Jim Poggi
By Jim Poggi
My tacky analogy of the month: urinalysis testing is a lot like flossing. Everybody agrees it’s important, but not everybody is really doing it.
Now that I have your attention, let’s examine the facts. You have cool customer promotions on a variety of national brand and private brand urinalysis systems with no capital investment required year-round, right? And you are placing a bunch of urinalysis systems every year, right? Yes, on both counts. But, is your urinalysis business growing along with the rate of new placements? I contend it’s not. Go check your sales reports. I’ll wait. Just as I thought. Lots of systems going out; not so much revenue coming back. Why?
If you ask 100 primary care clinicians to tell you about the value of urinalysis, you will get a convincing story ready to make you buy a urinalysis analyzer: “Urinalysis testing is non-invasive, well proven, has powerful screening tests for diabetes, kidney disorders, urinary tract infection, liver disorders and dehydration. It should be used on every senior patient visit.”
Everybody knows urinalysis is useful. But, if you took a minute and asked your key physician customers to tell you how many of their last 100 annual physical or diabetes follow up patients got a urinalysis and they gave you an honest answer, I am willing to bet the number would be small. Probably under 20.
Admittedly, I am working with empirical observation, but no real data. But, here are my observations. In my annual physicals over the last five years, I have not had a single urinalysis. The only urine testing I had in the last five years was a mandatory drug screen for a consulting client. (BTW: I passed.)
In talking with other professionals in our business, I get the same acknowledgement. Their experiences are similar. And, when you go into the rest room of the average primary care practice, where are the urine cups we used to see? Where is the pass-through door to the sample handling area? I almost never see them anymore. When was the last time you had your physical and the nurse handed you a urine cup, told you to give a sample, put it on the counter and the doctor will see you in a few minutes?
Action items
Ok, now that the whining is over, what do we do? I would target a modest number of my key customers and arrange a visit with my best urinalysis supplier and have a real discussion of how the practice uses urinalysis and how often. Probe for:
- How often do you use urinalysis to initiate or modify a patient treatment plan?
- Is it part of your annual physical protocol?
- Is it part of your Medicare patient annual visit?
- Are you using newer tests like albumin/creatinine ratio to follow up on your established diabetic patients?
- Do you routinely encounter patients, particularly elderly, with urinary tract infections? How is the practice handling these patient situations?
- Do they believe their urinalysis testing program is being implemented effectively when necessary for patient care?
Some of your thoughtful physicians will experience a wake-up moment. And, chances are your urinalysis supplier is satisfied with the placement rate of systems and has resigned themselves to a low rate of test strip growth because “everybody is already performing urinalysis and it is a replacement market.” I believe urinalysis is presently under-utilized and subject to re-visit with thoughtful customer visits and discussion.
Pointing out the obvious can increase the number of truly needed urinalysis tests performed by your customers every day. In the process, you will sell other ancillary supplies: urine cups, urine controls, paper towels, hand sanitizer. You might even sell a few drug testing cups, but the focus here is routine health screening, where I believe urinalysis is becoming a missing link. For the really bold, offer a free box of urine cups to the practice and put a dozen of them in the rest rooms and five stacked up in every exam room as a reminder. You might even ask your urinalysis supplier to dust off those old urinalysis wall posters and let you pass a few around to your customers. Sometimes, the classics work.
If you take the time to re-visit urinalysis with your key customers and how it is used for important patient screening and follow up purposes, I think you will be surprised at the results. The testing is so useful and so fundamental to good patient care, I am convinced that a timely reminder will get your highly engaged customers to increase their urinalysis testing and that they will thank you down the road. You can also take the time to review newer urinalysis tests to determine which ones might add useful diagnostic information. Albumin/creatinine ratio testing appears to be under-utilized. You can also make it easier and smooth work flow by reminding your customers that they can connect their urinalysis systems (check with the manufacturer first) to an LIS or EMR system and track patient results and make sure they do not miss any needed billings also. True, there is a cost to connect, but for proper work flow and to avoid missing patient healthcare data and billings, there are good reasons to connect the urinalysis data to LIS and EMR. They would make sure to connect a hematology system or chemistry system. Why not urinalysis?
So, take my dare and select some key customers for deep discussions on how they use urinalysis. Granted some of them will chuckle and wonder if you “have lost a wheel.” But the thoughtful ones are likely to have a wake-up moment. How cool is that? And, as an added bonus, I believe you will see your urinalysis revenue grow. So, run the program, gather customer feedback and run your sales reports. Let me know the results. I’ll wait.