Patient Retention and Customer Referral, Article three, Consultation Room

In this the third article I would like to move on to the consultation room, initially I would like the cover the environs of the room but also the consultation practice itself. I shall attempt to cover the room and the structure of the consultation in this article and explore the consultation in a deeper manner in the next. We have reached the consultation room, the inner sanctum, the place where we have traditionally thought the real action occurs. It is indeed all of those things, but I hope I have showed in my previous articles that it is indeed not the whole story when it comes to Patient journey and engagement.

When you enter your consultation room, take a good look around it and ask yourself, what does this room say about me and my day to day practice? I undertook this exercise after I had been in practice for a while, initially when I started my practice day to day thoughts just centred on my audiometery and hearing instrument fitting, my main worry was that I did not make a mess of these elements. After I had settled down and realised I was the king of practice, sorry can't resist. I began to concentrate on the sales elements that we all undertake in our consultations, slowly but surely finding my consultation style. With this done I began to look at my consultation room, it's appearance and design and how I could change that to engender the perception I wished and allow me to connect with my Patients.

I realised that my consultation room was a mess, between hanging cables, the bane of our existence these, tackle boxes full of tubing etc the usual day to day detritus of a practice. I also realised that I sat behind a desk, talking to my Patients, when I thought about this clearly it seemed immediately the wrong position to be in if I was trying to engage with my Patients. So with this in mind, take a long look at your consultation room, store your cables and paraphernalia out of site, whatever you use during one consultation, put it away afterwards. The only things that should be visible on your desk are the fixed apparatus that we use every day. An audiometer, a computer monitor and a keypad, your otoscope and very little else.

If you do not have proper storage, get some built in or indeed buy a nice piece of furniture to store everything in, keep it tidy and keep everything in its place. There is nothing worse than searching like an idiot for something whilst your Patient looks on. Change your desk aspect; place it in order that the Patient and their significant other sit beside you as opposed to across from you. This allows a greater feeling of engagement with your Patient, it also closes the physical gap between you and them, allowing the Patient to relax somewhat and as the consultation moves on to emotionally engage with you in an easier manner.

Position the equipment on your desk including your computer screen and keyboard in an aspect that always allows you to be looking towards the Patient and the significant other. This allows constant engagement with both of them, if you want real long term commitment from your Patient you will need to engage with their companion/family also. This is imperative; engagement with the Patient's companion will increase the commitment to you and your advice from the Patient. That engagement needs to start from the initial consultation, if not during the actual making of the appointment.

The Walls of your consultation room also need to be looked at strongly, do you have anatomical display posters, and are they properly farmed and hung? Again do you have manufacturer posters, are they properly framed and do you update them? If you do indeed have manufacturer posters, why do you? I am still unsure if it is indeed a good idea to have such marketing elements in a consultation room, having those elements does not speak of an independent clinician. Having half a dozen of the different Manufacturer posters speaks of a supermarket, I am not sure if there is an in-between so hang a nice relaxing picture instead and of course your qualification.

Keep it clean and tidy, tidy up during the day if need be, you wish to be perceived as a consummate professional with a deep sense of empathy and caring, you need to display that consistently. Before you open your mouth, your practice initial communications and the deportment of your staff has already said a great deal.

In order to have a maximum effect, the actual consultation needs to be well planned and enacted, in the planning stage you need to think strongly about Patient perception and psychology and what indeed you hope to achieve. Whilst Audiologists or Dispensers are mostly caring and motivated by the opportunity to make a real difference to somebody's life, we got to eat, so assisting somebody is balanced with making a sale. Most of our Patients, do not want to buy, in fact the last thing they generally want is hearing aids. It is with this fact in mind that we see the challenge we face every day, how do you convince somebody that they need a product they do not want without falling back on the optimal negotiation position (the head lock for those who don't know).

With these stark facts in mind you need to design a consultation that allows you to convince them of the benefits of a device without any perception of a hard sell. This is possible, not only is it possible but there are gifted Dispensers doing it with effortless ease every day on instinct, for you and me I am afraid we have to work at it. You may think that planning a consultation to influence people surreptitiously is underhanded, but if like me, you think you are an excellent clinician who deeply cares for your Patient. Does it not follow that you should undertake every possible action and explore every avenue to ensure a Patient comes into and stays in your care?

The stages of a consultation are qualifying to see in fact if a Patient has a loss, overcoming objections to meet any queries, worries or objections that a Patient or indeed the significant other has and closing the sale. The consultation does not necessarily fall in that order, the initial part of the consultation should be a mixture of qualifying and overcoming objections which leads to testing and then the close. Think deeply about this process, come to conclusions and then design a medical record card that follows the flow that you have chosen and includes headlines that cover all the questions that you wish to ask and indeed answer.

For instance, any attitudes to hearing aids should be assessed before the test, because any conversations that you have around BTEs versus ITEs, binaural versus Monaural, lifestyle needs, medical contraindications to certain devices etc will be seen as advice at this stage. After the test it will be perceived as you selling your point of view. Every professional should use the COSI and integrate it into their consultation, I have written of it before and I still think it is one of the most powerful tools which encourages emotional connection with your Patient and allows you to really understand their lifestyle needs. It also allows you to clearly manage their expectations and to agree a roadmap for your Patients care. All of this from an A4 piece of paper that practically explains itself.

Client Orientated Scale of Improvement, COSI and its uses for your practice.

Emotional engagement is the key, when you make an emotional connection with your Patient it allows them to trust you and feel that you not only understand them, their needs and problems, but you care enough to try your damndest to fix those problems to the best of your ability. This is the key to Patient retention, the crux of the matter, if a Patient feels cared for, that they are not viewed as just a wallet with cash in they feel that they are in a worthwhile relationship. If they feel that they are in a worthwhile relationship, they will stay in it, not only will they stay, but they will tell others about the wonderful caring new friends they have found.

The point is simple, to keep a Patient and gain their friends, treat them like a human being, treat them like they matter to you, their problems matter to you and more importantly the outcomes of their care matter to you. Because these are the things that matter to them.

Patient retention and Customer Referral, Article 1 of a series.

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This is the first in a series of articles that I hope will help you, maximise your business opportunities, serve your Patients well and thrive in what are tough economic times. I would like to stress that my only qualifications for this advice are a lifetime of varied, diverse and sometimes personally terrifyingly stressful employment. That and common sense, oh and elements that worked for me when I was a practicing Dispenser.

With the prevailing economic situation, particularly in Ireland, but indeed also in the rest of the world, businesses of all sizes are looking at strategies to maximise opportunities and decrease risk. It appears to be something that is prevalent within our industry as more and more businesses find themselves with decreasing returns on traditional marketing elements and the prevailing sense of downward pressures on margin and therefore profitability.

While it certainly seems that return on investment on traditional marketing appears to be almost nonexistent, more and more of the people I speak to on a daily basis feel that they have to invest in these strategies for want of anything else to do. Although traditional marketing is still valid I feel that a key area that has been ignored is customer retention and referral. One of the key buzz phrases that are in ascendance at present in our industry is Patient Retention.

It seems strange to me that this concept almost seems to have come out of the blue for some people in our industry; customer retention is probably the central tenet of every industry in the world but appears to be new to us? What is Patient Retention and indeed how best can we achieve it? Patient Retention is simply the concept that your Patient is so ecstatically happy they will never go anywhere else.

How do we achieve this, the holiest of grails, in our practices as we move forward? Patient Retention is a long term goal, something that will really begin to affect your bottom line in the future, or is it? The efforts that you put into ongoing Patient Retention can immediately affect your bottom line through customer referral. In order to achieve Patient Retention and customer referral, you need to put comprehensive and all encompassing strategies in place that makes your Patient ecstatic about you and your practice.

In order for customer referral to happen, you need to make your Patients evangelists for your brand, happy customers are just not enough. A happy customer may tell a few people how good you are, but evangelists will become active advocates for your business, publicising your brand far and wide. Word of mouth sales are indeed the best sales, because most of the impediments that traditionally exist to a sale have been removed prior to your consultation. The strategies that you put in place to bolster your Patient Retention are also designed to increase customer satisfaction and will lead to evangelist customers. A more common term for these Patients is Relationship customers.

Most Patients have no brand awareness when it comes to hearing instruments, their loyalty or otherwise is based on the perceptions of your practice and their perceived treatment at your hands. This is of course with the exception of once you go Widex, you never go back! Shameless plug alert, I am sorry, I just can’t help myself. So what you need to do is to take every opportunity and make opportunities to shape their perception of your brand, the brand of you and your practice. While some patients leave a practice because they move away or indeed die, the majority of them leave because of a perceived attitude of indifference.

Feeling ignored when entering the office, being rushed through an appointment, leaving without having questions answered, or not having a problem solved in a timely manner may be sufficient to cause a patient to search for a new practice. Since the routes traditionally used appear to have become ineffectual and the cost incurred of acquiring a new patient has correspondingly exponentially increased. It would appear that the retaining of a current patient is critical to the profitability of a practice. It has become critical to maintain a relationship with a Patient for as long as is possible and to design strategies to service this need.

Developing a relationship with a patient may be the best way to maximize not only patient retention, but furthermore, patient satisfaction and patient satisfaction is the route to evangelism. There is some evidence that an overwhelming majority of consumers, make important purchasing decisions based upon relationships, and we have no reason to believe that our industry is any different. Relationship buyers are customers who like your products and services. They build a relationship with your employees and they think of your company as the primary supplier of their needs within your category.

They do not want to be bothered to have to shop around every time they make a new purchase. They look for quality, good service, helpfulness, friendship and information. If you supply these things, they will stick with you. Every element of your practice has a direct effect on the perception of your Patient/Customer. From your shop front and display, waiting area, receptionist, consultation room, consultation manner, presentation skills, after sales service, communication style and so on and so on. The fact that there is so much for you to think about and possibly change should not deter you from doing it with gusto. In this article I would like to discuss the Patient journey and how within this journey you can best effect your Patients perception of you and your brand. The rest of the articles will address the other areas of your practice.

Our Patients/Customers have become ever more sophisticated and most businesses should adapt their planned Patient engagement and service scheduling to reflect that. The general model for Patient engagement I suggest to increase Patient engagement would be:

• Test and sale
• Fitting
• Rehab visit/Fine tuning Visit at one month
• Possible further Rehab/Fine tuning Visit
• Service Call at six months to continue at six month intervals.

This journey is designed to maximize Patient engagement with you and your practice which gives you maximum opportunity to shape and enforce a Patient’s perception of you and your practice. This journey also allows for several communications a year with your Patient, structured mailings that don’t feel like junk mail. I believe that less is better with direct marketing, I have watched for years the some elements of our industry bombard their Patient database with mailings about new products etc with dismay.

The introduction of the Patient Journey to your practice allows you to mail your Patient on a regular basis with communications that are perceived to have real value for them. It also allows you to maintain your Patient engagement and keeps you in their minds. The structure of the Patient Journey also allows you to introduce the subject of new technology at a seemingly apt time.

You will mail your Patients every six months to return to your office for service, you can also mail them perhaps twice  yearly campaign offers on ancillary products such as buy two packs of batteries get one free, or buy re-fill drying capsules get cleaning tablets free. It is important that the mailings are structured and well thought out; they must also be pertinent to the Patient. Don’t forget a Christmas card, get them printed, take the time to personalize them, have yourself and your staff sign them and send them out.

If your Patient is returning to you every six months, you do not need to send them offers on new technology, you can tell them about it, show it to them in person. If done properly and at the right time it will not appear to be a sales push, it will merely be more of your famed education and good advice.

What briefly follows is the structure of the service calls that I adopted

Service Call 1: Review Patient’s experience, clean aid, clean mould if necessary, change wax cap if necessary, change tubing if necessary, fine tune aid if necessary, ask about need for ancillary products. Time scheduled 15 to 30 minutes.

Service Call 2: Review Patient’s experience, hearing scan test, clean aid, clean mould if necessary, change wax cap if necessary, change tubing if necessary, fine tune aid if necessary, ask about need for ancillary products. Time scheduled 30 to 40 minutes.

Service Call 3: Review Patient’s experience, clean aid, clean mould if necessary, change wax cap if necessary, change tubing if necessary, fine tune aid if necessary, ask about need for ancillary products. Time scheduled 15 to 30 minutes.

Service Call 4: Review Patient’s experience, hearing scan test, clean aid, clean mould if necessary, change wax cap if necessary, change tubing if necessary, fine tune aid if necessary, ask about need for ancillary products. Time scheduled 30 to 40 minutes.

Service Call 5: Review Patient’s experience, Clean aid, clean mould if necessary, change wax cap if necessary, change tubing if necessary, fine tune aid if necessary, ask about need for ancillary products, talk briefly about new technology & current offers. Time scheduled 15 to 30 minutes.

Service Call 6: Review Patient’s experience, hearing scan test, clean aid, clean mould if necessary, change wax cap if necessary, change tubing if necessary, fine tune aid if necessary, ask about need for ancillary products. Openly discuss changing to a new product and assess readiness. Time scheduled 30 to 40 minutes.

Service Call 7: Review Patient’s experience, Clean aid, clean mould if necessary, change wax cap if necessary, change tubing if necessary, fine tune aid if necessary, ask about need for ancillary products, talk briefly about new technology & current offers. Time scheduled 15 to 30 minutes.

Service Call 8: Review Patient’s experience, hearing scan test, clean aid, clean mould if necessary, change wax cap if necessary, change tubing if necessary, fine tune aid if necessary, ask about need for ancillary products. Advise changing to a new product and assess readiness. Time scheduled 30 to 40 minutes.

This schedule allowed me to meet my patients on occasions where I was calling them for an appointment, not them chasing me. It increased my engagement with them and allowed me to build a real and strong relationship with them. Whilst this patient journey is a major element of the strategy for engagement, it only facilitates the other strategies and procedures that you put in place. You need to put a clear and stringent communication policy in place in your practice that everyone is aware of and adheres to. The policy should cover everything from how you expect patients to be greeted on the phone and indeed in person to communications structure, who, when, why.

When is a mail sent, two weeks before a service call? Who does a follow up telephone call to verify the appointment? When a telephone query is made, who actions it, what answers are given etc. Exactly how long is too long for the return of a phone call? The key to success with communications strategy and relationship building is a well designed and well maintained CRM. A CRM is only as good as the people who enter and read the information on it. I kept a simple word file on every Patient with details, name of children, comments made at appointment, membership of groups, interests etc. This allowed me to review these notes before every consultation to refresh my memory with these details.

The perception that you and your staff remember the minutia of a patient’s life is what builds relationships. How is so and so? Did so and so get that job? Did your Grandchild so and so get over the measles? I remember you love the Opera, did you hear such and such is coming to town? These comments are the foundations of a relationship; they show that you have a real interest in your patient and their lives. Train everybody in your practice including receptionists to prepare their own notes that allow them to maximize their engagements with every patient.

There are plenty of commercial CRMs available relatively cheaply now, particularly cloud hosted ones that allow everybody within your organization to access centralized data that allows you to remain current on your customers, the activities pertaining to them that have occurred and notes pertaining to them. Get one and use it religiously, but put a clear policy in place that every person in your organization follows. That is the only way that it will maintain its usefulness and maximize its full potential for your business.