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Medical Practice Business And Marketing Articles

Article #38-- Oct. 2012                                        

“Trust—How To Build It, Use It, Prosper From It”

A patient trusting you remains the solution to your medical
career success and prosperity any way you cut it.

Trusting is an emotional process by which a person gains assurance that their belief in their doctor’s professionalism will be confirmed over time. This emotion happens only when it is preceded by a doctor’s display of professional competency, knowledge, and special gifted talents and skills.

Trust is accelerated when that patient feels understood, respected, and compassion shown. This implies that the trustworthiness of a doctor is perceived by the patient at every interaction with their doctor in their ongoing healthcare.

The question then arises, are you trustworthy? Can you improve your trustworthiness even more? How does doing that improve my medical practice in any significant manner?

Building trust is essential to all relationships

Trusting people can definitely be improved. Learning how to trust people is important. It’s essential in our society today because of the increasing skepticism, cynicism, and fear of making the wrong choices. In medical practice it’s the increasing lack of doctor-patient rapport.

Dave Bowman, human resources expert, describes in his article, “The Five Best Ways to Build-And Lose Trust In The Workplace,” five effective ways to create trust in business settings, which are also reliable in personal trust experiences.

1.   Establish and maintain integrity: Your integrity is the cornerstone for trust. Integrity is established by keeping you “word” or promises, being truthful, being always reliable and dependable, being adherent to your core beliefs, completing all tasks, and remain functional regardless of diversity.

2.   Doing what’s right: Not doing it for expediency. It means that doing what’s intuitively right may conflict with your personal beliefs, which may put you at personal, social, or professional risk .

3.   Communication Clarity: The value of clarity in communication is critical to understanding, decision making, and expected compliance, especially in medical practice. This is also important to effective medical office management. When you avoid explaining your goals, visions, and expectations to your employees, they will inevitably look to their own previous experiences for direction and what they perceive to be compliance with your ideas. Focus on shared goals, not personal.

4.   Constant improvement: It includes both your medical practice and medical practice business management. As Samuel Arbesman reminds us in his book, The Half-Life of Facts: Why Everything We Know Has an Expiration Date, medical students are often told that what you have learned will be outdated in five years. Medical facts, procedures, information, knowledge, strategies, perceptions, and advice are constantly changing.

5.   Personal Maturity Adaptations: As your maturity ripens over time you become more malleable, more forgiving, more likely to accept the unintentional mistakes and blunders of our peers and patients, and you adjust your personality to a “let’s get along” mode. The sooner that happens the better doctor you will be. Also, the more trustworthy you become because of your basic need to be a naturally social human being.

Destroying your trustworthiness, can occur with just one single happening      

Once you permit your emotions to override your reasoning, the probability for a permanent regretful event opens. The irrational and unexpected emotional verbal blast reaches beyond the victim’s eardrums. That rampage, whether physical or verbal, reverberates for days, weeks, or years in that victim’s mind.  

The recoil from a single event is often enough to terminate a relationship in medical practice or in any business. This is the kind of thing that significantly and permanently changes how the other people who witnessed this disturbing experience, as well as the victim, see you. 

It’s something that’s remembered as something to be avoided in the future—who knows if you can be trusted to never do it again, like a ticking time bomb. Apologies help reduce the impact, but not the memory. Future relationships with others who heard about it are also affected negatively.

I have witnessed many of these disturbing episodes in my medical career between patients, doctors, nurses, and other professionals. And, I remember them as if it happened yesterday.

Many times the conflict is of mild consequence and later forgotten. Even then, the memory may be recalled due to some triggering effect, and then can interfere with the expected good results evolving from the subconscious or conscious mind.

Other ways your trustworthiness comes into doubt   

1.   Inconsistent behavior or actions - Repetitive changes in how you respond to the same issues create confusion and uncertainty. A pattern of vague or variable behavior means the recipient must never trust how you will respond to issues. It often is the case when patient’s fear revealing their secrets to doctors, which may draw criticism or even insults from their doctor.

2.   Mindset for your personal agenda - Every time you hurry through your patient schedule, you are doing this. You can’t hide it but you can soften the impact on your patients. My favorite trick for doing that I learned from Robert B. Cialdini, PhD, in his book, “INFLUENCE: The Psychology of Persuasion.”

His in-depth studies about human behavior are recognized world wide. A person’s intrusiveness into another’s intended activity can be accepted, tolerated, or pardoned when the intruder presents the person with a reason for the intrusion. Almost every time when you offer a person a “because… ” reason for stepping into their space, that person will not be offended.

Otherwise, they will. The reason doesn’t even need to be sensible. Learn how to give “because” answers for butting in to a patient’s scheduled office time and visit.

3.   Not remembering your patients - Patients expect their doctor to remember them, at least greet them using their first name, or in the case of an older patient, their last name with the appropriate prefixes (Mrs. XXXXX).

The problem is resolved by first scanning their medical record for what you did for their last visit, their name, and treatment before you see the patient. It takes about one minute... time well spent.

Doctor’s who enter the exam room and don’t remember the patient or their last visit reduces the patient’s confidence in them... and therefore a bit of their trust. Normally, doctors don’t
remember patient’s names or last appointment treatment.

Patients are disappointed when their doctor doesn’t remember them or their problems, even though we know that we do not have a photographic memory. Try the “one minute drill.” It’s probably the most effective way to create loyalty of your patients that I know.

4.   Dishonesty with patients - This can be outright lying to them or simply avoiding important issues related to their medical care. It’s a complex issue that is skewed by events, personalities, and medical diagnoses. The question here is, “Do we have a responsibility to reveal everything to the patient about their care and treatment, even that we consider it to be potentially damaging to them?”

The concern about medical malpractice risk arises when you limit what you tell patients. Does full informed consent ring a bell? If you’re doing major surgery, do you tell them they might die during the surgery or afterward? Most doctors know how much to tell patients because revealing too much will make patient’s run elsewhere. The next doctor may tell the patient the same thing, but by then the patient may accept it (the second opinion myth).

The solution I’ve found useful is by using semantics. Some words are powerful and hit the patient like a sledge hammer, and some are weak that mean the same thing but cause no terror.

Instead of telling a patient they have “malignant cancer,” you can tell them they have a “tumor” that might spread.

Instead of telling a patient they have an “incurable disease,” you could tell them that their disease is, “something that will be needed to be followed
for a long time.”

What angers patient’s is discovering later what should have been told to them in the beginning. Patients are not lost because you do that... a fear among doctors.

5.   Rigid mindedness - My last year of medical practice an associate physician agreed to do surgery on a patient of mine because my hospital contract was ending and I was told not to do surgery the last 3 months left. A month later the patient came to me and told me that the doctor refused to do the surgery as he had agreed.

Turns out that he had a standing rule for himself that a patient had to sign a special consent document in the preop room. It contained rather outrageous statements protecting the doctor. The patient refused to sign it and left the hospital with her husband in a rage.

When I confronted that doctor about that problem, he was absolutely unwilling to bend his own rules under any circumstances. I had no idea he felt that way and he didn’t mention it to me during the arrangements we made.

Doctor’s who practice in a dictatorial manner toward their patients often demonstrate their weaknesses—such as insecurity relative to their knowledge or skills, overt arrogance, or fear of malpractice resulting if they try something different and it goes wrong.

Learn to bend as much as possible with patient’s wishes or even demands. Patients will respect you more and show much more loyalty to your practice. It’s not hard to prescribe alternative medications, or not do certain procedures during surgery, or refuse certain types of treatment
for their medical problem.

6.   Show your incompetence - If you have areas of incompetence, don’t ever reveal that to patients. I’m not saying that a gynecologist shouldn’t tell patients that he doesn’t do heart surgery. What I am saying is that when you don’t feel completely comfortable doing a certain procedure or treatment, then refer the patient to an appropriate specialist.

Patients understand that approach to their care. It indicates to them how much you care for their welfare and outcomes to be top notch.

On the other hand, when a doctor blatantly stutters around in front of a patient trying to decide on the appropriate treatment and has to go look it up in a medical textbook first, patients quickly lose trust in the doctor.

The solution here is to stick to one proper regimen of treatment and if necessary call the patient the next day and change the prescription, while telling them that you consulted with another doctor to find a better treatment you hadn’t heard of. It doesn’t mean you can’t tell patients that you don’t know the best treatment for their condition, but don’t make a fool out of your incompetence in front of the patient.

7.   Berate other doctors - Doing this in front of or directly to your patient gives the patients a clear view of what you also think of them... at least it’s their perception. Making statements about how badly the previous doctor treated your new patient is just shooting yourself in the foot.

Most intelligent patients know that such statements are an indication of your own insecurity. The act of belittling someone else is an attempt to elevate your own status. It’s a rather dismal personality habit that serves no one but yourself.

Professionals who berate other professionals don’t deserve to be called professionals. This type of professional evolves into an outsider in the local medical community and commonly loses many patients and referred patients as a result.

Trust is the glue of life. It’s the most essential ingredient in
effective communications. It’s the foundational principle
that holds all relationships."
      ---Stephen R. Covey

The author, Curt Graham MD, is an experienced physician, marketer, medical business expert and consultant, highly recognized as an author, information marketer, and expert in rescuing medical practices from financial failure. Learn from his medical publications what isn’t taught in medical schools and that you must know today.
Click here now to learn how to reach your maximum medical practice potential and profitability.
©Copyright 2004-2012, Curtis Graham, M.D.  All Rights Reserved.

        handwritten signature of Dr. Graham


Professional Prods

Should you have the inclination to avoid taking advantage of the lessons on this website concernphoto of 1920 auto packed with baggage and kidsing marketing your private medical practice, you might consider the possibility of your family ending up as this photo shows you from the 1920s. Never happen...right?

You might find that you'll need to be moving your medical practice often to support your family--kind of an ultimate example of a traveling doctor earning a living making house calls
as you go.

This rather negative picture of medical life should at least make you wonder a bit about where medicine is headed under a second Obama term in the White House. Now we know!


ARTICLE---DAN KENNEDY photo of Dan S. Kennedy, millionaire maker

The Renegade Millionaire Way

by Dan S. Kennedy

Test and Grow Rich

“Testing” is an ugly topic. Why? Because testing variables in advertising direct mail, phone scripts and sales presentations requires discipline, diligence and patience. To get it right, you can only test one variable at a time. This means that if you change a headline, you can’t change anything else. Plus you have to make sure all other variables remain the same, like the mailing day or a war breaking out that has everybody watching CNN day and night or the President getting caught again with his drawers down or a hurricane hitting.

Frankly, most business people will just not go through the “detailitis” required to test - which is why it’s a very good idea to model proven promotions. And in some cases where you’re only going to use something once or twice or you’re dealing with a very small number, it’s just not worth testing; instead, you take your best shot. But let’s assume you’re working on something you intend to use over and over and over again in some significant quantity, so that it’s worth real effort to fine-tune it...

I have some tips for you: first of all, there’s non-testing testing - huh? Well, I describe that in my book ‘The Ultimate Sales Letter’ (available at ), where I talk about the steps to take with a finished sales letter before you actually mail it. Second, there’s split testing, which is the fastest way to test and get to a reasonable conclusion. Let’s assume you have a postcard and you want to leave everything the same but test four different headlines, and you have 4,000 similar addresses to mail to. You do “nth name testing”; that means Headline #A goes to every 4th name, Headline #B to every 5th name, Headline #C to every 5th name, etc.

So you evenly divide the list without bias among the headlines being tested. Some media (like Val-Pak or Money Mailer) will let you split test within a single buy. Third, there’s testing against a control. A “control” is a marketing strategy that already works well and you’re using it on a continuing basis - maybe it’s a series of letters you mail every month. You have been using it long enough you know what it produces. You have a “known” to measure against. Now you can start trying to improve that control, ideally one step or variable at a time.

If I’m trying to beat a control, here are the “hot” variables I’ll look at closely, to see if there’s room for improvement:

  1. The offer
  2. The guarantee(s)
  3. The urgency of response
  4. The big idea or big promise
  5. The overcoming of skepticism i.e. credibility and believability
  6. The style or tone of the writing itself
  7. The look of the piece

By the way, little, very testable things DO sometimes make very big differences. Recently I showed an example in my newsletter of a guy who just added four rubber-stamped words to the outside of his envelope, and beat his control by 300%. I once brought a TV infomercial back from the dead by raising the price of the product.

Gary Halbert saved the Pearl Cream advertising by adding a particular bonus. In 1984, after attending my seminar, a dentist in Sacramento changed five words on his Val-Pak coupon and went from getting two or three new patients a month to 15 to 20. This is the sort of thing that makes direct-response advertising as frustrating as golf. (Did you happen to see John Daly miss a put seven times and scratch himself out of the tournament a few weeks back? Ugh.)

Obviously, you can’t test if you can’t, won’t or don’t collect accurate data. You have to code every offer, and track where every ounce of business comes from. If you have employees who are lax about this, you must educate them about the importance, discipline them if they goof it up, and ultimately can’em if they won’t do it right 100% of the time. I confess that I fly by the seat of my pants in my business more than I should, but I can’t fire me, God knows there are days I should. Anyway, I can assure you: the clients I have with the best profits and incomes possess the best information about where their business comes from.

Let me switch gears and talk briefly about another aspect of “testing”. This is actually how all highly successful entrepreneurs view everything they testing. They do NOT see things in the context of “success” or “failure” like ordinary people do, and as a result they do not become “de-motivated” like most people do. See, most people drain all the vitality, courage, optimism and git-up-n-go out of themselves by focusing on all the things they do that don’t work out well, as a compilation of failures.

But successful people understand the powerful impact of that negative reinforcement on their own self-image (somewhat akin to the impact of pouring a gallon of toxic waste into a pint of clear water, drinking the result, and wondering why the stomach backs up into the esophagus). Instead, they carefully organize the things they do into a series or sequence of experiments, testing options, and focusing on the ones they find that work. And they fully expect to go through any number of experiments that don’t pan out before walking away from the lab with a winner. This not only has practical relevance, it has profound psychological ramifications.

Just like a little tweak in thinking can make a big difference in the results of say, an ad or a flyer, a little tweak in thinking can make a giant difference in the life results experienced
by an individual.

DAN S. KENNEDY is a serial, multi-millionaire entrepreneur; highly paid and sought after marketing and business strategist; advisor to countless first-generation, from-scratch multi-millionaire and 7-figure income entrepreneurs and professionals; and, in his personal practice, one of the very highest paid direct-response copywriters in America. As a speaker, he has delivered over 2,000 compensated presentations, appearing repeatedly on programs with the likes of Donald Trump, Gene Simmons (KISS), Debbi Fields (Mrs. Fields Cookies), and many other celebrity-entrepreneurs, for former U.S. Presidents and other world leaders, and other leading business speakers like Zig Ziglar, Brian Tracy and Tom Hopkins, often addressing audiences of 1,000 to 10,000 and up. His popular books have been favorably recognized by Forbes, Business Week, Inc. and Entrepreneur Magazine. His NO B.S. MARKETING LETTER, one of the business newsletters published for Members of Glazer-Kennedy Insider's Circle, is the largest paid subscription newsletter in its genre in the world.


masonic emblem bright colored American flag  Curt Graham, M.D.
   2404 Mason Ave.  Las Vegas, NV 89102
    E-mail = cgmdrx(at)
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