Watch out for those “invisible costs”

that cut into your practice’s profits

By Terry Silance

Each time you write a check to a manufacturer, pay your their buy-in on both the problem and the solution. Remem-
insurance premium, or sign payroll checks it’s obvious that ber, your goal is to provide patients with a consistently excep-
these expenditures are among the costs of doing business. tional experience. So, survey patients on a quarterly basis to
Such expenses are easy to see, which makes them easy to ensure that you and your team continue to improve.
track, measure, and manage. Another way to measure patient satisfaction is by track-
But there are other costs that are not so easy to see. Your ing your closure rate (the number of patients who made a
practice is a series of processes and systems. When all is purchase divided by the total number of people who are
running well, it is efficient and effective. But, when one or tested and receive a recommendation for hearing aids) and
more processes or systems fail or falter, it can result in “invis-your return rate. If you consistently have a high percent-
ible costs” that can take thousands of dollars off your bot- age of patients who are identified as candidates for hear-
tom line. Let’s look at some of these costs and discuss what ing device, yet walk out the door unsold, or of patients
to do about them. who return their hearing aids for credit, that may indicate
that something in their experience has left them uncon-
INVISIBLE COST #1: POOR PATIENT EXPERIENCE vinced of the value of amplification or has created a bar-
It has been shown that people will tell twice as many friends rier to purchase that you failed to uncover and overcome.
and family about a poor experience The patient experience contin-
they have with a company than a ues through their emotional and
good one. And, one study found “…almost half of rational justification of their pur-
that the people who are told about chase. For example, if buying the
the poor experience with a company consumers indicate they hearing instrument causes the
are five times less likely to do busi- patient financial strain, he or she
ness with the company than is the have chosen to avoid a will find a reason to be dissatisfied
original dissatisfied customer. In fact, with the device or your practice and
almost half of consumers indicate specific company come back to return it. In fact, a
they have chosen to avoid a specific recent survey indicated that offer-
company because of a friend’s neg- because of a friend’s ing patient payment plans is a sim-
ative experience.
When a patient leaves your prac-
negative experience…” ple, yet very important element to
the patient when considering a pur-
tice feeling dissatisfied, whatever the chase.1 Patients indicated that hav-
reason, it will cost you. Now, of course, you can’t please every- ing a payment option is second in importance only to
one, but if your practice consistently delivers less than satis- achieving good quality hearing.
factory service, your referrals will slow to a trickle and your So, make sure you offer patients convenient and com-
name and reputation within the community will suffer. fortable ways to fit their new hearing instruments into their
This raises the question, what kind of experiences do your lifestyle and budget. If you are experiencing high return
patients have when they are in your practice? If you don’t rates, or even those considered the “industry average,” con-
know, you need to ask. Conduct short (3-to-5-minute) phone sider that offering a monthly payment plan, such as that
surveys of patients who have come to your practice and pur- offered by CareCredit, has been shown to reduce return
chased a hearing device and also survey a sample of those rates by up to 75%, while creating a much more satisfying
who did not purchase. Specifically, ask these consumers for experience for patients.
feedback on how they were treated by your team, from the
initial phone call through post-fitting follow-up. Then, based INVISIBLE COST #2: AN UNTRAINED EMPLOYEE
on the feedback, identify those areas in which you and your Employees cost you much more than salary and benefits.
team excel and those areas that need to be improved. They can cost you patients. They can cost you sales. And
they can cost you even when they leave your employment,
Identify and address your weaknesses especially when you factor in the cost of staff turnover.
Once you’ve uncovered your weaknesses, involve your team Often, your patients interact with your team more than
in brainstorming over lunch to develop ways to improve the with you, so you have to be able to count on every mem-
areas that need attention. By involving your team, you get ber of your team to treat patients the way you do. The key

46 THE HEARING JOURNAL I nv i s i b l e c o s t s c a n h u r t yo u OCTOBER 2007 • VOL. 60 • NO. 10

is to hire smart and train constantly. There
are, broadly speaking, two types of employ-
ees: givers and takers. The taker’s perspec-
tive is self-focused, and such employees
are primarily concerned with what you are
going to do for them. The giver is prac-
tice-focused and patient-focused. These
employees have a nurturing attitude. So,
when hiring, identify the “giver” and hire
for attitude. You can train skills much more
easily than you can change an employee’s
attitude.
Training is a good investment
It can be very difficult to fit employee
training into a practice’s busy schedule.
However, nothing is more important to
the success of your practice than a well-
trained team. Audiology is a service pro-
fession, which means that patients are
much more likely to judge a practice on
the people who work there than on the
products it dispenses. So invest in your
most important asset—your team.
Hold weekly Lunch and Learn ses-
sions. And look to your manufacturers
and other partners that provide tools you
can use to improve your team’s clinical
and interpersonal skills, focusing on com-
munications techniques, which is the
number one area where sales are lost.
INVISIBLE COST #3: INEFFECTIVE
COMMUNICATIONS SKILLS
From the minute a prospective patient
calls to schedule a consultation, what you
say and how you say it will either posi-
tively or negatively impact your practice’s
profitability. When potential patients call,
typically they will decide within 2 min-
utes whether or not to trust you with their
hearing health. If the phone is answered
poorly or if the patient is put on hold or
treated as if he or she is not important to
the practice, it will cost you.
Although the first minutes on the
phone are especially critical, throughout
the entire patient experience there are
opportunities for your team to use com-
munications skills to effectively guide
patients to the desired outcome—an opti-
mal fitting.
On the phone
When a prospective patient calls your
practice, the objective of the person who
handles the call is to set an appointment.
This is your first impression with patients,
48 THE HEARING JOURNAL
and, yes, the old adage is true: You will
never get a second chance to make a good
first impression.
From the initial greeting through the
conclusion of the call, the prospective
patient will begin to form an opinion about
you and your practice. That impression
will largely determine if an appointment
is set and whether or not that person will
ultimately purchase hearing instruments.
Ask a friend to call your practice and
record the phone call. Review the tape
with the team and determine how to
improve this critical communication skill,
keeping in mind the ideal outcome of
scheduling an appointment with a spouse
or other family member present. Again,
look to manufacturers and other partners
to see what resources they have available.
“…when potential
patients call, typically
they will decide
within 2 minutes
whether or not to
trust you with their
hearing health…”
Many have proven scripts you can use for
training and role-playing. Here is an exam-
ple of a phone script, developed by Von
Hansen, which is available from Care-
Credit:
Practice: Good morning. Thank you for
calling ABC Hearing. This is Diana.
How can I help you?
Patient: Good morning. I was wonder-
ing how much your hearing aids cost.
Practice: Thanks for calling ABC Hear-
ing and I’d love to answer that ques-
tion for you. First of all, who am I
talking with?
Patient: My name is Betty.
Practice: Well, Betty, are you the one
experiencing a hearing loss or are you
calling for a friend or loved one?
Patient: I’m calling for my husband.
Practice: Has your husband had his hear-
ing tested recently?
Patient: No, but I’m sure he has a prob-
lem. He seems to miss most of what
I nv i s i b l e c o s t s c a n h u r t yo u
our grandkids say and he can’t hear
in church. I think it’s time we looked
at getting a hearing aid. But I wanted
to know how much they cost.
Practice: Betty, the first step is to get your
husband’s hearing tested. As you prob-
ably know, there are different types of
hearing loss and different types of hear-
ing instruments. The only way to know
which one your husband needs is to
have him come into the practice and
go through a complimentary hearing
evaluation. Then, based on the tests
and the hearing professional’s recom-
mendation, I can give you an accurate
idea of cost. But, Betty, generally hear-
ing aids can range in price from a few
hundred dollars to two or three thou-
sand dollars, depending on the tech-
nology and quality.
Patient: Wow! They can cost thousands
of dollars…each?
Practice: Yes, for advanced digital tech-
nology. But, Betty, we are committed
to helping patients enhance their
lifestyles by improving their hearing
health. That’s why we make it easy with
a convenient monthly payment plan
that makes even the best technology
comfortable for our patients. I’d like
to get you and your husband in for
that test. We have appointments avail-
able on Tuesday and Thursday. Which
one is better for the two of you?
Patient: I need to come with my hus-
band to the appointment?
Practice: Yes. When it comes to your
husband’s hearing health, we know
you want the best for him. And we
appreciate your calling for him. We
don’t want him to miss any of the
important information the hearing
healthcare professional will be shar-
ing, so we request that you accom-
pany him so you both can meet with
the professional and understand your
husband’s hearing health needs. Can
I put you on the schedule for Tues-
day afternoon at 3 then?
Patient: Yes, that will work fine.
Practice: Thank you for calling, Betty.
We look forward to meeting you and
your husband on Tuesday at 3.
Welcoming your guest
Every patient is an invited guest in your
practice. Make the environment welcom-
ing and have your staff treat each guest like
OCTOBER 2007 • VOL. 60 • NO. 10
a member of the family. For example, when
a patient first enters the practice, have your
front-office person stand up, come around
the desk, and greet the patient by name.
Invite the patient to sit down and get com-
fortable and let him or her know if the doc-
tor is running on schedule.
Practice: Good afternoon, Betty. Wel-
come to ABC Hearing. You are right
on time for your 3 o’clock appoint-
ment. Is this your husband?
Betty: Yes, this is Arnie.
Practice: Hello, Arnie, and welcome. Dr.
Jones is very excited to meet you both
and looks forward to helping you
achieve hearing health. He is right on
schedule, so it will only be a few min-
utes. If you could complete this short
New Patient Questionnaire, it will
help the audiologist during the exam-
ination. And, if you need the rest-
room, it’s right down that hall to the
left. Do you have any questions that
I might answer for you before the
examination?
These communication techniques will
make each patient and family member
feel welcome and comfortable with you
50 THE HEARING JOURNAL
and begin to establish a trust relationship.
The consultation and
recommendation
The most critical opportunity for com-
munication comes during the consulta-
tion and recommendation. During the
consultation, the patient will decide to
accept or decline your recommendations.
Look for signals of “readiness.” Remem-
ber, patients buy emotionally but justify
their purchase rationally. So, when dis-
cussing patients’ hearing health, let them
know how the recommended hearing
devices will enable them to do what they
enjoy. Did they talk to your team about
their grandkids or about enjoying live con-
certs? If so, tie the benefit to their specific
area of interest. Here is an example:
Practice: Arnie, you mentioned how
much you enjoy live outdoor concerts
at the park. In that environment, we
believe this digital device will help you
capture every note and enjoy the
music again.
Also look at body language. Is the
patient attentive and engaged or does he
or she look disinterested? If so, the person
I nv i s i b l e c o s t s c a n h u r t yo u
may have hidden barriers and objections
to your recommended hearing health plan.
To uncover these concerns, again, relate
the device and benefit back to the person’s
interests.
Practice: Arnie, you mentioned how
much you enjoy live outdoor concerts
in the park. That’s why I explained
that we believe in that environment
this digital device will help you cap-
ture every note and enjoy the music
again. But, I’m sensing that you aren’t
very excited about it, which makes me
think there is a question I haven’t
answered for you or that you are con-
cerned about the hearing instrument.
Can you share with me why you are
hesitating about something as impor-
tant as your hearing?
Patient: Well, to tell you the truth, I guess
I just didn’t expect to pay almost
$5000 for hearing aids. I’m not sure
I can fit that into my budget.
Practice: As I mentioned to your wife
on the phone, our practice is com-
mitted to helping you achieve opti-
mal hearing health. That’s why we
offer a monthly payment plan. Our
patients love it because they can get
the hearing aids that work best for
them and not be concerned with the
cost. Can I share with you both some
information on our monthly payment
plan?
SUMMARY
Sometimes what you can’t see can hurt
you, especially the invisible costs that drain
a practice’s profitability. From attitude to
communications skills, your team will cre-
ate an experience for your patients. If the
team’s attitude or communications skills
are not as good as they could be, the
patient’s experience will be less than
remarkable. The result will be decreased
sales and referrals and increased returns.
Even though these are not costs you can
see, they will impact your practice’s bot-
tom line.
Terry Silance is National Director of Sales, Audiology/ENT,
for CareCredit, where he began the Hearing Healthcare
Division 5 years ago. He has worked for a hearing aid man-
ufacturer and is married to an audiologist. Readers may
contact the author at tsilance@carecredit.com.
REFERENCE
1. Inquire Research: Patient Financing Cardholder Survey,
March 2006.
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