Have you ever asked yourself, “Why do your patients select you and your practice for their medical care?” Most medical practices offer the same service, i.e., evaluation and treatment, at approximately the same cost, and produce similar outcomes. After all, how many ways are there to treat a urinary tract infection, diabetes, hypertension, or arthritis? Most doctors are trained to offer similar services, which typically produce identical outcomes. So, why are your patients selecting your practice? Even if you have a new treatment or a new procedure, referred to as “first movers’ advantage,” someone else will soon learn the skill and offer the same thing not in years but in months. This article will discuss that all-important question of why and help you answer that question for you and your practice. After reading this article, you will not only answer the why but also improve on your answer for the what and the how.

Suppose you ask most physicians why patients select their practices. In that case, they will pontificate and spout that it is the superior quality of their care. But ask those same physicians how they measure that quality, and you will see doctors blinded like deer looking into headlights. The message I want to convey at the outset of this article is that most physicians, including myself, have no idea why their patients choose their practices. Added to the complexity of this conundrum is that if the doctors don’t know why their patients select their practice.

One of the most popular sites on the Internet is TED.com. This site offers thousands of 14-minute lectures that cover every topic, from archaeology to Zen Buddhism, including the latest and greatest innovations in medicine. One of the best TED talks I have seen is Simon Sinek, the author of Start with Why, which is a recommended book that explains the Golden Circle and how to go from why to how and finally to what. The talk has been viewed over 18 million times.

For example, if some asked a physician the what, how, and why questions, they might answer something like the following:

• What: I’m a doctor taking care of patients
• How: I use cutting-edge technology to treat medical conditions and have a wonderful staff that will make your visit to my practice a positive one.
• Why: I have good results and a quality practice

Now, would you like to schedule an appointment and become my patient?

Contrast that with the doctor who goes in reverse and starts with why:

• Why: I want to guide you to a healthy lifestyle and keep you well and out of the doctor’s office
• How: I use state-of-the-art technologies to evaluate your current state of health and provide you with an action plan to achieve the optimum sense of well-being. I have a caring office staff that will make your visit to our office an enjoyable experience.
• What: I am a physician with years of experience treating patients just like you.

Now, would you like to schedule an appointment and begin your journey to healthy living by joining our practice?

Every single organization on the planet, even our own careers, always functions on three levels. What do we do? How do we do it? And why do we do it? When all three questions are thoroughly answered, it provides us with a marketing focus that can help us stay at the forefront and allow us to direct our energies toward providing the best care for our patients. When all three pieces are in balance, others will say, with absolute clarity and certainty, “We know who you are,” “We know what you stand for.”

Whether doctors realize it or not, all great and inspiring medical practices and organizations think, act, and communicate in much the same way. Those practices that fail to consider and address the three questions will struggle to differentiate themselves from other practices in the area or region.

Every hospital and medical practice know what they do. These are the services that doctors and hospitals provide our patients. We are all in the healing profession. We are all interested in making those who are sick feel better. Every doctor and practice believe that they provide outstanding patient care. Yes, that may be true, but that isn’t going to endear yourself, your practice, or your hospital to those trying to avail themselves of health care services.

Some doctors and hospitals know how they do what they do. The “unique value proposition” or “USP” are the differentiating factors that set us apart from our competition, the things we think make us special or different from everyone else. If we are all healers, use the same diagnostic and therapeutic skills, and do it the exact same way, then our “how” is no different than the “how” of any other medical practice. This will not make us stand out nor be unique to those who need our services. Your patient or potential patient could call any doctor or specialist or visit any hospital in the area if the services were all the same.

It’s a sad truth that very few doctors, practices, or hospitals can clearly articulate why they do what they do. Why is a purpose, a cause, or a belief. It provides a clear answer to why we are doctors and why we work hard to become doctors, caring for our patients. Why does our practice even exist, and why should our practice or hospital matter to anyone else?

Making money is not a why. Revenues, profits, salaries, and other monetary measurements are simply results of what we do. The why should inspire us to provide even greater service to our patients.

The traditional approach

According to Mr. Sinek, all companies, organizations, and medical practices naturally communicate from the outside in (Figure 1). We go from the clearest thing to the fuzziest thing. We tell patients what we do, we tell them how we’re different or special, and then we expect a behavior like a patient making an appointment, scheduling a procedure or surgery, or recommending our practice to others who may need our services.

The problem is that what and how do not inspire action. What and how do not motivate patients as there is no difference in other practices that do the exact same thing, i.e., provide the exact same what and how. Facts and figures make rational sense, but we don’t make decisions purely based on facts and figures. Starting with what is what commodities do. Starting with why is what successful and unique practices do; they go from the inside of the Golden Circle to the outside. The inside-out approach can serve as a source of inspiration for everyone on the team.

Some examples of a medical practice why include:

• The Mayo Clinic: We inspire hope and contribute to health and well-being by providing the best care to every patient through integrated clinical practice, education, and research.
• MD Anderson Cancer Center: We are a catalyst for civility and collaboration to enhance MD Anderson’s creativity, effectiveness, and integrity.
• Cleveland Clinic: To provide better care for the sick, investigation into their problems, and further education of those who serve.
• Dr. Neil Baum: Providing happiness through wellness.

Leaders and organizations with the capacity to inspire, think, act, and communicate from the inside out start with why. When we communicate our purpose or cause first, we communicate in a way that drives decision-making and behavior. It literally taps the part of the brain that inspires behavior.

There are so many instances in modern medicine where we are told that we can’t do something. Modern medicine wouldn’t be where it is today if we truly believed that we couldn’t do something that improves the lives of our patients. We would have prevented smallpox and polio, treated infections with antibiotics, been able to transplant organs from one individual to another, and used computers to operate robots that perform intricate surgeries, decreasing the time of the procedure, reducing blood loss, and minimizing pain after the procedure. Often, senior doctors and administrators will declare that it’s not possible to change or do something differently—such as creating a culture based on why the practice or hospital exists rather than just focusing on the what and the how. And yet, when they start to examine the assumptions, we realize that that’s all they are—a resumption of the status quo. When those assumptions are challenged, they dissolve, progress occurs, and we can provide better care for our patients.

Bottom line: All physicians are trained to diagnose and treat medical illnesses. Most of us accomplish this similarly, using the same diagnostic skills and therapeutic options. To differentiate ourselves from others in the community and region, we need to start with why we do what we do and then focus on what and how. When we understand the why, we will make ourselves, our practices, and our hospitals different and special from the others in the area.

Neil Baum is a urologist.