[Excerpt from upcoming book, Prescribing Change: How to Make Connections, Influence Decisions and Get Patients to Buy Into Change]
I like to think of questions like peeling back the layers of an onion. Try to think of the onion like a brain. The outer layers of the onion are analogous with the outer layer or neocortex of the brain which is responsible for logical and rational thoughts. This is obviously a very important part of the brain, but not the lead decision maker. We need to go deeper to connect with the decision-making part of the brain. Questions are the tool we use to accomplish that. Peel back the layers!
Layer 1 – thoughts, facts and details
Below are some examples of Layer 1 questions. These questions are designed to gain a basic understanding about the patient. While this book is applicable to any healthcare profession, I’ll use eye care as an example since this is the space I am most familiar with.
How old are your glasses?
How often do you wear contact lenses?
Do you have sunglasses?
Tell me about any problems or concerns (yes, I realize this is not really a question)
Gathering thoughts, facts and details are very important. A doctor or medical professional must have a good understanding of this information to provide the best care. However; from the patient’s standpoint there’s no real emotional connection to this information. As you recall, we need to dig deeper with our questions to uncover the emotional reasons for making decisions. The questions above are engaging the logical, conscious part of the brain – the outer cortex. The old (subconscious) brain responsible for decision making is saying, “Wake me up when something interesting happens.” If you want to be more influential with getting people to accept your professional advice, you need to connect your recommendations to their emotional motivators, not their logical ones. Peel back the layers!
Layer 2 – assessments and explanations
Layer 2 questions involve asking people to further assess and explain the information they provided from the Layer 1 questions. Below are a few examples.
Would you ever consider wearing contact lenses?
How does that problem affect you at work?
How did that condition impact your grandfather?
We’ve moved past basic thoughts, facts and details. We’re not quite at the point where the patient is crying out, “Oh doctor, please help me! I’ll do anything you ask!” but getting patients to open up about their emotional concerns regarding their vision and health is critical. Layer 2 questions allow us to say to the old brain, “Psst, you might want to pay attention to this.”
The old brain doesn’t obsess about facts and details. The old brain is very emotional, but the tradeoff is that it’s not very intelligent. It struggles to process or make sense of words and abstract concepts. Medical information and clinical recommendations are not nearly as impactful without the old brain’s involvement, and to get the old brain’s attention the information you provide must be relevant. And I don’t mean relevant to you! Sorry, but the old brain doesn’t care about you. At all! It doesn’t care how many years you trained to be a doctor, how much of a burden your student loan payments have been or whether or not your practice is successful. The old brain (yes, even the one in YOUR head) is very narcissistic. That being the case, appealing to its own self-interest is a very effective way to gain influence. What is the old brain most influenced by? Desire for gain and fear of loss!
Layer 3 – desire for gain, fear of loss
In the world of selling, desire for gain and fear of loss are considered the two dominant buying motivators. If we want patients to “buy” our ideas, recommendations or sometimes even products, it only makes sense that asking better questions should lead to the patient telling us their dominant buying motivators in their own words. Below are a few example questions that get patients to reveal this information.
If we could treat your dry eye, how would that impact you at work?
What impact would this condition have on your quality of life if it worsened?
Ah, there it is! The old brain. The decision maker. Nice to meet you! Thanks for joining us. You know that problem you’ve been so concerned about? We were just having a chat about ways we could help you.
If you can get people to reveal this level of information, you are no longer selling them, they are selling you! They are selling you on why they need you and your products or services. Telling someone else they need something is never as effective as them telling you why they need it. Get people to sell you on what they hope to accomplish and why they scheduled an appointment with you.