Updated on: September 23, 2013

Welcome to the Business World

By David Block, MD, PhD
Original story posted on: September 21, 2012

EDITOR’S NOTE: The following is a transcription of Dr. David Block’s segment on Talk-Ten-Tuesday.

When I was in high school, I was a nerd, and not, how you say, successful with girls. My SATs were great, my GPA was great, and I knew everything worked. I’d see a girl of my dreams, go up to her and talk to her about calculus or cell physiology, and then ask her for a date. Nope.

Why was I always alone, I wondered? If you could not get a date in the 60’s, something was terribly wrong. If only I could have listened then to what I’m saying now. But puberty put me in a new business 50 years ago, and I had not the slightest idea about sales and marketing.

So, listen...

Attention all CDIs. You and your HIM partners are now in a new business, a separate business inside the hospital. You are no longer a nurse, giving and taking orders in a 2,500-year-old culture of “mind your manners and know your place.” You dress different now. You walk different. You sure talk different. You carry a new set of tools and instruments. You used to know less than a doctor, they told you; now you know more, you tell them. You used to make decisions depending on what somebody else said; now you make your own.

You are in the compliance business. This is not “billing compliance,” although that’s part of it, or “quality indicator compliance” – also a part, for sure. Nor (is it) “value-based purchasing compliance” – although that’s part of your business, your mission. You are actually in the profession of compliance: you are one of the few people in healthcare doing what you do because it’s the right thing. No wonder you’re passionate. No wonder you burn out.

Because you’re in this new compliance business, you have to learn to (teach) sales and marketing to your physicians. Every business demands it. Docs used to tell you what to do. Now you relate to them in a new way. They are the prospective clients for what you are selling. And make no mistake, you’re selling compliance.

You see, you can’t tell them what to write in a chart. And you can’t guide them, like you did when you wrote clinical care plans. So you try to sell the old “win-win”: if you write XYZ, then you win and we win. And this certainly is the message from your consultants, your CFO, your friend doing the MBA so she can get that promotion and move up in life, and probably your physician adviser. Done delicately, and sensitively, that approach will work with many of your docs. Or you could try the “you know you ought to say this in the medical chart because it’s the right thing, and we do the right thing, doc, we always have” (route). That works sometimes, too.

But often, and maybe even very often, you get the chart slammed in your face. You don’t get to finish that marketing call at the nurse’s station and you never close the sale. Well, why not?

Look at your marketing brochure. That marketing brochure, folks, is your query. That query is, without anything else to soften the blow, the only way you have to market, to find out if that doctor is willing to buy based on what he thinks he needs. And that query is, without anything else, the only way that doctor is going to know what you’re selling. You are asking a person to change her actions, her behavior, her performance, that’s worked for her for years and years, just on the basis of a piece of paper, maybe with coding numbers and coding words and some abbreviations. Of course you say “please change.” That’s very thoughtful. Ineffective, but thoughtful.

The query is just your brochure. You need to make a presentation. And remember, folks, 84 percent of CDIs in the Association of Clinical Documentation Improvement Specialists (ACDIS) survey last week said (that) one-on-one presentations were the best way to gain cooperation, to close the sale.

You need to learn the art of the elevator presentation, just like I did back in Tilden High School. The elevator presentation is the 15 seconds you need to get that doctor interested in what you’re marketing and selling so that you can go on to illuminate and educate and corroborate (regarding) what’s on that written query. And that’s when you close the sale.

I use the Brian Walter technique. Look him up on the Internet. He’s a presentation guru, and his approach is pure. It’s three stages, and just three words: wow, how, now. Got it? Wow. How. Now.

  1. Wow: You have eight seconds for wow. When you meet somebody, that’s how long you get before (his or) her attention wanders. You’ve got to say something that snatches … attention right back onto your sincere and passionate presentation. You’re going to sell yourself. You might try, “How can I help you get everything that’s coming to you for all your work on this patient?” (Or) “How does your diagnosis explain what you say about this patient’s condition?” “How can I work with you to get you what you deserve?” Do not try, “I’m Pistachio Nuts, the CDI, and you aren’t capturing medical necessity for ICD-9 OR 10 ... look at these codes ... yada yada.” You figure out why this approach won’t work; the solution has to do with me in high school.
  2. How: You know you have that doc when you see her eyebrows raise, or hear her say, “Huh?” or “What do you mean?” Watch her body language. Give her one or two sentences for the hook: “Well, COPD doesn’t justify a critical-care stay, and probably not your CPT...” Do you want to give him the codes? Sure you do. They matter to you, and to everybody else in AHIMA (the American Health Information Management Association). Likely your doc couldn’t care less.
  3. Now: And now you have the right to present her with what Brian Walters calls “the three most powerful words in sales:” “Now, for example.” Now, you are the source of certainty and safety, of protected doctor status, of restored fairness in a world of confusion. Now you’re telling her about respiratory failure and how to document it and why she needs to. Now you close the sale.

Wow, how, now: the businesswoman’s best friend. Good luck in your new business venture, young CDI. Live long, and prosper.

About the Author

David Block is a physician and has a Ph.D from New York

University. He taught linguistics and medieval literature for three years in Illinois before entering the Abraham Lincoln School of Medicine at the University of Illinois, graduating with honors in 1979. He is a registered neutral in the state of Georgia and is a founding partner of HealthCare Mediation, LLC, in Athens, Ga.

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Disclaimer: Every reasonable effort was made to ensure the accuracy of this information at the time it was published. However, due to the nature of industry changes over time we cannot guarantee its validity after the year it was published.