Here’s the scenario: A new naturopath starts her practice. She’s fresh out of school, heavy in debt and a little freaked out by how much her time is worth. I hope people aren’t turned off by the price, she thinks.
Anxious to make sure she’s ‘worth it’ to her clients, her first patient visits are a blockbuster. Lots of face time, handouts, meal plans and recipes – a veritable rainforest of paper. Satisfied that she’s over-delivered, she sits back and waits for the return visit.
Sadly, it never comes.
What’s the problem? It’s called giving away the cow – providing too much information in one visit. It’s a natural form of generosity, a normal reaction to not owning your fees, and an important part of informed choice. Unfortunately, information overload is not always a great business or health care decision.
The expression comes from the concept of not giving away the cow when you can sell the milk – once you give away the cow, customers don’t need to come back anymore. They’ve got an unlimited supply of milk. In the world of alternative and holistic medicine, the analogy is particularly relevant to information and lifestyle-based practices – naturopathy, nutrition, fitness and the like – where the product can be as much about knowledge as it is about treatment.
The implication from a CAM business perspective is pretty clear: if you give your patients the whole enchilada in one visit, maybe they won’t need to come back. They’ve got the works. Why pay more? Adios revenue stream.
However, the profit motive doesn’t sit well with many practitioners, I know. Fortunately, this is yet another example of good health care and good business being perfectly aligned. Knowledge overload is not helping patients. Taking a complex and extraordinarily difficult process like lifestyle change and trying to provide it all in one visit is not only impossible, but it’s overwhelming, depressing, and counter-productive. The most likely outcome is lower profits and lower patient success.
The solution is to take baby steps. Resist the temptation to tell your patients everything on the first visit. Stretch it out in manageable steps, and tell them you’re going to stretch it out in manageable steps. And if you can’t stomach the business argument for not giving away the cow, give some thought to the health care side – are you really helping? Are your patients capable of making huge, all-encompassing changes, or are you scaring them off? Wouldn’t you rather give better care, and have more financial success in your practice?
Moo.
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Nice metaphor. I think it’s hard sometimes to not do that but I like the way you’ve phrased that–making it MORE useful to the patient, rather than coaching it in stinginess.
Good post!
Thanks Dan. I definitely found myself doing that at the Bastyr Teaching Clinic – and the pts didnt come back.
The pts who did come back were the ones who I said, ‘See you in a week and we’ll address the pre-op strategies’ or ‘See you in 2 weeks and we will discuss food re-introduction.’
I like to keep my ranch going so Im keepin my cows.
Best
Ben