From Optional to Essential: Helping Clients Prioritize Their Healthcare (Even When Money is Tight)

[00:00:13] DAMIEN:

From optional to essential: helping clients prioritize their healthcare, even when money is tight. I think this is a very topical subject at the moment, so I'm excited to bring some ideas about it here today. For those who don't know me, my name is Damien Adler. I'm one of the co-founders here at Zanda and head of customer success. In terms of background, I'm a registered psychologist and previously co-founder of a group psychology practice, and now, as of last year, I can also claim to be a best-selling author. We got our lovely Amazon bestseller badge on our book, The Nine Secrets of Successful Health Practices. Thank you to everyone who purchased it and boosted it through the ranks.

[00:01:02] DAMIEN:

Without further ado, let's jump straight into today's topic, because I'm just excited to talk about this. Looking at the atmosphere at the moment, there's anxiety about the economy. There's obviously a lot happening in the world that adds unpredictability, and the landscape is constantly shifting, with prices rising and so forth. I don't need to tell you this, you already know it yourself.

[00:01:32] DAMIEN:

So what we're going to cover today is what to do in a rising-cost environment, how to get your positioning right, how to communicate the value, and tips to make it easy to continue care. The kernel of today is really about valuing what you do and communicating that with clients, because how they prioritize makes a very big difference to their own health, and of course to your practice as well.

[00:02:05] DAMIEN:

I'm going to move through today fairly quickly, as always. My usual disclaimer at the start: I'm not here to preach or prescribe and say there's one way to do things. Every practice is a little bit different, every practitioner is a little bit different and has their own ideas. This is not a one-size-fits-all. Where I come from is the idea of sharing ideas, and hopefully there are things that resonate with you and you run with them, because there are many different ways to do things. I'm going to take you through the way I think about this and the way I find helpful, and trust that you'll get some value and be able to take some actionable steps afterwards.

[00:02:52] DAMIEN:

So what's happening in today's landscape? People are reviewing what they spend more closely, and that makes sense. Whenever there's a concern around the economy, around rising costs of living, whenever there is uncertainty, what we all tend to do is review more closely what we spend. We start prioritizing, and we start thinking about where we can cut costs. This is something we need to be really mindful of in the healthcare space, because without careful management we can end up positioning health and healthcare as something clients start to see as optional, or that can be paused or deprioritized.

[00:03:46] DAMIEN:

Now, this is not a new problem. It has always existed, in terms of assisting people to make good decisions about their health and investing in their health. But it is of course more relevant when people are feeling more uncertain about their financial position and about the economy overall. So it brings it into focus. What we've really got to work against is the tendency for people to deprioritize their health and their healthcare, because we know that is not good for them, short term or long term. And of course that flows on to health businesses: if practices are finding their patients are devaluing and deprioritizing, then that has an effect on the financial health of the practice itself.

[00:04:41] DAMIEN:

I think we can all relate, and I don't need to go into too much detail about today's landscape. Wherever you are in the world watching this, you'll be across the different events occurring that contribute to this background sense we need to be mindful of.

[00:05:03] DAMIEN:

The opportunity that most practices miss, I think, is that when financial pressures increase, we can lose the opportunity to be clear about value. When we fail to do that, we can almost end up buying into and contributing to the sense that healthcare is something that can be deprioritized. There's an opportunity to reposition and refocus the way we present ourselves as healthcare practitioners and providers, and to sharpen our emphasis on the value we're delivering and the difference we're actually making to our clients and patients.

[00:05:48] DAMIEN:

Sometimes that can drift a little bit, because internally we know the value we bring, we see it every day in the outcomes we deliver for our clients. But that can mean we forget to focus on it and message it, and make it clear so that current clients or prospective clients actually see that value.

[00:06:20] DAMIEN:

Clients really want to know, firstly, can they afford this. But the question behind affording it is whether it is worth prioritizing over other things, because depending on people's individual circumstances they need to prioritize some expenditure over others. So the question in their mind is a practical one about whether they can afford it, but that's somewhat a surface-level question. It's really about whether it is worth prioritizing, and whether the value is there to make it worth prioritizing.

[00:07:02] DAMIEN:

If you think about your own decision making when you're looking at cutting costs, you will usually find ways to afford and prioritize the things you see delivering real value, and the things that are more expendable or aren't giving you any value you're more likely to cut. That makes basic sense, it's standard human behaviour that we all do. But we need to focus in on it in the context of our practices.

[00:07:48] DAMIEN:

So we need to get the positioning right, and we need to make sure that we as health practitioners, health administrators, practice owners and our teams have the right mindset to begin with. If you see the healthcare you provide as optional, then clients will too. Even if it's subconscious, even if in the background you think people don't really need my services, or they'll probably be okay if they disengage from treatment, or if there's a background doubt about the value you're providing and the impact you're making, that will subtly show through in the way we present to clients, and it will signal to them.

[00:08:44] DAMIEN:

Essentially, clients take cues from you about how you position your work. So if you soften, if you excessively discount, which we'll talk about in a second, or if you hesitate, your clients are going to feel that too. If you're unsure about the value, that's going to get communicated, both overtly and subtly, because people are always reading each other and picking up non-verbal cues as well as overt ones.

[00:09:20] DAMIEN:

What I'm talking about here is in no way about being salesy, or pressuring clients, or trying to lock clients into treatment they don't need. We all have ethical guidelines around making sure we're only providing treatment to clients who genuinely need it and that it provides value, so I'm not talking about anything deviating from that. What I am talking about is making sure we're clear ourselves on the value we're providing and the benefit our clients are receiving.

[00:10:02] DAMIEN:

If that's something you think may have drifted over time, it's worth spending a little time thinking about the impact you're making on clients, the successes you've had, and the way you've been able to move the needle for people. It can be important to do that with your team, including your admin team, so that everyone is aligned and clear, with the value they provide front of mind. It starts from there, because when you genuinely know it and understand it and feel it, that's naturally going to be communicated to clients if and when these conversations come up.

[00:11:03] DAMIEN:

The next thing to think about is that we've got to see health as the foundation of everything, and not just a line item or an expense on a credit card statement. This is not a difficult position to hold, because when we stop and think about it, and you ask anyone to reflect on their life and what they value most, or what they'd notice most if it was taken away, people will universally say their health. It doesn't matter whether we're talking psychological health or physical health.

[00:11:48] DAMIEN:

Health is the foundation of everything else: work, relationships, energy, motivation, decision making. If we think about our ability to respond to difficult financial circumstances, when people are going through hardship, having financial difficulties, or being laid off, having their health intact is actually more important during those times than perhaps when everything is smooth sailing.

[00:12:24] DAMIEN:

So this is really about helping people see the truth of the way our lives are typically structured. They are structured on a foundation of physical and mental wellbeing, and that becomes the foundation everything else is built on. If clients are weighing up whether to spend money on a bunch of things versus continuing with their valuable healthcare, then helping them see that health is their priority makes it easier for them to prioritize when they need to make decisions about cutting certain things to afford others.

[00:13:00] DAMIEN:

It has always surprised me. I've been working in this space now for going on 20-odd years or so, in private practice and in practice management, and I've seen different financial ups and downs while working with patients directly. Over a long period we had times where people went through different financial hardships, and it's amazing that when people prioritize something, they will find ways of affording it and making it work. People are often a lot more resourceful than we might initially give them credit for.

[00:13:50] DAMIEN:

We saw that even in our own psychology practice. When there were difficult financial times in the economy, some practitioners would find clients dropping off, and we'd hear that appointments were being spaced out a lot more, or clients were disengaging for a while because they couldn't afford it. And we'd notice that other practitioners wouldn't have that same level of drop-off at all. They were equally good practitioners, there wasn't anything fundamentally different about the quality of care or the skill they had.

[00:14:30] DAMIEN:

What we learned over time is that there were differences in how practitioners would position, remind and reinforce the idea of value. Where clients saw the value and were getting those messages from confident practitioners, they'd be more likely to continue their treatment even through personal financial difficulty, whereas the clinicians who weren't remembering to talk about that, and to bring treatment back to client goals and outcomes and the client's priorities, would see clients more likely to drop off.

[00:14:59] DAMIEN:

So it's a reminder. This is not saying in any way that the financial difficulties people face from time to time aren't genuine. I'm not dismissing that, or suggesting there aren't circumstances where people run into real financial barriers when it comes to accessing healthcare. Of course that can happen. My argument is that how we prioritize the messages we send makes a huge difference, and people are a lot more resourceful than we often give them credit for.

[00:15:40] DAMIEN:

Many times I've seen, for instance, an individual adult client have a financial difficulty, and family or friends or work or someone else will end up funding their treatment through that time, because the client sees it as so important, or those around them see it's making such an impact, that they find a way to overcome the financial limitation and continue with the treatment and the benefits. That's probably enough on that particular side, but the takeaway is: let's think about health as the foundation.

[00:16:22] DAMIEN:

So this "I can't afford it" narrative typically manifests as "I'm not sure this is my priority right now." We need to stay empathetic, of course, and I'm assuming that's the default state for the vast majority of practitioners. But what we don't want to do is collapse and minimize our value, and start easily saying, well, let's deprioritize, let's discontinue treatment for a while, or let's do other things that aren't going to be in that client's best interest.

[00:17:04] DAMIEN:

Of course, if there are sensible changes you can make to treatment frequency that do not impact progress, I'm not suggesting we have hard and fast rules. But what we see is that sometimes people quickly fall into the trap of making suggestions like that when they're not in the client's best interest and not clinically indicated, reducing the frequency of treatment. So don't jump to those things prematurely, or signal that the treatment isn't important.

[00:17:45] DAMIEN:

Your role, the way I view it, is to help your clients reach informed and clear decisions about their treatment and about what they are prioritizing and what they're not. How do we do that? I think the best way is to make the link between the treatment they are receiving and real-life outcomes. Looking at the care you provide and what the daily benefits are for your clients: the more we can connect the input, the treatment, with the benefit, the higher the perceived value is going to be, and it will stand out.

[00:18:26] DAMIEN:

So we're thinking about what this has helped them do better. We need to avoid being too abstract or too clinical about it, and instead link it, having lots of conversations to make sure treatment is set up around achieving the client's identified goals and making them as practical as possible. Where we can, and where it's appropriate, measure those things, and then keep anchoring treatment back to what is most important to the client, being able to show the progress. If there is a lack of progress, then it's about shifting the treatment approach or modality or whatever it might be.

[00:19:12] DAMIEN:

We've all been there, and I've had this happen myself, where at times therapy, in my case as a psychologist, can start with one set of goals and over time drift and become a bit more unfocused. Rightfully so, if that continued, the client could start to see a disconnect between the time, effort or money they're spending and whether they're actually getting the right value.

[00:19:58] DAMIEN:

So being disciplined matters. Even though a client might enjoy the session, or find there's a therapeutic benefit to coming in and talking about things, if it's not aligned to clear goals and clear outcomes, then when times get tough they're more likely to see that treatment as less essential and it'll be one of the things that gets cut. It'll be different in the different contexts you operate in, but I think the principle is universal.

[00:20:40] DAMIEN:

Next, use simple language. In fact, I think this goes with any form of treatment: demystifying and avoiding jargon is important no matter the context, even outside of this. The more we can use simple language, and use the client's language, the more impactful it will typically be. So identify what goals they have, record and capture that in their words, and then reflect on progress against the things they say.

[00:21:25] DAMIEN:

We can use our own clinical language in the way we document things, and in the way we might talk to colleagues, because we want to be more precise. But in terms of communicating with our clients and patients, the more we can keep it simple and easy to understand and avoid jargon, the better the connection they can see between the expenditure, financial and time, and the value they're getting out of it.

[00:21:50] DAMIEN:

So how do you communicate value? My argument is that it should be consistent across each of the touch points. Sometimes when we talk about this subject, people get this idea in their mind that it's a one-off discussion, like how do I sit down at my next appointment and suddenly bring this value conversation in. I'm not suggesting you do anything awkward or unnatural, but rather weave it into your own mindset and into the natural discussions you're having with clients.

[00:22:35] DAMIEN:

That can be, and I think should be, at all the different touch points. Whether that's the first enquiry, whether they're booking via an online portal, or it's a phone call, or they walk in: what opportunities do you have there to send positive messages about the fact they're thinking of booking an appointment, or that they have booked one?

[00:23:10] DAMIEN:

What might you put in the follow-up emails? You might have an automation set up to send a welcome email, and you can put messaging in there about how wonderful it is that they've chosen to engage in treatment and work on improving their health, or whatever it might be. You've got an opportunity at multiple touch points: that first enquiry, the booking flow, appointment confirmations, the lead-up to an appointment, and after an appointment. Again using automations, it might be sending them information about how they're progressing, tracking that, and reminding people of it.

[00:23:55] DAMIEN:

And then of course there are the in-session conversations, which is probably what jumps to mind the most, and that is super important. I've talked a fair bit about that already, having those conversations to link treatment to their goals. And then in any follow-ups, making sure they're happy with the treatment they've got and that they are getting the value out of it they were looking to get.

[00:24:30] DAMIEN:

Having that loop means that if someone does disengage from treatment, there's a process to follow up, to try to re-engage, and to understand what may have happened, whether it just slipped off the radar for them or whether there was a value disconnect because they weren't perceiving the benefit, or it wasn't aligned any more with what they were looking for. It'll be different for each practice and each modality, but the type of thinking I want to get across today is how we communicate and reinforce the value you're providing, as well as making sure we are of course delivering on those things and ensuring treatment remains focused.

[00:25:12] DAMIEN:

Okay, so make it easy to continue care. Most of the drop-off isn't actually about price, it can actually be about friction that pops up. Time, effort or small barriers can matter, and they start to build up. If people have some financial pressure, and then it's a little bit hard in terms of the appointment times you have available, or there's something about your booking process, or about flexibility. Can you offer telehealth if the kids are home sick? Can you quickly switch modes? Things like that can stack up and lead to disengagement.

[00:25:50] DAMIEN:

So, tips for making things easy. Having online bookings, because that means people can jump on and make bookings at a time that suits them. They get home from work, deal with the kids, the kids go to bed, and it's 10 o'clock and they think, I need to make that appointment to see my chiropractor or my physio or my psychologist. But if you don't have online bookings, they think, I need to do that tomorrow, and of course that can easily drop off.

[00:26:35] DAMIEN:

Make sure next steps are clear. If you have an onboarding process, make sure people are getting follow-up emails after they've made the first appointment, and in the lead-up to it send them online forms to collect any information you might need ahead of time. Send them useful tips before their first session about parking, and a location pin that you can schedule automatically, to make the whole thing smooth. And then things like telehealth, allowing people to switch to telehealth easily if needed rather than cancelling the appointment.

[00:27:20] DAMIEN:

At the end of the day, if things are confusing, inconsistent, or very reactive, we tend to see more drop-off and disengagement. If we've got clear, consistent, confident messaging and systems backing that up, those things stack up and we get better engagement.

[00:27:45] DAMIEN:

What are other ways we can reduce friction without making it awkward? Removing financial friction. You can offer things like prepayments, online payments and stored credit cards. Within Zanda you can do this, and if your practice management system has the features that allow it, make sure you're using them as much as you possibly can.

[00:28:20] DAMIEN:

If someone has an outstanding debt for some reason, or a no-show fee that needs to be paid, allowing them to deal with that online reduces awkwardness, reduces the chance they're going to avoid the next session, and reduces financial issues from building up. Say someone has an outstanding invoice from a previous session, or a no-show fee, and then it comes around to the next session. Now they're thinking, I've got to pay for that previous session and today. Human nature is often to avoid, particularly in financially tight times, and so they may end up no-showing that second session to avoid the awkwardness, or the problem of not being able to pay for both.

[00:29:00] DAMIEN:

So the more you can take care of any outstanding debts as quickly as possible from when the event occurred, the better, and allowing people to do that in a frictionless way, the better. Have clear cancellation and no-show policies, where you can separate clinical work from payment conversations. Not always: there are circumstances where those two things do need to be discussed together, so it's not a hard rule, but sometimes it can be helpful to separate them out and have administrative team members take care of that side of things.

[00:29:38] DAMIEN:

Another thing you can do is use systems to support consistency. Even if we start with good intentions, trying to do things manually is pretty hard for all of us, and for your admin team. So using the automation features your practice management system has can make a big difference. In Zanda you can do things like sending automated SMS notifications and email reminders. You can set up workflows that have certain triggers, which could be collecting outstanding invoices after a certain time, and those things just happen automatically. You can use client recalls if they haven't had a session for a while, and customize all of that, and set up any follow-up automations you might have.

[00:30:25] DAMIEN:

So again, reducing friction and increasing the value makes a massive difference, and it keeps engagement high even when things are a little bit tight.

[00:30:45] DAMIEN:

A few more practical tips and we'll finish up. Identify the areas where you might accidentally be signalling that the treatment you provide is not that important, or that it's optional, or that it could be deprioritized. That's somewhat a self-reflective exercise, but if you operate in a team, also think about where they may be signalling that, and what messages you might be sending out to the team as well.

[00:31:20] DAMIEN:

Identify any gaps in your follow-up processes. Adjust how you frame ongoing care to make sure it's really emphasising the value, and the idea of health being the foundation. High performers actually invest more in their health, and that's not an accident, because it is the foundation. So really drive that point home.

[00:31:55] DAMIEN:

Improve one key touch point. Maybe an email, an opener, or a recall message, just to start off with. You don't need to do everything at once, and I always say that when I do webinars because I don't want to overwhelm people. Changes and improvements in the way we run our practices always happen incrementally. So just do one thing a week, or whatever makes sense to you, but make a start. Make a list of things you think you can improve, and then implement them one at a time.

[00:32:35] DAMIEN:

And then make sure you align and train your team on messaging, so everyone has the same view, and that includes admin staff. Admin team members might have a lot to do with making and rescheduling appointments, and we want them feeling confident about the value being provided, and make sure they're on board and aligned.

[00:33:00] DAMIEN:

Key takeaways. Clients prioritize what feels important and clear, and your role is to provide that clarity and help them make the right decisions and see the value. Small changes in communication and in the systems you use can have an outsized impact, and you can do that by leveraging your practice management system. Zanda is built specifically to do those things and make your life a lot easier. And importantly, this isn't about hard sells or pushing. It's about being clear with yourself and with your team, so that clarity and that sense of importance naturally flows out, means you're being more consistent, and makes your practice easier to engage with.

[00:33:20] DAMIEN:

That's the key thing I wanted to talk about today. I said I'd try to keep it short and sharp, and hopefully I've delivered on that.

[00:33:45] DAMIEN:

Just a few announcements. We've talked about the book: if you'd like to grab a copy, go to our website forward slash secrets and you'll be able to get yourself a copy. We also have an ideas board, so if you're in a Zanda account you can go to Help and submit an idea. We love that you can upvote on ideas. We get so much value from seeing that feedback, and it allows us to build the things that provide you with more value. We look at that constantly and it informs a lot of our roadmap, so if you haven't done that, go in there. You can suggest ideas, vote on other people's, and see the things getting traction.

[00:34:30] DAMIEN:

Then we have the Zanda Academy, where you can learn and do different courses that we're putting on there around different aspects of not just Zanda, but we're building that out into other areas of practice management. So check that out if you haven't already.

[00:34:55] DAMIEN:

And here's some more information on resources. You can email our support team, jump on our website, or book a support call, live on Zoom or by phone, whatever you like, with our team members. Whether you're a prospective new customer or you've been using Zanda for a while and you just want a health check to have a look and ask how you can get more out of it, and what things we'd suggest, our team love doing that. They go through your account with you, look at how it's set up, and make some suggestions of things you can do.

[00:35:21] DAMIEN:

And finally, check out the Practice Hive. You'll see that little logo at the top of your screen when you're logged into the account, and in there is all the update information about when we release new things, so it really helps you stay on top of everything. I believe that is everything I've got. So thank you very much. I hope you found some value, and some things you can take away from this. I will see you next time. All right, take care.