. Through patient satisfaction feedback platforms like Press Gainey or Net Promoter Score.

Peers

If you are a physician this includes colleagues in the field, but also includes aspiring providers, referring providers, and competitors. At ASRM and other conferences. In private conversation

Employees: 

On LinkedIn and sites like Glassdoor. At networking events and your own office.

People you do business with: Your vendors, expert advisors. How you treat them and pay them gets around, too.

Media: 

The coverage that you do or don’t have from reporting outlets.

Reputation isn’t always fair. It is what it is. It doesn’t matter if one negative story in the press is a stain on your search results. It doesn’t matter if competitors drag your name through the mud, if a few former employees have an ax to grind, or if some former IVF patients take a negative outcome out on you. A sterling reputation is hard to come by.

A strong reputation is not necessarily equatable to a strong brand, either. And vise versa.

BRAND IS WHAT YOU SHOW OF YOURSELF

While reputation is what your five constituencies perceive and say about you, brand is what you give them to recognize you and associate with you (or not). Reputation is sometimes reactive. Brand is meant to be proactive.

Brand does at least four things that reputation does not do. It 

1. Multiplies 

2. Differentiates

3. Expresses, and

4. Promises
   

1. Multiplies
   The simplest definition of brand is simply, a mark. No; logos, slogans, taglines, and ambassadors are not in and of themselves, a brand. Nowhere close. Still, these symbols allow companies to scale their message and perception to a magnitude and readiness that reputation cannot.
   “Brand functions as a multiplier” -Mark Di Somma, Brand Strategy Insider.
   

2. Differentiates
   The purest form of differentiation is recognition. A successful brand allows each of the aforementioned groups  to recognize an organization’s position and differentiate it from its competitors instantly. An artisan coffee shop may have a wonderful reputation, but you recall Starbucks’ mocha lattes, the way they name the sizes of their drinks, and how they write your name on the cup just by seeing their logo.
   

3. Expresses
   We’ve chosen to split the concept of brand identification into the two concepts of differentiation and expression because differentiation allows consumers to identify you out of a crowd, while expression allows them to use you as part of how they identify themselves.
   
   There is an abundance of research, including this study from Elsevier, that shows how “consumers seek new ways in which they can express their personal identity through brands”. The more our field serves and works with newer generations, the more they use brands to express themselves. 
   
   “The core of Gen Z is the idea of manifesting individual identity. Consumption therefore becomes a means of self-expression.” - (From McKinsey & Company,  ‘True Gen’: Generation Z and its implications for companies’  byTracy Francis and Fernanda Hoefel
   

4. Promises
   Reputation is the judgment of your promise. Brand is the promise. Patients and clients set their own expectations in the absence, and sometimes in spite, of a clear promise. The more strongly your brand reinforces your promise, the more you are able to impact the measure by which you are judged.

REPUTATION PLUS BRAND

When fertility companies fail to distinguish the difference between brand and reputation, they are at a competitive disadvantage because of how reputation and brand bolster or undermine one another. 

Reputation and brand overlap because they are both born of positioning and culture, but they are not equally synonymous.

In the absence of the intentional formula ‘reputation plus brand’, fertility business owners are left with the results of ‘reputation minus brand’ or ‘brand minus reputation’.

Consider the four advantages that a robust brand is meant to secure for your company. The last two, expression and promise, are particular vulnerabilities for reproductive health companies.

If you would like to further explore the brand and reputation potential of your fertility business, we address that in our Goal and Competitive Diagnostic.

The Diminishing Returns of Fertility Business-to-Business Marketing

It’s just B2B fertility sales. How many challenges could there possibly be?

Oh, not many, just...

1. Fewer qualified prospects 

2. Limited time and access

3. More gatekeepers

4. Long sales cycle

5. Short sales window

6. Detached point of sale and

7. High regulation

Other than that, I can’t think of a single reason why it would be harder than ever for companies to sell to fertility centers. In other articles, I'll address why lack of change has relegated many B2B fertility companies to commodity status. Here, I will attempt to define the principal challenges that fertility companies face in marketing and selling to fertility centers. I will also try to explain why these very challenges inhibit fertility organizations from investing in alternative approaches to solve them.

1. Fewer prospects

Stat News reports more than twice as many private equity affiliations were made among REI and OB-GYN groups from 2017 through 2019 than were made in the previous seven years. For some companies, this means huge customer growth. For others, in certain cases, it means half as many potential customers when networks negotiate exclusive deals with other vendors. 

2. Limited time and access

When the groups are larger, the dynamic usually changes to an enterprise sale where there are more decision-makers (though many small fertility practices have the characteristics of an enterprise sale). Even when there is still one principal decision-maker, she or he frequently needs the blessing or inclusion of many others. When committee decision-making takes over, it only takes one skeptic to derail the verdict. Most of them are gatekeepers.

Among independent fertility practices, who are often the most viable prospects, the senior partners’ responsibilities as physicians almost always take priority over their responsibilities as business owners. I agree with Dr. Paco Arredondo that physicians have the intelligence and training that can set them up to be entrepreneurs, but I agree by Dr. Andrew Meikle’s definition, that most of them are not. I won’t go into why--I wrote a four part series about why most fertility practices are not entrepreneurial ventures--but this business owner-physician tension greatly reduces the time that they have to make business decisions. When they have so little time to focus on the core responsibilities of a business, they often delegate the duties without the autonomy. Also, gatekeepers...

3. More gatekeepers

Fertility sales reps often view gatekeepers as administrative assistants or receptionists. Here is a more encompassing definition of gatekeeper that will better direct your attention to the access you need. A gatekeeper is anyone who cannot say “yes”; they can only say “no”. 

4. Long sales cycle

It can take months and sometimes years from first meeting to when the client is actually ready to purchase. They have construction delays, breakups with partners, and sometimes they wait for the pain to hurt worse. It usually takes a long time to get in the door, wrangle stakeholders for follow-up meetings, get the yes, the signature, and finally get the payment. 

5, Short sales window

It’s “hurry up and wait”... until it’s “hurry up again”. A practice is opening up now. They won’t need another office for years. They may never need another lab. They only buy this type of equipment every several years or even a couple of decades. They just got out of a network affiliation and hopefully, they’ll never have to do that again. The short sales window is the yin to the long sales cycle’s yang.

6. Detached point of sale

You don’t buy an IVF lab at the click of a button. There isn’t a single digital point of sale for many business dealings in the fertility field. Because of the long-term relationship dynamics of the enterprise sale, single-source attribution of marketing efforts is sometimes impossible.

7. High regulation

For some segments of the “fertility industry” the disclaimers have to be longer than the content. There are some limits to interactions, joint ventures, and messaging with and to physicians and practice owners.This difficulty may be obvious but the challenge compounds because it prevents many companies from making the necessary move to being a media company.

CAUSE OR EFFECT?

These seven challenges have certainly made your job more difficult. Still, it’s the (not so) strategic response to these challenges that compound the sales pain many fertility companies are feeling. The solution involves brave decisions in positioning and the activation of the position by putting forth oneself as a media company. I’m not talking about putting out a couple of webinars. Be sure to subscribe to Inside Reproductive Health and Fertility Bridge to be alerted about the coming content that describes the solution in more detail. 

Read about how we help B2B fertility companies differentiate themselves and increase sales here.

The 6 Pillars of the Fertility Referring Provider System

By Griffin Jones and Stephanie Linder

Give referring providers some credit.

Not all of it..but some.

Contemporary thinking about the impact of physician referrals on the REI practice tends to be polar. On one end, MD/DO referrals are responsible for the lion’s share of new patients. On the other, MD Referrals are dead and everyone finds their practice on the internet. Bent to their extremes, each pole is factually incorrect.

These are the facts as produced by a 2020 Fertility Bridge survey of over 250 REI patients from across the United States

• 60% of REI patients are referred by a physician 

  • That’s a lot, but it’s far from 100%

• 21% of REI patients say their MD referral was the most influential factor in choosing their REI

  • That’s the #1 slot, but 21% is far from a majority, and it’s almost neck and neck with location (20%) and recommendation from a friend or relative (19%)

While it is remiss to favor a referring provider strategy to the exclusion of all others, it’s equally irresponsible to forgo a system for reliably growing and nurturing referrals and relationships. In order to sustain and grow referrals, your Referring Provider Strategy is built from six pillars. 

1. Reporting 

2. Ancillary Services

3. Content 

4. Events 

5. Outreach

6. Referral Follow-Through 

By systemizing these six pillars, IVF centers are able to grow and sustain referrals without always adding the overhead of an additional physician liaison. 

1. Reporting

Reporting is the first pillar of the referring provider system because time and money are wasted whenever it isn’t correctly established. Three key performance indicators measure your referring provider efforts.

1. New Patient Volume

2. Number of Referrals

   1. Total referrals-EMR

   2. % of attribution-patient reporting

If your practice or your goals for growth aren’t large enough to do much outreach, then you only need to measure these two KPIs. Before you put substantial effort and resources into outreach, however, you must report on activity and results across these six categories.

It’s important to consider both practice groups and individual providers for two reasons. 

1. Your top referring physicians may not be accounted for in your top referring practices

2. If you have served a provider’s patients very well, the earned trust can readily leverage a relationship with their partner

If 60% of patients are referred to your practice by a physician, that means 40% are not.  But 100% of pregnant patients are sent back to a physician for OB care.  Therefore, a powerful way to focus your target list is to look at the OBGYNs to whom you’ve returned pregnant patients but have not referred to you.   

Roughly 25% of physicians that provide OB care for fertility patients are never recorded as a “referral” in most IVF centers’ systems.  However, if they’ve heard good things from your graduated patients, and seen the results of your care, they have reason to engage you.  

Activity is recorded in a CRM. Results are recorded in the EMR. 

2. Ancillary Services

30% of patients that see your practice for a referral Semen Analysis  or Hysterosalpingography, will return within one year for a fertility consult.  SAs and HSGs are not just useful tests; they’re powerful lead generation tools.  Offering them creates a very low barrier for outside providers to refer. 

1. Accept outside SA or HSG referrals

2. Promote services separately (content) 

3. Return results for SA and HSG to providers within 72 hours of the service performed 

4. Educate referring providers on how to interpret results (events, content)

3. Content 

Once you’ve identified your targets and solidified your ancillary services, you need captivating content to reach and promote them.  As before creating any content, it’s important to establish brand guidelines. Beyond the look and sound of your brand, referring provider content must include three differentiators

1. Performance (Success Rates, Technology, Lab, Embryology)

2. Patient Care (Staff, Physicians, Communication) 

3. Access To Care (Finance, Ease of Appointments, Insurance)

These differentiators appear across five key pieces of content: 

1. Referral pads

2. Referring provider page 

3. Differentiator checklist 

4. PreConception panel

5. How to Interpret Semen Analysis guide 

Checking these items off of a to-do list does nothing to ensure their effectiveness. Messaging and design is paramount for helping the message to be received and this is where good creative comes into play.

4. Events

Thorough and poignant content makes for cogent event agendas. The return on traditional outreach had diminished for years prior to COVID-19. The pandemic only accelerated the need to rethink the same fruitless methods of calling on doctors and clinics. 

Four events increase provider referrals and positively impact relationships. Each of them can and should be done both virtually, and in person. Feel free to turn them into lunches and dinners when appropriate, but the content must be good enough that you don’t have to.

1. Provider to Provider Meetings

2. Provider to Group Visits

3. Open Houses

4. Single-Topic Educational Events

5. Outreach

Even among groups with excellent physician liaisons, no one can supplant the REI’s ability to build physician relationships. Your reputation as a trusted educator is crucial to building a referral network.  REIs must be accessible, present, and communicative.  

Four forms of outreach in which the fertility specialist has an irreplaceable advantage are

1. Residency rotation

2. Medical school and residency relationships

3. Membership in local medical and specialty societies

4. Grand Rounds / Journal Clubs 

 Once a trusting relationship is cultivated,  leveraging other staff becomes far more effective. When REIs are unable to participate, outreach to referring providers should be delegated in this order:

1. Advanced providers

2. Nurses

3. Physician Liaisons and Marketing personnel

4. Front staff 

The Physician Liaison supports these efforts strategically: 

1. Total office calls

2. Updating target accounts, including wellness providers

3. Semi-monthly touchpoints

4. Content and event coordination

5. Referral follow-through coordination

6. Referral Follow Through 

Good News: You’ve gotten people to refer to you

Bad News: Now you have to keep them happy

Once a referral has been made, maintaining and growing the relationship requires follow-through in these forms: 

1. Thank you note for initial referral 

2. Semi-monthly touchpoint 

3. Post-consult referral note immediately following the patient’s consult 

4. Graduation update. If the patient is successful in achieving pregnancy, provide medical records, note and inform OBGYN that the patient will be returning to their practice 

WORK THE SYSTEM, GROW THE RELATIONSHIP

Though MD/DO referrals are not the overwhelming source of REI patients that they once were, they still do account for the most common influential factor in choosing a fertility specialist. Growing physician referrals isn’t about hiring a “door knocker” to distribute pamphlets and drop off bagels. A Physician Liaison may be an incredible investment or a complete waste of money for you.  First, invest in your system, considering the six pillars of reporting, ancillary services, content, events, outreach, and follow-through.