Of these, only the first option represents a "win" for your practice. Yet, many treatment counselors hesitate to ask for any kind of commitment from the patient Too often they settle for the third option, allowing the patient to escape without making a decision. Why? Because of the internal conflict they feel during the case presentation process.

Treatment counselors can experience a sense of conflict for many reasons. They may fear the rejection that comes with a "no" answer. They may worry about being perceived as too pushy or aggressive. Or perhaps they don't feel they have the right to ask the patient for a decision. So instead of pushing ahead for the desired outcome -- a "yes" answer -- they settle for a "maybe" in order to relieve their own sense of discomfort.

Regardless of the source, inner conflict on the part of the treatment counselor represents the #1 reason why case presentations fail.

Overcoming the Conflict

To help your counselor get over this obstacle during case presentations, explain that:

• Conflict is a natural, unavoidable part of the case presentation process. However, the counselor's job is to help resolve the conflict, not avoid it.
  
  
• The best way to resolve the conflict is to get a definite "yes" or "no" response, not a "maybe." A "maybe" feels like it resolves the conflict (because it allows the patient to escape) but until a decision gets made, the conflict still exists.
  
  
• When patients hesitate to make a decision, it usually represents an unspoken request for more information. The appropriate response is not to back off, but to review the benefits of the planned treatment and make sure the patient understands them.

One of the best techniques for helping treatment counselors overcome their discomfort and lead patients toward a "yes" is the assumptive close. With this approach, the counselor explains the benefits of the treatment and then asks a question that assumes acceptance of the plan. That puts the burden of the decision squarely on the patient and away from the treatment counselor.

Examples of assumptive closes include:

• Would you like to schedule an appointment for next week?
  
  
• Would you like to put this on your credit card or use our own financing program?
  
  
• Do you feel comfortable with the terms we have discussed? If so, please sign this consent form.
  
  
• Would ten a.m. next Friday be convenient for you?

Now comes the hard part. After making the assumptive close, the counselor must stop talking! Otherwise it takes all the pressure off the patient and puts it back on the counselor. Train your counselor to get comfortable with the silence that sometimes follows an assumptive close and always let the patient speak first.

In some cases, the patient simply won't make a decision. When that happens, stop the selling process and allow the patient to withdraw. You don't want to drive them away for good. Instead, offer to follow up by phone, saying, "It seems like you need a little more time. Why don't I give you a call next week and see if you have any more questions?"

Remember -- the primary goal with case presentations is to get a definite "yes" or "no." You won't always achieve that outcome, but by helping your treatment counselor focus on the benefits to the patient rather than their own sense of conflict, you can dramatically increase your success rate.

Additional Resources There are plenty of books that can improve your treatment counselor's selling skills. One I always recommend to clients is "Relationship Selling: The Key to Getting and Keeping Customers," by Jim Cathcart (Berkley Publishing Group).

There are also a number of good Web sites that focus on developing selling skills. Check out www.learntolead.com. You have to wade through some product offers in order to gain access to the articles. But once there, the content is excellent!