Ep 41 | Combining Virtual Visits + In-Person Care

Annie: Well, hey there, Leah.

Leah: Hey, Annie, how are you doing?

Annie: I'm good. I'm really interested in our topic today because I actually don't know a lot about how I feel about this or even what I think about it. And so I'm excited to process with you how to combine virtual visits and in person care.

Leah: Yes, I think this is going to be a great topic today because we're really going to be able to brainstorm like how this could be beneficial during the current pandemic and ways we can utilize these different platforms we've learned and been using and how we can start incorporating or those who are incorporating in person care, you know, like how we can work all together with both areas. So I was really thinking like, what ways could it be helpful to combine this, and I think the first thing that came to mind was just reducing the time that we're in person with people was kind of like the first, why would you even think of doing combo visit. And I think that's so important right now. You know, we're all trying to keep our families that we're trying to work with safe, and it definitely gives us another option for doing that. Was there any things that you were thinking, like, what would combo care be helpful for.

Annie: I mean, I think specifically for me living in such an expensive place, I've always wanted an office and I've always dreamed of like, that's where I would do prenatals and that's where I would do back to work consults and I could do pump fittings there and I can't afford an office. It's just too expensive. And then, you know, and then I get into with, you know, doing home visits, it's like, I really don't want to drive for 45 minutes and have to look for parking to do a 30 minute prenatal and, and that can be really hard. It's like that 30 minute prenatal takes up the same amount of space in my consult day as a two hour home visit at the end of the day, like doing, I can't do more visits because I'm still driving around, they still take all this time. And so I really am like, would never have thought before to offer a client. Well, let's just do a follow up virtually because that's not something that anybody was really thinking about. That you would do with somebody who is in your geographic area.

Leah: I never was it really even on our radar. Yeah, I really think so, especially for people that were close by. We might have thought like, yeah, if I'm, you know, helping somebody across the country, maybe, but if it's close by, it just seems like that was always the The smart, sensible thing to do. But now the smart, sensible thing to do and certainly can really help us with time management and and the economic impact is to be able to combine some of these virtual visits. I always also was thinking how doing some combinations could really help with access. of care. You know, we both carry a busy client load, which if you have to add in driving, that's a lot less time that I'm available. And, you know, for these one off visits, like you said, it can be hard to like, Oh, I really need to check in with you in, you know, three days, but oh my gosh, I'm already booked out. It makes it so much more challenging. But when we have like combinations where sometimes we're in person and sometimes we're virtually, you could really set it up so that you could have more easy access to getting those check ins, getting more follow ups. I know for sure, I have had like. A gabillion more follow ups being virtual and have really, really liked getting to have a closer kind of connection to the progress and everything. That's been so neat and I think my, my families are really enjoying that as well. Like, I know you're utilizing that a ton in your practice. You've talked about that before.

Annie: I've definitely seen that it feels like easier to just do like, yeah, well, we're just going to check in and it can be at this time. They're also they're easier to reschedule, move around. Um, I'm able to do, you know, when in these really acute circumstances say, okay, I saw you Friday. We're going to do another virtual on Tuesday. And then we're going to do another virtual on Friday and all of a sudden I've seen somebody three times in a week instead of saying like, okay, I can come back. I'll be in your area next week. And, and then feeling stressed if they, if that time doesn't work. And then I'm like, okay, like, but I'm going to be on the other side of town and how am I going to get there? And what if I'm late? And just, you know, all of those things. And I, you know, I really love that we're seeing the use of virtual visits local purposes. You know, consultants who have been for a very long time and being pioneers. And these were offering skills and Specialized where they're, you know, they're offering something that they really might be the only person who does that, or one of a handful of people who do that. And they're also meeting the needs of families who are living in areas where there is not an I-B-C-L-C who is geographically available to see them. That is a real need. And um, you know, just thank you to those people for seeing that need and being stepping up to fill it. And I also really like that I. Don't have to have that excuse to do virtual visits because I could just be like, I'm just a normal lactation consultant who lives in New York city. I know all of the local referrals. I can, I have been on your street corner, even if I'm not there right now, where you live, you know, and, and that we can have that connection even virtually. I really, really appreciate that.

Leah: Yeah, definitely. So I think that. this combining both virtual and in person care could come with, you know, multiple variations, not just one way to do that. You know, I was kind of brainstorming about this and was thinking, well, you could do a virtual on the front end. Kind of get that intake process out of the way and all, you know, going through all the history and maybe even looking at a couple of the issues and having them start on some things and then, you know, really identifying the critical, maybe more hands on pieces that you needed to do and scheduling that for the time in person, which I really feel like you could shrink that down, you know, from two hours to like 30 minutes if it was just, you know, oral assessment or, you know, something like that, that was really in person or weight check.

Annie: And that model makes a lot of sense. You're basically using the virtual visits as triage and management. And then there, there is a hands on component, but it's really a targeted intervention. So where the hands on piece is actually like this is the special thing we're doing. We have to do this one thing, we're going to be in and out, but the bulk of our care is going to be done virtually. And then the flip side would be where you are establishing care with the family in person, you know, whether it's in home or in the office, but then follow ups are happening virtually. So where you're saying, okay, I've I've had my eyes and my hands on this situation. You and I have established an in person connection. But now what I'm doing is I'm facilitating, I'm there to help you meet your goals, and we're just going to be checking in on how, how's it going towards your goals. And I guess within that, there would be room for, you know, let's do a, an in person check in. But you're really establishing that like, We're not really doing in person for follow up. And I think in both models, it's like we're kind of imagining that the in person piece is comprising a pretty small portion of the care and that most of it is going to be delivered virtually.

Leah: Yeah, I agree. And I think it's, you know, a really neat hybrid because I can think of many ways that parents are going to feel more secure about interact, you know, the work that they're going to do with you, because it's like, you kind of go into it knowing this isn't a one and done, like, I've got this person that's like committed to see me, you know, at least two times in two different ways, you know, I just feel like the parents feel more secure about what they're going to get out of it, but it does come, you know, then to start thinking about, well, are you going to have some change in your, like your pricing structure because you got to present to the family, like, This is basically going to be, I'm going to see you two times. One's going to be in person, one's going to be virtual. And what were your thoughts about that? Like as far as, you know, making it a package deal or just setting it up from the get go, like this is my cost for this and this is my cost for this and you're going to have to pay for both of them. Or I don't know, what were your thoughts on that? Because this is an area I know you think, think through well, you know, like the financing and then we've got to think about all the like, Superb insurance. Oh, my God. Fun components of it. What were your your thoughts as you kind of were thinking through this?

Annie: Well, you know, I think that it's we're gonna have to move away from the whole like this is this huge amount of money. I'm gonna come in and I'm gonna be at your house for a really long time. And then I'm going to provide follow up care by, you know, email or text or phone or whatever it is that you're doing. So this is kind of that's the kind of the traditional in person model is this comprehensive initial visit, which, you know, I've done those for years and that and they they we do them because They're good. They work. And, you know, people are, you know, they understand what that model is. And now here, we're going to be saying it is going to be some kind of combo. There is a package element. And I think what you, when you're coming up with your pricing, what you want to think about is how much do you want to emphasize that this is more than one visit? Like, are you offering I have virtual visits and this is what they are. And if you want me to come in person, I'm going to charge you this. Or are you saying like, I like how you put it. This is one visit in two stages and you know that that, you know, coming up with that pricing to say, okay, how much time am I going to be spending on the in person? How much time am I going to be spending on the virtual? What does that add up together? You'll split it up for the super bill. It's going to be two different dates of service, but really thinking about breaking down your pricing in a more granular way, it might mean going to an hourly model, a time based model and not a, you know, what's included model service model.

Leah: Yeah. Yeah. That's a good way to think through it, because I think, you know, we are the end goal is to, like, try to parse down the time that we're spending in person. I think that's what a lot of the goal of combining a virtual and in person care model would be. because we're coming up with this during a pandemic. We're thinking, I mean, I think maybe later when the pandemic is over, that's what I keep thinking when the pandemic is over, we might be utilizing it because it does really help with like getting the follow ups in and scheduling stuff. Like there are some really big advantages, but right now we're thinking safety and, and really trying to promote, you know, the best. And I think it's so important that we consider like the timing aspect because in the end that's kind of like the end goal. So that's a really good perspective to think through your pricing and how you might be shifting it during this time. And it does seem to go along with insurance codings, which are. A lot of them have the time based aspects, so that's helpful as well.

Annie: I think another way to look at the time too is, so you've got the time for the visit, but also what kind of time frame do you think is ideal for a client relationship? So like thinking about. When you've had those those clients where things went really well, how much time did that relationship span of active clinical management and thinking about packages that take that into consideration and saying, um, you know, like, okay, I'm going to offer a latch support package. I think I have, you know, like the idea being we're going to see you three times over five weeks. virtually and maybe or maybe it's like three virtuals and one in person check and you're going to schedule them within this amount of time because you know from your experience you're like yeah it's like we need some space for them to work things out but I don't want too much time to go by and then actually like using that to frame it to your families to say, this is what it looks like. This isn't a, I, I, a one and done thing. I'm not here. I'm not here to wave my magic wand. I'm not here. As we said in our, how to become an IBCLC episode, I'm not here to come in and latch your baby. We're making a commitment to work together. I'm here to support your goals and I'm not expecting anything to change right this second. It's going to take time.

Leah: Yeah. Yeah. That's definitely a good consideration. And I think, you know, because we're in this new area, we've got to be thinking outside of the box on marketing and how, you know, we're not going to be able to go and keep with our old marketing strategies because that's not what is appealing to people anymore. Like, hey, I'll come hang at your house for a really long time is maybe not high on everybody's list of how they want to interact, but they don't want to miss out on the support. And I think that's such a important way to be thinking through how you might establish the wording and the marketing around this combo of care. And I mean, I think the last thing that you would need to be thinking through is just like the scheduling aspects of it because it is a little challenging knowing that sometimes you're going to need to be in your, you know, your off virtual office space, and then sometimes you're going to need to be in your clinical office space or you're, you know, doing if you're doing in person care in in the family's homes. And so You know, I don't know. I was kind of like trying to brainstorm different ways that you might do this. Did you have any thoughts that came to your mind right away as you were kind of like picturing how this might work scheduling wise?

Annie: Yeah, I mean, I, and this might say more about my own personality than anything, but I really, I like to be in a zone. And stay in a zone. I don't do well when I'm blending my day, you know, where I'm like, okay, in the morning, I'm virtual in the afternoon, I'm in person. So I, you know, like psychologically, because of the, you know, the effort of managing home visits, I just want to have a day where I'm like, okay, this is what I'm doing. And I'm prepped. I've got what I need. I've got all my supplies. I'm not, you know, mixing with my own family until I'm done. You know, this is, it's just carved out as a bubble because I find the virtual visits, I mean, I'm fitting them into family life. I mean, both of my kids. are doing virtual school and I'm like, okay, when are you in your class? Okay, that's when I'm making an appointment available first. And that's sometimes that's easier. And so I have to leave the house and make all the effort to leave the house. I want to just really make the most of that day. Um, and it's, it's very similar to like the thought process of like scheduling home visits and how that workday goes. I mean, I think if you have an office. It definitely makes sense to have an office day. But like, thing is you could like be in your office and do virtuals from the office, but, um, you know, having like one day, cause then you're like going and you're like, you're cleaning and you're in that headspace of like, I have to be super vigilant. And then you can be, have a home day where you're like, I mean, like. Your own home day, you're like, I'm just doing virtuals and like, I, I don't have to like, like take, take it down a notch. Yeah, right. Exactly. I could just like be dirty, you know, , like, it's

Leah: fine. Yeah. Yeah. , I know it is a lot to think about and then I know some people as they're going through this, you know, pandemic have, you know, been trying to do like one in-person family a day to kind of think through like, ugh, all the cleaning and everything doing it back to back like is a lot for. For some people, you know, that might not do the in the zone Annie style, you know, it might be like I can do it once, but that's it, you know, and they might need a break. So that's another thing, you know, could have like mornings are your virtual time. And then, you know, every afternoon you have Like one or two, you know, that you're seeing in person is another way to think about it. And I know, yeah, with like all the cleaning and the, and the extra vigilance that it takes, that might, yeah, might appeal as well. So there's definitely some scheduling things to think of. And I think having like a plan ahead of time, like a schedule, like, um, a plan for your packages. Like, how are you, how are you going to systematically schedule this? Like, you're going to always do the virtual and then, like, two days later, they need the in person or, like, is it always going to be three days later? Is it going to be the next day? You know, like, that kind of thing. You'd really have to be thinking through that, I think, ahead of time so that scheduling just flows a bit more easily and you kind of can get your week booked out. I know that always helps my brain. It's like I know what the week ahead of looks like, you know, if it's gonna be a super crazy week or not so crazy week. I definitely like to have that like in my head starting out. So there's a lot to think of, but I I'm so excited that now we're kind of opening, you know, brainstorming about these different options because I think there'll be ways that we can really serve the families who need our support and helping us think outside the box about creative ways that we can make that really beneficial to them as well.

Annie: Definitely. I mean, this is a great conversation. It's one that I think is really evolving. And you know, you're, you're more experienced with the in person than I am on the other side of this. It's been a lot harder for me to get to people in person and I miss it. I miss it. And I, you know, I think seeing the opportunity, you know, to really push yourself to find what works for you, you know, so those of you that are doing in person consults, thank you for doing them. Thank you for being safe. Thank you for working so hard. And for those of you that are not yet doing in person care because of whatever excellent reason you have for it. Thank you for honoring where you're at because it is. There are no right answers. There's no one thing that you have to be doing. Just be flexible and remember that at the end of the day, it's about helping families meet their goals. And we are equipped to do that with whatever way we can. Absolutely.

Leah: Well put, well put for sure. Well, it's been really great talking to you today, Annie, and I'm excited for all that we have in store over the next couple of months.

Annie: I love it. Well, as always, thank you for joining us. Thank you for listening and thank you for your support. Talk to you soon.

Leah: Bye.