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  • Jason Riis

I don’t sell, I offer. Managing patient aspirations respectfully

Updated: Apr 8, 2019

Physicians have to both reign in and broaden patient expectations.


Reigning in is perhaps the more familiar task. Patients can be in denial about the severity of their condition and unrealistic about probable treatment outcomes. So, often, you have to lower their expectations.


But broadening patient expectations is important too. Patients can be shy and embarrassed to ask about cosmetic or sensitive treatments. Patients can be unaware of what is possible with new technologies. And patients can be ignorant about how age and sun will ravage their skin without preventive, proactive care. Physicians can broaden patient expectations by frequently showing possibilities and inevitabilities. Show patients their options, even if they don’t ask. And show them their future, even if they aren’t currently worried about it.


But how do you do that without feeling like a salesperson?


Dr. Gary Goldenberg’s motto on this point is, “I don’t sell. I offer”. Here are some examples of how he does that. These quotes are paraphrased from our interview:


When he sees a patient for a skin check, and notices rosacea, he’ll say to the patient:

You may have noticed those red veins around your nose. That’s rosacea, and I can clear it up in two easy treatments. Let’s finish your checkup because your health comes first. We can talk about that fun stuff after, if you like.


When he sees a patient with dry skin he often makes an even stronger offer:

I ask, ‘what is your skin care routine?’ When they tell me they don’t have one, I say, ‘What do you mean you don’t have one, come on, you’re in a dermatology office. You need a skin care routine!’ At that point the patient is usually interested in hearing me out. I have these cards where I check off what I think they need. While I finish the exam, my assistant goes and prepares the items to show the patient after. This package was personalized for their needs and they appreciate that. They also appreciate that I don’t pressure sell any of it. I offer it. If they want it fine. If not, that’s fine too. But I intentionally and personally, offer!


On the cosmetic side of his business, he gets a lot of patients coming in with a specific interest in Botox. He makes clear that he has more to offer:

I will of course give that patient Botox if that is what they really want and need. But new cosmetic patients usually know so little about their skin and the available treatment options, so I try to do a full cosmetic consultation. I examine the surface of the skin, the deeper layers, the texture, and the dynamic muscle movement. I describe fat grafting. What I am doing is planting seeds. These are the things that are available. Let’s talk about immediate, short term, and long term options. I don’t sell these things. I offer them, so that the patient is informed and can make a good decision about how to spend their money, over time.


Good sales people put relationships before transactions. They don’t do pressure sales which can damage a relationship. But they are still very proactive. They offer – intentionally and personally. Dermatologists can do that too.

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