How To Identify What's Working And What Isn't - Practice Perfect Podcast Episode #1

Practice Perfect: Actionable business information to take your medical practice to the next level. Now your host, Nick Dumitru.

Nick: [00:00:27] Welcome to the first episode of Practice Perfect, the podcast for medical professionals and anyone that's running a professional services business as opposed to a bricks and mortar store. I want to thank you for joining me today. Before we get into it, today's topic is going to be all about the number one problems that most cosmetic and medical practices face but that you may be facing and not even be aware that you have. I'm going to get into that in just one second. Before I do, I wanted to talk to you about why I started this podcast. When you're listening to marketing information, when you're listening to business advice, it's often coming from individuals that are used to working with businesses whether that B2B or B2C. It doesn't matter but the tactics and the strategies that they use are often not applicable to a medical practice. I'll give you one simple example. In many states in the U.S., provinces in Canada and in many countries, Western countries, around the world. We have laws and regulations around fee splitting, where you are not allowed to share your income from a patient with any other third party. Now this differs from state to state and the severity of it and how much is policed tends to differ. But generally speaking if someone comes into your practice and offers for you to do a referral arrangement in lieu of a kickback, that can put your practice in jeopardy.

Nick: [00:01:51] The other thing you might see is outrageous discounts or crazy tactics that can leave you feeling embarrassed. You've still got to go to the annual meetings and meet your colleagues and you don't want to be that guy or that woman, you know the one I'm talking about — the one that everyone snickers about behind their back. The one that nobody truly respects. Even though they may be doing OK they have lost the respect of their peers and they've lost what they worked so hard for over the years all for the sake of trying to make a buck in their practice and over the Internet. So the reason that I started this is to have a discussion to have a platform to talk about tactics and techniques that can get you more patients, get you more business, get through the lifestyle that you want, but still leave your dignity intact. You don't have to sacrifice who you are, who you've become, what you've worked for to be successful in your medical practice. So that's the reasoning behind it and that's why we're here today. That's why I'm going to be bringing you information that works, information from the field, information that we use with our own clients, things that we're actually doing, not just theory not, just something that sounds good on paper but hasn't ever been proven or tested. We're going to be talking about tactics and techniques that have made seven and eight figure businesses out of six figure businesses six figure practices. So let's get into it.

Nick: [00:03:13] As a doctor I know that it's hard. It's not easy to not have somebody to confide in and that's the situation you're probably in. That's the situation most of our clients are in. When you talk to people at the meetings when you meet your colleagues you know it's very acceptable to speak about cases. It's acceptable to speak about difficulties you may have had in surgery or when an implant didn't work or whatever other medical mishap may have happened. You're probably comfortable to talk about that but you're not comfortable talking about this. You're not comfortable talking about the downfall the struggles that you're having. There's also a sense of competitiveness sometimes. It's an interesting dichotomy because there is competitiveness but there's also the collegial attitude because you're still fellows. So there are a lot of things that are keeping you from getting the support system that a regular business person would have. They would have someone to talk to without feeling embarrassed, without feeling like they're disclosing secrets, without feeling that they will be judged or that others will talk about them and, let's face it, the medical community is a pretty tight knit group. It's a pretty small community in terms of doctors at the end of the day and it's hard for anyone to keep anything truly secret. And for that reason I find a lot of doctors, and you may be one of them, are feeling left lonely and with no place to go or turn to and that's what I hope that this podcast will be for you. It'll be a place for you to turn when you're out of options, when you're not sure what to do next and when you're not sure where to turn to get answers. And I will try to bring you the highest quality information possible. All right down to business.

Nick: [00:04:50] What I'm going to talk about today is the number one problem facing most practices and it's not getting more leads, it's not getting more inquiries to the practice. This is something I've seen happen frequently and I'm seeing it more and more these days with the clients that we take on. And, that said, even though they're getting a flood of leads, a flood of inquiries to the practice, they are not able to convert them. And the number one problem facing most businesses is not a traffic issue to their website and it's not leads, not inquiries. It's taking those inquiries and turning them into paying patients. And there's a lot that goes into that and I'm gonna discuss a few of those things with you today. So let me know if this sounds like you when you're listening to this. When someone calls your practice are you absolutely certain that your staff is picking up the phone? When someone e-mails are you absolutely certain that 100 percent of those e-mails get answered in a timely manner preferably within 5 to 10 minutes that the bare minimum within an hour or in some of the worst case scenarios I've seen is over a day sometimes three days before someone gets back to them? Are you sure your staff is doing everything possible to treat that incoming lead with the value and the care that they deserve? If you can honestly say yes, then fantastic.

Nick: [00:06:05] I find that most people even when they answer yes, when you do a little digging, they don't record the phone calls so they don't truly know what's happening. If they do record the calls, no one's vetting those calls no one's checking them to see that the staff is doing a good job. No one's auditing the e-mail logs. No one is even checking the spam folder in most practices. Most people that we deal with we ask them you know how often do you check the spam folder. Do you go in there two to three times a day just to make sure that nothing got stuck in there that there's not a patient waiting for a reply? That there's not somebody that inadvertently went in there because your spam filtering software put them there by mistake? And the typical answer is that they don't know. They, they just don't know. And when you dig into it usually no one's checked the spam folder for quite a long time. Definitely not daily. So those are just a few little things that we see. And if you can honestly say that you're doing that for everything that's fantastic. I would wager to bet that that's not the case which is not bad news. Right. So if you're listening to this and you're feeling a little bit down about it if you're feeling that oh crap. How could we have missed such obvious thing? It's fine. Look at it as a positive anything that you learn anything that you hear and anything that will be going through today. That's new information and that you can act on is great news for you because you have an upside you are no longer stuck. If you can fix something, if you can do something about anything that you hear, that means that you're moving your practice forward. You're moving yourself forward and you're getting more out of what you've already got. And that's the goal.

Nick: [00:07:37] The first part of tackling a conversion rate problem is tracking. What I mean by tracking is when somebody calls, e-mails, texts your practice that you log that inquiry, and then you track that inquiry through its full lifecycle and find out what happened. Now, we'll usually go with 30 to 90 day life cycle with most of our clients because anything beyond that is a bonus. There are people that will take six to 12 months to 24 36 months to make a decision to have surgery, but at the end of the day you can't optimize based on a 36 month lead. You want to try to optimize and maximize that three to six month window because that will put money in the bank and that will give you the stability in the cash flow that you need. And then we look at all of the rest of it as kind of a bonus and we can go back retroactively and see what that real number was after 12 months. But when you want to make a difference you want to track over the initial period so that you can adjust and spot any problems in your business. Now, if you don't have software in place to do this I don't want you to feel despair. If you can get it great. There's great tools out there like Sales Force and HubSpot cloud based tools that you can put in. There's software dedicated to cosmetic practices cosmetic dental practices whatever particular field that you're in. There's usually software that can do that. It's oftentimes expensive and you may not want to invest in it just yet and I'm here to tell you that it's fine. You can do this with just a spreadsheet, for now as long as you're doing something. The danger only comes when you do nothing. And that's where I don't want you to be. I don't want to be not tracking absolutely anything moving forward. So that's your first action step: are you tracking these leads? Are you tracking them from the inquiry to the booking? That's the first number that you want to have. And are you tracking the booking to the show?. How many people booked versus how many people actually came in? That's another important number. Are you tracking them from the show to the close? How many actually booked surgery and then actually had surgery after that? Right. Another important thing people do cancel from time to time, but if you have all these numbers in place at least you know what's happening. And another number I want you to track is the average sale. The average sales amount. This is important because sometimes you can have your staff giving out discounts which takes you into the negative depending on what you paid for your leads. So you want to make sure that you've got all these numbers tracked on a spreadsheet through the lifecycle of the patient and spot any errors.

Nick: [00:10:01] Now I will from time to time speak to people that are claiming to be doing this. They say that they have their numbers tracked and that they know exactly what their closing rate is. So I will ask a doctor sometimes, you know, what's your close rate on the leads that come in on the patients that come into your office? And they'll tell me anywhere from 25 percent to 80 or 90 percent. But there is a danger in that. And the danger that most people are not tracking cold versus warm leads. So was this patient referral or were they someone that came in from an advertisement online with no previous knowledge? Because if you are having problems closing a referral you've probably got bigger problems than just tracking, right. Like that's a big big issue. There should be a pretty much a gimme. He still has to work that case. But you should be able to close a high percentage of people that are referred to you from other patients that have spoken highly of you.

Nick: [00:10:52] Now cold prospects, people that are coming in from your marketing efforts, that's the important number because while you can do things to help your patients refer, you're really at their mercy. You don't have control over that, right? You can try to incentivize, you can try to keep in touch with them, make sure that they know about you all the time and then they will refer when they come across someone that is refferable. But that is extremely hard to scale. That is not something that you can go to your marketing company and say, hey spend another 10 20 30 40 50 60 thousand dollars on ads this month and get me more business because we can handle more. You just can't do that with referrals. It would be extremely difficult to motivate someone to randomly and spontaneously refer people to you if that person is not ready, especially with something like plastic surgery. I'm not saying it's impossible or that we haven't done it but it's not where you want to start in your practice.

Nick: [00:11:45] So the cold leads. And when I say lead, I'm referring to a patient that is inquiring about a medical cosmetic procedure or a medical procedure of any kind that you perform and you're doing it as a service to get paid. I'm not talking about a list of individuals for example that may have been scraped online or bought from a database. I'm talking about a patient that has selected you as a person to contact as a doctor potentially for them and that has a chance of moving forward. OK. I just wanted to clarify what a lead was when I say lead. Now the advantage to that call leads like I said is scaling and being able to grow your business in a predictable manner. And I want you to start tracking those people separately, because they need to be treated much differently than someone that comes in as a cold referral. For the most part it will take a little bit more work and that's the number that matters to your practice. The referral number is great but as I said you should be doing a good job. You really want to try to scale and grow and get the lifestyle that you want out of your practice and the way to do that is to advertise, bring in those people, move those people from a prospect to a patient, to a person that's had a procedure with you and has paid.

Nick: [00:12:54] So let's talk about how to do that. It's all well and good knowing that you have to do that, that you have to track. But how do you get someone from being a prospect to a patient. The important thing to know about that process is that, and this doesn't matter what field you're in. The important thing is that they do three things. They have to know who you are. They have to like who you are and they have to trust what you can do and that you're an expert. Alright? So I'm going to go through those three things again because they're crucial. They need to know you. Right. And I'm not talking about your medical credentials only. I'm talking about you as a person. What are your hobbies? Are you a family man? Are you a mother? Do you have brothers and sisters? How do you spend your holidays? We do this through social media. We do this inside the practice with the photos that are displayed in the consultation room in the doctor's office. The Thank You cards That are displayed. Stories newspaper articles, anything that you've got that can get them prospect to like you or to know you will go a long way to them closing into a patient because people want to buy from people that they know and they don't want to buy from strangers. Were hard wired, you know stranger danger from when we're kids. Don't talk to strangers, right. It's beaten into us. We then turn around and teach our kids the same thing because we know that strangers are not safe and they can take advantage of us and they can do things to us that we may not like. They can rip us off. Right. So if we don't know the person that we're buying from our guard is very high, right. That patient's guard is very high and she's very critical and she's trying to find reasons that she wants to buy from you but that you're legit and that you're not ripping her off. So getting them to know you is a critical part of the process and it's one that I find that it's overlooked on most plastic surgeons' websites and it's overlooked on a lot of websites in general where they will treat it as a cold interaction very businesslike, completely unfriendly. Social media is very cold, it's all about business, and this is not just for you what I'm speaking about. That's your entire staff. They are interacting with the staff. You have to get them to know your staff. You have to post your office parties online. You have to post birthday celebrations that you're having at the office online. You have to post what's going on there. Do little videos. Before the person even hits the floor in your practice, you want to make sure that they know as much as possible on that they are engaged with you and with your team. Now the next part of that the knowing can become a positive or a negative. But they have to like you. They have to build a bond with you in such a way that they start to trust you. They want to be part of what's happening there right. So your staff has to be friendly on the videos. They have to be approachable, they have to be kind, they have to be empathetic, sympathetic and knowledgeable, all at the same time. And you have to be the same way. So if you're not good on camera, stick to pictures and words. If you maybe have a voice that's not agreeable and you've been told that before. Don't put your disadvantages forward. It's OK to acknowledge the faults and to work around them.

Nick: [00:16:11] Now the last thing that I mentioned is that they have to trust you. Trust at the end of the day comes down to authority. I tell our clients this story. I'm a man obviously. Typically I dress and work attire, Either a business suit or casual business wear. If I went up to a female and I told her take off your shirt let me see your breasts. What do you think would happen to me. If your answer is some sort of violent act and possibly imprisonment, that's exactly correct. But think about yourself now. As a physician you wear the cloak of authority and you are looking at people's bodies every single day with no objection and no consequence. And what's the difference between you and I. What makes you different from me is that you have a medical degree and you can wear a white lab coat and then you can behave as a physician and do things that the rest of society and the populace couldn't do and it's very important that you understand that. It's very important that you acknowledge the power that you have with that and understand that it has nothing to do with your years of medical school. It has nothing to do with how much work you've put in. It has everything to do with societal conditioning to doctors. And I'll prove that you. A conmen, and there are cases, where a conman has put on a physician's outfit and acted as a doctor. There are cases where that's gone on for years and that person has behaved and acted with the same rights and privileges as a physician without any of the schooling. So now you can understand the schooling didn't matter to that person. So he never went to medical school. He does not have a degree, but he used the conditioning that the physician is trusted and has gone to school and has a degree and has specialized knowledge and has put on the uniform of a doctor and acted as one. So understand that trust comes from authority and authority and expertise is what gets people to trust you. And it's not the actual expertise. You could be a great physician. But if that's not well communicated it becomes completely irrelevant. So how do we gain trust? Trust is built by demonstrating knowledge and in the absence of that individual being able to sit next to you during a surgery and observe how great you are and how skilled you are and how well you manipulate the instruments and with what dexterity you're able to perform, you have to start doing that communicated through your website. Your online videos, your YouTube channel, your social media. And I'm not talking about filming your surgeries I'm talking about displaying specialized knowledge that is different from your competitors. The number one thing that you have to do as a physician, if you want to market your practice, is differentiate from everybody else. You don't want to be a "me-too" in the market. You have to communicate what you do that's different, and you have to show them that it's better, and through that process they get to trust you. And that's in addition to the authoritative items like your diploma, your schooling history, all the other great things you know the associations that you belong to, those are given. But above and beyond that, you have to demonstrate a specialized level of skill that's advantageous above and beyond all of your competitors.

Nick: [00:19:32] So let's say that you've done all that. The patients come to your practice. They've engaged with you beforehand. They know who you are. You know about your family your dog, Boo-Boo, and everybody in the practice, they know them by the first name. They think it's a fantastic environment. You're an expert, they can trust you they walk through your office, they see or diplomas but they still don't buy. And they go home. And they don't call back. And that's the case that I see in a lot of practices. And when I asked them why that is, it's usually just blank stares. We don't know. We don't know what happened. We did everything right. And I'll tell you that the number one thing that's missing is a reason for the person to move forward with their surgery. And there can be a lot more things, but for the purpose of keeping this podcast to a reasonable length, You know please come see us at ThinkBasis.com And get the show notes there. Feel free to engage with us there. Ask any follow up questions that you have and I'll be happy to reply to your emails when they come in and go through any kind of specific questions that you have.

Nick: [00:20:36] But right now I want to talk about the principle of scarcity and the act of taking action. In the absence of a reason to take action, most people won't. So understand that you're not only competing with other physicians, with medispas, with other choices like going to the gym if it's liposuction, for example, and maybe trying to lose that weight in other ways or a diet program with the weight loss doctors. You've got all of these competitors but in addition to those competitors you've also got the option of doing nothing. The person doesn't have to do anything. They can stay comfortable, not risk pain, not risk discomfort, maintain the status quo and keep going with the thing that was keeping them unhappy in the first place. In the absence of pain or motivation, the status quo is just fine for most of the population. So you need to start thinking in your practice what can I do to motivate that person to buy. So the principle of scarcity means that people will go after that which they perceive to be in short supply. So if your time is in short supply, if your surgical availabilty is in short supply, that can often be enough to motivate them forward. So one critical mistake I'll see a lot of practices make is when they're talking to their patient, they will say something like, yeah sure we can get you in next week or the week after that or next month or in January or in June July. They just give the patient all sorts of options. It's almost as if the patient shouldn't make a decision right now because she could do it at any point. Instead of that even if you have unlimited availability, start by giving the patient one maybe two choices. We could do your surgery next month or in two weeks at 8:00 a.m. or I've got an opening two months from now at 3:00 p.m. Which works for you? Oh I'm sorry, neither of those works. Oh, okay, I'm going to have to try to work around something. When would be a good day free? I'll try to shift something around. See, rather than trying to serve them, you're managing their expectations and you're managing their perceptions of what you're offering and how busy your practice is. We make all of these thousand subconscious and unconscious decisions about the situation that we're in. Our brains are hardwired to keep us safe. They are hard hardwired to get us food, to get us resources so that we can survive. And if the resources are plentiful we don't need to feel a sense of urgency. Everyone's heard the story of the grasshopper in the end. And if you haven't, look it up, it's a nice little children's story I'm sure you're familiar with it. But basically the ant was working all summer preparing for the winter and the grasshopper was just playing in the field and doing nothing because he had no sense of urgency. And when winter came obviously he was in trouble while the ant had plenty.That same conditioning and that same ancient mechanism in the brain keeps that patient from taking action when you present abundance and availability so you have to try to remove that from the situation. You have to remove it from their mind and start to move them along the buying path. So the other thing that that mechanism does, is it takes them from considering whether to do it or not, to when to do it. So you see in the mind that's a critical step forward. I'm not just thinking about should I do it or not do it right. The choice is not should or should not. It's when. And that's a step closer to them having the surgery as opposed to getting stuck in the should I should I not I could do it any time let me call you back. You want to move beyond all of that. So scarcity is a powerful motivator and it can be applied.

Nick: [00:24:22] So I used availability, right, so that is limited surgical time as scarcity. You can use time as scarcity. Let's say that you happen to be going away for a month. Oh, Dr. Jones is going away for a month. He's got conferences. If we don't book it now I'm not sure when things fill up as he's gone because he's not here. People choose their dates and it could fill up. I'm using time scarcity now, time pressure due to an event. I'm not asking you to lie, it should be a legitimate event if you're planning to travel have that as a trigger for your staff to start using it to try to increase your closing rate. But that's a different kind of scarcity. It's a time deadline type of scarcity. If appropriate you could try price scarcity. If you've got a reason why, let's say you know you're going to be raising your rates, or you want to reward people that take action and you can do that in an ethical manner, then what you can do is offer some sort of price bonus if they book their date on the spot. You know that's not my favorite kind of tactic but it's another kind of scarcity, so you've got two days, one day right now to make a decision, if you would like to get this FREE BONUS OF 500 or a thousand dollars towards your surgery, whatever it might be that you decide to implement: an extra 10 units of Botox or an extra syringe of Juvederm with your surgery — whatever it is that you feel you can give away. To move them to take action. Look at it. Talk to your staff, brainstorm internally and try to apply.

Nick: [00:25:53] The other thing I want to talk about when it comes to conversion is the fact that a majority of patients will not make a decision on the spot. You cannot necessarily close everybody that comes in, especially if they're very far upfront and they're buying cycle, they're not ready to make a decision within the next couple of months. They're maybe going to see two other doctors or they've seen a couple and they want to see a couple more. So how do you gain the sale when you're not even there?

Nick: [00:26:20] And what I'm seeing more and more and that's happening is that physicians are not paying attention to the other decision makers in that patient's life. When she leaves your office she should never leave empty handed and she should not leave with generic materials and photocopied pieces of paper that look unprofessional and that reek of a lack of caring. When that patient goes home she should be going home with a carefully crafted package that illustrates everything about you, why you're a great physician and a great humanitarian, a great human being, why your staff is so friendly, and your specialized knowledge and authority on the surgery, as well as the results that can be achieved if she moves forward. And you want to send her home with that because, oftentimes it's not the patient's decision alone and it's not because I'm not saying that her husband may have something to say in it and that's not right because she should be independent. It has nothing to do with that. It has nothing to do with independence or a woman's right to choose what to do with her own body or external pressures. It's simple human nature. We want to get a second opinion. We want to get the people in our lives to approve of what we're doing because we're afraid of them saying I told you so if something goes wrong. We don't want them to say well see I told you so. That's what everyone's afraid of more than bad results more than thinking that it's not the right doctor for them. They're really worried about their husband, their friend, their mother, their girlfriend, their daughter, their wife (if it's a man having surgery), telling them I told you so you should have gone their wedding. Trust me. They want it to be a joint decision. They want the other person's approval and they want that sense of safety that, yes, another human being also recognizes that this is the right place to go and I'm going to go with it. So I call it toilet material mostly because I always picture the wife going home, the husband grabbing the package going on the toilet and reading it over and making up his mind about what happened. It is how we communicate that very easily because I think that a lot of sales are lost on the toilet. You know that's just a metaphor for when the person gets home and has a private moment to read over the materials their significant other or mother or a trusted adviser is looking over the material and making a decision about you without you being in the room to defend yourself. So if you're not putting in the effort on that front on what goes home with the patient, you're letting yourself down. You're basically screwing over your own practice by not making the effort to send that patient home with materials that will fight for you and fight for that person to go to the right place, which is your practice, to get the right kind of procedure as opposed to going to a doctor that is inferior in skill, knowledge and expertise. And if you're sending them home with that kind of weak material that's not fighting for the patient or for you, you really have no one else to blame but yourself. And that may be a little bit harsh and I'm not trying to be harsh, I'm trying to get through to you and make you understand that you've got upside. You've got potential you've still got options. To improve your practice. It can still move forward.

Nick: [00:29:46] So I hope that's been eye opening. I hope that it's given you something to think about and more importantly, I hope that it's given you something to take action on because taking action is the only way to move your practice forward. I'm happy that you're listening to this. I'm happy that you've joined me here for the past while and I hope that you've gotten value out of that. But what would make me happy is if you went and took action on the advice that you've received today. If anything has resonated with you if you've gotten any aha moments, or I should do that, take a note right now. If you're driving, pull over. If you're jogging stop and write yourself an e-mail on your phone or take a note on your phone. If you can't do any of that call someone and tell them to take a note for you. But I want you to write down the ideas that have come from listening to this and I want you to turn them into a to do list and I want you to either get your staff to help you implement it or go back to your practice and start working on it and move your practice forward.

Nick: [00:30:47] I'll keep bringing you this information. I'm going to keep joining you. This is our first episode together. If you are one of the people that have gone back to episode one or if you're just joining me at episode one I want to thank you. I think that all the information that we put out is going to be valuable and I want to try to bring you the very best advice that I can. I'm going to answer any questions that come in. I want to visit ThinkBasis.com. That's T H I N K B A S I S dot com and check out the podcast section. We'll put show notes there. Engage there. Leave us an email or a live chat message with any questions or anything to clarify and I will bring answers for you on the next episode. So thank you. I will speak to you next time. All the best for your practice. Thanks for joining me.