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Healthcare Sales: Diagnosing Doctors’ Decisions

If patient behavior affects diagnosis, what does that mean for the behavior of the healthcare sales rep?

It’s perfectly understandable to assume that those in professions characterized by scholarship, research, and data analysis would be more influenced by the workings of the pre-frontal cortex, the reason and logic area of the brain, than by the emotional centers located in the limbic system. Understandable, but wrong.

When it comes to decision-making, physicians are just as subject to the overwhelming power of the emotional brain as are their non-STEM neighbors. Even, according to two separate studies published recently in the journal BMJ Quality & Safety, on decisions related to one of their core scientific functions, the diagnosing of patients.  “Most reps demand a level of cognitive function that physicians have neither the time, energy, nor inclination to invest.”

In the first study, researchers found that even when the medical issues were identical, the doctors provided less accurate diagnoses when faced with disruptive patients (e.g., demanding or aggressive). “And the effects weren’t small,” writes  Julia Belluz in her article on the studies in Vox. “When the patients’ medical problems were complex, the doctors made 42 percent more mistakes diagnosing difficult patients compared with more agreeable ones.”

In the second study, diagnostic accuracy was 20 percent lower for the annoying patients, even though time spent on diagnosis was the same. The doctors also tended to recall more about the behaviors of difficult patients, forgetting their clinical histories.

According to Belluz:

The researchers suspected physicians' mental resources are so taxed from thinking about how to deal with tricky patients that their ability to process medical information becomes impaired. ``If resource depletion affects simpler, everyday problems,`` they wrote, ``it is not surprising that these highly complex cognitive processes are impaired if a substantial proportion of mental resources is seized by the confrontation with emotional experiences triggered by patients’ troublesome behaviors.

These findings have important implications for healthcare sales reps.

We know from neuroscience that data-based decision analysis of any kind is a “highly complex cognitive process” requiring approximately 300% more calories than “mental cruising,” and that the brain waves emitted during such activity are precisely the same as those produced by plunging our hand in a bucket of ice water. Heavy analysis hurts; it’s not our natural inclination, and it’s easy to derail.

And yet, most healthcare reps, in a well-intentioned effort to appeal to their customers’ clinical interests, inadvertently demand a level of cognitive function that physicians have neither the time, energy, nor inclination to invest.

Reps who know how to trigger these natural responses sidestep the heavy lifting of logical analysis and clear a path to yes.

In these studies, researchers’ speculation of “taxed mental resources” as the cause of debilitated diagnoses is likely correct, but there’s a little more to it than that. It’s not just that more mental resources allocated to managing patient emotions are inhibiting cognitive function, but that the physician’s emotional brain (the limbic system), as the default taskmaster of the logical brain (the pre-frontal cortex), is more easily overcoming their cognitive function when engaged by negative emotional factors.

Here’s the critical insight for the sales rep: The same is true in reverse. A positive emotional engagement will align with what the brain is already inclined to do just as effectively as a negative one. Reps who know how to trigger these natural responses not only sidestep the heavy lifting of logical analysis, they clear a path to “yes” rather than put up the cognitive barriers for “no.”

The evidence that a doctor’s diagnosis is influenced by emotional factors during examination may be bad news for the misbehaving patient, but it’s good news for the skillful sales rep.



Physicians’ Emotional Skills Suddenly Matter

More people are expressing their opinions about doctors and healthcare services in reviews online. Actual medical competence is not on the top of their list.

How do you feel when you leave your doctor’s office, the hospital, or a medical procedure?  Public patient reviews are a level of transparency still alien to the medical community, but which are having an impact on the bottom line, and forcing physicians to recalculate the value and importance of what was once referred to as “bedside manner.” Especially because patients are far more likely to rate their experience as much or more on their overall experience – emotional factors being a large part of that – than on procedural or technical expertise.

In discussing the trend of social media sharing by healthcare consumers with ProPublica reporter Charles Ornstein, NPR host David Greene pointed out that related professionals like massage therapists and acupuncturists are consistently rated much higher than conventional medical practitioners, presumably because people generally feel good about those experiences.


I also think those professions are much more attuned to competing for patients, because those patients pay more of those bills out of their own pockets. I think that they are more attuned to social media. In fact, I think that they encourage patients to go and write reviews on social media, whereas doctors are just, sort of, really opposed to it. And, I think historically, doctors have not really had to compete for patients per se ... They hope that you will go to them for their competence, for their skill, and pay less attention to these other sorts of issues. But they’re beginning to creep in there.

Listen to the entire interview:

And read Ornstein’s full article here.