Overcoming Medical Salesmanship

I love my doctor.

It’s not because of his bedside manner. He was often in a hurry and abrupt. It’s not because of his expertise, though he’s a recognized expert in his field. And it’s not because of his surgical prowess. When he implanted markers in my prostate, it was needlessly uncomfortable.

I love him because he delivered what he said he would deliver. But that wasn’t entirely by chance. I had to ask him solid questions, and I needed a basis to evaluate his responses. I also had to recognize that doctors are not only expert medical providers, but expert salespeople. But how does a non-expert actually deal with medical salesmanship?

The doctor's objectives vs the patient's objectives

When the prostate cancer patient presents for possible treatment, the doctor has two main objectives: they want you to conclude that they offer the best treatment option, and that they are the best person to deliver it. If you are not convinced of both, the doctor loses you and the revenue you represent. But the doctor has an advantage: they're an expert!

So, your first objective is not to be star-struck by their expertise. By developing your own expertise, you can hold your own, can engage in useful conversation, and can more effectively evaluate the treatment and the provider. A corollary to this is to stand your ground. You need to be able to question the doctor’s responses, or you might end up just questioning yourself. Simply accepting a doctor's responses because "that’s what the doctor said" can lead to unmet expectations.

When I asked about proton therapy, the photon provider said, “Proton might be useful for pediatric cases, but we don’t refer prostate cancer patients to proton.” He subtlety conveyed that proton was less appropriate for both older patients and for prostate cancer patients. But that inference, I've found, is incomplete at best.

It becomes your responsibility to have enough background to delve more deeply into medical responses, thereby establishing accurate expectations.

How I separate fact from sales pitch

That’s also how to separate fact from sales pitch, and how to identify the negative sell, just like the one from the provider above. From the prospective surgeon I heard: “once your prostate is out, your cancer will be totally gone, and you will be peeing like an 18-year-old!” Wow! That sounds great, sign me up! Except that that line is pure sales pitch. There are lots of assumptions in that comment, and there are material issues that have been omitted. It is on you to ferret these things out up front, or regret can occur when final results differ from initial assumptions.

Be careful, too, that your research is not just bias confirmation. My father had prostate cancer, and he experienced serious side effects following prostatectomy. This led me to a strong bias against surgery. But having such a bias is not useful to me, I learned. It can lead to hearing what you want to hear, and asking questions that just confirm that bias. A more objective approach leads to better data-gathering and can keep you from overlooking important details.

Hiring a doctor is not unlike a job interview

Hiring a doctor is not unlike a job interview. But as the hiring manager usually knows what they are looking for, the cancer patient usually begins unsure of who and what he wants. Hiring managers rarely hire the first applicant they interview, but cancer patients might actually do that, especially if the first doctor is aligned with the patient’s bias.

It makes sense to hire a doctor like a hiring manager. Interview doctors that represent various treatment options. Pose the same questions to all, and use answers you receive to optimize future questions. Ask each provider if you can follow up with additional questions. A complete survey of multiple providers can lead to a more considered and complete decision.

Knowledge is key

After the initial shock of a cancer diagnosis, it can be very difficult to conduct an effective search for a treatment provider. Invariably, everyone you interview will be a rock star! But how do you choose amongst rock stars?

Knowledge is key. Don’t be star-struck. Try to identify sales tactics, and negative selling. Eliminate any initial bias and approach the process like a hiring manager willing to interview candidates until the right one emerges. By doing so, hopefully your expectations will be met, and you will love your doctor, even after your treatment is over!