Feature Article:

Solving Marketing Challenges — Focus on Relationship Building and Patient Loyalty

By Shelley Simon, RN, DC, MPH, EdD
Founder, Beyond Practice Management

What motivates some patients to remain with a particular doctor or practice for many years, while other patients leave after only a couple of visits? Why do some refer, but not others? How do you move a patient beyond being simply satisfied enough to stay with your practice to being so highly satisfied that they refer their friends, family members, and colleagues? Healthcare practitioners have been asking themselves these questions for years — decades, really — and almost every practice building seminar and program available today attempts to address the issue. And yet, practitioners still struggle.

You probably already employ many of the techniques and tactics that are designed to build patient loyalty and result in better retention and more referrals. Some of these include having a pleasantly appointed office, placing an emphasis on convenience for patients, sending handwritten thank you notes, mailing birthday cards, making follow-up phone calls to patients after an initial treatment, and using referral appreciation programs. These practice building tactics, along with the ability to skillfully ask satisfied patients for referrals, are all effective to some extent if they are used consistently.

In this issue of Practice Your Way I propose that practitioners augment these tried and true tactics (those congruent with their personal practice styles) with interpersonal strategies and methods that can deepen relationships with patients, establish greater levels of trust, and build stronger patient loyalty. Doctors who connect with patients beyond the level of social connection, friendship, or an attempt to make them feel like ?family? are rewarded with improved retention and more referrals.

Here are ten points for you to consider if you are sincerely interested in building a practice that is notable for patient loyalty and referrals.

1. Understand the true purpose of marketing. Effectively marketing a service business is largely about building trust and developing relationships. The purpose of marketing, according to Tom Asacker, author of A Clear Eye for Branding, is to ?create and maintain a strong feeling with customers so they are mentally predisposed to continually choose and recommend you.? Successful marketing also requires being relevant and unique. Asacker says, ?You want to be important to people?s lives, to make a difference, and be the only one who can deliver it the way you can.? Which leads us to point #2.

2. Identify and build your brand. We?re not talking about a practice logo, marketing ?look,? or tagline, although you want those tools in your marketing kit. Branding that builds genuine patient loyalty goes beyond what the eye can see. It?s brand at the emotional, sensory, and gut feeling level. Branding is who you are and how you represent yourself. Your brand is what your practice is known for, how you engage with patients, and what people can depend on you to deliver (visit after visit and to anyone they refer to your practice). Your brand is a compilation of your most important strengths. People feel the need to justify their decisions to themselves, so they look for differences upon which to base their decisions. Have you ever bragged about your accountant or financial planner, touting why they are better than anyone else?s? What would a patient referring a friend or co-worker to your practice say about you? ?He listens better than any doctor I?ve ever been to see.? ?She goes out of her way to find resources and solutions for me.? ?The entire staff is warm and caring — you can feel it the minute you walk in the office.? Identify your brand and leverage it to see patient loyalty and referrals increase. Don?t be shy about showcasing your uniqueness, your difference, and your strengths.

3. Tap into what patients want. In order to appeal to a patient?s needs or desires, you must first understand their motivations, values, and priorities. Human beings tend to want to be around people who make them feel valued, hopeful, and connected. We want to associate ourselves with people who inspire us to be the best that we can be. And we want to feel respected and trusting. You?d be on safe ground assuming that your patients want most of these things. But beyond that, each patient is unique and has needs and wants that are as individual as they are. Being tuned in to what a patient currently wants and being sensitive to their evolving needs help you be more resourceful and innovative as you care for patients. This is an excellent way to set yourself apart from other healthcare providers and help you build memorable, lasting relationships with patients. And this brings us to point #4.

4. Understand what patients are actually paying for. Doctors like to believe that patients are buying their expertise. Yet most people cannot evaluate your expertise and/or they simply assume you are expert by virtue of your credentials. What patients can assess is whether they experience positive outcomes, if the relationship they have with you is meaningful, if they feel valued, and if they receive a high level of service. Interestingly, patients tend to assume that doctors who are genuinely caring are also highly competent — but not the other way around. What do ?caring? doctors do? They listen more than they talk, they ask great questions, they answer questions in ways that patients understand, they remember what is important to each patient, and always put the patient?s agenda ahead of their own.

According to internationally known branding expert and author Harry Beckwith, ?If you?re selling a service, you?re selling a relationship.? Practitioners who have been to too many seminars take this idea and run with it, but at a superficial level. Some even come away thinking that practice success is based on their own charisma, dynamism, or extroversion. Do not be alarmed if you are not extroverted or charismatic. Remember, relationship is not all about you. Relationship does not mean being entertaining, engaging in casual chitchat, asking about grandchildren, or complimenting a patient on his tie. Relationship means communicating authentically and from a place of curiosity about what a patient really needs and wants from you and keeping the focus on why the patient is in your office (i.e., for quality care, for their own needs, and not necessarily to be friends with you).

5. Outcomes matter. Practicing good interpersonal skills and maintaining solid doctor-patient relationships are important for developing patient loyalty. But what really matters to patients are outcomes and results they can feel, count on, and talk about. Patients may come to you a few times because you are caring and pleasant, but they won?t keep seeing you for care based on your winning personality alone. Patients must trust you to help them improve their health, see results, and learn something from you in order to make it worth their while (i.e., time and money) to continue as your patient. Remember, patients refer their friends and family members with comments like ?I?ve never felt better,? not ?He?s a great conversationalist.?

6. Integrity » trust » relationship. Integrity involves fundamental behaviors like keeping your word, being honest, providing a consistent level of service, and being reliable. Practitioners who demonstrate a high degree of integrity are seen as genuinely trustworthy. Building trust requires the practitioner to continually put the patient?s interest ahead of his or her own and display a genuine ?other? orientation. You demonstrate this by being interested rather than interesting and by not treating every interaction as an opportunity to share your message. You do this by being caring, empathetic, compassionate, and by listening — always listening. All of this adds up to practicing with integrity. Without integrity, there is no trust, and without trust there is no enduring relationship.

7. What have you done for me lately? One of the most common mistakes practitioners make — the mistake that keeps them from building lasting relationships and delivering ?wow? service — is that they focus primarily on the early part of care. They wrongly assume that once a patient is happy, they will stay happy and continue to utilize the services of the practice. Each patient?s experience is the sum of every small experience they have while they are in your office and while they are in your care. Ask yourself, ?If I were this patient right now, what would I really want in terms of education, care and service?? This goes back to an important point that we?ve made in earlier newsletter articles — that the patient is always thinking, ?What?s in it for me?? What you do ? or don?t do — at every point during a patient?s course of care makes an impression.

8. Never take loyalty for granted. A successful external marketing campaign will encourage people to try you out, but only good clinical outcomes and an authentic relationship with you will keep them coming back. Always remember that a patient?s willingness to return to your office for continuing care depends only partly on their need for your services. They can easily choose another provider or even a different modality for care if they are not happy with what they experience in your practice. A patient?s decision about what to do next in terms of seeking care may well be based on their most recent experience in your office. Never take loyalty for granted. Never underestimate the power and value of the one-to-one relationship patients have with you and staff. Patients return to practices where they feel connected, have a sense of belonging, where there is mutual esteem, where they are treated with respect, and where their care results in positive outcomes.

9. Word of Mouth marketing isn?t new. Third party endorsement or patient referral has always been the foundation of healthcare marketing. What is new is that the bar for what patients expect in the way of service is higher today than it?s ever been. Being good isn?t good enough to get patients talking about you. Outstanding is the new good. Polls repeatedly show that the quality of customer service is on the decline across industries. If you?ve tried to reach a real person by phone about your credit card statement or flown a major airline lately, you know this is true. And yet, consumers — your patients — continue to expect high quality service. When you consistently exceed patients? expectations, they become what author Ken Blanchard calls ?raving fans? — patients who would not dream of taking their bodies anywhere other than your office for care. They refer friends, relatives, neighbors, co-workers — anyone and everyone who may remotely benefit from your services.

10. Know and appreciate your ambassadors. In his bestselling book The Tipping Point, author Malcolm Gladwell says that people who refer fall into one of two categories: Connectors or Market Mavens. Connectors are social. They have a gift for knowing people and naturally make connections among their network. Market Mavens are people who have ?the goods.? They have a desire to be of service and influence others. Data banks of information, they know how to get the best deals and the best service and they share information with enthusiasm. According to Gladwell, ?Word of mouth begins when someone along the chain tells a connector or a maven.? Learn to recognize these patients in your practice, cultivate them, and express your appreciation accordingly.

This article has covered a lot of ground that both supports and complements the tactics and strategies you use to build your practice. Cultivating long-term relationships with patients is best achieved not by tactics alone, but through developing and using superior interpersonal skills, in understanding each patient?s experience, by establishing a brand identity, and by delivering a ?wow? level of service. I hope that you?ll consider these ten points and determine which ones would be good topics for discussion with your staff as you plan for the coming year. Throughout 2008 I?ll expand on many of these ideas in future newsletters. Stay tuned. In the meantime, thank you for being a loyal reader of Practice Your Way. I wish you a healthy and prosperous New Year.

What's New:

Dr. Shelley Simon in Print

Dr. Shelley Simon is quoted in the current issue of Today?s Chiropractic Lifestyle. Speaking about how doctors can better manage their own stress, she says, ?There are chiropractors who personalize someone?s decision to not get care. It?s very stressful when a chiropractor doesn?t realize that it?s the patient?s choice . . . Chiropractors take it personally and that?s where they get into trouble.? Be sure to read the full article in the December/January issue of TCL.

Watch for the premier of Dr. Simon?s regular column in Dynamic Chiropractic starting January 1, 2008. Beyond the Basics will appear approximately every six weeks.