By Kriss Barlow, RN, MBA
Relationship building with doctors can often be derailed because of perceptions. These perception challenges often fall into three major categories:
- Negative feelings at a personal level
- Negative feelings based on feedback from patients about their treatment and experience
- Market place perceptions about the organization and or its people. This is more often the challenge for those who are working to re-inventthemselves and geography, reputation or medical staff misfires have left them on the low end of status rankings.
Let’s take a step back and understand what happens as perceptions are formed, and then look at some ideas to manage it and move the relationship forward.
We’ve all heard the adage, “Perception is reality.” Logically we know that just because we see something a particular way does not make it so. The challenge is that the individual defines “reality” based on their own biases and beliefs. So when a physician says his expertise is not valued at the organization, it is very real, very personal and very difficult to challenge.
Take the case of the doctor who had a residency experience at Acme Hospital. He felt that residents were not valued by the leadership because they did not get to share the meals in the doctors’ lounge. Clearly, there were old wounds and bad baggage as he told the story some 10 years later. And while logically we all appreciate that the CEO had a much different reason for the decision, the former resident, and now potential referring physician was staid in his beliefs – and unwilling to refer. Can you imagine the sales success if a rep went to this doctor and tried to talk about patient experience? They would walk away without ever getting to the core of perceptions and referral bias.
In the role of influencer and advisor, the first step is listening, learning and understanding their reality. Once you have a pulse on their perception of what was done and why, you have the ability to define a plan that recognizes their reality.
Let’s face this fact head on – while physicians are always trying to do what is best for their patients, in many situations they have multiple “best choices.” The perception part of the equation when there is personal baggage, quickly allows them to overlook your organization. So how do you manage this?
Step One: Get To The Heart Of The Matter
- Use good questions to explore past experiences
- Learn how they like to be involved and engaged with the referring doctors
- Gather insights about their last visit to your facility and the reason why
- Learn who they know and like, or don’t like, and why
All this needs to be done in a very non-judgmental way, and it may need to be parsed out over several visits. Remember too much exposure too fast on personal perception issues may make the prospective referral source feel vulnerable.
Step Two: We Get It
If you are able to find one “soft spot,” then begin to work on this area. Primary care physicians will always like it if you say that the team is working to make changes. They will also feel better about their disclosure if you share that many physicians have engaged in defining improvements in the area.
Step Three: Move It Forward
It is easy to get caught in the cycle of asking, listening, shared empathy and then asking again. If you are going to advance the relationship, it will be important to isolate the emotional negative and work to: 1) Show it is no longer an issue, and 2) Show that value in the experience now will far outweigh that one negative.
Here’s a script that might better illustrate this. “Dr. Smith, at Acme, we have demonstrated that there are times when our short-term decisions have had an impact that falls far short of what we intended. But, changes in that process demonstrate that we are willing to learn, fix our mistakes and admit that we should have done things differently in hindsight. As well, you agree that the location of our facility makes the surgical experience so much easier for your elderly orthopedic patients. I hope you will keep giving me the chance to talk to you about it.”
Frankly, the personal perceptions may be the most sensitive to manage and realistically, there may be times when the personal baggage is just too much to overcome. But more often than not, once exposed, discussed and managed, your relationship sales efforts can be explored.
“You Did Not Do Right By My Patients”
The advantage of this perception is that the physician or their office staff is passing along perceptions of another person. It is not as personal, so often data and follow up can be deployed to manage the situation.
Get the Facts
Listen and document as they give the details. If you need to offer to call the patient directly because many important details have been forgotten, then do so.
Never Tell Them They Are Wrong
Sometimes a leader will want to push back and say that the patient had it all wrong, or that the patient was impossible to please. Let the leader scream to you about the injustice, then work together to manage the patient’s reality. Confront the reason for the perceptions, look at solutions, recognize that patients often see it different; find a way to make certain operations is on board with you in managing the situation.
Put It In Writing
Send a note back to the physician that details the patient’s perceptions, what you have done with the information and what the patient can expect moving forward. Don’t forget to remind the physician that you were grateful they were willing to share.
With your next visit, bring a copy of the letter, share the approach and outcomes again and then transition to the business at hand.
Dealing with Market Place Perceptions
Marketplace perceptions about the organization and its people are best dispelled with tools that demonstrate otherwise. If the physician remembers your organization from the 80’s because that was their last visit to the campus, find a way to do a tour. If they won’t come, invite their staff. If they perceive you have lesser quality, use outcomes data and consistently show where you are ranked. For some organization, they may benefit from the purchase of national data. In this situation, it has less of the emotional tug, so rational approaches can have good success.
As you work with negative perceptions, step one will always be to determine the nature of the perception. Once that is uncovered, you can define your plan for providing the right messages, at the right pace to earn an opportunity. The goal here is to change their perceptions to match your reality!