HEALTHCARE: Opportunity in the Eye of the Perfect Storm

Healthcare:
Opportunity in the Eye of the Perfect Storm

By Kim Michael--Contributing author John Collier--CEO  Innovative Managed Care Solutions Copyright March 2015

As anyone in healthcare knows, healthcare in the United States is undergoing significant change right now, much like the famed “Nor Easter” that Bostonians refer to as “The Perfect Storm”.  “The Perfect Storm” is when many different weather patterns combine at a single intersection to become a “super” storm.  That is essentially what is happening in healthcare. 

First we have the Affordable Care Act, which will likely add many millions of previously uninsured Americans (or Americans forced to change insurance companies to an Exchange ACA Plan) to the category of the insured, however the percentage of young and healthy people that the government had hoped to sign on did not materialize as planned.  Instead the majority of the first wave of the newly insured were the older and sicker segment of the population whose need for more healthcare per capita, reducing their overall contribution, seriously skewed the delicate balance between risk, cost and utilization.

Next we have the massive and costly system conversions, stemming from requirements by the federal government and the ACA.  This added meaningful use to the equation, including electronic prescribing, and adhering to quality standards, for physicians, at least called PQRS which many hospitals and healthcare systems across the country entered into in hopes of better controlling costs and creating better clinical outcomes through unified platforms and greater transparency. 

What many did not anticipate was the vast amount of time it would require to complete, and the massive demand on internal resources it would inflict in relearning and retooling to accommodate the new technology, all while simultaneously working on the original system.   

And if that was not enough, add to it a completely new medical coding system (ICD-10) that will convert what was once 13,000 codes (ICD-9) to over 68,000 codes –which will change on October 1^st, 2015.  Example: Instead of coding for a patient who has had a toe amputated, coders will need to select the code that it is the third toe on the left foot.  The new coding process involves much greater specificity and significantly more detail in physician documentation, which leads to another issue that many coders have with the process, even before ICD-10. 

Healthcare associations across the country are already warning that this alone will result in a black hole that will devour resources on a massive scale, increase denials, slow revenue and reimbursement cycles, and require staffs across the country to be completely retrained, and payment systems retooled. 

And if that is not enough to adequately call the current healthcare environment--the “Perfect Storm”.  Add this to the mix:

                     *The Federal Government’s mandated that all hospitals update
                                    to accommodate Electronic Health Records (EHR).

                     *CMS fee reductions reducing reimbursements to hospitals often at or below

                       Cost.

                     *Federal government cutbacks (sequester impact).

                     *More regulation on both hospitals, physician groups, and insurance

                       Companies.  

And beyond the provider’s doors, the world of third party reimbursement is changing as well.  A snowball of increased patient pay involvement predicated by the rising and unchecked costs of healthcare, perpetuated by the Affordable Care Act will soon create a patient responsibility/liability “crisis” across the country that will likely impact millions.

For an industry that is slow to change, the part of the Perfect Storm that has already hit has left healthcare and the business of healthcare—reeling; and there is still more to come.  But there is a light at the end of the tunnel. 

Our system of healthcare is broken.  I think most people will agree on that point.  In 2000 The Word Health Organization ranked the US as 37^th in the quality of care and first in cost per capita.  Since then a number of studies doing similar rankings consistently find the US either last or near the bottom, though it has yet to be established how these metrics are derived.  Even so, it seems to be evident that  Americans pay the most of any country in the world for healthcare and yet the quality of that healthcare is seriously in question.  Even so, there are people (and organizations) who are making huge profits, while the majority of the healthcare industry is struggling just to survive, somewhat mirroring the polarity in the US between the “haves” and the “have nots”.

The one reality of healthcare, and the one least talked about, is that “true healthcare reform” in this country will not occur until there is a solid commitment to fix the pieces that are broken.  We can reduce fees, cut cost, increase the number of insured people to off set rising costs, but until we decide to fix what’s broken, it will continue to be broken.

How we got here (and why) is an interesting story. 

Historically healthcare originated from different seeds of the same tree--two distinct sides to healthcare.  The clinical side, which dealt with treating patients, curing disease, tending to the care of others, and tracking outcomes became one branch; and then there was the business of healthcare, how those services are billed and reimbursed became another. 

As these two branches evolved through the years they became two separate platforms and strangely, platforms that did not talk to one another.  To get them to communicate a third language had to be invented which was called medical coding.  Procedures and services had to be translated into numbers and codes for the business side to know how to bill for them-but before that could happen it had to go to a device called the “Charge Master” which took the codes and translated them into costs so the billing platform could bill for them. 

Now complicating this even further was the physician’s part of the bill that was separate from the hospital’s systems, and of course any services like tests, lab work, x-rays, etc. were also billed separately and did not match up because often times one did not know what the other was actually billing for.  So at the end of the day there was no single point, where everything was actually visible— except the patient. But because of the complexity of the statements, few patients had any understanding of what they were actually looking at.  Insurance companies took on the role of managing costs by reviewing services and paying claims, but not really managing the actual care of the patient, which was often left up to the Primary Care physician, but once the patient was referred on to either another doctor, specialist, or hospital, his or her ability to manage that patient’s care became almost impossible to track and consequently impossible to manage. As a result cost overruns, unnecessary tests, redundancy in treatment and even fraud could occur with little or no ability to control it.

So this is where, at least one of the lights at the end of the tunnel can be found.  Most of the advanced systems that providers are embracing the idea of converting to a unified system; the idea of a single platform that integrates all of the platforms that didn’t, or couldn’t talk to one another before, theoretically creating a single pathway that a patient’s care, and the cost of that care, could be mapped and thus managed to create better outcomes and reduce interoperability.    

But there are still other major pieces of this puzzle that need to be fixed.  Recently I spoke with a friend who needed an MRI.  One location quoted him $700 while across town he got a quote for the same test and it was $10,000.  Same test.  There is a huge discrepancy (and little or no consistency) in the way healthcare is priced.  Prices vary from physician practice to physician practice, hospital to hospital, demographic to demographic, and region to region; simply based on what the market will bare.  But history has proven that market driven healthcare pricing rarely serves the needs of the patients and often opens the door to what, in other industries, would be labeled “price gouging”.    

The same is true of insurance companies, all of whom negotiate different terms and have different fee structures for each hospital, forcing many hospitals and physician groups to have literally hundreds of separate contracts on file; complex contracts that are constantly being updated and changed, causing a ripple of costly inaccurate payments to occur.    

And if true cost control is ever to happen, America has to address the cost of pharmacy and drugs.  In all of these focus areas, each arm or leg of the healthcare industry is extremely powerful because of the money they generate and the influence they wield, but none more so than the drug companies.  Drug costs in the US are many times higher than any other country in the world.  At one point during the ACA negotiations the government considered allowing Americans to buy drugs abroad, from places like Canada where drug costs are far less, but the power of the US drug cartel crushed it.  But if reform is to be driven by pricing, why not open the doors to competitive world pricing like the world’s oil market?  This is the one area of healthcare reform where price driven reform would work and significantly balance (and reduce) drug costs through competition.

So all of these pieces of the Perfect Storm, if managed properly, can have a happy ending, but it will require America to rethink what “reform” really means, and to realigning itself with the best practices that serve the needs of the patient--both clinically and economically.  

Surviving the Graveyard of Negative Paradigms by Kim Michael Copyright February 2015

PARADIGMS-GHOSTS OF THE PAST

There is a story about a Russian bear named Bongo.  Bongo lived in a ten foot by ten foot cage, on display in a small village somewhere in the south of Russia, where his owner made his living charging admission to see the bear.

Bongo spent his days walking from one side of his cage to the other and then back again; day after day, week after week, month after month for many, many years.  Finally at the urging of the town’s people his owner agreed to return him to the wild where he could live out the final years of his life in freedom.

Bongo was taken to a remote part of the forest and there, he was set free.  Years later his owner returned to the place where he had set Bongo free only to find the skeleton of a dead bear, with a ten foot path worn in front of it.  The cage that Bongo lived in for years was gone, but the cage that was still in his head was stronger then ever.  Sometimes we as human beings are unaware of the cages that we create for ourselves and then live with.   

The one constant of the world is that nothing is constant.  The base of our knowledge is never static, nor should it be.  What is true today may not be true tomorrow.  By not allowing yourself the ability to see those changes and the new possibilities they represent, you are doomed to only what you once knew.  The reality of this is even more true for business, and sales in particular.

I believe one of the single greatest sources of lost opportunity is what I refer to as “causalities of doomed history”. They are people who live in the past of their own failures; they failed and the memory of that failure continues to haunt them. As is often the case, “bad” experiences are often “emotional” experiences, which means they can be anchored heavily in how we think and react moving forward.

Even years later, despite the likelihood that the same people are no longer there, the weight of that bad experience continues to blind to the present because they can only see the past.
Over the years I have encountered a curious phenomenon that I have literally seen happen over and over again.  Let me set the stage for you.  We begin with a company that has been in business for a number of years, maybe not an old company necessarily, but a one that has an established sales force.  Then one day a new, inexperienced salesperson is hired and in a matter of a few months, sometimes even weeks, the new person is selling more than people that have been there for years.

The question is why?  It would be easy to attribute it to youth, or maybe because new people tend to be more aggressive, more energized, or maybe even smarter; but interestingly none of these reasons are the real reason.  

I believe the real reason is ignorance…yes ignorance.  Ignorance, despite popular opinion, does not mean stupidity, nor does it have the negative connotation that many ascribe to it.  Ignorance is merely the lack of knowledge in a specific area.  The kind of ignorance that I am referring to here is the same ignorance that affected Einstein, or Edison, or Currie; and it is the same kind of ignorance that I suspect lies at the heart of almost every great human achievement, the fact that it was conceived and created by an individual who did not know they couldn’t do what they did.    

New salespeople often come to a new job without the baggage of knowing what they can and can’t do, and yes they make mistakes, sometimes very painful ones, but they are also often successful in finding opportunities that were in front of the rest of us the entire time, the only difference is we are blinded by the artificial boundaries that we have created for ourselves.  Unfortunately they become the ones that others who follow in our footsteps will unconsciously take.

Paradigms are the pathways we create, models of not only how we act, but how we think, and they are not necessarily bad.  The actual definition for paradigm is, “a model or example”.  In this case the paradigm is an evolved methodology of thinking. We learn that a stovetop can be hot, but that knowledge is not limited to just one stovetop.  The knowledge is generalized and we concurrently know that all stovetops “can” be hot.  The danger in paradigms is when the only thing we consider about stoves is whether they are hot or not.   All the other perspectives of what a stove could be are no longer seen and we develop what is called paradigm blindness.

What is sad and all too often the case; not only do we condemn ourselves to the failures of the past, we can pass on those paradigms to others without even knowing it.

PASS DOWN BEHAVIOR

If being a causality of our own doomed history was not destructive enough, we can, and often do, pass on our attitudes to others.  Whether it be a note in a database from years before, or just an attitude, like ripples on the water that eventually wash up on some distant shore with no recollection of the pebble that caused them, we become epicenter of events that may occur far beyond our station and far into the future

Robert Coeffman, a Harvard PHD specializing in emotional response behavior, tells a story about a test involving monkeys.  It began with several monkeys in a cage.  At one end stood a tree with a piece of fruit at the top.  Eventually when one of the monkeys discovered it and climbed the tree to get it, as soon as he touched it the entire group was sprayed with water, apparently something that monkeys don’t particularly like.

Eventually another monkey would try it and then another with the same result, all of the monkeys were sprayed.  In time the monkeys stopped trying, in fact they would not even go near the tree. 

Then one of the monkeys was removed and a new monkey put in his place, but when he tried to get the fruit the other monkeys would beat him up.  This continued on and one by one the original monkeys were replaced until all of the original monkeys were gone, and though none of the new monkeys had any memory of being sprayed, none would try for the fruit, or even get near the tree.

Now humans, you would think, would be different because of their intellect and their ability to reason, but history has not proven it to be so. 

A good friend of mine who is African American told me of an even more provocative and startling example.  He was in the process of writing a book on his family’s history and in the context of that research became interested in what he called “slave” behavior.  For anyone who is not familiar with  the term “slave” behavior, it is a mindset passed from one African American generation to the next, over hundreds of years.  He was amazed how much certain attitudes of slavery continued to have an affect on people a hundred years later, despite the generations that have come and gone and were not actually the generation where the paradigm began.  In the broader sense, we are all products of our past whether its origin is ours, or someone else’s.

In business the life cycles are much shorter, and as a result the strength of the past is much more visible.   The battle to overcome our past regardless of race or circumstance is a constant battle, and new attitudes can only come about when we learn from the past, but not embrace it so vehemently that it becomes our future.

I try to impress on the people that I teach, regardless of their age or their personal circumstance that what they absorb from those around them, must be taken with a grain of salt.  Learn to see past the artificial boundaries and discover for themselves what is real, what is possible, and then act with abandon on what you know to be true.

   Perfecting the Art

   of "Not Selling"                                        

      Kim Michael Copyright January 2015

     The world is changing and so too, the world of sales.  There was a time when people would answer the phone and get excited about winning something, or of getting something for free.  Not any more.  The constant barrage of sales pitches and the relentless way they are being thrust at us, have changed the way we think.  People now know nothing is for free.  You leave your name and number in a bowl for a drawing and within three days you will have a dozen telemarketers calling you.  You buy something at a store and leave your email address and suddenly your getting twenty emails a day, often from the same company.  All of this has a market changing quality to it that extends into the professional world.

      I am constantly amazed at how many variations there are of methodologies to selling.  My first foray into professional sales was "features and benefits", then it was “relationship" selling, then it was "solution selling” and most recently I saw the idea of “insight” selling—all valuable components of selling, to be sure, but for anyone who thinks any one of these are the "do all” and "be all" to successful sales—they will find out very quickly, the real world does not revolve on methodology.

     The first thing I recommend anyone do when they first join a sales team is remove the word “sales” from their vernacular.  The word pigeonholes others into believing you are the same type of individual who has called them a dozen times at home, or the insurance salesman who won’t leave, or a host of relentless others who won’t take “no" for an answer.  As professionals we live in the backlash of the sins of others, and to overcome it we have to be different.

     My experience has been that the most successful people in sales are the ones who are able to leave the concept of “sales” at the door step.  They make selling a “human” interaction—which it is.  They listen more than they talk.  They ask the kind of questions that open doors rather than break them down.  And they realize that a client’s emotional needs are as important (if not more) as the hard asset needs they are there to address.  And finally they are proactive, leading the process instead of merely reacting to it.

     We don’t have to come armed with a multitude of sales tactics to find a prospect’s needs and close deals.  We don’t have to be better analysts of a prospect’s business than they are, and in most cases we aren’t.  We are only required to be experts in a few areas and what makes us more effective in those areas is that we can be “focused", where our clients are often wearing many different hats at one time.  True, good relationships will lead to bigger and better opportunities—which makes the process of growing a relationship “organically” far more important.

     One of the greatest sales of my life is when I asked my wife to marry me and she said “yes”.  Did I know all the her needs at the time of the close?  I guarantee the answer is no.  Did she know mine? Again... the answer is no.  But that relationship over the years opened new doors for me, new ideas, things I would not have experiences or even thought of, suddenly were on my horizon.  That’s what a good relationship is, that’s what effective partnering is.  What I brought the the table were abilities and perspectives that she did not have and visa versa.

      Today companies come to outsource companies looking for more than just specific solutions to problems.  They may start out there, but beneath those initial needs, they are also looking for good relationships and good partnerships that add to their horizon in a way that each finds value in the other’s involvement, each becoming a good steward of the other's needs, and expanding each other’s horizon.  Those relationships, like marriages don’t end with “yes”- they begin with “yes”.

The Myth of the Cave by Kim Michael

The Myth of the Cave

By Kim Michael

September 1940--four teenagers looking for a lost dog stumble into a cave in the south of France and what they find there will forever change how we look at our own past.  The cave is known as La Grotte de Lascaux and what made the discovery so unusual was that the walls extending the entire length of the massive chamber were covered with more than 600 drawings; extraordinary drawings in both detail and beauty, drawings that would easily compete with those of the most highly skilled artesians of today.  And yet amazingly, the drawings were not only old, even by today’s standards of what we consider old to be, these drawings were “ancient”.  They predated the Dead Sea Scrolls and the Pyramids of Egypt by literally thousands upon thousands of years.  In fact most experts now believe the drawings to be no less than 17,000 years old.  So who made the drawings and why?   

Anthropologists wrestling with this question for the last sixty plus years now believe that the creators of these amazing artworks were actually the early Paleolithic inhabitants of the area, a race of people that before the stone age.  Based on artifacts that were left behind it has even been suggested that the early dwellers may have considered the cave to be a sacred place; perhaps even a “magical” place. 

When I saw the pictures the thought occurred to me, “What would make a cave, or for that matter, a wall of drawings--“magical”?  Art that commemorates historical events is not magical.  If the intention of this art was to memorialize events of a people who had no written language, the cave and its drawings may have had a special significance, but it would not be considered magic. 

Another theory that has been put forth through the years is that when fires were used to light the chamber that the drawings on the walls would appear to move, or more to the point, come alive.  As interesting as the premise sounds, it is hard for me to believe that these accomplished artisans would really have mistaken the shifting light of a fire for anything but what it was.  That coupled with the fact that the drawings were in caves to begin with, meaning many were probably created by firelight would alone suggest to me that their creators probably had more than a passing understanding of flickering light and stationary pictures.    

No, for me to believe these early inhabitants thought something about the cave was magic, something more sophisticated had to be involved.  Then while looking over one of the many pictures depicting a tribal hunt, the light suddenly went on in my brain and in that moment, I saw it…the magic. 

Now, to understand this, you do not need to see the picture I saw, or the cave that it is in for that matter, but you do need to imagine yourself, seventeen thousand years ago, standing in front of the picture and looking at it.  The first thing you would notice is the amazing detail.  You can literally see everything, what the terrain looked like, the warriors crouching at their stations as a stampede of animals rush between them.  And then the kill, every detail frozen in a single moment so deftly displayed that you actually see the actual methodology they used; and then the successful outcome, the animals as they are field-dressed and carried back to the village. 

But where is the magic you may ask?

Consider now, as you stand looking at the drawing, that it is not the day after the great hunt, but the day before!  The great “magic” of the cave, I believe, was the belief that anything drawn on the walls would become “real”.  But the great magic of the cave was also the great myth of the cave; in that the magic was not in the walls, or the paint, or even in the cave itself, but rather, in the hearts and minds of those who had made the drawings.  The magic was the “planning” of the picture, and the more thorough that process became the more likely it would be that the magic would happen.  That same magic exists today though we call it by other names, “business plans” and “goal setting” or mapping out our dreams. 

Until we take an idea to the next stage and remove it from the medium of our mind and give it life by committing it to paper, mapping out the details and making it real, an idea will remain only that, an idea.  But when we take the magic next step, the magic of the cave will begin to happen and "The Myth of the Cave" will cease to be a myth.

Conquering The Fear of Cold Calling by Kim Michael-2008

Conquering The Fear of Cold Calling

By Kim Michael

Kim Michael is a nationally recognized author of Business Development articles, public speaker, teacher, ghost writer and novelist. His current writing project is a revolutionary new Project/Website entitled "The Quintessential Salesman”, devoted to the Inspiration, Encouragement and Empowerment of Sales Professionals to reach their full potential. 

As energy prices continue to skyrocket and the cost of travel dramatically increases, companies large and small are once again turning to the telephone.  Though it continues to be one of the most cost effective tools in the sales arsenal of business outreach tools, as anyone who has ever been in sales will tell you, “cold calling” is one of the most intimidating and difficult tasks you can undertake. I have seen former CFOs, and CEOs, sweat beading on their foreheads, hands trembling, as they made call after call, only to fail miserably.  

What many fail to realize is that using the telephone effectively is a cultivated skill.  Experience does not replace expertise and unless an individual has made the investment in understanding and developing this highly specialized communication skill, it is unreasonable to expect that they can succeed using it. 

By far the greatest common denominator for failure is fear.  No one wants to admit it, but even seasoned sales professionals cringe at the idea of making cold calls.  So what is it about making a cold call that strikes such fear in us?  We all fear what we don’t understand. Developing a methodology that allows you to break down the process and replace the unknown with something that is well planned and emotionally comfortable is where we have to begin. Like any skill, using the telephone requires practice, knowledge, and above all patience.     

At this point it is important to distinguish the difference between telemarketing and actual telephone prospecting. The concept of tele-marketing is different than true sales prospecting, particularly B to B, or B to C sales. It is a simplistic approach based on the use of marginally successful predigested dialogue that often is written by people who don’t understand the fundamentals of successful telephone usage themselves. It is also perceived to be solely numbers driven.  Unfortunately what works for basic “widget” sales significantly changes when you cross the widget boundary into the world of large, complex, and often protracted business relationships.  

Though ultimately, numbers are important, it is not so much the number of calls you make, as much as it is the number of effective calls you make.  In fact, making too many calls with no results should be the first red flag that you’re not making the right kind of calls. Any telephone effort that is not “results” driven rather than numbers (or task) driven will never reach its full potential.       

Developing a methodology that increases potential is where the true success of using the telephone begins.  The following is a step by step approach to the techniques, that when applied to the individual talents of the seasoned professional, transforms the common telephone into one of the most viable and effective tools in the first offensive line of any company. 

As with any business the selling cycle of your particular company is unique and my intention is not to imply that all business outreach criteria are the same, but the fundamental way you go about getting your message across is.  Even so, it is important that you realize that you still have to do the heavy lifting yourself; these are only the guidelines that will enable you to get you there.    

PRE-CALL PREPARATION: 

1. MARKET UNDERSTANDING 

Before making the first call it is important to make adequate preparations. It begins with product knowledge and understanding your market, and how your product or service fits 
into that landscape.  

2. FOCUS:

Create a master plan.  Set up your target prospects.  Both time and momentum are lost when you have to stop to think about who to call next.    

3.  FIRST FIVE SECONDS:

The first five seconds of a call will often determine how an entire relationship is defined.  Introductions should be fluid and concise; and your voice should be relaxed and succinct. Remember the most important element of a successful call is telling the recipient what they need to hear, not what you want to tell them.  As with all sales initiatives, it’s also about listening, not only to what a prospect says, but also the way he or she says it.  Knowledge is the driver, but emotions are the vehicle.  

4.  PRACTICE TALKING POINTS:

I am not an advocate of canned scripts, but having fluid and concise talking points and practicing them until they become second nature is extremely important.  It is easy to fall into the mindset that sophisticated rhetoric implies professionalism. It doesn’t.  We all think and remember in three second intervals so making statements simple and concise tends to get the message across more effectively, without sounding pretentious. Stumbling verbally is the surest way to imply a lack of expertise and you risk loosing control of the call.  

5. FAMILIARIZATION:

Use the Internet to familiarize yourself with your prospect.  If the Internet is not available there are various publications that will give you a quick overview of your prospects and then consider how they can best use your product or service.  If the prospect has a past history, review those notes as well, but don’t allow yourself to be tainted by the previous sales person’s lack of success. Take time to reach your own conclusions.  

You can also use reference material to find out the names of various individuals within the organization. Mentioning familiar names or market specific trends in a conversation implies a common history. Using names within the organization, particularly management names, will imply that you have other relationships within the organization and will significantly lessen the tendency of some lower-level individuals to try to shut you down prematurely.  

6. NAMES: 

Practice pronouncing difficult names.  If a name is particularly difficult, write it out phonetically and put it in your notes for easy reference. The fastest way to ruin the illusion of an implied history is to mispronounce a name.  I will often call the CFO’s office (even though he or she may not really the individual that I want to reach) just to be referred to a particular person or office. “I just spoke with Bob Peterson’s office and it was suggested that you would be the best person to talk to.” The likelihood of someone trying to get rid of you is far less if you are referred by someone higher up.  The more you know about your business and the various players, the more you will be able to overcome the obstacles that can suddenly pop up.

  

7. GATEKEEPERS:

Secretaries have an ever-evolving responsibility as “gatekeepers”.  They should always be referred to as “assistants” and they can make a huge difference in your success. Always use their names when talking to them and always have the sound in your voice that you already know them. People respond unconsciously to a warm voice that sounds familiar.  

8. THE POWER OF A  QUESTION:

Again the first five seconds of a call are critical.  Even before giving your initial introduction, try asking a question using that person’s name.  “Sarah, can you help me I’m not sure I’m in the right place?”  This stops the initial qualifying that we all do and focuses the individual on helping you rather than trying to size you up.  Thanks to telemarketers we are all increasingly sensitive to the canned “How are you today?”  True, it is a question, but it’s the wrong question. 

 

9.  CALL BUSINESS PLAN:

           A. Every call requires a business plan. Before you call, you should already know what 
             you want to accomplish.  

          B. Make an outline of all the  information variables that you will need to make the 
               call and the goal successful.  

          C. Questions are the key to understanding any opportunity.  Take time to consider 
               the questions you need to ask and how you will ask them.  You can often lead 
               a sales process just by asking questions and how those questions are answered 
               will often tell you how serious your prospect really is.   

          D. Determine the decision makers from the decision influencers.  How many deals have
               been lost just because the  wrong people were involved?   

POSITIONING:

Positioning is one of the finer nuances of telephone sales and perhaps one of the most critical.  In a way, positioning is like an acting job; it is the art of sounding as if you are on the same level as your prospect, whether they are a manager, or a director, or even a CFO.  

This does not mean you should try to mimic these levels, but you should have the same tonal comfort and familiarity in your conversation. People are more relaxed and typically more honest when they perceive they are talking to a colleague.  

As you begin to develop this technique of “Implied Same Status”, keeping your voice relaxed and friendly also requires “balance”.  It is easy for “friendly” to become “gushy” or worse, pretentious, and once that boundary is crossed, it is very hard to go back. I once had a trainee listen to my calls so she could better understand the dynamics.  At the end of the day she said to me, “This was helpful, but tomorrow can we call people who don’t already know you?”  She looked surprised when I told her,  “We already did.”  The truth was every call I made that day was to people I didn’t know.  The illusion was not perceptible, even to someone who was looking for it.So why does the sound and intonation of your voice make such a difference?  

We all have an unseen “Body Language” to the way we speak. At least 75% of what we communicate when we talk (even on the phone) is non-verbal.  If your speech pattern is uneven, or laced with nervous breaks, or you unconsciously use a reverse inflection (ending sentences with a rise making them sound questioning) it sounds as if you are unsure of what you are saying, or worse, untruthful.  If you sound anxious, your prospect unconsciously will become anxious as well. We transfer what we project.  Even a smile can be heard and felt.  

Also you must learn to listen while you talk. People will tell you if they are listening. They will respond, shake their heads, make sounds (often non-verbal) of agreement or disagreement. These are called “listening receipts” and if you aren’t getting them, they probably aren’t listening. You never want a person to stop listening before you stop talking.  If you sense this is happening, ask a question.  Soliciting a response is a good way to regain control.  

Understanding these basic personality links and how they reflect in our speech patterns helps us understand how what we say is perceived, and absorbed, by others.  The way to best develop this skill is to listen to yourself. Using a tape recorder is one way, but the best way I’ve found is to call my own voice mail and leave a message.  When you do this, you will hear things that you have never heard before and ultimately, you will never sound believable to others, if you don’t first sound believable to yourself. 

COLD CALL FUNDAMENTALS:

1. TITLES:    
   

 Use self-describing titles that are devoid of the word “sales”.  The mere word 
 “sales” in any context tends to set an expectation that can put some prospects
 on the defensive.  Introduce yourself as a business manager or some 
 other “non sales” delineation.        

        

2. RESPONSE:

When a  prospect asks for something, respond immediately. Waiting gives 
them time to forget you, or worse, why you called.  

3. CALL BACKS:

Never assume that just because you have not heard back from a prospect 
that they are not interested.  When I teach telephone techniques I tell 
people (jokingly of course), You need to stamp this on your forehead 
so you see it every morning when you look in the mirror; PEOPLE DON’T 
CALL BACK.  You have to lead the process.  

4. NEGATIVITY:

Never react negatively.  This is by far one of the most difficult aspects 
of telephone prospecting, but it is also one of the most critical.  You can 
make an enemy and doom your chances of a sale in a heartbeat if you 
allow yourself to get caught up in a negative call.  As an associate of 
mine always says, “Take the high ground, because in the final analysis, 
it is the only way to see where you’re going and how best to get there.”

5. CONFIRMATION: 

When you send an email or a contract, always call back to verify that it was 
received. At the same time schedule your follow up call.  This will tell you 
how serious your prospect really is, and at the same time, insure they won’t 
be perturbed when you call back.  When you do finally make the follow up 
call, reference your previous call, who you are, why you called and their suggestion 
of the best time to follow back up with them.  Countless deals have been lost 
only because the prospect forgot about the original call and was too embarrassed 
to admit it.     

6.  LIVE PEOPLE:

Always try to talk to a “live” person.  If you get a voicemail hit “0” and see where 
it takes you.  The road to failure is littered with people who leave voice mails 
thinking the prospect will call back.  Again always remember, PEOPLE DON’T 
CALL BACK.  If you can’t talk to the targeted person, the next goal should be 
to talk to his or her assistant. If “0” doesn’t take you to someone else, hang up 
and call back and find a live person (it is that important).

7. LEARNING TRAVEL PATTERNS:  

Anthropologists study the movement of prehistoric man by looking up to the cave’s 
ceiling. Tracking the soot and smoke residue of campfires and torches help them 
determine where the inhabitants spent their time and how they lived.  To some 
extent, that is what you do when you talk to assistants or secretaries:  Does your 
prospect come in early, do they stay late?  When is the best time to call back?  
Even when are they most likely to be sitting at their desk with no gatekeeper 
around?  Getting email addresses and/or direct phone numbers (even fax 
numbers) will also help you shortcut the time it takes to make the connection.    

8. CLOSED DOORS:

Never accept a door that closes.   Every company has at least five doors through 
which you can enter and if one closes it doesn’t mean the effort is dead. I 
have seen inexperienced sales people continue to try to sell the prospect long 
after he or she has said no.  This is very dangerous in that you can create 
enemies that could hurt you later on.  It is always best to move on with a smile and 
try not to give them a bad reason to remember you. 

 9. VOICE MAILS:

 Voice Mails can be dead-ends, or they can be a great communication tool. Never 
 leave a message expecting a call back.  Again the cardinal rule is--PEOPLE DON’T 
 CALL BACK. They do, however, listen to their voicemails, and they usually listen
 to the entire message.  It is a great way to leave a brief overview of why you’re calling, 
 and also some “hook” that will catch a prospect’s interest.  If you can call back later 
 that day or the next, you’ve given them a reason to take your call.  Never wait more 
 than a day to return a call.      

   

          A.  TONAL EXECUTION:

         Voice mails should always be made exactly like a “live” call.  The same 
         intonation, the same warmth and they should always be as short as possible. 
         Initially, say your name slowly and even a bit over pronounced, then leave 
         your “direct” number. Using the term “direct” promotes the idea that you 
         are not a sales person.  Follow it with a concise one or two sentence overview 
         of who you are and why you’re calling, and finish the call by restating 
         your name and number again, not that you really expect them to call back, but 
         because it is expected.  

        B. LISTENING TO THE VOICE MAIL OF OTHERS

        Earlier we discussed the value of listening to yourself on a recorded call, but 
        what about listening to a prospect’s voice mail? I have purposely called companies 
        early in the morning, or after hours just to listen to my prospect’s voicemail 
        introduction.  You can learn a great deal about how to communicate with 
        an individual by first hearing how they communicate with the world at large.
        Invariably, people will introduce themselves as they preferred to be addressed. 
        If they use Mr. or Ms., you can minimize the distance this automatically creates 
        by saying the salutation, not as a title, but as a name.   People also tend to listen    
        at the same speed that they speak, so when leaving a voice mail, or when you      
        speak directly with them, pace your message accordingly.  If you talk at the same 
        speed they listen, they are more likely to absorb what you say.   They are more 
        likely to trust you as well.  There is a reason why the term “fast-talker´ has 
        evolved to mean someone who is untrustworthy or disingenuous.       

        C.  DIFFICULT CONTACTS:

        If the effort to make a contact takes a long time (days or even months), try to 
       vary the content of the voicemails you leave. Leaving the same message only 
       insures that your message will be erased sooner.  Also include a quick statement
       that you understand they are busy and probably haven’t been able to get 
       around to returning the call.  You never want the lack of response to be 
       because your contact is embarrassed that they haven’t called you back.

      D. REPETITION:

      Keep a list of numbers by your phone and intermittently call them throughout the 
      day, trying to vary the times, but not always leaving a message.  Eventually you will 
      make the connection and if you have taken the time to space out the messages 
      that you’ve left, and varied them, they are more likely not to be upset. This is where 
      a time date stamped contact management system is helpful.  When you make follow up 
      calls you are always more likely to get a person at the same time when you first 
      got them.  

      E.  EMAILS:

       Even though I prefer not to use emails, they can be particularly useful if you are 
      transferring information via a gatekeeper or assistant. Second generation 
      information is almost always flawed. Putting a concise message in their hands of 
      why you’re calling and who you are can be very helpful. If your message is 
      complicated, this insures that the decision maker gets the message you want 
      them to have. Again the message needs to be short and concise.  The higher 
      in the food chain the recipient is, the more concise the message needs to be.  

      F.  CALL COMPLETION:

      Once the call is completed, make notes, particularly the positives and negatives 
      that the prospect has given you. Respond immediately to requests, and begin 
      to form the plan that will lead to the close.  

Mastering these simple techniques will not insure that you will close every deal, but it will allow you to competently create an environment in which a favorable decision can be made, and that after all, is the ultimate goal of an initial cold call.