How 5-star reviews generated over $225,000 in practice revenue [PODCAST]

Listen and followApple PodcastsSpotifyYouTubeMore apps · Browse all episodes

“With my natural affinity for numbers, I analyzed the reviews’ precise impact after a few years, and the results were astounding.  The system generated over $225,000 during a 3-year period.  My practice acquired 162 new 5-star reviews on Google, and my partner and I generated over 200 5-star reviews on Yelp.  I calculated that each 5-star review was ‘worth’ over $900 to my practice in the form of new referrals, and the overall return on investment was 1,900 percent.  Needless to say, it was a huge success.”

Orrin Franko is an orthopedic surgeon and hand specialist.

He shares his story and discusses his KevinMD article, “How 5-star reviews generated over $225,000 in revenue for my practice.”

Did you enjoy today’s episode?

Please click here to leave a review for The Podcast by KevinMD. Subscribe on your favorite podcast app to get notified when a new episode comes out!

Do you know someone who might enjoy this episode? Share this episode to anyone who wants to hear health care stories filled with information, insight, and inspiration.

Hosted by Kevin Pho, MD, The Podcast by KevinMD shares the stories of the many who intersect with our health care system but are rarely heard from.

Transcript

Kevin Pho: Hi, and welcome to the show, where we share the stories of the many who intersect with our health care system but are rarely heard from. My name is Kevin Pho, founder and editor of KevinMD. Today on the show we have Orrin Franko. He’s an orthopedic surgeon and hand specialist, and he wrote the KevinMD article “How 5-star reviews generated over $225,000 in revenue for my practice.” Orrin, welcome to the show.

Orrin Franko: Thank you so much. I’m really excited to be here.

Kevin Pho: So we’ll get into the article a little bit, but first off, can you share your story and journey to where you are today?

Orrin Franko: Absolutely. Well, as you said, I’m an orthopedic surgeon. I grew up in Southern California, did my training in Southern California, and then also went off to Boston for med school, back to San Diego for residency, and fellowship in Cincinnati. Throughout that, I was actually quite academic in terms of my pursuits. Through residency, I wrote a number of papers and was almost certain I’d be going into academic medicine.

But through my journeys, I gave a couple of talks and met my partner at one conference I actually went to. He was in a small private practice, actually a solo practice, and thought maybe he could use a hand surgeon partner in a few years. So we kept in touch, and it turns out that I ended up joining his practice, and it was absolutely the best move for me. Being in small private practice, I think, is just amazing, mostly because I can still do some academic pursuits, but I also get to explore other aspects of being a doctor, being a surgeon, and being a business owner that I probably couldn’t do, or couldn’t do as easily, in a large institution. So it’s not really where I thought I would be when I was in training, but I couldn’t be at a better place.

Kevin Pho: Now, there are fewer and fewer physicians going into private practice, over the last year especially, in light of the pandemic. Tell me some of the challenges that you, as a private practice physician, faced.

Orrin Franko: Oh, I mean, I think you’re 100 percent right. Just to talk about that first point, I actually give a lot of webinars online through the California Orthopaedic Association about what it really means to be in small private practice, because I’m a huge advocate for it. I would just mention that those webinars are free and online, and if you search my name, you can find them.

But basically, I think you’re right. I think through the pandemic, it’s not that our challenges are less or more; they’re just different. My partner and I have had a lot of control over our overhead, and we’ve always run a very tight ship, so we were able to control our costs better than people. So while our volume dropped just like everybody else’s, we didn’t have high staffing and high rent costs, and with the PPP, of course, it helped quite a bit. I’d say we did a pretty good job.

Also, being in small private practice and having more control over my life, to be quite honest, if I needed more income, I could take a little bit more call, and that goes straight into my pocket. I could pick up some more cases. I could do a little bit more outreach. A lot of that is kind of where our topic and our article came from: If you do a little bit of marketing, you can influence your bottom line quite a bit.

Kevin Pho: All right, so let’s talk about that article. It’s on a topic near and dear to my heart. It’s titled “How 5-star reviews generated over $225,000 in revenue for my practice.” Now, for those who didn’t read the article, can you just walk my audience through it and share the story of why you decided to write it?

Orrin Franko: Absolutely. Well, I am younger, for those who are not watching but just listening. I’m 37 years old, so kind of borderline millennial, and I think a lot of people in our generation recognize the value of Yelp reviews and Google reviews. But that’s not so obvious to the older generation of doctors, and they really aren’t aware that people are going online and searching for doctors on Google or Yelp or Healthgrades.

So when I started practice, I told my partner this is something I wanted to do. He’s a little bit older, and he wasn’t so convinced, but I did it anyway. Me being a numbers guy and kind of academic-y, I of course collected all the information about where patients were finding us online, and I could analyze my billing software and find out how much money was being generated. Over a few years, it was quite obvious that there was a huge impact of focusing on online reviews, something that so many doctors ignore.

If you’d asked me five years ago, I would have told you that five years from then, every doctor would have recognized the immense value of having a positive online reputation. But here we are five years later, and I think really the needle hasn’t moved. Probably about 80 percent of physicians either don’t recognize the value or kind of minimize the potential value of having a positive online reputation. So my intention is really just to help people understand that it’s really good for you. It’s good for business, it’s good for patients, and it’s cheap and/or free, so I don’t see any reason not to do it.

Kevin Pho: So when you Google a physician’s name, there are a plethora of online doctor rating sites that come up: Healthgrades, Vitals, Yelp. There’s just a gamut of them. Now, how do you choose which ones you want your patients to respond to, and of all the ones that I mentioned, which ones have the most influence?

Orrin Franko: Oh, great question. Number one is Google. Google’s the late addition to the game, because now they have their own Google Business Profile for most doctors, and they have their own reviews. The best research shows that your online Google search ranking has about a 21 percent contribution from your Google score and review volumes. When you search on Google, obviously you get your search results in a list, but off to the right side you get what they call the knowledge box, where a business will be shown prominently with their website and their photos. That’s really what you’re looking for. That’s the most important.

I would say Yelp is probably the second most important. Yelp has a whole lot of issues that we may or may not get into today in terms of hiding certain reviews with their algorithm, about what they deem to be a valid review. So Yelp really frustrates a lot of people. Healthgrades and Vitals, I think, are reasonable, Healthgrades probably better than Vitals these days. And then there are all these other review sites, mt.com, share.com, I think U.S. News. A lot of them tend to just replicate the reviews that are already on Healthgrades and Vitals. [Remark removed by the editor.] I’m not really sure what they do, but they’re not original. But I would say Google, then Yelp, then Healthgrades.

Kevin Pho: Now, tell me some of your secrets. What are some tips that you can share with other physicians on how to get more 5-star reviews?

Orrin Franko: Absolutely. It’s actually not that complicated. Tip number one is if you don’t ask patients, they won’t leave reviews, hands down. Tip number two is you’ve got to ask them the right way. It turns out that if the doctor looks a patient in the eye, hands them a reminder card, and says, “Would you please leave me a review?” patients won’t do it. That’s probably not what you expected me to say. A lot of people think, “Well, if I just ask my happy patients, I’ll go ahead and pick up a few reviews.” The average response rate is about 1.3 percent if you do that.

Alternatively, if you email all your patients, if you had an automated system that would just automatically follow up with every patient asking them to leave you a review, the response rate is upwards of 8 to 10 percent. So this is really a volume game, and I always tell doctors, if you’re trying to pick and choose your happy patients, or if you’re a surgeon and you’re only asking your surgical patients, you’re really missing out on most of the positive reviews. The goal of your own reputation is that a prospective patient, someone who is evaluating you as a doctor, gets a reasonable impression of what their experience is likely to be in your office. You want a mix of surgical and non-surgical patients. You want every patient who walks in your door to leave a review for you, and you want to have hundreds of them.

Kevin Pho: So are you saying that you primarily use an automated system to get that 8 to 10 percent? Do you talk to patients individually and ask them to leave a review, even though the response rate is so low?

Orrin Franko: I’ve done everything. The reason I know all this is because I’ve been through every iteration, and I’ve analyzed it along the way. I’ve put signs up in my office. I’ve asked patients. I’ve had iPads on my registration desk, and I’ve had them do it in the office. I’ve handed out cards, and ultimately, I’ve transitioned to an automated system, and hands down, the automated system is the most successful, by a power of 10.

So I actually don’t ask patients anymore, with one exception, which is if a patient says, “I found you on Yelp,” or, “I found you online.” Then I simply say, “That’s wonderful. I’m really glad that’s working. If you don’t mind, I’d appreciate it if you left me a review.” But other than that, 90 percent of the time, I’m just automating it. And yeah, there are a lot of systems out there that do it. Basically, I looked at all of them, and I ended up building my own, because it was cheaper, easier, faster, and worked better than all of them. So I have my own system called SurgiSurvey, and it works extraordinarily well. A couple hundred doctors are using it now.

Kevin Pho: Now, do you funnel these patients to review physicians at a certain site? You mentioned Google being the most prominent, so do you preferentially have them rank physicians at Google?

Orrin Franko: Absolutely. It’s up to the person who’s using it, so I always recommend starting with Google. Once you get over 100 Google reviews, you have a little more flexibility. Then I recommend Yelp, and then I recommend Healthgrades.

Kevin Pho: So a question I always get asked is about negative reviews that may or may not reflect on the clinical ability of the physician. It could be something wrong with the office, or it could simply be false. So how do you respond to negative reviews that are clearly false?

Orrin Franko: You know, I’ve written articles and given a lot of talks about how to respond to negative reviews, and I could probably bore your readers right now with a lot of information about being sure to respect HIPAA, address the problem head-on, and demonstrate compassion and sympathy, but without disclosing too much information. But I’ll tell you, the best way to respond to negative reviews is by having a lot of positive reviews. A lot of people would say the best defense is offense, or what we say in surgery: The solution to pollution is dilution.

Basically, if I have 200 5-star reviews, I just don’t have to worry about that negative review, because everybody has negative reviews. Half the time, they’re not even your patients. It’s the patient who couldn’t get in to see you because of a wait list, or the insurance you don’t take, or the body part you don’t treat, and those reviews keep doctors up at night. Or it’s a patient in your office who you understand you’re just not having a great connection with. That patient’s not happy, and there’s just not much you can do about it. Maybe they got upset with the receptionist, and you think to yourself, “Boy, they’re just going to go online, and they’re going to torpedo my reputation.” But that only matters if you have two or three reviews. When you have 200, who cares? You know what? They’re going to leave a negative review anyway. The solution to pollution is dilution.

Kevin Pho: That is a quote I use myself in my own talks whenever I talk to physicians about online reputation, so I’m glad that we’re on the same wavelength. One question about Yelp: A question I often get is about the fact that Yelp hides some positive reviews, especially from users who do not leave a lot of reviews themselves. Now, when physicians who are frustrated come to you and say, “This patient left me a positive review on Yelp, but it’s not showing,” how do you respond to that?

Orrin Franko: Yeah, I totally agree. I mean, Yelp is a tough nut to crack. I don’t know anybody who has somehow circumvented Yelp’s algorithm. Basically, I think it’s just a numbers game. I tell people, if I can get you 100 reviews on Google, chances are 99 are going to show up, and if I get you 100 reviews on Yelp, chances are 20 are going to show up. But everyone’s playing that same game, and everyone’s getting their reviews filtered, so you just want to have as many as you can.

The other thing to know about Yelp is that their review algorithm changes all the time, and their numbers are always going up and down. Sometimes a patient leaves you their first review, and almost absolutely, it’s going to be filtered out by Yelp because it’s their first review. But over time, that patient may leave a review for a restaurant and a hotel and another doctor, and Yelp may learn over time that they are a real person with valid reviews, and it may reappear. So my Yelp score actually fluctuates. One day I have 47 reviews, some days I have 50 reviews, and then it goes back down.

Kevin Pho: We’re talking to Orrin Franko. He’s an orthopedic surgeon and hand specialist. He wrote the KevinMD article “How 5-star reviews generated over $225,000 in revenue for my practice.” Orrin, short of purchasing an automated system to garner patient reviews, what’s your number one actionable tip that you can share with physicians on how they can get a better online reputation?

Orrin Franko: I mean, I think short of purchasing a system, you would basically have to replicate what any system would do. The data is quite clear that you have to ask every patient, and if you can do it via email or text, go ahead and do it. The problem is that most practices don’t have the interest or time to start emailing or text messaging every patient, and there are obviously HIPAA compliance issues, to be quite honest, in terms of emailing your patients directly. So I think it’s really hard to do it effectively without using a system.

But I’ve got to admit to you that I think the systems are very inexpensive. I mean, we’re talking about under $1,000 a year to get up to 100 or more 5-star reviews. I actually did an analysis from my practice. Granted, I’m an orthopedic hand surgeon, so it’s different depending on specialty, but the value of one review in dollars for the surgeon is over $1,000. So imagine if you’re getting reviews and you’re generating new patients. One review is worth $1,000. You make your money back in your first review, and if you get 100 reviews, that’s a 100-to-1 return on investment.

Kevin Pho: And my final question: What’s your take-home message that you want to leave with the KevinMD audience?

Orrin Franko: The take-home message really goes out to people who aren’t a big fan of reviews, who think to themselves either, “I already have a full practice. I don’t need more patients,” or, “Nobody reads those reviews anyway.” I like to remind people that reviews are multifaceted. Yes, it’s good for new referrals, but it’s also good for patients who are coming to see you anyway. Even though they’re coming to your office, they want to know that they’re going to have a positive experience. So it doesn’t matter if you already have a busy practice. Your patients are going to be happier knowing that they’re going to a doctor that’s well liked, and you’re going to be happier when you go to bed at night knowing that your patients love you. Reading these positive reviews, it really makes you feel great. So I just wouldn’t discount it.

Kevin Pho: Well, thank you so much for sharing your time and insight, and thanks again for being on the show.

Orrin Franko: You’re welcome. Thank you.

Listen and followApple PodcastsSpotifyYouTubeMore apps · Browse all episodes