Last month I wrote about the biggest mistake you can make with your marketing, but a very recent experience showed me that there are a few other doozies as well.

Short personal story....

I mentioned I was going on vacation last week. Well, as I and my family walked into the Puerto Vallarta airport lounge in Mexico, we were directed to our prepaid transportation desk.

Being both polite and naive, I listened to the transportation desk attendant delivering an admittedly earnest and compelling sales pitch about special offers available to customers using their taxi service. I understood the offer to be for free tickets to some fun local attractions (that we were planning on doing) in exchange for having breakfast at another hotel the next morning, and being shown the property for possible future visits - it would be 90 minutes of our time in all.

I don't know what I was thinking - greed was probably a factor - but we said "yes" and duly showed up for our ride to the hotel at the appointed time the following morning.

Breakfast went well - we ate while a pleasant gentleman regaled us with the wonders of their timeshare program (why didn't I figure out earlier that this was a timeshare hustle?) My husband immediately cautioned him that we were not impulse buyers with big financial decisions, and the guy expressed his sympathetic understanding.

Time stretched on and the 90 minutes became two hours, and my 5-year old daughter grew impatient. "Only 5 more minutes" we were promised.

Not to belabor the story, at the two-and-a-half hour mark and under heavy pressure from the implacable salesman and his virulent female sidekick who kept sweetening the pot, my daughter was sobbing in frustration at being fobbed off with "5 more minutes", I felt both guilty and angry, and these sales people were impervious to our distress. They were demanding a decision that day. And now I was damned if I was going home without my "goodies" for all our trouble!

This is where the big mistake was made. Irrespective of how irresistible the offer had become, one fundamental error undid all its attraction. The sales people forgot who they were speaking to. They were so locked into their pitch that they ignored the humans at whom it was directed! They failed to see two angry, guilty parents on the other side of the table.

Effective marketing and selling - be it your medical practice services, your new whiz-bang tech tool or your consulting - are all about relationships, and connection.

Yes, you will need to practice and even perfect your "pitch", which may be about how to stay healthy or how to solve the XYZ problem your customers are experiencing. But when your pitch becomes a pedantic lecture, or an exercise in bullying, you will undermine all your effectiveness and persuasiveness. You will sever your precious connection with your audience.

One secret to getting all the business you want, that this vacation experience reminded me of, is to remember that people value feeling valued. Your sensitivity to their mood or situation will score big points - it shows you are truly paying attention!

PS: the second error, which you may have spotted, was the lie. The false expectation that we would spend only 90 minutes of our valuable vacation time exploring what was in fact an attractive future vacation offer. We were furious at being lied to about how much time this would really take. So, remember ..... no false promises either!

Here's another much more beautiful way to share a "better way to market" tip, thanks to this delightful short video sent yesterday by Robert Middleton.

The International Coaching Federation's annual conference ended recently and, while I did not attend it this year, some of its messages are continuing to reverberate through the blogosphere.

One conference presentation given by author and scholar Richard Tarnas concluded with a poem by Marge Piercy that most beautifully captures the joy of my work, and the spirit of so many terrific people whose tenacity and sense of purpose inspire me regularly.

After a great day of coaching, I realized I am blessed with such wonderful clients that I had to share the poem to express what it means to be working with such remarkable people!

And for you to remind yourself what it is to be of use, as you undoubtedly are, no matter what you feel about your work.

To Be of Use

The people I love the best
jump into work head first
without dallying in the shallows
and swim off with sure strokes almost out of sight.

They seem to become natives of that element,
the black sleek heads of seals
bouncing like half-submerged balls.

I love people who harness themselves, an ox to a heavy cart,
who pull like water buffalo, with massive patience,
who strain in the mud and the muck to move things forward,
who do what has to be done, again and again.

I want to be with people who submerge
in the task, who go into the fields to harvest
and work in a row and pass the bags along,
who are not parlor generals and field deserters
but move in a common rhythm
when the food must come in or the fire be put out.

The work of the world is common as mud.
Botched, it smears the hands, crumbles to dust.

But the thing worth doing well done
has a shape that satisfies, clean and evident.

Greek amphoras for wine or oil,
Hopi vases that held corn, are put in museums
but you know they were made to be used.
The pitcher cries for water to carry
and a person for work that is real.

by Marge Piercy  (Thanks to Andrea Lee for drawing my attention to this lovely poem)

What a pleasant surprise to read in the New York Times a couple of days ago a short article called A Model for Health Care That Pays for Quality!

At the risk of sounding cynical, I was amazed that an organization of the stature of the National Committee for Quality Assurance should be sensitive to the pressing needs of the front-line doc and actually propose paying them for time spent caring for patients. And even more astonishing - pay them for time spent providing care and advice via the phone or online. Almost like you have to pay a lawyer! Not many big bureaucracies have had the time or inclination to heed the plaints of depressed healthcare providers.

Yes, it's true - read what the article says:

"The idea is to encourage doctors to meet with patients for more than a few minutes during an office visit and to also compensate them, or nurse coordinators, for communicating with patients by phone and e-mail outside office hours.

Doctors would also be compensated for helping patients manage chronic conditions — like reminding diabetic people to take their insulin — and would be encouraged to transmit prescriptions electronically."

There is however more to this story than the few lines above indicate.

The big meeting in Washington DC, alluded to in the article, was the Patient-Centered Primary Care Collaborative (PCPCC) Summit, a gathering of the constituents instigating (or inquiring about) the widespread adoption of an access and clinical delivery model -- the "Patient-Centered Medical Home" for patients.

From the PCPCC website:

"The Patient Centered Medical Home (PCMH) is an approach to providing comprehensive primary care for children, youth and adults. The PCMH is a health care setting that facilitates partnerships between individual patients, and their personal physicians, and when appropriate, the patient’s family.

The AAP, AAFP, ACP, and AOA, representing approximately 333,000 physicians, have developed the following joint principles to describe the characteristics of the PC-MH.

...... Through the cultivation of comprehensive, interpersonal doctor-patient relationships, PCMH participants receive superior preventive care, disease management consultation, and lifestyle advice that will inevitably lead to healthier patients, alleviating the strain on emergency rooms and diminishing the need for costly, last-minute emergency procedures upon which many patients currently rely."

The catch  -- in order to benefit from the proposal for improved reimbursement, you would have to earn recognition as a "Medical Home" practice and meet the Joint Principles established by the four professional associations mentioned above.

How does this tie in with being an entrepreneurial physician?

One of the premises under which I work is that to be entrepreneurial is to be creative, thoughtful, and strategic about your practice. To treat it like a business that generates your income and that of all its employees, in addition to enacting its mission.

Therefore it's important to know what moves and trends are afoot that can impact your practice, and how you can capitalize on them.

If there are demonstrably better outcomes for patients belonging to a "Medical Home" practice, if they are more satisfied with their experience of you and your business, and if you can make more money doing the work you have to do any way, then it seems smart and entrepreneurial to take advantage of the opportunity!

To add your voice to the clamor for fairer compensation for your time as a primary care practitioner, contact your professional organization and urge them on in their efforts to work with the insurers and huge employers. And look into what it takes to earn recognition as a Patient Centered Medical Home -- it might just be your best business decision yet.

(Thanks to Jeff Van Ness at NCQA for his insightful comments and clarification of the issues).

Increasingly, web searchers and surfers are accessing videos as a means of finding the information they want.

An article titled Medicine on Demand in USA Today reveals how lay people are using video. But even more revealing are the current stats from the Pew Internet & American Life Project that are highlighted in a side column:

• 74% of all adults and 51% of people who have chronic health problems are Internet users.

• 79% of all adult users and 86% of those with chronic conditions seek health information online.

• 69% of all adult users and 65% of those with chronic conditions have high-speed service, which is essential for easy video viewing.

• 57% of adult users have watched or downloaded videos; 22% have chosen educational videos, and 3% do so on a typical day.

Putting the facts together, it's logical to predict that our generation of future clients or patients raised on a steady diet of TV (and YouTube!) will be increasingly drawn to visually-presented information. Especially with our rising rates of illiteracy!

Here's my interpretation of this knowledge:

• To educate, you will have the edge over traditional businesses or practices if you use video to convey your ideas and concepts. For example, present a short video on how to use an asthma inhaler, inspect the feet of diabetics, control food portions, assemble a "rainbow colored" healthy meal, prepare for a mammogram or colonoscopy etc.
• To market your business or practice, you will set yourself apart using informative videos that specifically address the needs of your potential clients or patients. An example for practitioners might be showing how to fill out paperwork before coming to your office, what your office looks like, an introduction to your staff etc. For other businesses, it might be a "talking head" of you addressing some of the biggest headaches your prospective clients are facing, and then hinting at the solution you provide (followed as always by a specific call to action - tell the viewer what the next step is they should take!).
  You might even go so far as to video the short testimonials of your company's "raving fans" if they are willing to speak up about you.
  (PS: Imagine creating videos in another language for your multicultural audience that struggles to read your pamphlets written in English)

Creating and sharing the videos is not as complicated as it sounds.

1. You can shoot a video using a webcam, a digital video camera and now days even a regular digital camera that should give you 5-10 minutes of video.
2. Pay attention to background, lighting, and your own appearance. Having that "home-made look" is okay as long as it isn't really shaky or tacky-looking.
3. Don't forget Craigslist or a similar community bulletin board if you want to find a local videographer - get prices as well as references. This does NOT have to be an expensive proposition!
4. Upload the video from your computer to a video-sharing site such as YouTube or Veoh. I see there is a new health-related video-sharing site called Icyou.com that looks interesting as well!
5. Copy the little piece of code that you are given on the video-sharing site (ask your kid to do it for you if this is unfamiliar!) and paste it to your website - your webmaster can do this easily if you are not comfortable working on your website. This will appear to "host" the video on your site.

In what creative ways are you using video in your business or practice?

And what do you think of this idea?

An article in the Washington Post yesterday reminds us of how the US healthcare system is failing many of this country's 44.3 million Hispanic patients.

"Compared to whites, Spanish-speaking Hispanics reported less favorable experiences when talking with health care providers or getting help from office staff, the study found. This suggests that these patients face more language barriers in doctor's offices, hospitals and other clinical settings, (researcher) Weech-Maldonado said."

When it is challenging enough for English-speaking to adhere to medical recommendations and treatments, how much worse must it be for a non native-English speaker?

I was fortunate to be fluent in Spanish whilst in practice, having spent a year in a student exchange program living with a family and attending high school in Costa Rica. My subsequent ability to communicate in Spanish proved a draw for many Hispanic patients -- a lucky move as I formed many rewarding and enduring bonds.

Moral of this anecdote: become fluent, at least in your ability to communicate about health, in the predominant "other" language of your region. This will prove to be a significant attraction to an inadequately served, and probably very grateful, market segment.

Here's another entrepreneurial thought:

What if you reviewed your most frequently proffered advice (how to take diabetic medications, how to use an asthma inhaler, what this surgery entails, prostate cancer treatment options, use of sunscreens for babies and children - you get the story!) and hired a translator to prepare easy-to-understand materials, including CDs or videos, for your patients?

Sounds pricey? Not in this age of global connection.

An excellent and less-expensive resource for services such as copywriting, translation, educational material preparation etc. is Elance. This site provides access to numerous freelance services delivered by talented and qualified service providers from all over the world.

There is an informative little YouTube video on the home page explaining how you put a project out to bid (spend some time describing accurately what you want the project to be). You can specify that your provider be fluent in English, and what region of the world they should come from. Follow the steps in the project submission process. Then let the bids roll in!

You can assess the prior performance of the service providers by seeing feedback others have provided. Here is a useful article by an experienced user of Elance (and the other similar service providers - Rentacoder and Guru -- Guru actually specifies a "translation" category).

So....let's get practical, with a here's-how-to-do-it piece.

1. Decide what you want translated.
2. Decide on the medium of communication - a flyer, a CD, a DVD.
3. Go to Elance. com or Guru.com and hire a) a translator and b) someone to create your flyer with graphics etc, or c) someone who can create an audio product or audiovisual product.

You may spend a couple of hundred dollars producing these patient-friendly communication tools, but I suspect you'll be handsomely rewarded with a new stream of appreciative patients in return!

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PS: I am going to lay low for ten days as I am going on vacation with my family to enjoy a "first" -- my first experience of fall foliage -- North Carolina and the Blue Ridge mountains in this case! This is special for a South African who has only lived in California since arriving 23 years ago in the US.