Ideas In Action: New Meanings for Old Sayings

July 2007

It’s not what you say, it’s how you say it

If it ain’t broke, don’t fix it

Getting back to basics


In my marketing work with medical device companies and their customers, I’m finding that some of those old sayings that have been around forever have new meaning that’s applicable in the world of elective medicine.


It’s not what you say, it’s how you say it

Parents learn quickly that with kids, it’s important to teach about tone and manner in conversation. These little lessons seem to have a big impact, not only on the playground but throughout life. Similarly, communication experts tell us that 90% or more of what gets communicated between people is non-verbal.

A similar principal applies to the workplace, where your workday can typically be separated into two components, the content (what you do) and the process (how you get it done). In the world of refractive surgery, there’s been a lot of focus placed on content and little emphasis put on process. Surgeons invest heavily in equipment and skill to provide surgical procedures such as LASIK. This is the content piece that comprises “what” gets done, and the outcomes are spectacular.

However, equal emphasis on the process or “how” seems to be lacking in many practices.

And that is precisely where the real opportunity exists to improve the experience of your customers. The processes you put into place should all be designed to lead your customers to the conclusion that their experience was remarkable and memorable.

During this year, my monthly column in Cataract and Refractive Surgery Today (, has focused on how to improve quality in the refractive practice, often referencing the work of the International Council for Quality Care. This organization is devoted to helping physicians work on the process side of the ledger and have an abundance of tools and resources available. I strongly recommend their two-day Physician Strategy College for anyone who wants to live out their “perfect day” at work on a regular basis. The ICQC can be of big help: (


If it ain’t broke, don’t fix it

You’ve heard it a million times: “If it ain’t broke, don’t fix it.” With sincere apologies to my 8th grade grammar teacher Mrs. Foulkes, I offer an updated corollary that applies today: It’s broke. And it’s definitely time to fix it.

The “it” I’m referring to are the systems in place to effectively capture and cultivate the interest initially expressed by people seeking your services. A decade of market data in refractive surgery has proven that doctors aren’t doing well when it comes to creating an experience that is over- the-top remarkable for their paying customer patients. Most surgeons I talk to believe they’re doing a reasonable job in this area, but they fail to recognize just how high the bar is when someone is asked to pay $5,000 or $10,000 to have their vision improved.

Our firm has done telephone assessment studies to assess how well surgeons’ staff members are answering calls from prospective customers for refractive surgery. The bottom line: the processes used to answer the phone are inadequate and are largely broken. Leaving this unfixed has consequences, one of which can be seen in the charts comparing the price and demand for LASIK with that for breast implants over the past decade. It’s clear that plastic surgeons are doing a better job of creating and protecting the value of their main offering.


Getting back to basics

The lack of sophistication by medical providers on the telephone is not what consumers considering multi-thousand dollar purchases should be receiving. Unfortunately, the problem extends beyond the phone and into the very practices themselves. It’s not that staff don’t try to be nice or helpful; it’s just that systems are typically not in place to make certain that every encounter with every customer is truly nice and helpful. Doctors often relegate these issues to the list of “little things” that can be worked on later. However, it is the little things that can often make a big difference, especially when you are a provider of a premium-priced service that is dependent on the discretionary-income of your target audience.

My recommendation is to go back and examine those routines which have become “automatic” and see what can be tweaked and improved to create greater connection with your current or future customer. The Ritz Carlton calls these their service “basics”, a set of 21 principles that guide an environment described as “ladies and gentlemen serving ladies and gentlemen.” I hope that’s motivation enough for you to get back to basic.


Shareef Mahdavi
President, SM2 Consulting

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