avatar Nick Dumitru

You have to have the mindset that you need to win the business out of the market. You don’t deserve the business. You have to take it. You have to win it. You have to be better than the competition.


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

Nick: [00:00:22] Welcome to Practice Perfect episode number three. In this episode we’re going to discuss how to create a fantastic patient experience. The reason I want to talk about this topic is because the patient experience can make a big difference in how well your practice does. The patient experience is the difference between getting more of those prospects to turn to clients and getting more of those clients to turn to referrals and send other happy patients YOUR WAY. More patients like them that had a great experience, more patients like them that will send other happy patients because they will have the same experience. What I’m talking about of course is patient flow. So what is it?

Nick: [00:01:05] If you’re not familiar with the term patient flow refers to the process of how operation moves through your clinic, from when they get into the door to when they leave. I like to expand that definition and also include everything from the point of initial contact, the first phone number or email, right through to the follow up sequences that you have after they visited you even after they’ve had their surgery. To do this, what I’d like to do is take you on a journey of a cosmetic patient that’s walking through a clinic and as I’m doing this I’d like you to just pause and picture that situation picture that scenario and contrast that with every stage of that journey and how your practice is handling it. I think that you’ll find a lot of opportunities for change, for growth, for improvement and we’ll discuss the specifics of what you can do after this story. So let’s get into it.

Nick: [00:02:02] I’m going to tell you about Joanna. Joanna is a fictional patient. Joanna is going to be the one going through this journey with us. I want you to picture Joanna as your ideal patient. She is female. She is in her mid to late 30s. She wants to have a procedure done. I want you to picture the procedure being one that you perform, one that you’re excellent at, one that you can do better than your colleagues, one that your patients tell you you do a great job at. Joanna picks up the phone after seeing your advertisement, after coming to your website and she calls your clinic, calls the office and the phone picks up in two rings. Pleasant receptionist is on the other end. She answers all of her questions with empathy. She gives her the information that she needs. She asks all the qualifying questions to make her feel like she knows what she’s doing. She offers to book the consultation. That goes well, they find a great time. She gives over her information, her email, her phone number, her name. Everything’s going very smoothly. Joanna feels confident that this is the right clinic because the receptionist has told her about you. She’s credentialed you. She’s credentialed the procedure. She’s told Joanna why it’s advantageous and why she’ll be happy. And she’s selling her the appointment the whole step of the way. Getting her excited about her change, getting her excited to meet you and to come into the office. The call wraps up and Joanna puts down the phone and no more than two or three minutes later she gets an email from the office. She picks up her phone has a look. It’s the same receptionist that she spoke with detailing the time of her appointment, confirming the details of the procedure and at the top of that email is a video. She clicks on the video. It’s a video of the reception staff and the doctor welcoming her, telling her about the appointment and how exciting it will be, telling her about where the office is located, giving her a quick introduction to the office, a quick walk through so that she can see where she’s going and what it’s going to be like when she gets there, telling her that she’s made a great decision and thanking her for booking her appointment. Joanna puts down the phone after watching the video, and she starts to feel excited. She starts to feel like she’s made the right decision. She stops looking at other places online even though she’s booked a couple of other appointments (they didn’t get back to her). So she really feels that your practice is the place to be. She thinks that you’re doing a great job and that you’ll be able to perform her surgery really really well.

Nick: [00:04:25] The day of the appointment arrives she comes on time. She pulls up to the office from the outside. It’s a nice well-kept building. Parking was easy. She knew exactly where to park because the video told her so. And the day before she got a confirmation e-mail. That e-mail told her exactly where the parking would be, how to get up to the office and what to expect. Joanna had absolutely no hiccups because she knew exactly what was going to happen. She opens the door and walks into the reception. The first thing that she notices is that the office has a very pleasant smell. It’s a floral fragrance, not overpowering, not synthetic. It doesn’t cause issues with her allergies. It doesn’t make her feel weird but she does notice that smell and that’s a smell that she’s going to note on her other visits because it’s the same every time she comes in. The sounds that she hears are some soft music, not your typical radio with a gaggle of advertisements, but a carefully curated set of songs that drown out any kind of noise in the background, that drown out any procedures happening in the office, that drown out any discussions that the receptionists are having with other patients, that staff are having with themselves in the back. Not too loud, just enough to provide some background noise and cover any kind of wandering noise around the office. She feels very comfortable because she knows her information is protected. People aren’t going to overhear. She steps up to reception. She says her name. The receptionist greets her with a friendly smile, takes her information, asks her to sit in the waiting area. So Joanna goes and sits down the waiting areas comfortable. She looks around. There’s a large screen TV playing some videos of happy patients. Before she has a chance to get bored, somebody comes up to her and brings her a drink and a snack: a coffee as well as a water. It’s her choice which one she wants to have. And a little snack on the side so that she can stay busy while she’s waiting. She’s also given the forms that she needs to fill out. These come on an iPad. It’s very simple for her to fill it in. It comes prefilled with part of her data that the receptionist’s already collected so she doesn’t have to do extra work. She finishes the form and submits it and enjoys her snack. Then she’s brought into the consultation room. The staff take her over. She sits down. She notes how clean and tidy it is. She notes how hygenic everything is, how everything is put in its proper place. She speaks to the doctor. He’s friendly. He listens, he doesn’t rush her. He takes the time to listen. He answers her questions. He asks questions of his own. As she is preparing to have the physical exam, she looks around the office and notices that there are diplomas there. Thank you cards. There’s photos of the Doctor and his family. She feels very comfortable that he’s a respectable individual, that he’s very qualified. He has the education that he needs to do the job. She sees the thank you cards. She knows that other people have trusted him and continue to trust him. She thinks that once she gets her a great result she’ll do the same thing and give him a nice thank you card and maybe a small gift.

[00:07:28] The physical exam goes well. She doesn’t feel embarrassed or violated. The physician was very professional. He treated her with courtesy. He was sympathetic to her plight. He didn’t belittle her in any way. He didn’t make light of her situation even though she feels maybe it’s not such a big deal but it’s a big deal to her. And he iterated that to her as well. She puts everything back on. The doctor thanks her. He asks her if she has any last questions and then walks her out to the staff. The staff take her in a separate private room. She sits down. The staff discuss her options with her, booking times, costs, fees. Everything is really good, but Joanna says that she needs to speak to her husband, just wants to tell him that she’s made a decision and just get his approval. The staff isn’t pushy, they understand. They ask Joanna for her permission to contact her. Joanna of course says yes. Joanna goes home. She talks to her husband the very next morning she gets a call from the office. It’s the same reception that she spoke with, the same one that she met when she walked into the office, the one that she hit it off with, the one that she laughed with on the way out. She is very impressed by the fact that somebody called her the very next day. The receptionist asks her if she’s ready to move forward and if she has any other questions. Joanna says that she is. She’s ready to go. So she puts down her deposit and she books her surgical day and gets ready to have her procedure.

Nick: [00:08:53] Between the time of booking and the time of her procedure she gets two e-mails from the office with additional information and videos from the doctor telling her about the procedure and how easy it’s going to be and how great she’s going to look, what to expect on the day that she comes in, what to remember to bring, what to do the night before. All the information she needs, she receives in a timely manner by e-mail or by text message. She confirms her appointment by text message and she goes to her surgery the day of the surgery.

Nick: [00:09:23] The staff is there to welcome her. She’s brought into the office. Everyone treats her extremely well. She’s very happy. The procedure goes well. Post procedure care is excellent. Nobody ever leaves her alone. She was promised that before and they delivered. Someone is with her every step of the way. She’s never left alone after the procedure. She recovers. They give her a custom bag to take home with everything she’s going to need. She doesn’t have to worry. Everything is spelled out very clearly. Everything is outlined for her in simple steps that she can follow even if she’s groggy, even if she’s in pain. She takes that home. That evening, she gets a call from the office asking how she’s doing. Asking if she’s ok. Joanna can’t believe the level of care, how good everything’s going. In addition to the phone call she also gets a video from the doctor explaining what to expect. Explaining what’s normal what’s not normal, her mind is set at ease. She feels good about what’s going to happen. She knows that as long as it’s within what was explained that nothing’s wrong. She has a nice comfortable recovery. The staff follows up with her the whole way. She feels cared for and that she wasn’t discarded after the surgery after the procedure was done and the money was taken. She feels like part of the family. She feels like everyone was a professional. Everybody took care of her and they actually cared about her well-being. Once she’s fully recovered Joanna goes back to the office. Everything looks great. Her after photos are taken. She’s asked to give a testimonial and she gladly does it. She couldn’t have been happier with how things went. Everything from start to back went absolutely smoothly for her. When she had a concern, she knew who to call. Everything was in her post follow a package. The staff followed up with her before she needed to, before she needed to even book her appointment, they were calling to book it for her, for her follow ups, for her final follow up. Any aftercare that was needed was provided. Joanna had a fantastic experience and anytime somebody talks about having a cosmetic procedure she jumps at the opportunity to refer.

Nick: [00:11:25] Okay, I want you to come back from this story. I want you to come back to the way things are now in your office in your practice and ask yourself if you can give that level of care. If you’re doing the things that I mentioned. If your patients know that you’re better than everybody else, if they know that you are providing better service, better care, more information and a higher standard than your colleagues — that they made the right decision to go with you. If you’re not even sending out an email or a custom video or getting the patient excited about her procedure and her choice in her appointment, even the consultation appointment, there’s a lot of room for improvement. You should be happy that there’s room for improvement. You should also be a little annoyed that it’s not happening yet, but knowing that you can make changes. And the reason that I wanted to take you through that story first is because, through story, we can identify situations. We can, in our mind, walk through our own practice. We can walk through an ideal situation and see how they match up. The way the patient flows in and out of your practice is one of the key components to raising your bottom line, raising your conversion rates and making the most out of your advertising and marketing. .

Nick: [00:12:37] So Let’s talk about some of the key areas that we discussed in this story. One of the most crucial areas of any practice is the front desk, the reception area and the waiting area. The reason that these are so important is because this patient doesn’t know yet. She doesn’t know your staff. She doesn’t know what to expect. She’s possibly a little bit nervous and that first impression that she has when she comes in can carry right through to when you ask for the deposit for surgery. If she walks in and things are disheveled, if things are not in order, if the receptionist is rude or uncaring or takes too long to acknowledge her, she’ll carry that perception through to her consultation with you and she’ll carry that perception all the way through to when she needs to make a decision and put down her deposit for surgery. And if the initial expectation is negative, she’ll be very hesitant to go through with surgery, no matter how the rest of the experience goes because she’ll always have that nagging doubt. So you’re opening the door for your competitors to steal that case away because remember all the associations and all the governing bodies educate patients to see more than one physician. So just because she’s come to you doesn’t mean that she’s going to pick you. She could be seeing 2, 3, 4 other plastic surgeons at the same time and you have to have the mindset that you need to win the business out of the market. You don’t deserve the business. You have to take it. You have to win it. You have to be better than the competition. You can’t have a sense of entitlement. I’ve seen this more than one time where doctors will go to school and they’ll come out to build a practice or they may have been in practice for 20 years and they get a sense of entitlement and then they wonder why the market has moved past them when their website looks like crap. When the receptionist doesn’t pick up the phone, when his receptionist isn’t friendly because she came from a hospital environment possibly and she’s just treating everyone like a sick person rather than a cosmetic patient. And if you’re in that situation, if you’ve got a sense of entitlement, I’m going to just give you a little bit of tough love and tell you that you’ve got to stop it right now. The world is moving forward. You have to win the business. It’s a competitive environment and you have to do better in the competition and the good news is that with technology you can. .

Nick: [00:14:42] There Are automated e-mail sequences, automated text messages, automated chat and Facebook. You can raise the standard with technology and you can train your staff to do the right thing. But what you can’t have is a feeling of entitlement and that the world owes you something just because you went to school or just because you’ve been in practice for a long time and people respect you. The fact of the matter is that money doesn’t care, doesn’t care about what you feel you’re owed. Money flows to those that make the effort, to those that make the change and to those that hustle and get the business out of the market. And that’s how you have to start thinking. You’ve got to move beyond what you’re currently doing and be better, not just better than what you’re doing now but better than everybody else. And it’s possible, it’s very possible, but not if you don’t have the focus right. What you focus on is what changes and if you’re not focusing on the patient flow and the patient experience, that experience is going to suffer. You can’t leave it up to your staff alone. You have to monitor it. You have to monitor the incoming calls and you have to verify that everybody’s doing the right thing. And one more thing I want to mention about that is that it has to be consistent.

Nick: [00:15:49] If you do something great one time and badly the other time it won’t matter how well you did the first time because the patient will feel robbed even if she is not entitled to what she got. I’ll give you an example. Let’s say that you’re going to get a haircut. You go into your haircutting place and you sit down. You’re brought in ice coffee and a snack, no charge for them. They ask you if you’d like a glass of wine. They are legally licensed to serve and they do this. It’s a high end haircutting place. You say sure, I wouldn’t mind a nice red wine. You sip on your wine while you wait for your appointment. You go in. You get that extra special treatment. You get a shampoo which you didn’t ask for. You just wanted a quick cut, but they give you a quick scalp massage and a shampoo. You go, you have a fantastic haircut. When you leave, they hand you a little chocolate and a thank you card and a glass of water for your ride home. You feel fantastic. You look great. You feel great. You feel like you get treated well. And you didn’t have to pay any more than when you were going to pay for the haircut. Everything was included. Everything was free. They told you that everything that you got was a bonus for being a special client. Now you went in the same situation happened. It was great. Three months later you go in again, time for another haircut. But this time the manager isn’t there. He’s on vacation. So the staff decides to just take it easy. You know we don’t need to do the coffee and wine thing. We’re going to give them a great haircut. Everything’s fine. You sit in reception. Nobody offered you coffee. You’re feeling a little awkward. No one ever offered you wine. You know it’s free so you don’t feel right asking for it or demanding it because it wasn’t something that you’re paying for. It was a bonus from them to you. It Was a special gift. And all of a sudden even though you weren’t entitled to any of that, you feel like your experience is diminished even though they have no obligation, absolutely no obligation. They’re going to do everything else that you paid for. You’ll get a great haircut. They’re friendly they’re nice they smile. But you didn’t get your wine. And you know what? You also didn’t get that bottle of water for the ride home. Again nothing that you were entitled to. These are all special bonuses that that manager was giving away because he wanted you to have a fantastic experience. And even though he didn’t pay any more. And even though you weren’t entitled to anything you feel like you got less. And why is that? For one simple reason. It was a simple lack of consistency. So that’s the danger with implementing these processes: is that you want to make sure that your staff is consistent with them. Don’t start and stop something because it will reflect negatively on you even though nobody’s owed anything. They’re going to say that that place just, you know, wasn’t as good as I remember. I felt like they used to do a better job. I don’t think they care so much anymore. Even though they weren’t entitled to what you give them. Giving them nothing and doing nothing is not an option because then you lose the business to the guy that is. But being inconsistent is just as dangerous and you can lose business. Over time You lose referrals you lose loyalty by a lack of consistency. .

Nick: [00:18:44] So That’s the first concept I want you to keep in mind. I want you to take notes to be consistent, and if you’re going to improve an area in your practice I want you to improve two areas for now that I want you to focus heavily on.

Nick: [00:18:56] The first is the reception area and the most important thing in the reception area is influence and managing boredom. By influence I mean making sure that the things in the lobby, the things in the waiting area, are things which will help the patient make a decision. Before and after photos, thank you cards, testimonial videos of patients. Don’t put out magazines, fashion magazines, things that have absolutely nothing to do with your practice. Also don’t be boring. I’m not advocating that you do as self promotion and pamphlets of Botox, which is the other thing that drives me nuts when doctors will take generic materials and just put them in the lobby, put them in the waiting area and think that they’re going to pick up additional business or that it’s doing something for them. You have to stay focused on what matters, and what matters is getting that patient to know, like, and trust you. If you listen to the previous podcast you’ll understand what that means. So when you’re crafting your materials tell stories. Tell stories of your patients if you want to put something there. Make your own magazine where you discuss different topics. Put in the effort. It’s a one time investment to design a magazine or you can have one every month if you’ve got a non-surgical business doing CoolSculpting, Botox, people that are coming in on a regular basis. You could even take that magazine and get them to subscribe to it. You can be interesting and self promoting at the same time, and that’s how you have to think. So you have to try to influence the patient. You have to give her perception that you are the place that’s unlike any other. Let the other guys advertise fashion magazines and things to do around the city. The worst I’ve seen was in our local market here there’s a magazine called Elevate and it’s a magazine about cosmetic surgery. And they will offer it to plastic surgeon offices for free. I walked into one of our clients office and I saw a Elevate there. The whole back of that magazine is filled with advertisements for other doctors and I asked them why do you have this here? And they didn’t know, it was just knee jerk. I said get this off the table because you don’t want your patients sitting there, browsing your competitors before they go to see you. That’s just not the right thing to do. Seeing their before and after photos, it’s all spreads and a magazine of before and after photos. You want to control the medium, you want to control the message, you want to be interesting and you want to be influential.

Nick: [00:21:20] The other thing you have to do is manage the perception of wait, the perception of boredom. And why I call it a perception is this. I’ll tell you a quick story about where this comes from. It’s a story that circulates around in marketing circles. It’s a story that’s been posted before but I find a lot of doctors and you may be in that same situation. But a lot of doctors don’t know about this. Before I tell you this story, I want to point out one thing: is that time doesn’t exist. Time exists only in our mind. Time can be short or it can be long. When you’re having a great time, when you’re doing your favorite hobby, when you’re on a fantastic date, when you’re connecting with colleagues at a conference discussing an interesting medical topic, a couple of hours seems like a couple of minutes and you’re sad when the evening’s over. When you’re stuck somewhere bored, your phone battery died, you’re waiting for your car to be fixed. They told you it would be ready now, it’s two hours later and you’re still there, that time can seem like a week. You’ve got nothing to do. You’re just waiting and waiting. And that same two hours will seem exponentially longer than when you were having a great time. So time is only perceived in the mind and it can be perceived as long or it can be perceived as short and we have the ability to influence that. And I’ll give you the example now. I’ll tell you that story I promised I would. .

Nick: [00:22:40] There was a high rise in New York City and they had elevators. And these were some of the newest elevators in production when elevators just started to get popular when people started to trust them. They all went to the fair and saw the demo of the guy that invented the elevator. You cut the cable, there are special breaks that made elevators safer. It was around that time when people started to use them and it allowed for the construction of high rises. But what this building manager had to contend with was a lot of complaints. There were people complaining about the long wait for the elevator. I can’t believe how long it takes. So he brought in engineers to study the problem. They looked at it. They timed it and they said, you know, it’s only a few minutes. It’s not really that long and the technology is what it is. We can’t really make it any faster. It’s a tall building and we have to bring everyone up and down. So this is where we’re going to have to deal with here. You’ll just have to deal with the complaints. The building manager was desperate. He didn’t want to get these complaints. He wanted to do a great job. He didn’t want to deal with irate tenants and angry visitors. So he called in a consultant and he asked the consultant what can we do? The consultant looked at the problem and he thought, strange, they’re not waiting very long are they? They said, no, but they’re still complaining, they think it’s a long time. It’s New York City, you know how it is. Yeah, I get it, so the consultant evaluated the problem and decided that you know they’re really just they’re bored. Boredom is what the issue is, so how can we manage the boredom? And he suggested that they add elevators into the lobby, into the waiting area, the elevator waiting area, she goes just add mirrors there. So, the building manager added the mirrors and all the complaints vanish. Why? Because people had something to do for those couple of minutes, that was more interesting than just staring at a wall. They could look at themselves, they could look at other people, they could sit there being annoyed by the person next to them in the mirror without glaring at them so they can avoid any kind of social awkwardness. And that problem was solved and since they did that, you’ll notice that mirrors are commonplace in hotel lobbies, in large buildings. They’ve become very common, either on the elevator or at the elevator waiting area or both. .

Nick: [00:24:50] So This concept of managing time and managing the perception of time is very important because if you’re leaving your patients in the waiting room, simply waiting, right, so in the story I explained how Joanna was brought a snack, how Joanna was brought a drink, how she was bribed forms to fill in, all of those activities are designed to shorten the perception of time. It breaks up the monotony. It breaks up the person just sitting there browsing through the one or two magazines that they’re bored with and starting to get irritated and having a negative experience. It’s that perception and the wait and the experience and the influence that I want you to focus on first. If you can fix your reception, generally the rest of the process goes a lot smoother. I’m not saying it’s the only thing you have to focus on but it is one of the primary things.

Nick: [00:25:41] The second area I want you to focus on is where the patient has the consultation. Most of the practices that we work with, I find that the doctor and the receptionist have never sat in the chair where the patient sits. So the first thing I want you to do after listening to this, you may be listening to it in the car, you may be listening to this at the gym. The next time you’re in the office what I want you to do is sit down where that patient sits. It could be an examination table. It could be a chair in the office. It could be both if you move them from room to room. Some places will have the consultation in our office and the exam is a separate exam room. But I want you to go and sit as a patient and look around. Look around your office. If you’re not in the office, close your eyes and just try to remember what’s there. You may not be able to so I want you to take this podcast, go back and just listen to this. Listen to this while you’re sitting there. Look around the room. What’s there? What does the patient look at? Can she see diplomas? Are diplomas in the line of sight or are they behind her? Can she see photos of you in social situations? You with family you holding a baby whatever it might be that softens you up a little bit. Can she see examples of gratitude from other patients? What is it that she’s looking at? And more importantly, and here’s something that most people don’t consider, is what is the person that came with her, it could be her husband, her boyfriend, her best friend, her mother — what are they looking at? Because they’re not there to engage with you. The patient is and the patient may be engaging with you but that other person is looking around the room. What are they seeing? What are they seeing that is influencing them to guide your patient to choosing you? Don’t discount this at all. The reason why I’m mentioning this is that it can take your closing rate from 25, 50, 60 percent above 70, 80 percent. And I’m not talking about referral patients. Everyone goes, I have a higher closing rate. OK are they new patients or are they referral patients? It they’re referral patients and you’re not closing them you’ve got big big problems. So we don’t talk about the referral patients because those are gimmes. Those are things that you should be closing anyway. Right and if you’re screwing that up then you’ve got to really take a deep dive into what you’re doing because something’s off there. I’m talking about the cold patients, scalable ones that you’re getting with advertising. If you can start closing more of those, what would it mean to your business? If you manage the perception in the reception area and you increase the conversion on your consultations, what would that mean to your bottom line? What would it mean if you got your consultation percentage up by 10, 20, 30 percent? How much more money would you make? How much better off would you be? If you can see a brighter future, I want you to go back and start making these changes. I want you to get your staff together and explain what you’ve just heard. Let them listen to it if they have to and start making a change. Start winning the business out of the market because the world doesn’t owe you anything. You owe your patients. You owe yourself. You owe your family. You owe your staff and you owe it to your future to do something about it. Creating a fantastic patient flow is going to be the key to unlocking your practice and unlocking prosperity.

Nick: [00:28:48] I hope this was helpful. I hope you go and you take some action. If you have any questions. By all means visit us and ThinkBasis.com where we hold the podcasts or just google Practice Perfect podcast. You can also reach me on LinkedIn. Just look for my name, Nick Dumitru. Just Google me on LinkedIn. Reach out to me. I’ll be happy to answer questions if you’ve got them. I always love to hear from listeners. So I’m going to wrap it up. I hope that you’ll go out there, you’ll make change. You’ll do well. I’ll catch on the next podcast and have a good day.