In the professional setting, “selling” has generally been regarded as a dirty word. Prior to 1975, professional advertising was extremely limited and very narrowly defined, to the extent that a professional could not properly advertise prices, claim to possess any special abilities, or even appear in a radio or television advertisement. However, a couple of landmark Supreme Court decisions changed the rules, and not long afterward professional advertising and marketing had become rather commonplace.

In the hearing industry, different segments of the industry look at selling in different ways: Generally, audiologists tend to prefer the term “patient advocacy” or “consulting” while hearing aid specialists are comfortable with the word “selling.” Similarly, while both hearing aid specialists and audiologists advertise and market their respective businesses, the audiologist is usually more reluctant to engage in the ”art of selling” within the clinic.

Consultative Selling: A Professional Obligation
The truth is that savvy medical professionals understand that selling is an integral and necessary part of running a practice. However, it is the specific methods that are used—or, perhaps more accurately, perceived to be used—that create disdain for the function of selling within a health care setting. Traditional, outmoded selling techniques like pressure tactics, bait-and-switch gambits, and hard closes are the typical techniques most commonly associated with the selling profession. Fortunately, wise professionals recognize these techniques for what they really are: con artist tactics, not selling. Much of the concern that many professionals have about selling, therefore, is a misunderstanding about what selling is and what it is not.

The word “selling” conjures up cliche images of the used-car salesman and characters like Herb Tarlek, the high-pressure, plaid-pants advertising salesman on WKRP in Cincinnati. In reality, selling is little more than the transference of passion in the presence of need. Consider the golfer who buys a brand-new putter and immediately experiences lower golf scores. As most any golfer will attest, after 18 holes on the course with that individual, you may be convinced there is no better putter on the market, regardless of price. All of that passion communicated in the presence of need (eg, a couple of missed 4-foot putts will do the trick) and you are well on your way to being “sold.”

Closer to home, consider a client who is experiencing serious difficulties in her social and family life created by a hearing loss. If she is fortunate enough to have a cherished friend who has recently experienced a significant life transformation after experiencing the benefits of a hearing aid, she may well be “sold” before she ever walks into your clinic.

People don’t mind being sold if there is not a hidden agenda or a selfish motive involved that does not also include their own benefit or well-being. Selling is simply communicating, and communication is, by definition, a two-way process. Real selling is mostly listening and understanding—a form of counseling or, more specifically, consultative selling. We already know that the individual with a hearing loss has a need, so a hearing care professional with empathy, and a passion for helping hearing-impaired individuals, is well-positioned to provide a solution.

Consultation: Joint participation in planning a strategy, activity, or change.

Legitimating: Seek to establish legitimacy by claiming authority (eg, training/education is legitimating).

Coalition: Using the aid or support of others (friends or family, for instance).

Inspirational appeal: Appeal to values, ideals, or aspirations.

Personal appeal: Appeal to feelings of loyalty or friendship.

Rational appeal: Use of logical arguments and/or factual evidence.

Exchange: Offer an exchange of favors, or a promise to reciprocate.

Ingratiation: Attempt to create a favorable mood before making a request.

• Pressure: Use of demands, threats, or persistent reminders (often seen as the primary selling tactic).

TABLE 1. Influence strategies. Source: Hellriegel & Slocum.2

What many professionals fail to see is that they are always selling, whether they care to admit it or not. In any health-related field, there is bound to be one or two treatment options that the professional views as “optimal” for that individual client. In any transaction, a strategy is used to influence the purchasing decision (Table 1). As mentioned previously, “pressure” is the strategy most commonly associated with “sales tactics,” and the one most likely to create a negative impression. In many instances, legitimacy (see Table 1) is afforded to the dispensing professional, but while few clients will fail to have a knee replacement if necessary (despite the costs involved), there are many who will decide against a hearing aid if they perceive the price to be too high—regardless of your legitimating influence.

This leads us to a sobering, yet inevitable, conclusion: The consequences of doing a poor job of selling the hearing-impaired client on a positive treatment option is that he/she will likely become more socially isolated, will see their quality of life continue to deteriorate, and may even experience serious depression and a variety of other problems that can be viewed as “symptoms” of their hearing loss.1 From this perspective, it is the professional’s responsibility not only to sell, but to be very good at selling.

Bringing Sales into the Professional Setting
Every professional, regardless of his/her discipline, should have three distinct objectives in serving the customer:

1) To treat each customer with courtesy and respect.
2) To provide quality care through their products/services and to always act in the client’s best interests.
3) To be sufficiently accessible to the customer, particularly after the first interaction with the customer.

These three items can be categorized as dealing with 1) interpersonal issues, 2) quality issues, and 3) support issues. In each of these three areas, selling has a significant role to play.

Interpersonal issues. People rarely purchase products or services from someone they do not like or trust. In other words, consumers are sold first on the individual from whom they seek care. Starting with the initial phone call, the patient is making conscious and subconscious decisions about you, your organization, and your products. Therefore, every part of your business is important in the sales process! It is startling how little time and attention is given to items like how the receptionist answers the phone and deals with questions, the cleanliness and professionalism of the waiting area, or how much time is actually spent establishing expectations.

Quality issues. Today’s consumers are fairly sophisticated. People buy products that meet or exceed their needs and expectations—in other words, they have made the conscious decision that the benefits of the product are greater than or equal to the amount of money they must spend. Whether they are “buying” or you are “selling” is a matter of perspective; the fact remains that customers must be “sold” on every product before they buy.

Support issues. People will almost never buy a second time from a company that doesn’t provide adequate follow-up services or deal effectively with post-purchase issues. Despite any favorable first impressions, customers can get “unsold” very quickly.

For the professional, the key to embracing “selling” as a productive business concept is to understand that serving (or selling to) an individual with a hearing loss is encapsulated in the following principles:

1) Provide an atmosphere of dignity and respect throughout the process.
2) Avoid assumptions about motives, needs, or financial limitations.
3) Ask effective questions, and listen to answers carefully.
4) Set the proper expectations for the entire process—testing to follow-up.
5) Determine the client’s expectations for the process and align the solution(s) to those expectations.

FIGURE 1. Successful consultative selling hinges on critical listening skills that lead to realistic expectations and effective solutions.

Despite prevailing wisdom, the most common reason consumers don’t buy a hearing instrument (and experience the value of better hearing) actually has less to do with cost than perceived value. A common question I have asked dispensing professionals around the country is, “How much is too much to charge for hearing aids in your area?” The answers vary dramatically, but the real answer is that any amount of money is too much for the consumer to invest if the hearing aid doesn’t provide the value (benefit) the client expects. That is the primary reason why a significant percentage of hearing aids wind up in a drawer.3 In fact, Kochkin has shown that it’s virtually impossible to please a customer—even if you give them a free hearing aid—if the device provides them with little or no benefit.4

Therefore, all communications with the client should be carefully planned to promote the proper expectations for both the dispensing professional and the consumer. In essence, starting with your initial meeting, you are forging a contract between the client and yourself. Patient needs are elicited by using specifically targeted questions, then listening very closely to the answers. The failure to provide an effective solution (ie, the failure to “sell” a hearing aid) is usually a direct result of failing to meet expectations (either before or after the actual dispensing of the device). This is most often created by erroneous assumptions that stem from a failure to listen and/or ask the proper questions.

Some health care professions are adept at mentally placing the patient into the typical scenario where pain or discomfort occurs. This has the benefit of showing the professional what may be causing the pain, but it also illustrates the affect that the patient’s health problem poses for his/her quality of life.

Hearing care professionals should spend the time doing exactly the same thing. Rather than simply asking if the individual has trouble hearing in a restaurant or in the car, time should be taken to place the individual mentally into the situation where hearing loss has negatively impacted their quality of life. Asking the following questions will allow you to establish what their expectations:

• When did you first become aware that it was having an effect on you?
• What effect does it have on you when this happens?
• How important is it to you to find a solution for this challenge?
• How would it impact your life to improve your hearing in this situation?
• What do you expect a hearing aid to do for you?
• How do you expect your hearing loss to be affected by wearing a hearing aid?
• What single situation do we need to impact for the hearing aid to make a significant difference in your life?

Selling is Integral to the Health Care Process
I have rarely spoken to a successful dispensing professional who doesn’t view this business as one that is built on relationships. Positive relationships are built on trust and understanding—two things that rely directly on effective communication and aligned expectations. Consider the process that your customers go through in order to purchase a hearing aid: introduction to the company, testing and evaluation, product introduction, fitting, counseling, and follow-up. If the customer is not sold on the need for a hearing aid after testing and evaluation, any price is likely to be perceived to be too high. Further, if you ask the customer to make a decision on technology based on price—in the absence of established need—the purchasing decision has been relegated to a decision on a commodity, which almost necessarily requires a second opinion (“I’ll think about it”).

The secret to productive selling is that it is most effectively accomplished by asking the right questions, setting the proper customer expectations, and understanding the customer’s needs. It takes more time to dispense this way, but the results are more satisfied customers who are passionate about your services—and that can’t help but result in more direct referrals.

Kelly Riggs is a training and development consultant based in Tulsa, Okla.

1. Kochkin S, Rogin C. Quantifying the obvious: The impact of hearing instruments on quality of life. The Hearing Review. 2000;7(1):6-34.
2. Hellriegel D, Slocum JW. Organizational Behavior. 10th ed. Mason, Ohio: Thomson South-Western; 2004.
3. Kochkin S. MarkeTrak V: Why my hearing aids are in the drawer: The consumers’ perspective. Hear Jour. 2000;53(2):34-42.
4. Kochkin S. On the issue of value: Hearing aid benefit, price, satisfaction and brand repurchase rates. The Hearing Review. 2003;10(2):12-25.

Correspondence can be addressed to HR or Kelly Riggs at [email protected].