By Les Willis, Student Dietitian
On the face of it combining sales and healthcare appears to be the ultimate oxymoron. However, this perception rests substantially on misconception. As healthcare professionals start to embrace 'social marketing', where we use the successful techniques of the marketer to achieve social and individual benefit, we can do the same as practitioners by borrowing the best (ethical) techniques from the salesman to help our clients/patients/service users/customers (patients for short) to achieve their health goals and benefit them as individuals.
Coming from a sales background I have had the privilege of working in the most and least reputable sectors and of having worked with some fine and not so fine salespeople, my ideas are gathered from my and their experience in the field, and my own experience as a sales trouble-shooter in the retail sector, and of course the time I spent in, and delivering, training.
The best salespeople do not sell you something you do not want, instead, they take your desire or need, help you recognise it, and then fulfil it. Selling people things they didn't want means very quickly they become disillusioned, they do not come back and the tell their friends about what has happened, and more often than not, whatever you sold them gets discarded. This is ineffective sales, and it is ineffective healthcare. Instead, a good salesman spots those that have a need or desire, gets their customer to tell them about it, then fulfils their needs; in this process the customer sees what they can and cannot have and is helped to adjust their expectation to the reality of their buying situation – after all an Aston Martin at a Ford price is nice – but it is not going to happen, and if it did, the Aston would be a lemon. The parallel with healthcare is un-missable, our clients have needs and desires, some of which we can meet, some we cannot. Our job as healthcare practitioners is to help them realise what is achievable and achieve it.
Being a good salesperson is based on simple principles, learning those principles and how they are best deployed can help us be better practitioners.
1) Sorting the wheat from the chaff
Sorting the wheat from the chaff means we spend our time effectively, it is also possibly the most difficult part of patient centred practice. It is difficult because it means we allow people to walk away, if someone does not want us to help them we have to be prepared to graciously let them do that, accepting their choice. For the salesman this means learning that it is not a sale that is walking away, so as healthcare professionals we have to accept that was not someone who we could help today. Good sales means leaving the possibility of return open, and so does good healthcare. This is where a good supply of relevant leaflets and a pen come in useful.
This is not only often a difficult principle to master; running counter to our natural instincts be us in healthcare or sales, it is also not always the easiest thing to do. This difficultly arises because we find it difficult to ask the question directly, in sales it can be as simple and blatant as 'are you buying today?', and in healthcare it is a little more subtle. In essence it is about reading people and looking for those key signals, such as 'I don't know why the doctor sent me here' for example. We can open the door, but only our patient can walk through.
2) Feature, Advantage, Benefit
This is a foundation of effective communication, and one that most people do not do at all. Talk to any expert and you will see that they move seamlessly from feature to advantage, it is easy to do. However, to effectively communicate we need to convey benefit. In healthcare we are used to talking about health benefits, and so it is natural to think that these benefits translate easily for our patients and that they too see them as benefits. Unfortunately they are advantages: let's see how this works:
- Feature: low saturated fat diet
- Advantage: lowers your risk of heart attack (SIGN 2007)
Lowering the risk of heart attack is seen as a health benefit, however, in a group that has never had a heart attack, it is just an advantage. Taking this example through, we can see that a benefit is something tangible and specific.
- Feature: low saturated fat diet
- Advantage: lowers your risk of heart attack
- Benefit: you will still be able to play football with your son as he grows up
Conveying a benefit means that we have to have been active listeners, getting a good grasp of what is important to our patients. It sits comfortably with patient centred practice because it is about what is important to them as individuals. People rarely want to do something like lower their cholesterol just to see if they can, their goal reflects a bigger picture, talking in terms of feature, advantage, and benefit shows that we are in tune with that picture too.
3) Overcoming objections
Some people find this concept difficult; it is easily changed from working with to unethical persuasion. The difference can be a fine line, remembering that overcoming objections is about exploring and negotiating and an essential part of the process helps to keep us working with our patients, objections are simply barriers to success not roadblocks to be demolished. However, just because it can be difficult does not mean it is any the less essential. In fact, it is difficult because it is so important.
Overcoming objections addresses the fact that people have barriers to change; and more importantly that what they say is very often not what they mean. In sales the easiest one is 'it is too expensive'; this can mean anything from 'I haven't got that at all' to 'I will get laughed at if I tell my friends I spent that much' – and many in between. After all I am sure we have all used it at some time. As dietitians, it could be 'my kids won't it eat it', 'I don't like fish' for example. The key here is not to fall at the first hurdle, or ignore it – because if you ignore a hurdle you fall at it. Address objections head on – take them as signs that your patient is engaging – if they are engaged then they are interested in what is happening. With 'I don't like fish', you could say 'I used to be like this, but I found that I can get this one in light breadcrumbs and its lovely'. The key is opening up an appropriate dialogue, uncovering what lies behind the barrier and having ideas and suggestions to move past that barrier that have been developed together.
Overcoming objections is important; barriers addressed in the consultation are more easily overcome when the patient leaves. In combination with feature, advantage and benefit, overcoming objections means that the patient (and the customer) is able to sell the change to themselves and others. We exist in social networks, and our changes are expressed in those networks, be they a wide screen TV or eating some fish – we explain our choices to others (even have to justify those changes) and by exploring concerns and barriers we make embedding those changes as habits easier.
In sales nothing has seen more ink spilled than the subject of closing; it seems to have almost been elevated to the status of mystical art. Yet, closing simply means getting commitment. It is moving from discussion of features, advantages and benefits to action. As dietitians, action is what we are all about, closing is essential on the road to achieving a change – buying that car or stopping those take away meals – the principle holds; without commitment nothing happens.
As well as gaining commitment, closing rounds things off nicely, it helps the transition to the end as its name suggests. However, salespeople are notoriously bad at closing; the reason is fear. They are scared that after all their hard work the customer is going to say no anyway. This fear has a number of sources, people have said no, and they are going to say no, however perfect the process it has been, we have to accept that. We minimise it by effective sorting of the wheat from the chaff, by talking in features, advantages and benefits, and by uncovering and addressing the root of any objections that may have arisen. However, we still doubt that we have successfully negotiated the road from start to finish with everyone still on board and happy to arrive. Like sorting, closing needs us to ask the question 'are you happy to commit to this?'
In closing and gaining commitment, nothing seals the deal like writing it down; especially the customer writing it down. And it holds in healthcare; people commit when they are involved in the process, and putting their name to something is a terrific way to embed that commitment in their consciousness. Be that contracts, plans, goal sheets, notes section of leaflets, anything we have at our disposal to have our patients leave from us feeling that they have made a solid commitment. We have to not be afraid, but realise that commitment to change is essential to achieving change – and that getting that commitment plays a key role in precipitating that change.
I hope from this rundown that I have shown how, as agents of change, we have a tremendous arsenal of techniques that allow us to be more effective in a short space of time while remaining patient focussed. We have short consultations, and a lot of people to see, by being able to target those we can help, communicate effectively, target our advice effectively at what is important to our patients, and overcome their barriers and then commit to change. By borrowing techniques from other professions we are better able to achieve our goals as healthcare professionals, and those of our patients.
SIGN (2007) Risk estimation and the prevention of cardiovascular disease. Scottish Intercollegiate Guidelines Network