By Jim Poggi
Looking beyond revenue metrics, how defining your ideal physician office lab – and partnering with point-of-care leaders – can sharpen prospecting, strengthen relationships and drive long-term territory growth.
From time to time, it is good to review our lab customers’ businesses, either formally in meetings with our manager or roundtables with management and other lab sales professionals. The focus is typically on performance: what does our lab customer revenue, margin and future business forecast look like?
These are important topics, but they stop short of asking the underlying question: what do our best POL customers have in common? In other words, how would we define our best customer?
Additionally, the exercise of identifying the traits our best customers have in common should help us identify our best few prospects to maintain and grow our lab business. The exercise of understanding what our best customers have in common is important and helps keep us sharp and productive as we manage our territories and deliver on customer and company expectations.
No matter how often we conduct a customer review formally, we should conduct our personal customer review routinely and make sure we are managing our lab business optimally. In this column, I plan to outline the many characteristics our best customers have in common and to point out some red flags we need to be aware of as we qualify new prospects.
A full view of the customer
Customer qualification is yet another activity where we can and should obtain as much information from as many sources as possible. This helps us get a 360-degree view of our customers.
One source of information we sometimes forget or ignore as we consider what the best POL customers have in common is the input from others, particularly members of the IDN point-of-care community. Most IDNs have a point-of-care coordinator (POCC) team in place to make sure POC testing is performed in compliance with the testing requirements of the IDN for quality of results and that POC testing does not duplicate testing done at the core lab location. This team is responsible for helping manage testing at every POC site, including the ER, the floors and the physician office labs that belong to the IDN.
I have had the opportunity in recent years to engage the POCC community through a series of webinars to understand their viewpoint on point-of-care testing, share my viewpoint that lab testing needs to be available to initiate or modify a patient treatment program, and to understand how closely aligned we were. I presented a series of lab webinars to the POCC community including topics like “Test standardization: some practical guidance” and “Point-of-care testing: cost vs. convenience.”
Since I am a known advocate for POL testing and my presentations make the point that POL testing is the best way to assure patients and care givers have results they can use to influence patient behavior for better health outcomes, I was not sure what kind of reception I would receive. I found the POCC community surprisingly receptive.
My presentations depicted their role as counselor and expert colleague rather than the “police.” They mostly agreed that POC testing for the right reasons is important, and felt that they were frequently caught in the middle between their IDN responsibilities to manage POL practice performance and ensure most testing went to the core lab, and the POL viewpoint that the POCC were the police and were limiting their ability to test. Most members of the POCC community are looking for allies in their goal to have the POLs they manage perform testing at a high level and for these labs to be well organized and compliant with CLIA and other regulatory requirements.
If you engage them as allies and sources of information rather than the enemy, I am confident you will be able to work together in harmony to provide the highest level of service to their POLs. Given the fact that the majority of salespeople avoid the POCC coordinators, you should find a receptive audience looking for help. Can you get them to agree to migrate some testing to the POL location? Sometimes they will support this goal with IDN management if there is a compelling reason to do so. Overall, they agreed with the argument that “lab testing needs to be available to initiate or modify a patient treatment protocol.”
Through this lens, respiratory testing, glucose for chronic diabetic patients, hemoglobin A1C under similar conditions and other POL tests we would consider routine make sense to them. Since their ability to influence IDN management varies due to the policies and procedures of their IDN and the perceived quality of lab results in POL locations, you need to develop a relationship with them to understand the overall testing policies and procedures of their organization and the extent to which they are able to support POL testing.
To do this you need to establish trust and respect with them and to let them know that you will ensure any POL testing you establish or support in their IDN will adhere to the highest standards, and be compliant with IDN and regulatory requirements.
With an increasing number of physician practices under the ownership of IDNs, it is important to understand what the IDNs in your area also consider “the best POL.” I strongly recommend you develop relationships with your POCC teams. When they see you as an ally, they are more likely to help you put compliant POL testing in place and to help you identify POLs that need help from you and your trusted lab manufacturers.
Understanding that your job to identify what the best POLs have in common is a team job, it also makes sense to engage your trusted lab manufacturers to get their opinion and understanding. Aligning with their viewpoint on what the best POLs have in common will make your sales process more effective. Don’t be surprised if you receive a lead or two from a manufacturer who is confident your understanding of POL testing matches theirs. This is a long-term game and the relationships you develop now will bear fruit for years to come.
Commonalities among the best POLs
Now, let’s look at what the best POLs have in common. Simply stated, these are medical practices you would recommend to a family member. They are also practices you would consider as your personal medical practice.
I will be focused on the attributes of the lab, but there are more basic practice attributes to consider that also influence how the lab is run. Is the practice well organized? Is the front office staff polite and helpful? Does the practice staff have little to no turnover? Does the waiting room appear welcoming with patient-friendly information available? Is it obvious whether patient appointments are on time, or are there long waiting times?
From a POL viewpoint, the two most important factors in my opinion of whether they would be on my list of “best POL” are whether the lab director is actively engaged with the lab, and the satisfaction and engagement level of the lab staff. This may seem obvious, but a lab director who does not actively manage the lab is usually not a good sign. The lab director is the leader of the lab with responsibility for overall lab management, test selection, regulatory compliance and even the morale of the lab staff. A key element of their job is to know and understand CLIA and other lab regulations, and to be able to communicate this information effectively to the lab staff.
Lack of active engagement by the lab director leads to a lack of direction for the staff and can lead to several adverse outcomes, including poor management of daily activities, the risk of poor lab results and even the possibility of a failed lab inspection.
Lack of engagement by their leader often leads to a lack of engagement and low morale by the lab staff. The lab staff needs to believe that their job is important to the overall health of the patients and work to create results that are high quality and delivered on time. The lab staff is responsible for the daily activities that result is a high-performance, well-organized lab. They need to believe their job is important and fundamental to help the practice achieve the goal of quality patient care.
From time to time, every lab will become aware of deficiencies they need to correct. The best customers correct deficiencies they uncover quickly and consider deficiencies as challenges to be met and conquered. They keep a few resources on hand, including you, your valued lab manufacturers, COLA and others to call on when the need arises. They know that failure to assess staff competency every six months and failure of CLIA non-waived labs to enroll in and successfully complete proficiency testing surveys are the top two lab deficiencies, and they carefully manage their activities to ensure they are fully compliant. They put systems in place to list every CLIA requirement and permit them to create documentation to prove that they are compliant.
There are some excellent electronic lab management tools that make CLIA compliance easy. Using these tools is a great way to ensure they would pass an inspection, but, at a more fundamental level it creates a smooth-running lab that produces excellent results day after day.
The best POL labs are not “book end” customers. What is a book end customer? Book end customers are customers whose behavior is far from the mainstream.
One book end customer views the lab as nothing more than a cash cow. They look for the most highly reimbursed tests they can perform, often bringing in new equipment to perform these tests. They also tend to cut corners on lab personnel salaries and other areas of the lab. They view regulations as the enemy and do the least amount possible to be compliant. These customers tend to be the ones that frequently ask for better prices and are likely to shop your business for better deals.
The other book end customer is fascinated by the latest technology. They want the latest instrumentation and testing methods whether they have the specific patient need for it or not. Their problem is that they jump from one instrument to another as lab technology advances. If and when they depart from the practice, they leave a substantial challenge to return the lab to a well-managed condition with only the appropriate instruments in use for appropriate patient testing.
Administratively, the best POL customers shine, and you can recognize their labs the minute you walk in. The lab is neat and everything is in its place. The staff is cordial and not stressed. They may be busy but they have a workload they can handle and the right instruments and equipment to handle the work. Every element of the lab reflects this level of thoughtful organization. They know when their leases are due and have a plan for instrument upgrade or replacement as needed.
For the best POL customers, staff training, which is one of the most frequently cited deficiencies by inspectors, is up to date and the training is put to good use by the staff. All the many lab appliances are calibrated and up to date. From the centrifuges to the rockers and rotators, every lab appliance has a label on it showing its current calibration date and the date the next one is due. They order reagents and lab supplies from you on time and on a routine basis, typically using your customer portal. They stay up to date on developments in new testing technology and use the philosophy of testing patients when needed to institute or amend their treatment program.
Maybe most importantly, they have a system in place to list every CLIA compliance requirement. They log their accomplishments against each requirement and always know when their next activity is due. Quality control and proficiency testing are taken seriously and are logged in the same electronic system that they use to manage their other CLIA requirements.
And they manage the lab for the benefit of the patients and care givers they serve. Their mission is clear and they perform their activities at a high level. While they may be busy, they respect you and your trusted lab manufacturers and make time for business reviews and lab reviews.
Being able to identify the best POL customers is a skill that takes years to develop and a commitment to ask others for their help and input. Once you identify the customers and prospects you would want to have yourself or a family member utilize, your territory will benefit. To be the best, identify the best and make sure they are your customers.