Let's talk about what really moves the needle for growth in the cardiovascular space. We spend countless hours – and sometimes too much of our precious and scarce financial resources – on perfecting sophisticated marketing campaigns and polishing our brand reputations. Each important and valuable. But if I had to distill nearly four decades of experience across every conceivable provider setting into one core truth for building patient volume and grabbing market share, it’s this: accessibility beats everything.
And to be crystal clear, I’m talking ambulatory access. The front door. Not the urgent work-in, the “if they need me right away, they can call my cell phone,” which I’ve heard too often. I’m talking scheduler to scheduler, getting a live human and an appointment in a reasonable time – not measured in weeks but days.
I can almost hear the collective gasp. You might ask with a touch of indignation in your voice, "Access is more important than quality?" In many instances, the answer is sadly yes. "More critical than our world-renowned specialists or our cutting-edge technology?" Still yes. Not that these aren’t important. They absolutely are. When it comes to patients visiting your office (not the emergency department [ED]), what matters most is how quick and easy it is to get an appointment.
Think about it from the perspective of the patient. They know heart disease is still the number one killer, and now they hear they need to see a cardiologist. As the the professionals, we may know their issue isn’t immediately a matter of life or death, but they don’t. In their heads, they have a ticking timebomb. What are their primary objectives? To be seen. To get answers. To start a plan.
Now think of it from a referring physician’s vantage point – which I had the privilege of witnessing live and in person as part of a consulting project. Imagine a busy family practice office with lots of activities. The doctor comes out of the room and says to his medical assistant (MA), “Get Joel a cardiology appointment with Dr. Smith.” She then disappears into another exam room to see the next patient. The MA picks up the phone and calls Dr. Jones to schedule a consult.
After she hangs up, I ask, “Didn’t your doctor say Dr. Smith for the cardiology consult?” She says in a matter-of -fact tone, “She did, but I don’t have time to navigate Dr. Smith’s system and negotiate an appointment. It’s much easier at Dr. Jones’ office.” Case closed.
If your esteemed Dr. Smith, with impeccable credentials and a waiting list that stretches into the next fiscal quarter, is pitted against Dr. Jones, who is perhaps less of a household name but can see the patient within a few days, who do you think wins that consult? More often than not, it’s Dr. Jones. The path of least resistance, of quickest resolution, are powerful forces.
This isn't to denigrate the importance of providing high-quality, safe, effective and high-value care. Quality is the bedrock, the “table stakes” foundation upon which everything else must be built. Patients deserve it, and our professional ethics demand it. But exceptional quality delivered too late, or not at all because patients chose an alternative, becomes the proverbial tree falling in an empty forest. They'll have already found their way to a more accessible alternative. Our most discerning patients also tend to be those with the best insurance.
Illustrations by: Lee Sauer
The magic, or perhaps the strategic imperative, is making non-emergent care – the office consult – easy and accessible. Patients coming through the ED have already chosen or had that choice made for them. Here we’re focused on the ambulatory front door.
Consider the power of a streamlined system where a referring scheduler can get a patient booked with a cardiologist, or an appropriate advanced practice provider (APP), within a reasonable timeframe – say, a few days to a week for non-urgent but necessary consults – with minimal friction. That's not just good service; it’s a potent market differentiator. It’s how you become the default choice, the go-to group that makes everyone’s life easier.
In all my travels as a consultant, I’ve never heard a cardiovascular program feel they spend enough on advertising and marketing. Then I inevitably talk to the marketing department only to find huge investments in this space. While these campaigns can certainly build awareness, they pale in comparison to the effectiveness of easy access.
Our mantra, therefore, needs to shift. While we continue to push quality and outcomes, the operational focus for growth has to be relentlessly centered on access. This isn't just about adding more appointment slots; it's about re-engineering the entire patient intake process. Making it easy. Are your clinic templates optimized? Are you leveraging APPs and the entire care teams to their full potential for appropriate new patient evaluations and follow-ups? Are your schedulers empowered and trained to be facilitators of access, not as gatekeepers protecting the realm? Is your phone system a welcoming portal to the practice or an inadvertent barrier? Are you using the electronic health record to its highest advantage?
Over and over in cardiovascular programs nationwide, I've seen the strategic advantage of access. The groups that obsess over minimizing the time from referral to appointment, that make their schedulers heroes of efficiency, are growing market share and volumes. They understand that being easy is a profound strategic advantage.
While we chase the accolades, the five-star ratings and the groundbreaking research, let’s not lose sight of the most fundamental driver of overall program patient growth. It’s not complicated, but it does require diligent, persistent effort. When it comes to cardiovascular program growth the three most important words are, "access, access, access.” Make it easy, make it timely, and watch the market respond.