The 5 Stages of Consumer Decision Making that all your patients use.

When patients buy your services, they all engage in a decision-making process. Research shows that one of the major problems with businesses is that they fail in supporting the customers in this process. By understanding your patients needs and concerns as they progress through the decision-making cycle, you can build better and more successful medical practice.

The consumer decision-making process

Imagine that you need a new cell phone. The first step is recognizing your need. (You can insert 'want' or 'desire' instead of need.) Though you may have an idea of which phone you would like to purchase, you research your options to narrow the possibilities.

If you're a male, you go online and investigate manufacturers, resellers, and independent consumer organisations. You ask friends and colleagues for advice, and you visit a few stores to "kick the tires." You compare you options and finally decide to purchase what seems to be the best alternative, based on criteria like design, features, price. For men, this is a linear process.

If you're female you go through a much different, non-linear, decision making process that takes into account different variables than males typically choose. Men perceive this process as introducing a lot of extraneous noise into what should be a straight forward decision about cost vs.. benefits. Women are actually much harder to please because they're also buying a cell phone based on: What color it is. How it fits in their purse. cute factor, etc. They're deciding how much 'faith or trust' to put in the business. One process is not 'better' than the other, they're just different.

Warning: This is where many men don't get it. Women are using criteria that men don't understand so men tend to disregard this process. While women are harder to please, they are much more loyal consumers if you can satisfy them initially. Men look for features, women look for faith. 

After your purchase, you assess whether it lives up to your expectations. You might find that the phone is able to do what the manufacture promised, but that the navigation is unmanageable. You decide that you will never buy this brand again.

Your decision-making process can be described as five different stages:

 
The customer decision-making process and its five stages

The complexity of this process can range from careful analysis to pure impulse. While an impulse buy, such as adding additional services or products to an existing appointment, can take place instantaneously, complex purchase decisions stretch over a long period of time. This buying process is an iterative process, where patients may collect information from different sources and repeatedly return to re-evaluate and compare the information they have found. Women are particularly adept at this and consider any number of points that you may not be aware of in this decision making process. One of the most important of these could be described as 'feel'. (Men typically descry this type of methodology, often causing them to dismiss what women see as the most important part of their decision making.)

The customer funnel

The Web is a great tool for information research. Studies show that the Internet is now the primary means by which people get key information. This counts for commerce in particular. People expect to be able to find information about products they are considering buying, even if a company doesn't sell its products online.

Considering peoples' high expectations about the information and services available online, it's disturbing to see just how bad commerce web sites are at selling.

Lets look at a study on consumer buying patterns online as an illustration: From their tests of consumer commerce, researchers from the usability consultancy UIE have discovered that the buying process acts as a sieve, where customers are inadvertently filtered out at each stage of their decision-making process. UIE's studies show that out of 100% of purchase-ready customers completely intent on buying, only 34% will actually make the purchase.

 

Studies show that  buying process acts as a sieve, where customers are inadvertently filter out at each stage of their decision-making process.

 

At the information search stage, 9% weren't able to find the products they were looking for because they couldn't identify the right product category or find product options. 8% of the shoppers who succeeded in finding products gave up because the product lists didn't provide enough information to identify purchase options, or because they were confused by going back and forth between product lists and product description pages in order to decide if the products would fit their needs.

UIE's researchers found that the major problems occur when customers want to evaluate alternatives. Only 25% of the shoppers who reached this stage proceeded to the next. Some stopped because they realized none of the products would fit their needs, but most because the product information was so inadequate that they couldn't tell if the products they were interested in satisfied their needs.

At the purchase stage, 13% dropped out because they didn't want to go through the required registration process or because they where disappointed by poor shipping charge policies.

UIE also found a surprisingly high amount of problems in the purchase evaluation stage. 11% percent of the shoppers where either so unhappy with a product that they returned it. Some of the shoppers told UIE that they returned a product because it wasn't what they expected, which suggest a failure in setting up the right expectations in the product evaluation stage.

Knowing the customers' decision-making process

The most interesting thing about the study is that while they observed critical usability problems because of inadequate or poor information:

• Customers couldn't identify purchase options
• Customers couldn't decide if the products would satisfy their needs
• The product presentations and descriptions raised wrong expectations, which made customers unhappy with their purchases

Businesses simply fail in supporting the consumer decision-making process by not taking their customers' information needs into account.

Recommended reading: Marketing to women.

As a Physician, you will have little chance of knowing exactly which information needs patients have when evaluating specific services or treatments. To support the ' decision-making process, you need to understand which needs and concerns they have when making a purchase decision. There will often be patients who unintentionally mislead you by discussing a number of issues that appear to be of equal weight when they really have an overriding concern. You need to recognize how to discern exactly what a patients hierarchy of wants is.

The most effective way of discerning what is motivating your patients is to ask a number of very specific questions during a consultation. Surface physicians are trained, sometimes through trial and error, to ascertain the specific motivations that brought a patient in so that they can support the patients decision-making process.

Information search

The basic prerequisites for patients making their way through the information search stage is that they are able to find services that fit their perceived needs, and that they can easily identify their available options.

In order to support the decision-making process at this stage, you'll need to know:

• How will potential patients be inquiring about purchase options?
• What basic information do patients need in order to identify purchase options?
• What information do patients need in order to decide which product criteria are important to them?
  

Evaluation of alternatives

The problem with the operations in most clinics is that there's systems in place to effectively solicit this information. We saw above how a large number of customers dropped out at this stage simply because the information provided was inadequate. They couldn't decide whether the products they were interested in would fit their needs. All of your staff (especially the physician) should be acting as a skilled educator, and have answers ready to any question or concern that the customer might have.

Some of the critical questions that you need answers to are:

• What information does the patient need when evaluating treatment alternatives?
• Which product evaluation criteria will customers be using and which are most important?
• Which concerns will the customers have and how can we address them proactively?
• How can we encourage patients to maintain contact with the clinic?

Purchase decision

At this stage emphasis should be on providing the easiest possible way for patients to carry their purchase through. In the UIE example, we saw how obstructive policies made the process difficult. Patients want an easy way to find out where and how to buy.

Purchase evaluation

The outcome of the post-purchase evaluation stage is a level of customer satisfaction or dissatisfaction, which is determined by the customer's overall feelings about the effectiveness of the treatment and the experience.

The number on effect on patient satisfaction is the management of patient expectations. Most patient dissatisfaction is a consequence of not encouraging accurate customer expectations at the product evaluation stage. In order to avoid this, we have to make sure that the entire system, from initial contact to treatment, sets up the right expectations.

Designing for customer decision-making

Once we feel confident about customers' needs and concerns, our next challenge is to decide how to present the information to the customers in a way that supports the decision-making process. This is as much science as art. It is common for physicians to inflate their abilities in this regard. It's been my experience that every physician can benefit from constructive criticism and  training in presentation. Patient feedback to physicians is clouded by the patient/physician relationship. The result is that physicians feel that they are perfect communicators when they are not.

Conclusion

The decision making process happens in every instance. When confronted with the poor state of customer service and retention in medical clinics, patient are left to choose between providers. At each step of the decision making process, these clinics lose patients because staff never perfectly addressed their perception of what would be a 'perfect solution'.

Your medical spa staff should  be supporting patients no matter where they are in the decision-making process. They should address their needs and concerns at every point. Understanding the decision-making process, and how specific customers engage with specific needs is a prerequisite for any clinic with an ambition to turn visitors into patients.

Medspa Patient Analytics: Who's looking at you?

Where are your potential clients coming from?

This image shows where visitors to Surface Medical Spas web site originated over the last 24 hours.

(It's interesting to not that Cape Town, South Africa and Ha Noi, Viet Nam are among them.)

Our Park City location receives the most out of state visits. I'd tentatively place that number at around 5-8% of our total patient volume. Many of these patients have second homes in Park City or are regular visitors. 

If your site is static I can guarantee that it's difficult to find and will only grow harder to find as the market grows and 'real' businesses enter the market. 

Biggest medspa challenge? No suprise: Getting patients.

AestheticRN posts these medspa statistics in a discussion thread here:

31% of income is generated by hair removal
42% of the medspas polled generate 0-$99k gross per year.
35% of the medspas polled see between 1-19 people per week.
52% of the medspas reported the biggest challenge was getting and keeping clients.

Med Spa Advertising: Define your positon.

Mindshare: What do your customers think of you?

Your business is defined by its 'position'. (What it means in a potential customers mind.) Every successful business takes a position. If you're a plastic surgeon that specializes in breast augmentation, that's your positon; the breast augmentation specialist. Apple = cool and easy. Audi = safe. Listerine = kills germs.

If you don't have one, you're in trouble. If you're in search of a position, figure what the always is. Then do something else. Toothpaste always comes in a squeezable tube. Business travelers always use a travel agent. Politicians always have their staff screen their calls.

Figure out what the always is, then do exactly the opposite. Do the never. Think about what physicians 'never' do.

Doctors make you wait.
Doctors won't give you a direct answer.
Doctors talk down to you.
Doctors charge you for everyting they can.
Doctors want to sell you something.

While these may be generalizations, you'll recognize that they are not far off of what your clients perceptions are.

Surface offers a number of things that potential clients don't expect. Some of these we do just because they're unusual and other docs don't.

We offer flat pricing and we'll tell you on the phone how much something costs.
We offer 1 hour free consultations with our physicians.
We focus exclusively on education not sales.

When I ask physicians 'why' they're doing something a certain way, the most usual answer is that 'everbody else is doing it that way so it must be the way to do it'. Wrong. Doing what everyone else is doing is the way to make your business nondescript and mediocre. Do what no one else is doing in ways that work for your clients.

What's with the Medical Spa price wars? Cheap is no way to build a medical practice.

Medical Spa physicians always seem to want to offer the lowest price. Why?

I speak with a lot of physicians. One of the first few questions that I'm asked has to do with pricing. (read the MedSpa Business or Med Spa Advertising Q&A here.) Physician and medical spa owners seem to be highly agitated by not offering the lowest price in town. This shows directly a lack of competence and belief in their own abilities. If you can't imagine why anyone would come to you except that you have the lowest prices, you have big trouble.

Anyone who will choose you based on price, will leave you just as quickly. That's OK if you happen to be able to deliver services at substantialy reduced costs compaired to your competiton (think Wal-Mart) but it's certain death if your not the clear low-price leader (think K-Mart). Does your Botox, Restylane, Thermage tips, or staff cost significantly less that your competition? No.

The only sustainable business you can build is a reputation on something other than price. Make a decison about where you want to be and start moving in that direction. No woman ever recomended Surface to her best friend with 'they're the cheapest'.

From Seth Godins Blog:

Cheaper is the last refuge of the person who's not a very good marketer. Cheaper is easy and cheaper is fast and cheaper is linear and cheaper is easy to do properly, at least at first. But cheaper doesn't spread the word (unless you are much cheaper, but to be much cheaper, you need to be organized from the ground up, like Walmart or JetBlue, to be cheaper). They are, you're not.

Cheaper is a short term hit, not a long term advantage. Cheaper doesn't create loyalty, because the other guy can always figure out how to be cheaper still, at least in the short run.

Is medical advertising ethical?

There is a new discussion area: Advertising + Marketing

 
The prevalence of advertising for cosmetic medicine brings out the charlatan element. Plastic surgeons and cosmetic dermatologists have been in this arena for many years but the addition to the market of doctors who have never advertised their services before brings the ethical conflict up more and more.

Here's what the American Medical Association says about advertising medicine:

2.2 Advertising
a. Confine advertising of professional services to the presentation of information reasonably needed by patients or colleagues to make an informed decision about the availability and appropriateness of your medical services.
b. Make sure that any announcement or advertisement directed towards patients or colleagues is demonstrably true in all respects. Advertising should not bring the profession into disrepute.
c. Do not publicly endorse therapeutic goods as defined under the Therapeutic Goods Act 1989 (C’th), contrary to the Therapeutic Goods Advertising Code.
d. Exercise caution in publicly endorsing any particular commercial product or service not covered by the Therapeutic Goods Advertising Code.
e. Ensure that any therapeutic or diagnostic advance is described and examined through professional channels, and, if proven beneficial, is made available to the profession at large.

Medical Spas: The Scarcity Shortage

Seth Gordons has been writing about The Scarcity Shortage in Fast Company. Scarcity is affecting medical spas in the same way that it does with every market. From the article:

"Scarcity, after all, is the cornerstone of our economy. The only way to make a profit is by trading in something that's scarce. This is why the music and movie industries are so terrified by the millions of people who download entertainment from the Internet every day. Downloading threatens to make supply virtually unlimited, and that could make their offerings about as valuable as those of some kids down my street who recently tried to run a stand selling freshly made mud.

The same thing is true for doctors, Web sites, T-shirt shops, sushi restaurants, thumbtack manufacturers, and brands of blank CD-ROM disks. There are 100 major brands of bottled water. Someone opened a fancy ice-cream parlor in Manhattan, and then there were six.

Medical Spas are right in the nexus of this change to cosmetic medicine.Where skilled dermatologists and plastic surgeons were the rule, medical technologies like IPL, lasers, Restylane, Thermage, Fraxel etc, provide scalable solutions that no longer rely on the 'scarcity' of physician knowledge. These technology solutions will put huge pressure on medical pricing in the future and it will only be those businesses/physicians who are able to distinguish themselves through brand that will survive. 

While the medical community has long been insulated from effects that other markets constantly deal with, that's no longer the case. Medical Spas will make most cosmetic medicine a commodity, no longer dependant entirely upon the skill of an individual physician but now offered as an 'almost' completely replicable solution. Medical Spas are changing, those that embrace the new paradigm have a chance, those that ignore it will follow the telegraph and full service gas station.

The 22 Immutable Laws of Marketing

At a mere 130 pages long, the 22 Immutable Laws of Marketing by Al Ries and Jack Trout is short by the standards of most books on marketing. But the book is arguably the most concise and accurate map of how markets decide on winners and losers. If you haven't read it, do.
The 22 Laws, e-book on Amazon. $9.56.

We're going to take the time to examine  some of the 22 laws and how they relate specifically to the medical spa market. (Just so you know, whenever we refer to medical spas we're referring to all cosmetic medicine.) The laws simplicity give some weight to their credibility. It's often the case that simple truths are the ones that communicate most effectively.