MSD Insider 0:00
Welcome to med shark insider with Bill Fukui, your expert host on all things medical, marketing, and SEO.

Bill Fukui 0:08
Hello, everybody, and welcome to another episode of med shark Insider. Today, um, we’re going to be talking about a topic that I think is somewhat, not really talked about, but I think everybody needs to deal with and, you know, in the back of their mind, they’re thinking about it, but nobody really talks about it, you know, and that’s price and price transparency. And today’s guest is really one of the leaders in the medical arena that has really kind of cut the water for a lot of practices to really just, you know, call the elephant in the room. And let’s, let’s, let’s address the things that consumers have the best, you know, the most interest in and that that’s cost, and how do we help our staff and help our practices become better equipped to deal not only just deal with, but how to leverage pricing and stuff like that. I think that’s what we’d like to accomplish in our conversation today. So I’ve got Jonathan Kaplan, who is actually a practicing surgeon. And he’s also the owner of built my BOD, which is a software platform that he introduced me to, I don’t know, wasn’t a couple of years ago, Jonathan, that used to, we’re getting older. Yeah. Oh, my goodness. I guess I’m getting older. Well, welcome. Jonathan, can you do me a favor and just give the audience a little bit of background? For those that don’t know you? I think a lot of people do, especially in the cosmetic and plastic surgery arena, but give a little background for our audience.

Jonathan Kaplan 1:39
Sure. Again, I’m Jonathan Kaplan, thanks for the introduction. And it’s funny you mention about price transparency, how it’s always in the back of everybody’s mind. One of the first episodes of the med shark inside of that I saw you on it was you’re talking to the founder of optical, and even though optical does a lot of other things. Y’all spent a lot of time talking about pricing and people calling out of skinny about cost and things like that y’all had talked about different solutions, and I’ll bring up our solution with Bill my BOD health. But my background, I’m a board certified plastic surgeon. I’m the youngest of seven kids, originally from Alexandria, Louisiana. My wife and I, we met in Baton Rouge, Louisiana after I finished my plastic surgery training at Cleveland Clinic, I moved back to Louisiana, in 2007, after Hurricane Katrina hit, hit New Orleans, and kind of shifted a lot of the population to Baton Rouge. And so a job opportunity came available in Baton Rouge in 2007. Only because of the biggest US natural disaster ever to hit. And so an opportunity came up I went to work at Our Lady of the Lake hospital as an employed plastic surgeon and they treated me really well I was the first plastic surgeon they ever hired. So I was able to run the practice as though it was my own even though it was honestly on their dime. And, and after about six years, as I started to get into more cosmetic procedures, I really wanted to have my own operating room that was really the driving force while ultimately left. I mean, I had access to the surgery center, but you know, surgery center patients or cosmetic patients in a surgery center, you’re next to people getting colonoscopy next to kids getting tubes in their ears and screaming and crying. So it’s not the best environment for cosmetic patients. So I really wanted my own operating room. And so we looked around and we actually found a job listings, job listing on the American Society of Plastic Surgeons website, about a practice in San Francisco. The doctor was retiring and he had his own accredited operating room in his practice. And he wanted to have somebody come and take it over. So we moved to St. Well, first we came to check it out in 2013 and February of 2013. And we got here we checked it out. It was legitimate. It was a real operating room. It was accredited. It was in Pacific Heights. Looking out on to the South Tower of the Golden Gate Bridge. And pretty Yeah, it’s pretty incredible. We couldn’t really believe it was like, you know, this seems too good to be true. But the part that we didn’t understand is that everything was like six times as expensive. And when I say six times we did the math. It’s truly six times is it really? Oh my god, the amount we were paying for mortgage went up by six. Oh my God by six. Yeah. Wow. Saying that either means we got a really nice place here. We had a really terrible place back in Baton Rouge. So you can figure that out. But

Bill Fukui 4:26
oh, maybe a combination of both. Maybe a little bit of both.

Jonathan Kaplan 4:30
So we so we came and checked it out. It was legit. I had my attorneys check it out, count and check it out. They said yeah, this is legitimate, his tax records look appropriate and everything. So we moved out here in the end of May, beginning of June 2013 took over the practice. He stuck around for about four and a half months and then retired which was the plan. So it’s been mine for the last almost eight years now. It’s pretty great. Great. And we love it here. We’re here for good I’ll be actually on another webinar webcast talking about the experience of buying a practice. I don’t want to get too much into that here. But the kind of just the financial aspects of it are how we valued it. And but we took it over bought it with an SBA loan, which back then an SBA loan, like people think SBA loans are great now, because that’s how you get the PPP loan. And they think it’s just oh, you get your money in two weeks, regularly. The SBA doesn’t send you your money for about five months. Yeah, I was gonna say, it was it was like ridiculous. And I went through, you don’t go through the SBA. I mean, ultimately, the money comes from the SBA, or it’s guaranteed by the SBA, but the money, you get it from a bank, and I went through Chase Bank, and so you would think there’d be some institutional knowledge there. But it was awful. They it was like the person I was dealing with. It was the first time they had ever done an SBA loan. It was yeah, it was, it was really kind of a painful process. But I’ve rethought my opinion of the SBA, because the PPP was so efficient, and they did a great job with that. Anyway, so we took over the practice, and now I’m here for almost the last eight years. Well, that’s the quick background on me

Bill Fukui 6:05
now, and that’s great. You know, and and with that kind of background as a practitioner, not as a business consultant, even though you now you’re, you’re talking about business related operational getting loans and stuff like that. And we kind of talked early in our conversation today. I said, Do you have an entrepreneurial spirit that I respect, I have a tremendous respect for you. And the way that you think, what made you start thinking about, you know, price, transparency and stuff as that related to your practice, because I know it’s stuff that practices deal with every day. But you were one that kind of, I guess, embraced it, I guess,

Jonathan Kaplan 6:49
we were, you know, we’re in the trenches, just like any other doctor. And while I was at Our Lady of the Lake Hospital in Baton Rouge, during those first few years, I was in practice there. Again, I was there for six years from 22,007 to 2013, and then moved here. But in those first couple years in Baton Rouge, we had patients just like any other practice, not even just cosmetic, any practice, people ask me how much something cost. And so we had people call and ask how much it cost. And I knew that there was like, at that moment, there was two ways of handling it, there was the one option of just going through all the pricing, explaining it all to the patient. And that will take a while and then the patient say thanks and hang up. And I was like, that was annoying. The other option was to say, Oh, well, you’ve got to come in for a consultation. So we can really know what what’s appropriate for you. And then that would just aggravate the patient, because they’re like, they don’t want to come in for a consultation for 45 minutes. And quite frankly, I don’t know why the doctor wants to do that. Because a lot of times the consultation is free. So you’re going to spend 45 minutes of time forcing the patient to bear their deepest insecurities, only to find out that they can’t afford it at the end because they have sticker shock. So I was like, Okay, those two options are just like terrible. We have to come up with another i Another a better way. And I was like, maybe there’s something online where a patient can check pricing. And the only thing I really found was, you know, there were different trade organizations like ASAPs and ISPs that had pricing. But it was only the surgeons fee. It wasn’t the ancillary fees like Oh, our anesthesia implants, I’m like, well, that’s like not really helpful. Because I mean, that’s like 50% of the cost, you’re not telling them about right and even more aggravating the patient sees the price on those websites, they come in, and like I thought a breast

Bill Fukui 8:26
exam is cost

Jonathan Kaplan 8:30
3000 And Florida, but But here, you have to get anesthesia. And the implants, but it’s so so we so that I just realized that that wasn’t adequate. And I was thinking about as like, you know, but the thing that’s frustrating is that when the patient does come in, it’s not like we’re making up the numbers that the patient care coordinator or the office manager, they have a fee schedule. I mean, you’ve got the numbers, so why not digitize it and make it available to the consumer. But then also thinking about it from, you know, from the consumers perspective, that’s great, you give them the pricing information, but from the doctor’s perspective, I realize you gotta have something in it for the doctor, you have to have you want some buy in from the doctor. So how do you make that beneficial for the doctor will require the consumer to put in their contact information first, to get the pricing, but you got to give them the pricing, don’t ask for the contact information and say, Oh, our office staff will follow up with you to provide that is not that’s not what I’m talking about that they they’re gonna feel manipulated when you do salutely. Absolutely. So I knew that. If we if you give us the pricing information, I promise you, as long as you gave us a real email address, you will get a true estimate based on our fee schedule in your inbox. And that was how I built my bot health was born. That we allow that started out as an iPhone app still is an iPhone app. But we’ve added additional platform avenues for people to check pricing either through a price estimator on embedded into their website. Also a chat bot now embedded into their website, the consumer can check pricing. And so now the consumer can check pricing, but only after they prove or contact information, and then they get an email directly delivered to them instantly automatically sent to their inbox. With a breakdown of pricing that basically, it’s all the pricing that the doctor has uploaded to our database, right so that we can immediately send that pricing out to the consumer. And then they get that instant gratification. And then the doctrine return gets the same email with all the patient’s contact information that they’ve provided. One of the interesting things about it is that I thought of this while I was employed by Our Lady of the Lake, this hospital, and I knew that it was it belonged to them, the idea belong to them. And so this is like 2009, when I had the idea. And so I I’ll never forget this meeting I had with the marketing department of Our Lady of the Lake saying, Hey, I’ve got this price transparency idea of how we can generate leads. And if you think about how we’re going to talk about this more later, but if you think about how the federal government has just now and 2021 forced hospitals to provide pricing on their website, you can imagine in 2009, how they were absolutely completely on are interested in the idea of price, transparency, 00 interest. And I’m not talking badly about Our Lady of the Lake as far as just the industry. It was the industry, but I was trying to explain to them, you know, I’m not trying to get you to show pricing for your X rays or for your gallbladder surgery. I’m just saying, I’m a plastic surgeon providing cash pay cosmetic procedures, how about just in my own little world allow this to happen? And, and I was asking if they wanted to pay to move forward and build this out, and they weren’t interested. And I was like, Well, you’re not being interested isn’t good enough, I needed on paper, I need you to release the rights to me. And in my subsequent contract, they added an addendum where they gave me complete intellectual property rights, the idea. And so I still have that piece of paper, signed by the CEO. And I appreciate them for releasing that to me. And so we’ve taken it on and built it out from there.

Bill Fukui 12:02
So what did you when you’re talking about price transparency, and doing that online, digitally? You know, on the website, etc. How does that How have you found that that is helped both in terms of lead gen, as well as you know, case, acceptance, your consultations schedule? I mean, because pricing is something that the consumer has that’s in the back of their mind through it, the entire buying process is not just because they picked up the phone and called that it’s still not a question when they come into the office, when they’re, you know, what, when they’re signing up, they’re in the consult room with the PCC signing papers? Absolutely. It’s on their mind the entire process. So how has doing more of the price transparency, upfront pricing and stuff like that, making that more accessible to consumers? Has that changed? You know, what a practice experiences in terms of patient experience as well as revenue?

Jonathan Kaplan 13:09
Yeah, I mean, it’s basically the centerpiece of my entire marketing model, everything that I do is based on initially providing pricing information to the patient. And I know that everybody’s down on pricing. And it’s just really strange, because how is healthcare the only industry where you don’t like, it’s funny, because you don’t expect to know the pricing ahead of time and health care. It’s not only that the health care industry doesn’t want to provide you pricing ahead of time. But the consumer kind of is like throwing up their hands like, Oh, of course, I don’t get the pricing. Like they’ve accepted that as a reasonable thing. Like, you know, we all want to know how much the car cost before you go to the dealer, or how much the house is before you go to the open house. So somehow healthcare has gotten a pass on this. And we can talk about the historical aspects. And I understand why it evolved that way. But people don’t necessarily think of that. And they just like, kind of assume that, yeah, of course, I’m gonna get pricing. And so the thing I have to explain to doctors is that, that you need to embrace it, because it is good for the consumer. And in the way we’re doing it. It’s good for the practice. But also realize that doctors were so down on this, the healthcare industry in general was so down on this, that I knew I had to have good data, to prove it to them. I was like, you have to undersell. The other thing I have to kind of also the caveat always have to throw out there is that this is not a race to the bottom, people will say, Oh, well, if you show pricing, that means you’re it’s you’re gonna have to be the cheapest now it’s like, no, that’s not what it means you can be the most expensive. In fact, patients probably think you’re better because you’re the most expensive. So that’s always been a strange thing to me is that because you talk about pricing, that automatically means that you have to get competitive, you have to lower your price. And now maybe that might be true for a lab test or an x ray, which is a commodity and it doesn’t matter where you go to get that lab test. It’s the same CBC. And so yes, that may drive down price, but that makes sense to me is like okay, if you’re not providing any kind of special service, you shouldn’t be able to be as expensive as you want to be. But if you’re doing a facelift or a breast dog, or you’re you have better results with your bariatric surgery, you’re quicker and do a better job and have fewer complications with your gallbladder removal than you shouldn’t be able to negotiate a higher price with the insurance company, although that’s not always feasible. But anyway, the point is, it doesn’t have to be a race to the bottom, it doesn’t have to be cheaper, but to convey this to doctors and get them to sign on since they were so against price transparency, we knew we had to provide some data. So that was what was so great about coming to a new place like San Francisco, it was fresh, and I was able to implement it into this practice. And so I was able to generate data over the course of the first year. And I got it published in a scholarly plastic surgery journal, annals of plastic surgery, we can include it in the show notes people can link to and it’s open source, and you don’t have to have a subscription to the journal. But we’re able to find just some top level numbers. Based over the course of a year all the leads that came in, that we generated through the price estimator on our website, we got all these leads, we follow up with them immediately. And of all the patients that came in for a consultation, we found that the patients that new pricing ahead of time, compared to the patients that didn’t know pricing at a time that they were 41% more likely to book a procedure at the time of the consultation, right and patients that didn’t know price. So that should be music to a doctor’s ears that like so you mean I’ll actually have a higher likelihood of moving these people from the exam room to the operating room. It won’t just be a wasted consultation that won’t end and sticker shock. And that’s what pricing allows. It’s got to be accurate pricing can’t bait and switch them. Right. That’s like the most critical thing to me. So that’s kind of one data point that we found in that study.

Bill Fukui 16:45
Well, I think, you know, you touched on a couple of things why, you know, this race to the bottom, why that doesn’t always apply to surgery. Because I think the one thing that that even plastic surgeries, practices that are really good on the marketing side and everything else, I think, and only because I’ve been in the medical marketing industry for so long, 25 plus years. What I what I see with patients, even today, that hasn’t changed. There is a fear factor, very subliminal Fear Factor, when it comes to having any kind of surgery. There is a you know, we used to say the same thing with when we used to do a lot of LASIK advertising and LASIK outcomes are very predictable. satisfaction level for LASIK is through the roof. Because it really is technology driven. It’s not surgeon driven. It’s technology driven. But yet the fear factor for you know, patients, when they’re interviewed when they’re getting ready to have the surgery done. Or they you ask them, Are you a little scared, scared to death, you know, and that’s when they’re honest. That’s when they’re honest. And that’s where that’s why they spend the little bit extra to go to places that they trust. Because don’t undersell that human element of fear when it comes to surgery, you know, there.

Jonathan Kaplan 18:14
And it’s I think it encourages patient loyalty to some extent, because like they know that you just came out with the pricing. I can’t tell you how many times we’ve had patients ask us pricing when they call to schedule a consultation. And they may not Schedule A consults too expensive. But they but they are kind of say over the phone, like oh, well, you’re actually going to give me the price. And like they asked for the price and kind of completely expecting us not to give them the pricing and say Oh, you gotta come in for a console. And they’re shocked. And that’s okay, if we’re too expensive, and they don’t book a console. Well, I don’t know why would have wanted to schedule a consultation with that person. Because so it’s that is the I mean, I’m not saying that price is the only pain point but it is the ultimate pain point, they can get time off of work. If they need to, they can schedule it another time, they can have somebody come and help out babysit the kids, whatever, they can figure those things out. But if they can’t get the financing, if they don’t have the funds, they’re not getting the procedure and they’ll have to go someplace else that maybe is less expensive. Now if you’re like worried they’re gonna go someplace else, because it’s less expensive, and then you lower your price. Well, that’s not price transparency, that’s just you making that decision. That’s that’s not our fault to providing pricing. And so it’s it’s really definitely encouraged loyalty with our patients. They’re so thankful when they come in for the consultation, like thanks so much for providing pricing. It’s just it’s just easier. It’s nicer. And I always hear other marketing people talk about oh, well, you know, don’t jump right into price, you know, explain to them the value proposition first and like, I get all that and I’m not saying there’s anything wrong with you explaining that the doctor is board certified, but but the patient knows you’re beating around the bush and it’s annoying. I mean, think about if you ask the price of anything, and somebody starts telling you all this what seems kind of extraneous at the time, like the value proposition and all and you’re like, I understand, I understand this is a legit I’m a doctor, I’ve seen him operate on Snapchat, and he’s seen them operate on Instagram, you don’t have to convince me that they’re like a real person and that they have good value, I just need to know the price need to know the price, I need to know the price, whether I’m going to schedule this content, whether I’m going to take time off of work, to come in, to do a consultation, or to do a virtual console now. And so I just, I understand that this is kind of an older school thought process of people talking about, you know, not throwing up the price. But this is an Amazon world, I mean, you’re, you’re going in the wrong direction now. Yeah, I have. And I know I have a vested interest in them, because I believe in this. But I want everybody listening to know that if you don’t believe in price, transparency, you’re not willing to offer pricing, you’re going to you’re going the wrong way, that’s it’s that That horse is out of the barn, all you can do now is mitigate what you think is the problem with it, or manage it, and do it in a way that’s on your terms, so that you’re generating a lead out of it when people come to your website, rather than people calling in you giving pricing over the phone, and then they hanging up. So you got to have to do pricing, eventually, we’re going to talk about this later about the federal government intrusion on now,

Bill Fukui 21:07
actually, we will definitely get into that because I have a saying, Yeah, you know, what I just to end that part of the conversation, I am seeing more and more websites, because I get I do assessments. You know, my my job is, you know, on marketing, digitally making recommendations to clients, I am seeing when I look at competitors of clients, or even, you know, prospective clients, I’m seeing more and more of what you’re just saying, the, you know, the horses out of the barn man there, it’s out there, and, and they’re promoting is a lot more frequently than they did even two or three years ago.

Jonathan Kaplan 21:49
I agree. One of the things they’re doing, though, that I’ve seen is that they’re saying, like, then honestly, if they don’t have our price estimator on their website, which is a little more streamlined and a little more automated, they’ll have like a thing, if you want to know price, enter your information in here. And it’s like a website submission form. And the reason I always think that that’s so lame is that when they do that, the person enters that information. And that means the office staff has to manually respond to those pricing requests. And if you really are encouraging people to check pricing, you’re gonna get a lot of manual, or excuse me, a lot of submissions, people requesting pricing. And sure, that’s great lead generation, but you’re also gonna have to manually respond to all those people. And especially if you’re not really responding them with like true pricing information, you’re like giving them a range of 5000 to 15,000. And that’s the problem with those manual processes is that it breeds laziness. And you’re like, trying to just you just send out an automated response. That’s not really accurate. That’s the thing that’s nice about ours is we don’t give them an average or a range. It’s like, this is the price. And you’re and so people will say, Well, what if they know maybe they’re not a candidate for many tummy tuck? Maybe they need a full tummy tuck, right? Well, we do. That’s what I always encourage people is like, well stratify your procedures, have a mini tummy tuck price on there and have a full tummy tuck price, have an extended Tummy Tuck price on there. And so when a person submits a wish list, saying that they’re interested in mini tummy tuck in your, through our platform, and we get their contact information, our office staff follows up and says, Oh, we saw your inch and a mini tummy tuck, like how much do you weigh? I mean, maybe they don’t jump right into it. But they asked politely. And when you find out that they’re 200 pounds, you’re like, Oh, this is a teaching opportunity for me to say, that’s not going to be the right price. Let me send you the correct price that will be more appropriate for that. And so you still have the opportunity to educate them before they get into the consultation. So that’s another pushback is like what if they choose the wrong procedure? Well, you get their consults, you get their contact information. So even if they choose the wrong procedure, right, you still have an opportunity to educate them ahead of time.

Bill Fukui 23:46
No, and I think you see that even you know, even with like breast dog, they they’re asking for breast dog, but really after you know two kids and you know the age that they need to live, there’s no way that just implants alone. They’re going to be happy with what they’re going to, you know, with the outcome, but you know that that’s a learning opportunity.

Jonathan Kaplan 24:07
I think less so many different breast procedures like breast dog with silicone breast or saline breast dog and lift was first talking to lift with sailing breast dog with ideal implant, breast dog with shaped implant. I mean, I understand it’s a lot of choices, they may not choose the right one, but again, after you get their contact information, then you can get

Bill Fukui 24:24
even more education. I think you can clarify that for them. I think you got a quick

Jonathan Kaplan 24:28
thing before in case you don’t ask me about it. Yeah. A lot of people are like, you know, we’ll get down on Well, we generated a lot of leads, but you know, not a lot of the patients came in for consultation. It is a numbers game, you need to understand that. It’s a sales funnel, and you’re trying to get as many people up at the top. Eventually they will come down at the bottom. These are people that are interested in cosmetic procedures, at least in my practice. So they’re getting these procedures done may not be beat by me but they’re getting them done somewhere. It’s not like they’re looking for a car and they stumbled on my website. They’re not in cosmetic surgery. So you have to understand that because pricing is so tantalizing, you will get a ton a crazy number of leads. And so maybe percentage wise not as many people will come in. But that percentage is probably a very large absolute number because there are so many leads you started with. The other thing is, they may not be ready to come in right now. But if you’re generating a ton of leads right now, you’re building a huge email marketing database. Absolutely. Now, if maybe you don’t have the money to like do a google adword or a Facebook ad this month? Well, let’s say you’ve built a email database like mine of 13,000, or 5000, email addresses. Now you own your marketing, you can send out an e blast whenever you want. And you’ll get you’ll get patients that way. So that’s the other thing about having a huge email database is like, again, you can own your marketing and you can you can decide what you want to do with it. You don’t necessarily always have to pay the Facebook’s and the Googles of the world.

Bill Fukui 25:54
No, and that’s a great point doc Kaplan, mainly because as a marketer, I’ve always said, you know, marketing can do one thing for you, it’s not going to make just sales. Marketing doesn’t do that. At the end of the day, it boils down to where the rubber meets the road, when people walk into the office talk to you over the phone, that’s where the rubber meets the road marketing will help you separate the wheat from the chaff. And somebody that you you kind of pointed out, I don’t care how much money they have, I don’t care if they have, you know, the worst. You know, they need rhinoplasty, whatever they need, they can need whatever you think they need. But if they don’t have a desire or an interest in what you do, they’re not a prospect, I don’t care how much money they make, I don’t care their age demographic, I don’t care. If they we all know that that person needs some work done. But if they don’t see it, they’re not a prospect. And I think that’s what marketing does. It separates those people, because they’re not a prospect, unless they have the one true qualifier. And it’s not money, it’s desire and interest, they will find a way to pay for a lot of things, especially the things that they want. Those are saying the same people, they’re walking out of the Best Buy with the new big, big screen TV. You know, I mean, think about that. But I think you’re right, I think marketing can help separate those people in the people that visit your site. And through social media and stuff, there have an interest. And I think that’s hugely valuable knowledge to know that, man, there’s value in my marketing, even if it didn’t turn into a patient. Man, I know who I’ve got 3000 people now who have an interest in what I do. And

Jonathan Kaplan 27:40
I think it’s points over the course of a year with a monthly email newsletter, they eventually may have the money, their tax refund check may come in, absolutely, they’re gonna go to that person whose emails sitting in their inbox,

Bill Fukui 27:51
right. And just being top of mind just and make sure that you’re helpful. And don’t just everything be promotional, helpful information is always you know, I’ve always believed in, in thought leadership content, always, even from the practice, only a percentage of your stuff should be promotional, a lot of it is about helping helping your patients, helping consumers make better decisions, and take care of themselves be better at it, helping them help themselves sometimes, is some of the most credible content that you can put out there, simply because it now puts you in a different light.

Jonathan Kaplan 28:33
And people talk about always like educating the patient, you know, providing enough educational content on your website, like you were just talking about? Well, I hate to tell you, but part of that educational process is how much it cost us exactly how they always withhold that we want to educate you just not on that.

Bill Fukui 28:50
I’m gonna tell you about that. I’m gonna jump a little bit forward. And you had mentioned, and we had this conversation earlier. Because I had a client that mentioned, oh, I got something because they own their own ASC. They own their own ASC. And then they got some litigate, you know, something on litigation about hospitals and surgery centers, required to put you know, price transparency, putting pricing on their website and stuff. So they were asking me and I was like, I don’t know anything about this, you know, at that time. And so we had the conversation, give us a little for those that may not be as familiar with us that don’t own their own ASC or work in the hospital, that type of stuff. What what is this legislation and what’s the requirements give us a little detail.

Jonathan Kaplan 29:44
So the the rules really apply to hospitals first, not not yet. ASCs but they’re probably feeling like they’re eventually going to be in the crosshairs. But what happened is during the Trump administration, he directed the Centers for Medicare and Medicaid Services CMS for short. If you go to cms.gov, you can find like a whole thing on price transparency. But he directed them to require hospitals to show pricing on their websites, hospitals, specifically, mostly hospitals that accept Medicare, which are most of them. And so what they did is they had two requirements. They said, first, you have to have a downloadable spreadsheet that’s machine readable or in can be accessible, but to the consumer, have a spreadsheet of all of your, excuse me of all your services. They also want to include supplies, but also services, and also how they change based on the insurance that’s paying for it. So like, if you’re doing a gallbladder at the hospital, they want you to show in the spreadsheet, how much the gallbladder costs from Aetna. How much the gallbladder costs from United Healthcare, how much cost from Cigna. So that was one thing a downloadable spreadsheet. So you can imagine it’s a huge spreadsheet in the hospital say, oh, there’s no way we can do it. Well, they have to do it, because CMS, is this, this decision by Trump to ask CMS to do it? Well, the thing is it’s mentioning about is it? It’s even though the Presidents have changed administration, it’s it’s something in CMS is purview to be able to do. So it’s still something that’s in effect, even with the new administration. So people were hoping that it was going to go by by with a Biden, it’s not true. The other thing it’s going to be, it would be a very difficult PR thing for Biden to say, oh, price transparency is not important. Yeah, I want to do that. Exactly. I really can’t reverse that. So this is something that’s happening no matter what, even though Trump’s no longer president. So CMS has said, that’s one thing, hospitals have to have a downloadable spreadsheet. The second thing is they have to have a price estimator tool, something that makes it easy for the consumer to see the 300 most common procedures at the hospital. And of those 300. That has to be the 70 procedures. So CMS said, you’ve got to do these at least these 70 procedures that include obstetric procedures, colonoscopy, his lab test, Psych, mental health things. So 70 CPT codes that you have to do, but you can’t just do those 70, you can choose the other 230. So you have to have a total of 300. So that’s what CMS has done. And that took effect on January 1, and people may be listening to this. Like, I haven’t heard about that. Well, hospitals have heard about it. I promise you there. They fought it. The American Hospital Association was suing against the saying that, Oh, we can’t we don’t want to release our negotiated rates, because that’s protected under the Trade Secrets Act. I mean, they were saying that these negotiates. Yeah, trade secrets. They’ve been using that excuse for years. And the federal government, though, well, the judiciary said no, that’s it’s not a trade secret. Right. So So that’s what’s happened since January 1, and I wrote a whole article on this in medical economics, about, let me count the ways that hospitals are not complying with this rule yet. And it’s like I listed 1010 ways, and some don’t have the spreadsheet. Some of them have the spreadsheets of just supply cost and not the procedure cost. Some of them don’t have a price estimator tool, and the penalty for them not complying. And I don’t know that CMS is actually levying any penalties yet. But it’s $300 per day, and you may think, oh, hospital, that’s no big deal. $300 per day, well, over the course of a year, that adds up to $109,500. So if and if you’re, if you’re, if it’s a for profit hospital with shareholders, they probably don’t want to be paying that

Bill Fukui 33:19
now. And what happens is, if it’s not on their radar, they don’t even think about it. And it’s amazing how quickly time passes. And then all of a sudden, they get this holy crap.

Jonathan Kaplan 33:32
It’s interesting about is that, you know, this isn’t just going to stop at the hospitals. There’s another law that’s coming through, and I guess it’s possible, they could slow it down, or there could be litigation and things. But there’s another law that’s supposed to go into effect from CMS that was directed by Trump also, that requires insurance companies to list all of their negotiated rates for with different entities, you know, like, what rate they have with Google what rate they have here there for different procedures. So that’s the next ruling that’s coming through that insurance companies have to list that. And the point of all this is that you may be in your own private practice, you know, maybe doing general surgery or internal medicine, or plastic surgery thinking, oh, yeah, I just do cosmetics. I’m in private practice. None of this applies to me. I will I will say that while I don’t know whether the federal government will ever institute these rules for independent practicing doctors, or for plastic surgeons, I don’t know if they’re going to do that. However, if the consumer is being told that they can check these shoppable services, that’s what they’re called, if you can check shoppable services, on hospitals, websites, well, how am I not able to check the most shoppable of services? In terms of cosmetic procedures? How am I not able to check pricing for that? So the consumer is going to be like, wait a second, I can check pricing on at the hospital, but I can’t check pricing in your practice. So now, even if the government doesn’t force this on doctors, individual doctors, it’s going to be consumer driven at the very least. Yeah. So people are going to have to have price estimator tool, because that’s going to be the most convenient way to do it, to be able to provide pricing to consumers, it’s coming. There’s no way it’s not coming up in the future. It’s headed down the road for sure.

Bill Fukui 35:10
You know, and I agree with you it is, as soon as the consumers acclimate to anything, whether it’s technology or an industry or setting expectations, wherever it may be. I remember years ago, we did a study on websites, and you know, those little three little hamburger menu things that they have that has the drop down to the menu. Yeah, we did a study on that, what, maybe four years ago, maybe four years ago, maybe maybe five? And how many people actually knew what that was? And how much engagement did those hamburger menus get? And did it really diminished user experience without having the whole row of navigation, traditional navigation? And it hurt? You know, years ago, man, it hurt the usability. But today, it’s different and consumers, consumers dictate consumers dictate what is acceptable, what it is, you know, demand. And at the end of the day, it is

Jonathan Kaplan 36:14
something as basic as that that’s such a great example of like, because I would have used an example, maybe a little bit more complex, like, you know, a year ago, most Americans probably didn’t know how to use Zoom. Well, yeah, I’ll know how to now. But I mean, a hamburger munity. That’s like, very basic, like, it’s really basic seems strange, five, four years ago, but now everybody knows, okay, everybody knows

Bill Fukui 36:34
what it is. So it’s very similar to what you’re talking about. Its consumers will ultimately create, create the marketplace for. And same thing, as I remember, even with social media, there was a lot of practices that didn’t do anything in social media, I didn’t believe in social media, when it came to plastic surgery. And they were it was all about websites and SEO, and pay per click, they really didn’t invest a lot into their own social media and, and have, you know, designated resources to really mark it in social media. But that’s, that’s changed today. I mean, that’s really

Jonathan Kaplan 37:12
too bad. Because social media, you can’t really delegate it very well. And it’s hard to do, like, when it’s hard to do, you get somebody to build a beautiful website, and it’ll work great. But social media, if you really want to have the engagement, man, it’s exhausting.

Bill Fukui 37:26
It’s exhausting. But that, but again, I’m

Jonathan Kaplan 37:28
into it, but it’s exhausting.

Bill Fukui 37:29
I know, I actually I know you’re into it, you actually have a really good following on social media. You’re you’re highly engaged, all your content is really personalized. It’s it’s custom. It’s not generic, really good stuff. But But I would agree, it’s a lot of work. But the consumers demand it now. You want those patients, you have to do some of this stuff.

Jonathan Kaplan 37:55
And that is kind of the positive feedback loop is that yes, it’s exhausting. It’s a lot of effort. But when patients come in, and they’ve been following you on social media for years, and they finally got the money together, or they just finally decided it was time, and that they kind of know about you. And I mean, it’s very much very satisfying to know that you put the effort into social media when you have patients like that. Because the other thing is, it’s it’s not just about generating leads from social media. It’s also the fact that because they’ve been watching you because we broadcast our surgery on Snapchat and Instagram Stories, with the patient’s permission, of course, the the thing is that the the patient comes in for a consultation, and it’s no longer just a 45 minute consultation, right, where they’re just now getting to know you. They’ve known you for months. And so it’s really a much better, more thorough, more educational consultation, because they’ve known you for so long.

Bill Fukui 38:46
Yeah. Now, wow. All good points. And I think it all feeds back into, you know, transparency is a great word, whether it’s pricing transparency, whether it’s knowing what to expect when you come in for a consultation, or when you have surgery. Transparency is really, you know, at the end of the day, what consumers are demanding now, and

Jonathan Kaplan 39:07
gradients with skincare products with their foods. Yeah. With everything with everything when you go to McDonald’s, now they have the calorie counts. Not great transparency, because now I feel guilty about eating.

Bill Fukui 39:20
Now I’m feeling bad. Well, super, Hey, Dr. Kaplan, I want to thank you for taking GE almost an hour out of your time, 45 minutes out of your time to kind of share your perspective. I don’t usually talk to people, providers that really understand pricing. Because they’re just scared of it. They’re scared of having to deal with it. Their staff is don’t like dealing with price shoppers and stuff like that. But I think, you know, at least you’re stimulating the conversation to call the elephant in the room. And not only just deal with it, but how can we leverage it I mean, at the end of the day, it’s it’s what can we do to be a differentiator? And that’s what marketing is, is what can we do to differentiate our practice? our resources, our brand online, that’s different than everybody else, in your case? A very competitive, you know, you know, Bay Area marketplace.

Jonathan Kaplan 40:21
I mean, they say that per capita, there’s more plastic surgeons here in San Francisco than it is that really, that’s what they say, I don’t know if it’s true. But even if it’s not true, I like the way it sounds. It sounds like

Bill Fukui 40:29
I think it I think it sounds really good. But partly is just because I’d like to live in San Francisco, it’s a great place to live.

Jonathan Kaplan 40:37
Come and join us anytime. Our marketing or marketing guru.

Bill Fukui 40:42
That sounds great. Well, Dr. Kaplan

Jonathan Kaplan 40:44
been able to succeed in San Francisco without a huge database of leads, and we would have not been able to do that without the price transparency. Yeah. 13,000 leads, I mean, an email database of active of 13,000 active email addresses. And yes, almost eight years, I couldn’t have done it any other way.

Bill Fukui 41:02
Yeah, I think, I think that that’s a great point. It is, it is about developing, not just immediate, direct response, what converts, there’s huge value in marketing, just in general, everybody talks about branding. But part of branding is maintaining, you know, visibility to the people that are your highest quality prospects. It’s kind of like, when I used to tell my wife, you know, I would talk about golf for, you know, golf things, because I’m big into golf. He knows zero about golf, you know, so I was at a meeting one time I said, you know, I mentioned Strix on to my wife, and she has no idea what that is. But to a golfer, we know what tricks on is because they developed the brand, you know, and you don’t have to be a brand everybody. But you’ve got to be a brand to the target audience that is has an interest in what you do. And I think that’s what you’re kind of, you know, getting bottom line is you got to brand to those people that 13,000. I mean, that’s, that’s what you need to brand to.

Jonathan Kaplan 42:08
Yeah, so hopefully, eventually, that we think of those 30,000 people, either currently our patients or eventually will be our patients.

Bill Fukui 42:16
That’s the way to look at it. Well, Dr. Kaplan, thank you again for all of your time, great insights, and I will get those resources that you mentioned links and I’ll make sure that I get those added you know, down below in the in the webcast so people can actually check them out.

Jonathan Kaplan 42:32
Great. Thank you so much. Appreciate you having me on. I was talking to you. We’ll be we’ll be chatting again soon. I’m

sure. Excellent. Take care. Take care have a BA

MSD Insider 42:42
thanks for joining us for the med shark insider with Bill Fukui join us next week for another dive into all things medical marketing. All episodes can be streamed at WWW dot med Shark digital.com/med Shark Dash insider

Transcribed by https://otter.ai