Sensitivity, compassion key for unique women's health biz

Sunday, March 31, 2002

Few medical procedures are more psychologically stressful than a mastectomy. The emotional pain caused by losing a breast can be further compounded by the hair fallout from chemotherapy. Therefore, referring physicians are looking for providers who show an abundance of sensitivity and compassion in treating post-surgical mastectomy patients.

"A close personal touch with the patient is very important," insists surgeon Ben Mack, MD, of Longview (Texas) Surgical Associates. "Women with breast cancer need very delicate handling. They need to know that their providers have a genuine interest in them and are doing their best to make them feel comfortable through this traumatic experience."

Treating patients with dignity is a universal approach with the providers contacted for this story, whether it's for post-mastectomy patients, expectant mothers or ostomy clients. The special demands of women's health make it a unique market segment, they say.

"Our mission is to make a positive difference in the way women look and feel about themselves - all our decisions are based on that philosophy," said Vicki D. Jones, founder of Women's Health Boutique (WHB), which has 18 locations across the country. "Selling a product isn't the most important thing we do."

Likewise, Ken Sandler, CEO of Medical West in St. Louis, says being successful in women's health requires a provider to be an educator, consultant, psychologist, beautician, and sympathetic friend.

"We're not just a medical supply company - we're a health care resource center," he said.

When it comes to identifying referral sources, women's health has perhaps the most comprehensive and diverse set of clinicians in the HME field. It's a market stratified across several sub-categories, the largest being breast cancer care and maternity. Surgeons and oncologists provide the bulk of cancer patient referrals, while obstetricians and gynecologists are the main sources for maternity clients.

Because WHB offers an extensive range of services under the women's health banner, the company has identified referral sources from various corners of the clinical community, said President Daina Pitzenberger. For instance, family, general and internal medicine practitioners all deal with breast cancer survivors who need regular follow-up care, she said. Vascular physicians and cardiologists typically refer lymphedema patients. Pediatricians may send over new mothers for breast pumps or nutrition supplies. And dermatologists may recommend the company for skin care products designed to treat stretch marks.

This well-rounded selection of services has forged a sales strategy WHB reps have termed "life stage marketing." The idea, Pitzenberger said, centers on caring for a patient with a particular condition and getting her to come back for other services.

"If we get them as young mothers, we want them to think about us for other medical needs as they get older," she said.

WHB's "life stage marketing" concept also works with women who come in as unwitting referrals from competitors, Jones said.

"What sets us apart is that we take the little things seriously - and sometimes it's these minor details that make a major difference to a customer," she said. "We helped a woman who got a breast prosthesis from another store and they didn't make an effort to solve her problem when it started leaking. She came to us for help and with a call to the manufacturer we got it covered under warranty. Although we didn't make a sale at that point, she comes to us for everything now."

Clinical referral sources aren't limited to physicians, either. Jeff Allspaugh, program director for Northern Illinois Health in Sterling, Illinois, says his firm routinely works with cancer care coordinators at the town's two major hospitals.

"Cancer care coordinators are registered nurses who specifically work with oncology patients," he said. "They are very interested in continuing education and aftercare - we work closely with them in those areas."

Allspaugh added that Northern Illinois co-sponsors local breast cancer awareness campaigns with the hospitals. "We consider the hospitals to be our partners in care," he said.

Sandler agrees that sponsoring events and peer support groups not only resonates with the referral community, but creates a lasting impression with the public as well.

"When the local media does a report on breast cancer, they come to us for information," he said. "We are seen as experts in this area."

Fortifying Medical West's image as a bona fide women's health resource is the company's hosting of a local breast cancer support group called Women In Common.

"There are plenty of support groups around, but they are usually affiliated with hospitals, so if your physician isn't a member of that hospital, the patient won't have access," Sandler said. "We have no affiliation so we're open to everyone."

The empathy generated by support groups also extends to Medical West's professional staff, several of whom are breast cancer survivors. As Sandler explains, there is a certain number of their patients who "find their calling" as mastectomy fitters after they've gone through the experience themselves.

"We don't seek them out," he said. "They come to us."

Non-clinical professionals such as hair stylists can also serve as effective referral sources, noted Kim Eubanks, senior vice president of administration for Davco Pharmaceutical and Home Health Care Services in Haverhill, Mass.

"Chemotherapy patients who lose their hair often get uncomfortable with the lack of privacy at hair salons," she said. "We specialize in helping women deal with appearance changes, so we regularly get referrals from their beauticians."

Respecting a patient's desire for privacy is paramount, Eubanks said, so Davco has worked out an arrangement with local oncology clinics to consult with patients on premises if they prefer.

"If, for any reason, a patient cannot come to our place, we will meet with them at the clinic," she said.

As medical professionals, referral sources really appreciate getting recognition for their efforts and Vicki Jones' forte is in putting together special awards promotions for them. For National Doctor's Day one year, she ordered gold star-shaped paperweights that were personally engraved with each physician's initials. The theme was to give each doctor a "gold star" for excellent performance. Similarly, for National Nurse's Week each nurse got a chocolate spoon with the message "We're stirring up women's health."

The campaigns generate a flood of hand-written thank-you notes, Jones said, pointing out that one doctor wrote "I haven't gotten a gold star since the fifth grade."

Because National Doctor's Day fell on the day before Easter this year, Jones assembled an Easter basket of goodies, including compression stockings, flavored coffee and biscotti. She planned to deliver all the baskets personally dressed as the Easter Bunny.

"When you do something creative and unique, everyone remembers it, from doctors to nurses to office workers," she said. "It leaves a lasting impression."

WHB has also waged a successful campaign to get physicians to see the business from the patient's perspective. For instance, when obstetrician/gynecologist Lynn Brazell, MD, was pregnant herself, the company furnished her with a maternity belt.

"Not only is the belt a wonderful mechanism, but the staff has the technical expertise to fit them properly," said Brazell, of the Northeast Texas Women Physicians clinic.

Moreover, when the doctor had a problem with the strap, WHB gave her a new one, which she said convinced her that they aggressively handle all of their patients' problems.

Physicians also like learning about products in greater depth, said Andy Boesl, marketing director for Home Medical in Medford, Oregon. Because the company offers a diverse line of compression garments, inservices tend to center on educating physicians about that particular product category.

"Surprisingly, physicians don't know that much about compression garments," he said. "Even vascular physicians aren't as in tune with it as you might think."

Even if some physicians are fuzzy about products, others have a sharp focus about what they want, says Pitzenberger, who says physician preference plays a role in inventory management decisions.

"We get input from them about which compression stockings they like and we use that to evaluate how many others may want it," she said.

The key message to physicians on compression garments, Boesl says, is how various conditions - from lymphedema to diabetes - can be improved by these products, whether they be TED hosiery, compression arm sleeves or upper extremity garments.

"By educating physicians about these products, we're giving them the tools to better serve their patients," he said.

Indeed, Sandler maintains that one of the best ways to keep referrals coming is to make the physician look good in the patient's eyes.

"A provider's service level - whether good or bad - reflects on the physician," he said. "By serving our patients well, it sends a message to them that the physician took the time to find the best provider available for them. And when a patient has a bad experience, they blame the physician for that as well." HME