by Juan Nodarse

In the first issue of Nutritional Wellness, I devoted this column to the Five Steps of Persuasion, and how marketing's role is to guide prospects or patients along those five steps.

Let's start by discussing how listening can help you on a one-to-one basis, and then expand to concepts you can apply internally in your clinic, and finally, to concepts you can apply externally within your community, and even within the chiropractic profession itself.

One-to-One Listening

Communications experts tell us that listening is one of the most powerful skills we can use to positively influence others. The ability to listen has been documented as one of the most common traits found in highly successful salespeople.

Whether your point of view is that you're just trying to communicate, or trying to influence your patients, your ability to listen to them will go a long way in terms of how quickly you can help move them along the Five Steps of Persuasion.

A popular training video, "Fish," tells the story of the Pike's Peak Fish Market in Seattle, and how it has become such a popular attraction. When one of the workers at the fish market is asked why it has become so popular, so successful, and such an attraction, he credits its ability to "be there."

Another way of looking at it is to consider the Disney approach. Disney teaches its employees that the minute they start working, they are "on stage" - and are expected to meet certain expectations regarding their behavior toward Disney customers.

Whether you choose to follow the Disney "on stage" approach, or the Pike's Peak Fish Market "be there" philosophy, your focus on your patients and your ability to listen will be essential in determining their satisfaction, their loyalty, and ultimately, their willingness to refer.

The same focus and listening skills you use with your patients should be used with your staff. I am constantly shocked at how much the average health care staff knows and hears; yet doctors never find out about it because they don't ask, or worse, don't listen.

Not only should you practice exceptional listening skills toward your staff, you should also ensure that your staff is "being there" and listening to your patients. E-mail me at and I will send you some listening information to help you and your staff improve your listening skills.

Clinic Listening Efforts

The commitment to personal listening by you and your staff is the first step in implementing a clinic listening culture. But there are other tactics you can implement to maximize the benefits that a listening culture can bring to your practice.

First of all, keep in mind that every contact with a patient is an opportunity to listen. Have everyone on your staff keep a spiral notebook handy, and urge them to jot down as much of what they hear as possible. You'll be amazed at how much good, pertinent information you will find in those notebooks after just a short period of time.

A slightly more formal listening process is to have a survey for your patients to fill out. You have many opportunities to conduct surveys of your patients, and if scheduled properly, they can be done in a manner that does not negatively affect your workflow.

One clinic I know has an ongoing patient survey that every "nth" patient fills out. In this manner, they don't bother patients very often; yet they have a regular flow of information coming in. Most patients wouldn't even mind if they were asked once a year to fill out a patient satisfaction survey - and doing it once a year may make it easier for you and your staff to coordinate. Either way, if you ask the right questions, the information you gain will be invaluable.

Another clinic I know of surveys its new patients upon completion of their initial phase of care. This is a time when patient satisfaction is generally very high; thus, it offers a tremendous opportunity to ask questions outside the realm of general patient satisfaction.

Also, don't forget that with the changes in technology, e-mail surveys are becoming very popular. And both consumers taking them and marketing researchers who are beginning to validate their usefulness are more and more accepting of e-mail surveys.

Perhaps the most powerful listening tactic is the patient focus group. Focus groups provide invaluable information, and if done properly, can actually be a very proactive marketing vehicle. For best results, focus groups should be done on a regular basis, in order for you to track the patterns of opinions.

Advanced listening clinics actually hold different focus groups for top patients, new patients, inactive patients, and non-patients. The information is not only powerful; it's also segmented in a manner that offers variants in how these groups see you and your clinic. In turn, it provides great marketing information for you to use.

Other Listening Efforts

Listening doesn't always have to mean actually doing a survey. Listening is a term that I use to connote everything you do to gather information that may give you and your practice insight to enhance your marketing efforts. There are many such tools and processes that you could use. Consider these:

• Freedemographics.com is a Web site that offers great general information about the demographics of your town.
• Many television stations and newspapers do regular marketing research. Ask to see this information. If you are an advertiser, or potential advertiser, you can even request that they ask questions about chiropractic.
• Your chamber of commerce or city government may also have pertinent facts or information that could be crucial for you, especially if you're considering expansion, opening new clinics, or moving.

Listening and Your Marketing Plan

If you'd like to get a marketing plan written, your listening efforts will be even more invaluable. Most of the information gathered during these efforts will fit in perfectly to the Situational Analysis part of your marketing plan. If you want to get a head start, focus your listening and information-gathering efforts on the specific needs of a situation analysis.

For example a SWOT analysis identifies your own strengths and weaknesses, as well as those of your competitors. It provides a more clear identification of your problems and opportunities that can provide direction for your listening efforts. You can ask or survey your patients about what they think you do well and what you could improve on (strengths and weaknesses). Or you could ask focus group participants what other chiropractors they've heard of, and what their opinions of them are. By directing your listening efforts to information that would fit into your marketing plan, you'll give your listening efforts even greater purpose.

In Conclusion

Listening can be one of your most powerful marketing strategies. Do it and you'll see a tremendous amount of information come your way. Do it well and you'll gain a huge advantage over your competition, or the average practitioner. Do it extremely well and you can truly differentiate your practice, enhance patient loyalty, increase referrals, reduce marketing waste, and give yourself added confidence that will pay off in your clinic's bottom line.