Reader D. asks:

“What are your most successful tips for closing the appointment on time with verbose patients?”

For those of you with “talk-heavy” consultative practices, a talkative client (or a series of them) can either throw a busy schedule completely off-kilter, or turn a not-so-busy schedule into a day of chatter that you don’t get properly paid for. Here’s our strategy for reigning in the chatty ones without being rude.

1. Use a Clock. You really can’t be on time if you don’t know what time it is. Same goes for your clients.

That may seem obvious, but it’s amazing how many practitioners don’t have a clock in their office. A watch can work, but it can be hard to glance at your watch in some situations—a clock may work better. Better yet, try two—one that you can see, and one that your patients can see, too.

2. Take Responsibility

Practitioners with real chops for managing time will tell you that an appointment isn’t just a meandering conversation. It’s a guided, structured interaction. And the guide is you, not the client.

An appointment that ends right on time isn’t luck. It’s not because of a cooperative client, or the ability to simply shut someone down mid-sentence and say, “Your time is up.” Appointments finish on time because the practitioner controls the appointment, not the client.

If your appointments run consistently late, you need to accept that it’s within your control to change that.

3. Lead The Interaction

It may be your job to guide the appointment to a timely finish, but talkative clients can be very persistent. Here a are a few tips to taking control of the appointment flow:

• Re-state the time frame. Chatty clients tend to forget how much time is available. You can gently remind them up front by saying, “We only have until 2:30, so we should get right to it.”
• Don’t ask “How are you?” with verbose patients. Stick to more closed questions that are specific to your patient’s complaint. Instead of “How are you?” try, “How are your headaches?”
• Don’t ask open-ended questions after the halfway mark. With verbose patients, you’ll need to start closing sooner. Don’t open up a whole new topic, or ask for more information after the midpoint. The first half is for them, the second half is for you – you need time to diagnose, treat, create a plan, explain, etc.

Any suggestions for keeping a runaway appointment on the rails? Let us know in the comments!

Related posts:

1. 5 Random Files: An Easy Way To Reactivate Clients
2. 3 Ways to Let Go in Practice
3. The New Found: Who Gets the Oh-So-Close Clients?

‘Life isn’t a support system for art. It’s the other way around.’
- Stephen King, On Writing

Replace “art” with “practice”.

You can agree or disagree, but I’m pretty sure it’s important to choose…

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As I dig deeper into the traits that successful practitioners share, I’ve discovered that–no surprise–they all tend to get a lot done, particularly when it comes to marketing. The problem, though, is that practice marketing can be a bottomless pit of to-do’s. It’s easy to become overwhelmed, confused, or intimidated.

We covered four questions to help get your marketing done a while back, and some tips on creating your practice marketing plan, but I want to share with you three things we’ve done so far this year that have simplified our marketing efforts, which in turn has allowed us to get more done.

1. Create Marketing Themes
To make things a bit easier this year, we “chunked” our marketing conceptually over the four quarters of the year. We used part of the framework from The Practitioner’s Journey, but you could use anything that works for you.

The theme of our first quarter was about increasing new patient numbers (The River). The next two quarters will be about leveraging our existing patient base more – promoting existing products and services, adding new ones, managing patient flow and scheduling (The Boulder). The last quarter will have more emphasis on shifting from practice to business, and planning our eventual transition to new space (The Valley).

This “theming” has created some tangible advantages. It’s allowed us to:

• Decide what to do next. Sometimes a huge task list just makes you want to bury your head in the sand and not do anything. The themes let us narrow the big pile down to just the tasks relevant to now.
• Focus. It’s easier to defer new “shiny” marketing ideas to a later time if you know that there really is a defined later time.
• Understand the big picture. Themes let you look at your entire marketing year in a sensible strategic way. Our themes for each quarter give us a “marketing plan in a nutshell.”

You don’t have to use the same themes we did. You could divide your year by marketing type, for example. Perhaps you want to focus on kick-starting your website efforts in one quarter, focus another on live talks or public outreach, and another on social media. It’s up to you. For us, the themes are just an effective way to stay focused and underwhelmed.

It’s worth noting that we don’t abandon one area of focus when we shift to a new theme. We didn’t give up on new patients after the first quarter, for example. But a lot of our new patient initiatives were kick-started at the beginning of the year, and then maintained or tweaked for the remainder. And we deferred a heap of new marketing and other practice changes and decisions to the quarters in which they belong.

2. Take Daily Action

A few years back Tara and I both experimented with exercising every day for a year. The objective was to do 30 minutes of something every single day. No misses. We’d always been active and healthy, but wanted to take it up a notch.

Not only did we feel great and never get a single cold or flu that year, it turned out that doing it every day actually made things easier. It just became a small thing to be done every day, like eating or sleeping. Taking the choice out of it seemed to simplify everything.

We’ve been applying the same strategy to our marketing efforts: Do one thing every day, no matter how small. The end result for us is the process is simpler, and the sum of all those small efforts is far greater than before. We’ve avoided the trap of “when I have time, I’ll do this big marketing thing”–we all know how that ends. Rather than have a “marketing day”, for example, we just do steady, tiny bits.

Unlike the 365 days of exercise, we’ve limited the daily marketing to 5 days a week, not seven, but the results are the same. Slow, steady, improvement, without the overwhelming dread of trying to take over the universe in one afternoon.

3. Track Your Efforts

It’s not hard to make a list of things that you need to do in the future. No shortage of those. But what about tracking what you’ve already done? There’s real value in seeing your progress, but it’s hard to “see” that progress in one place.

Tara has started to use a really simple tracking method–putting everything in the calendar on her mac after she does it. She uses a couple of specific colors to identify marketing tasks and, in our case, referrals into one of our treatment tools.

Here’s a quick peek at what I mean. The green entries are marketing tasks. The red entries are when we started tracking prescription rates for one of our therapies. It’s not rocket science…but it gets the job done, and I’m pretty sure it’d be just as easy to do in Outlook, or with a monthly paper calendar and a couple of highlighters:

This has a number of distinct benefits:

• Awareness. It’s easy to see with a click that things are moving forward. And we have a basic history of marketing efforts on one place all the time.
• Motivation. Once you get a steady streak of green bars, or red entries, it starts to become a bit of a game to keep things going.
• Reward. It’s remarkably satisfying to see all your marketing in one place. It’s something you don’t get from scattered entries in a daytimer, or random to-do lists.
• Results. The work’s getting done, and it’s is paying off in terms of better patient numbers, etc.

These strategies are all designed to do the same thing: to simplify the giant pile of stuff that is practice marketing. Our experience? If you can make things easier to grasp, then you make them easier to do. 

Related posts:

1. How to Create Your Practice Marketing Plan
2. Practice Marketing for Introverts
3. 3 Ways to Let Go in Practice

“Civilization is a stream with banks. The stream is sometimes filled with blood from people killing, stealing, shouting and doing the things historians usually record, while on the banks, unnoticed, people build homes, make love, raise children, sing songs, write poetry and even whittle statues. The story of civilization is the story of what happened on the banks.”
— Will Durant, Life, Oct. 18, 1963

One of the four metaphors in The Practitioner’s Journey is the River. It represents the uncertainty that separates you from your potential clients. Things like cost, fear, disapproval, time, skepticism, and other perceived risks. Attracting more patients to your practice is almost always about finding ways to get them across the river.

The greatest challenge, though, might not be the river itself, but the fact that we focus on it instead of the banks.

The river is competition, or a lousy economy, or lagging insurance coverage, or public skepticism. But everything that gets your clients across it–everything that grows your practice–happens on the banks. The bank is where we find the rocks for stepping stones. It’s where we build bridges.

The banks are within your control. The banks are where you can take action.

The river, like so much sh*t, just happens. Best to focus on the things you can change.

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1. We May Not Be Good, But at Least We’re Slow

It’s true. No one needs what you do.

No one suffers from a shortage of acupuncture or a lack of massage. No one is experiencing a chiropractic outage or struggling with insufficient naturopathy.

What they are short on is what those things do.

Or, to put it in limerick form for Saint Patrick’s Day:

In an office atop Mount Wapuzz
A practitioner tried to build buzz
Said the guru in the cave
With a dismissing wave
“‘Ain’t what you do. It’s what what you do does.”

Note: I’m pretty sure that last sentence has never, ever been uttered in the English language. Happy St. Patrick’s Day!

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We spend a lot of time trying to remember things. To-do’s. Appointments. Lists.  It’s the core skill set we’re taught in school, and we have a whole world of external memory tools to help us out–things like day timers and post-it notes, to-do lists and software programs, calendars and smart phones.

One of the great benefits of those tools is that they give us permission to unload our minds. To free up mental space with the confidence that there’s a system so that we won’t forget.

But what if there are things we should forget? Things like:

• The naysayer who told your patient that what you do is nonsense.
• The teacher who said it’s wrong to earn a living.
• The friend who said that telling people how you can help is just sleazy marketing.
• The colleagues who said it’s impossible to make a living because of competition or the economy.
• The pseudo-statistics that it takes five years to pay yourself, or that half your colleagues will be out of business in two years.

Those things are taking up mental space, too. And they hang around, and hang around, and hang around. We can’t remember what we had for dinner three Wednesday’s ago, but we can’t seem to forget that one person who criticized our work.

Unlike remembering to buy broccoli, putting these things in your ‘calendar’ by dwelling on them only makes it worse. We don’t need to remember these things. We need to let them go. We need to forget. And that starts with understanding that that you can’t remember what you had for dinner three Wednesday’s ago not because your brain is flawed…but because you decided it wasn’t worth remembering.

There are things worth remembering. And things that aren’t. Maybe part of success is knowing the difference.

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1. No One Needs More Information

The more I speak to practitioners, the more I’ve come to believe visit/treatment length tends to be a legacy issue. It’s not something we’re giving a lot of conscious thought to. You open your doors and do what you did in school, or copy another practice, and it pretty much stays that way. Most consultative practices have 2-3 different menu options, based on time. And they never change.

My sense is that sometimes those visits are too long – or that a shorter option should be put on the table. Here’s why.

1. Maybe Your Clients Don’t WANT Longer
Many of us are working from a simple premise that more time is better. Says who?

Perhaps it’s true to some extent, but who’s to say a client really wants a two hour initial appointment? Or a 90-minute massage? Either of those is enough to scare me off. Is it possible your clients don’t want what you think they do? Do your clients really need more time, or is it just better time they’re after?

“…for many clients, a 90 minute massage is not as appealing as it once was.”
-Irene Diamond, RT writing at Massage Today

2. Every Client is Different
Just because one talkative client can never get out of your office in under 60 minutes doesn’t mean everyone should have to stay that long. Why treat everyone the same? Are you building your visits around the slowest common denominator?

3. You Can Earn More
When we started offering a 15-minute acute care visit, we didn’t price it at half the price of a 30-minute visit–nor should you. It’s priced about 55-60% of the price of a half hour. That means that an hour made up of four 15-minute visits is worth more than a single hour treatment. Over time, the difference stacks up.

4. You Can Help More
Shorter visits simply mean you can see more clients in the same time period. It’s that simple.

5. More Flexible Scheduling
It can be a challenge to master the tetris-like game of fitting together appointments to make the best use of your time.

There’s nothing more frustrating that a week full of small gaps that add up to a lot of time in total, but that can’t be properly used because individually they aren’t long enough to fit someone into. Shorter visits give you more flexibility for filling those inevitable gaps.

6. You’re Better Than You Were
Let’s face it: when you started practice you were just beginning to master your craft. You simply didn’t have the…well, the practice. It makes sense that for many types of care, you can simply do more in less time once you’ve got some experience under your belt. You teach, explain, diagnose, set up, clean up, treat and process faster than you once could. Why not take advantage of that expertise?

Are your visits too long? Maybe, maybe not. Certainly, more time can be a selling feature, and some modalities simply require some minimum amount of time. But it might be worth asking yourself the following questions:

• Why are my appointments the length they are?
• What would be gained and/or lost if I shortened them?
• What would happen if I added a new, shorter option?

In the end, clients and patients are like Goldilocks. They need a visit length that’s just right. How close are you?

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1. A Simple Way to Offer Incredible Client Service This Year

We wrote recently about how to grow your practice with public speaking. That post focused mainly on finding places to speak, and how to turn speaking opportunities into paying clients. Since then, however, I’ve had a few discussions  with practitioners who want more help with the actual preparation and speaking part.

If you’re nervous about the idea of speaking, remember that it’s normal to be scared. Maybe even helpful. The key is to understand that great speakers are built not born. Are some naturally more comfortable? Innately better communicators? Born storytellers? Undoubtedly. But anyone can learn to engage an audience and deliver a presentation that gets results. Here’s how.

1. Outline First

To beat an old analogy to death, it’s hard to build a decent house without a blueprint, and the same goes for presentations. The structure is everything. It defines what you’re trying to say, and creates a logical flow. It’s also a huge help when it comes to creating great presentation materials.

Mostly, though, it helps create the story. You need structure to tell a story, and story is what makes it all work.

Story doesn’t necessarily mean “interesting anecdote” though. Here are the elements I consider important for your outline:

• One clear message. In one sentence, why have you brought everyone here? The story of this blog post is: Anyone can become an effective presenter by following a few simple rules. I like a clear objective that says, “Here’s why you’re all here. Here’s what you’re going to discover.”
• Clear structure. Think of the outline as your table of contents. The map. It says, “Here’s how we’re going to get to our destination.”
• Flow. Do the pieces fit? Does it make sense?
• Novelty or surprise. What have you got for your audience that’s new? Surprising? Did you know that it’s wheat, not fat, that’s driving obesity? Did you know that the antibiotics you’re using to fight infections might be helping to create them? Remember that these ideas might be old news to YOU, but for the general public, they help create that sense of curiosity that all good stories have.

Outlining this blog post, for example, I get something like this:

Intro

• Anyone can be great. Speakers are made not born.

Principles

1. Outline first
2. Rehearse early
3. etc.
4. etc.
5. etc.

Closing

• Leveraging your work
• Resources

There’s no rocket science here. It’s just simple clarity. Once sentence, plus a bullet outline. That’s all you need to get to the next step…

2. Rehearse Sooner

Once I have the outline, I’ll turn that into a few very quick PowerPoint slides, without any regard for appearance, concise wording, spelling, images, etc. And then I start rehearsing. Yep – right away.

Once the blueprint from Step 1 is in place, I can launch the slide show, stand up with my remote in hand, and start speaking as if I’m doing the talk live. Then I just make notes along the way.

To clarify, you don’t have to use PowerPoint to actually present. For me, it’s simply a tool at this point to start to develop the presentation and to start rehearsing as soon as possible.

Is it messy? Absolutely. Embarrassing? Definitely. But no one’s watching at this stage. And early rehearsing does a few critical things:

• Gets you comfortable speaking. The more you practice, the better.
• Generates new ideas. Speaking out loud brings new insights, phrases and related ideas out into the open that might never have come to conscious thought otherwise.
• Improves flow. Often, what seems like the right sequence or combination of ideas and slides in theory doesn’t work as well when you speak. The sooner you start speaking, the sooner you find the gaps and inconsistencies that only show up when you speak aloud.
• Gives you a feel for timing. You’ll start to get a sense as the presentation develops of how long it takes to cover certain areas. That’ll help you refine your presentation to the right length.
• Improves improvisation. Trying to fumble my way through my bare-bones outline creates more comfort with having to wing it when things go off the rails. Last summer I spoke to at a conference and my presentation files were corrupted. I had to speak for an hour and a half with no resources at all. S&*$ happens, and practicing sooner pays off when it does.
• Helps memory. The sooner you start rehearsing, the better you’ll know your topic, the less content you’ll need on your slides, and the less you’ll need any kind of memory aids.

The key takeaway is this: the best oral presentation is created orally. Sure you can write the whole thing down and read it. But you’ll get a better outcome if you build it in the same way you’ll be delivering it. It’s not about how soon before the event you start rehearsing. It’s about how soon in the process you start.

Use your outline, and start speaking. Then stop and jot notes each time you fumble or come up with something brilliant. Eventually, you’ll have a great story.

3. Do PowerPoint Right

Once you’ve got your presentation refined to pretty much it’s end form, you can start to refine your slides into something more presentable. (Assuming you’re going to use them at all.)

If you’re going to use PowerPoint or Keynote slides for the actual presentation, though, then use them well. The best single piece of advice I’ve heard is to pay by the word. Imagine you have to pay for every word you put on a slide. You’d almost certainly use fewer words and more images. You’d be less tempted to just put up slides and then read them to your audience. You’d be able to use larger, more legible fonts. You’d be less boring. And you wouldn’t insult your audience by reading to them like children.

In short, “paying by the word” drives great PowerPoint. Remember:

Your job is to tell a story that engages and inspires an audience, not read PowerPoint slides.

Some great resources for slide design:

• You Suck at PowerPoint
• Really Bad PowerPoint

4. Skip The Handouts

“The audience will either read your slides or listen to you. They will not do both. So, ask yourself this: is it more important that they listen, or more effective if they read?” – slide:ology

I don’t like handouts at all anymore – at least, not ones that are just printouts of slides. I send that out after by email or using slideshare.net so people can reference it, but I encourage people to just listen, think, and interpret, and then write down any key “a-ha’s” only.

Are there things worth printing on paper and handing out? Sure. But not your slides. Consider instead sending it out as a resource after.

Not printing handouts also is the single best way to encourage people to give you their email address so you can follow up. ’nuff said.

5. Respect the Audience’s Time and Physical Presence

Remember that you need to justify that there are many people burning time and money to be in the same physical space with you. Ask yourself, “Is this worth the audience showing up?”

• Could this presentation have just as well been a blog post or an article?
• Could I just email my slides to everyone and they’d be just as far ahead?
• What’s the benefit to the audience of being in this room together? Can I connect them to each other?
• What am I offering, right now, that they can’t get online or from a book?
• What is the audience gaining by being here in person that they couldn’t get in a webinar or teleconference?

Presentations are resource heavy. If I assemble 50 health care professionals in a room for two hours, I’m burning at least $10,000 dollars in billable time. Make your presentation worth it. I think This Dilbert cartoon says it far better than I ever could.

To sum up, presenting is something you can do, and do well. And it can be worth it. To get the most from your engaging talk, though, you’ll want to follow up. You can use the tips from our previous post for ideas. And if you’ve got ideas from your own experiences, let us know in the comments!

Related posts:

1. Tips for a Successful Open House
2. The Gift: A Free Practice Success Book
3. How to Grow Your Practice With Public Speaking

Furred one digs, searches
Feathered one pretends, avoids
Both heads in the sand

Which one are you in practice? The ostrich or the dog?

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One way to look at the big pile of people out there who might become your clients is to divide them into two groups.

The first is the kind that already knows what you do, and is looking for it. This group is small. But they’re sooo close to being your client. They’re already searching–you just need to be found.

The second group needs to be educated. They don’t know what you do, or how it can help. This group is huge. But you have to find them, and convince them.

Finding takes work. It involves relationships and credibility and time and money and effort. But it’s critical. You need to be finding.

Being found takes some work, too, but the convincing part is a lot easier. That’s why we all like being found.

The trick is that being found doesn’t look quite like it used to.

Being found used to be straightforward. You did something easy like put an ad in the Yellow Pages. Anyone looking for “massage therapy” could find you in the list. Getting good at being found just meant that you called yourself “AAA Massage Therapy” to get to the top of the list, or you bought the biggest ad. For that small, but already-convinced slice of the pie, that was a simple way to play the game. And generally the game could be won with a big enough budget.

The new “found” looks different. It’s not about your Yellow Pages ad, or the big sign outside.

• When someone searches for a massage therapist in their area, and your website comes up at the top of Google? That’s you being found.
• When someone is looking for a solution for infertility and your acupuncture practice comes up in Google Adwords? Yep. You. Being found.
• When someone searches for “Yourtown Chiropractor” and your Google Places listing comes up first because you took the time to claim it and complete it? That’s you being found again.

That’s just Google. You can add Facebook or Bing, or mobile search or whatever floats your boat. The difference? Not that it’s online, but that it’s cheaper. You can now be found by trying harder, instead of spending harder.

The new “found” rewards thinkers, adopters and triers. Not spenders. But the moral is the same: Spend plenty of time finding. But don’t forget to be found, too.

Related posts:

1. Grow Your Practice with Google Places
2. 5 Random Files: An Easy Way To Reactivate Clients
3. 3 Ways to Keep Chatty Clients on Time