Nonverbal Communication in the Patient Consultation
In aesthetic medicine, patient conversion can make or break the top line productivity of a practice. Ideally, the consultations that take place in your office turn inquiries into new patients, but often this is not the case. Have you ever felt that a consult did not go well, yet not understood why? While post-consultation patient surveys are a great way to capture this important information after the fact, there are ways you can effectively intervene during a consult when you feel things going awry.
You might think discerning an individual's confusion or dissatisfaction during a patient consultation is a complicated process, but it can be simpler than you think. Only eight to 10 percent of the information transmitted between two people in face-to-face communication is verbal. The other 90 percent is contained in nonverbal cues and tone of voice. In the patient consultation, most decisions are made based on “feel” and not necessarily by what is spoken.
Top 10 Cues,
During a consultation, the questions in each
patient's mind are: “Does the provider understand
my needs?” and “Do I feel comfortable with this
provider?” Observing the nonverbal cues or indicators
presented ahead can supply the clues you
require to answer these unspoken questions and
assure your patients and prospective patients of
your expertise, understanding, and sensitivity to
their needs. Integrating this information into the
consult can serve as a bridge where there are gaps
between what you are trying to say and what the
patient may be hearing. Consider these “Top 10
Cues” as guidelines to further understanding
between patients and your practice.
Rubbing the Neck
Rubbing the neck is a nonverbal sign that a person
is uncomfortable with what you just said. An easy
way to remember this nonverbal cue is to think of
the expression, “hot under the collar.” If a patient
rubs his or her neck during a consult, you may
want to back off for a moment. Backing off may
be as simple as sitting back in your chair and
allowing the patient time to digest information and
process what has been communicated. Mirroring
the patient's body language at this time can be
valuable. You also may choose to rephrase your
original statement in order to appear softer. Asking
how that person is feeling about what he or she
has heard can be an effective way to gain insight
into this nonverbal cue. If the patient is able to
articulate what has caused the discomfort, you can
address any concerns before moving forward.
Hands to Mouth or Hands to Lower Face
Covering the lower part of the face or mouth is a cue that may indicate the patient may not be quite honest. This is frequently something we see in young children who are confronted when they have done something naughty. This cue often occurs toward the end of the consult as you seek to gain commitment for surgery. A patient may be bluffing about getting services cheaper somewhere else or may say the cost is more than he or she can afford. This is your opportunity to ask more questions or probe for more information. It may be a cue for you to better communicate the value of what you do. You should not press for a decision at this time, because the patient is looking for a way out. If you proceed without first understanding the perceived barriers, you risk losing your patient completely.
Finger Behind Ear
When a patient places a finger behind the ear or
rubs behind the ear, that person is letting you
know he or she is interested and needs to hear
more. This nonverbal cue often takes place later in
the consultation and is a very important indicator.
If you see this, you have been given an opening to
share specificity about a product or procedure.
This is the perfect time to bring out the before and-
after photos and move the patient closer to a
buying position. Do not spend time reiterating
what you have already shared! This person is
ready to move forward and you should be, too.
Hands Behind Head
A patient who places his or her hands behind the
head is displaying dominance and power. This individual
is letting you know the significance of the role
he or she will play in the decision-making process.
Sometimes it is the significant other who displays
this body language during a consultation, and it is
important for you to ask for input at this point:
“What do you think about that approach?” or “How
do you feel about this?” If you fail to read this important
cue, you may not be heard thereafter.
Tension in Brow
An individual is demonstrating confusion or fear
when showing tension in the brow. This nonverbal
cue often is seen when a patient is worried about
safety of a product or procedure. You can regard
this as an excellent time to credential the physician,
procedure, and product you are discussing.
Having a strong understanding of safety data is
important for this issue to be resolved. You may
ask probing questions to better understand your
patient's concerns and properly address them.
Lack of Eye Contact
The eyes are “the window to the soul,” and good eye
contact is a sign of positive interaction and connection.
Patients who avoid eye contact are giving you a
strong message that they are feeling any number of
emotions that could range from the simple to the
complex: overwhelmed, anxious, intimidated, or simply
distracted. As long as the patient is feeling divided,
you cannot provide an effective response.
However, once the underlying barrier to communication
is identified, you can achieve success. How you
restore equilibrium and focus to the consult must be
carefully considered. You have a few moments to
gain the attention and trust of this prospective
patient and effectively communicate the warmth,
empathy, and openness that is so important to the
doctor-patient relationship. You may be able to pinpoint
and take steps to ameliorate the issue by quickly
reviewing conversation that immediately preceded
the lost eye contact. Connectivity and focus sometimes
can be restored with a
shared activity, such as
reviewing before and after
photos. Show-and-tell is
an undemanding joint
activity which can
serve to refocus
and center the
patient. Whatever
strategy you
employ, regaining
eye contact is critical
before attempting
to move from
consult to commitment.
Fidgeting With Hands
A patient who fidgets
is often communicating
anxiety
or nervousness.You will want to slow things down and put the
patient at ease before jumping in to an in-depth
discussion about diagnosis and treatment. Offering
refreshments such as tea or spring water can help
them to feel “at home” in your practice. Anxiety
also can be reduced by easing into the consultation
with a positive conversation about an unrelated
topic. You may ask, “What do you do for relaxation?”
or “Have you treated yourself to something
fun lately?” Avoid discussions about the weather or
topics that could lead to negative feelings or that
might heighten anxiety (e.g., natural disasters, politics,
or religion). If you are comfortable sharing a
personal anecdote or story, this is an opportune
time to do so; it may go a long way toward putting
the patient at ease and setting the tone for a positive
interaction.
Touching or Scratching Nose
Touching or scratching the nose can be a sign that
the patient doesn't like what has just been said.
This signal often is seen when price is mentioned
and can serve as an important reminder to you
that sensitivity about price is relative to perception
of value. Instead of waiting for verbal “push back,”
you should proactively communicate the value
your practice provides for the procedure being discussed.
Communicate what differentiates your
practice from other practices: safety or track
record, board certification, extensive training,
facility accreditation, follow-up care, or the number
of procedures done per year. In the end (and
before returning to price), you may ask a question,
such as “Are these factors important to you?” If the
patient is uncomfortable about a procedure choice,
offer options that might provide similar results.
Not Facing You Directly
If a patient subconsciously turns away from you
(i.e., shoulders are not parallel to yours), he or she
may be communicating a lack of focus or impatience.
This might be a patient that has a long buying
cycle and is there to gather information rather
than commit to a procedure. This person will be
more comfortable with you “mirroring” them or
looking at a common resource together. Seek ways
to re-engage, and seize the moment to credential
your practice. If you discover this individual's intention
of gathering information through multiple consults,
ask for a commitment to return to you for a
final follow-up session when he or she has greater
clarity. At that point, your prospective patient will
be better informed and you will know each other
better. He or she may not buy today but will soon.
Arms and Legs Crossed
A patient who crosses his or her arms and/or legs
typically is feeling defensive and is communicating
discomfort of some sort or somehow feels offended
by the interaction. This cue can be challenging,
as the person has moved to a strong negative position.
It is your job to do your best to be flexible
and open, yet remain committed to the best interest
of the practice. Flexibility may be needed in
the areas of scheduling, pricing, or promotional
expiration dates. Picking up on this cue and
responding appropriately can swing a patient's
perception quickly. Often, your flexibility and willingness
to meet the patient's needs is all it takes to
secure a commitment for a procedure.
Attaining a Higher Conversion Rate
Understanding the nuances of how your patients
communicate through nonverbal cues can dramatically
improve your conversion rate and, in the
end, your productivity. In addition, better communication
will create an opportunity to enhance customer
service, evaluate product services, and grow
word-of-mouth advertising. With nonverbal cues in
mind and a willingness to pay better attention to
body language, you may be better able to create an
environment where patients feel safe, comfortable,
and free to discuss all aspects of their health and
treatment goals. Careful response to directional
cues will allow physicians, aestheticians, cosmetic
coordinators, and other non-physician providers to
enter consultations with more confidence to deliver
what patients desire and, ultimately, to provide
the basis for a long-term, healthy relationship with
patients.
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