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Getting the YES!

Getting the YES!
Melanie Hecker, AuD
August 3, 2015
This article is sponsored by Widex.

Editor's note: This text course is an edited transcript of a live webinar.  Download supplemental course materials.

My name is Melanie Hecker, and I am a Professional Education Manager with Widex USA.  Today we will talk about how we can best help patients accept treatment recommendations, thus getting the yes. 

Learning Objectives

After this course, learners will be able to demonstrate successful and efficient ways to present treatment options to patients, explain ways to increase acceptance of recommendations to patients and discuss strategies to deal with objections from your patients and clients.


We are going to start by reviewing current protocols that you may or may not be implementing in your office at this time.  Next, we will discuss effective selling techniques and ways to position ourselves and think about selling.  Selling sometimes has guilt associated with it or makes some clinicians feel anxious, so we will talk about how to deal with that.  Then we will get into treatment and technology recommendations, followed by how to handle objections and retain our sales.

Your Motivation

Here are some questions I would like you to think about in regard to your day-to-day process as a clinician.  Answer honestly so you can think about where you stand.

  • Why are you in this profession? 
  • What motivates you to move your patient forward with treatment? 
  • What is it that you get out of your patient care and treatment? Is it because it makes you feel good?  Is it because you know it is the right thing for the patient?
  • Are you in a setting where you are compensated based on the influence of that recommendation that you are giving to the patient? 
  • Are you comfortable in the role of being a sales person?  At the end of the day, every single person is a sales person.  We are selling ourselves to our partners.  We are selling ourselves to our friends.  Within the clinic, we are selling ourselves to our colleagues and to our patients.  Are you comfortable in this role?
  • Have you ever received any training on how to sell or influence decision-making? 

Today, we will discuss some of the psychology of selling and making proper treatment recommendations.  Is this something with which you feel comfortable?  If not, how can we strengthen those skills to get you to a place where that is an authentic, comfortable recommendation? 

Patient Motivation

Here are some questions to consider in terms of your patients' motivations.

  • How do people come to your office for the first time - are most of them through physician or other patient referrals?  Do they receive some form of digital or physical marketing? 
  • Do you practice in an ENT clinic, hospital or university and receive traffic that way? 
  • Is your office set up as a “medical” office?
  • How much of the patient’s motivation is uncovered while being scheduled for the appointment?  Does the front desk staff know what questions to ask on the phone?
  • How much do you truly know about your patients before they come into their appointment?
  • What is your scheduling protocol, or do you even have a protocol? 
  • Does the patient come back to your office not knowing why they are being seen?   
  • Can your patients expect consistency and continuity coming into your office each time?

Family, Friends and Caregiver Motivation

In terms of the family, friends and caregivers of your patients, consider the following questions.

  • Do you ask for a third party, meaning a patient’s friend, family, or caregiver, to attend the appointment also?
  • Is your front desk incentivized to get that third party to attend, either through motivation or financial incentives?  While every clinic is arranged in a different way, we do know that having someone else present at the appointment helps move the process along for the patient.
  • How are you drawing out the experiences, thoughts, and concerns of that third-party attendee? 
  • Do you know before a patient comes in how the third-party person is affected?
  • They may be in denial and the only reason why they have come to us is to get a nagging spouse off their back.  The third-party attendee is often going to be your biggest ally.
  • How are you currently involving that third-party attendee in the consultation and recommendation process?  Are you joining forces in a way does not attack or put the patient on the spot?
  • How are you involving the third party in the testing process, or do you want to involve them in the testing process?


How do the following affect your motivation in your practice? 

  • Time
  • Stress
  • Compensation
  • Reimbursement
  • Competition
  • Reputation
  • Patient Satisfaction
  • Guilt

Each of you will have a different opinion as to which of these ranks highly on your list of concerns, but it is important to acknowledge that all these factors play some kind of role in your clinical care. 

S is for Selling

As already mentioned, we sell ourselves daily in every aspect of our life.  I feel there is a perception of guilt associated with selling, mainly because we do not want to view ourselves as the sleazy car salesman – and we are not.  We need to wrap our heads around what it is that we are doing and why are we doing it.  That goes back to evaluating why you are in this profession.

I like to ask clinicians to consider the difference between selling and making a treatment recommendation.  I was visiting an office recently, and the clinician was very uncomfortable with making treatment recommendations, so I asked why.  She said, “I just feel so bad asking patients to spend that kind of money.”  In reply, I asked her how well she was helping her patients by doing a hearing test, diagnosing them with a hearing loss, and then send them out the door with nothing to help.  We have not helped by merely telling them something they may likely already know.

That was an eye opener for this particular clinician because then she realized the fear of not wanting to provide a treatment or solution for a patient was a disservice.  We have the ability to help improve a person’s quality of life.  Much of this is getting ourselves to a place where we genuinely and authentically believe in what we are doing and that we are bringing satisfaction to our patients.  We can use the testimonials and successes of our previous patients to leverage that.

Take away that concept of being a salesperson if that brings any guilt or anxiety, and focus on what you really are – an agent of change.  We want to move these patients forward because we know that technology can change their lives for the better.

If you have seen the movie, Pretty Woman, you will remember the scene where Vivian goes shopping for clothes and the saleslady turns her away, assuming from the look of her street clothes that she does not have the money or the proper social graces to purchase clothes there.  After feeling judged, she confides in a friend who helps her purchase the clothes she wants from a different store.  Later, she goes back to the original store wearing her fancy clothes, looks at the saleslady and says, “Big mistake.”

I want all of us to make sure that we are not putting bias or judgements on our patients when they come in for our help.  We are there to genuinely listen and provide the best recommendation for them, and then let them determine how they want to proceed.

How do you Sell?

Do you currently have a protocol for how you offer hearing aids to your patients?  What are your current selling recommendations and techniques?  How are you currently handling objections, and what are you doing for followup? 

If you cannot answer those questions now, we will discuss each of them and make some recommendations for how you can fine tune what you are currently doing.

At what point are you making the recommendation to your patient?  Many clinicians do not start laying the groundwork for providing a treatment recommendation until after the hearing test when they either demonstrate a product or talk about what needs to be done.  Truthfully, we should be doing that from the moment that patient is on the phone scheduling that appointment.  The entire clinic should be on board with this.

What do you know about a patient before you bring them back?  Are you using questionnaires or a thorough intake?  Are you doing a pretesting interview?  Is it more of an interview to acquire of information, or is there some type of emotional component to that?

After the evaluation, how many options are you offering to the patient?  Does providing too much information overwhelm them?  Many clinicians present an offering of three different price points with an explanation of the features in each.  For most patients, that is going to be information overload.  In truth, the only patients who really care about hearing about the technological differences are often the engineers.

Are you reading your patient?  Every patient is going to have very different needs, so you may need to change your approach and dialogue according the personality and needs of each person.  Your approach does not need to be a textbook monologue, as this will not fit the elderly grandmother who lives alone and the young musician with noise-induced hearing loss. 

Effective Selling Goals

To be effective sellers, we first we have to realize what our goals are.  This should be focused on those motivations that we talked about at the beginning of the presentation, although I think we can all that we want to increase our patient satisfaction.

If we are providing the appropriate recommendations, we will have fewer unnecessary follow-up appointments, because we have already set the proper expectation for that patient through counseling.  We have met their specific needs with the appropriate technology, thus they are not having to spend as much time in and out of the office for fine-tuning.

This will increase satisfaction, which then increases word-of-mouth referrals.  It opens more time on our schedule for all patients. 

An additional goal should be to decrease our return-for-credit rate.  If we get off to the right start from the beginning and then program and verify the hearing aid appropriately and set the proper expectations, we will not have as many patients returning that product, which leaves them with a better overall impression about hearing aids.

Are we increasing our closing rate?  In our line of work, it seems insensitive to consider this, because these are people, not just numbers and statistics, so let’s change the verbiage.  How many of your patients who need your help proceeded with your recommendation?

For the health and success of your business, we need to aim to increase our average selling price and market share.  Are we providing the most appropriate recommendation or are we degrading or devaluing what we are recommending because we are not confident enough in the higher levels of technology?  Are we having a difficult time talking about those higher levels of technology and getting the patient to understand the benefits?

I would like to make a recommendation that you Google “Simon Sinek” and watch the short YouTube video called Start with Why.  One of quotes from this that stuck with me was, “People don’t buy what you do, they buy why you do it.” We talk to our patients about the “what.”  What can this hearing aid do?  How many channels does it have?  What kind of noise reduction?  We data dump on our patients with the technological information.  Most patients do not care about the what.  

Simon Sinek uses the success of Apple as an example. Apple does not have a huge market share, relatively speaking, but yet they an extremely loyal cult following.  One of the reasons is because they do not focus on their sophisticated technology.  Rather, they promote and market the why - they defy the status quo.  They show why you should have a product and how it can simplify your life.

Think about the big purchases or decisions in your life.  Why did you decide to marry your spouse?  You might say a lot of things, including, “Because it felt right.  I felt it in my gut. I just knew.”  It was the why.  It was the emotional aspect.  That, also is what gets our patients to move forward.

Our limbic system controls our emotional response and our gut feeling.  At the end of the day, our patients are not purchasing hearing aids because it is a rational decision; they come to you and make the decision to purchase hearing aids because it is an emotional decision.  The limbic system makes this decision more about the why than the what.

Emotional vs. Rational Purchase

We need to change the way that we present options to our patients to tackle the emotional center, because that is where solid decision-making happens.

Identify Specific Events

First, we need to identify specific events where hearing and communication are breaking down.  Using the Client Oriented Scale of Improvement (COSI) is a good way to make a list.  You can also use a piece of paper to write down your thoughts, but the more specific you can get, the better it will be.

When they give you an environment that they find themselves in, pull out as much detail as you can about that environment or event.  “How many people are there?  What are you doing?  Where in the group are you located?  With whom do you have the most difficulty communicating?  Are you able to stay on top of all of the jokes and conversations that are happening?”

Focus not only on events in which they are currently participating, but also on events that perhaps they have given up because of their hearing loss.  Have they started to isolate or remove themselves from situations that used to be fulfilling because they can no longer perform at a communicative level that is satisfying?  Be specific about these events.

Make the Events Personal

The second step the most important of the four.  Choose the top two or three priority situations for the patient, and make these events as personal as possible.  Start focusing on, “How does that make you feel?”  For example, if you have a patient who is in a quilting group, you might ask, “When you are in your quilting group and you cannot hear all the jokes and you find yourself laughing but have no idea what was said, how does that make you feel?”

This gets them to take ownership of the impact that hearing loss has on their life.  They may deny that because they do not want to think about how it makes them feel.  We are social beings by nature.  The greater the loss and the longer it has gone untreated, the greater the loss of social connections.

It is also wise to ask the third party that comes with the patient how the situation makes them feel.  Their responses may be enlightening for the patient, as well.  While that might make some of us uncomfortable, it is truthfully what brought them into your office.  They already have come to a point of realization that there is a problem, and if that patient does not realize it, well, the issue for them may just be that their spouse wants them to come in.  Show the patient how their environments are personal, not only for them but for those around them, also.

Patient Motivation to Change

The third step is where we focus patient motivation.  How much do they want to change their situation?  To me, this may be our biggest hurdle to overcome, because if the patient has zero motivation, it is not the right time, and nothing that you will say is going to move them forward.  If we push them forward when they are unmotivated, ultimately the hearing aid will end up in a drawer.

You may ask your patients, “Are you ready to make a change?  If I could help you not feel that way, would you want that?”  Then listen.  Stop talking.  Let patients explain and advocate for themselves.  I find that some of the most successful clinicians speak very little, and when they do, it is not about technology.  If you have done this right, the patient should ask you, “What options do you have for me, and what do I need to do now?”   You want the patient to become aware that this is a problem and then ask you for that recommendation. 

For your treatment recommendation to be appropriate, you need to make sure that you have a comprehensive understanding of the patient’s and third party’s frustrations, feelings, thoughts, and events.  Personalize the recommendations by centering them on those feelings, not around facts, technology or figures.  When done appropriately, upselling will not need to take place, because you will make the most appropriate recommendation from the beginning; that may or may not be top-of-the line for everybody.

Match their goals, do not overwhelm them with information, and make basic statements such as, “Based on X, I recommend Y for you.”  You do not have to rationalize, justify or validate your recommendation.  Just wait for them to respond. 

Other questions you can ask to make it personal are, “How would you feel if I could help you understand better in that environment?  How would you feel if you did not have to raise your voice for your spouse to hear you?  If I _________, would you ________?”  Wait for their response.  Do not plant seeds of doubt for the patient by talking too much or give them reasons to doubt what we are doing.  Be confident in yourself and your recommendation.


Every clinic handles the demonstration differently.  Demoing will enhance the patient experience and there are a lot of different ways to demo.  Depending on the hearing loss, they may see a significant difference in the office.  However, many patients in one-on-one quiet setting in the office do not see a significant difference, so demoing in the office can backfire.  If you are going to do a demo, I highly recommend having a third-party attendee who can also participate.  Allowing the patient to take the devices home and test drive them in their real world would likely be the most effective demo.

You may try a demonstration in a restaurant, like a lunch and listen.  Take these patients to that real-world environment and let them try it over lunch or dinner.  We feel so confident in our Dream 440’s ability to help a patient understand in noise, that this has been very successful for many of our clinicians.

On the other hand, the demo can backfire for a few different reasons, particularly if you are in the office.  One of the top reasons is that they have not had enough time to acclimate to that device or because it is not being used in enough real-world settings.

Another reason is because of low patient motivation.  If a patient is not ready, the outcome will likely be unfavorable, regardless of what things you do correctly.  They may not be willing to take it home with them or try it in the real world.

It is okay to identify that and tell patients, “I do not feel you are ready.” They appreciate that honesty.  When they see that you, the professional, feel that way, they will sometimes change.  Most of the time they will not, but it does open an opportunity to address it again later.  Be very open and honest about that.

Recommending Technology

Although I am recommending that you refrain from speaking directly about the technological specifics to the patient, it is imperative that you know these differences, because you are the one making that recommendation.

I am going to spend a brief moment talking about Widex Sound and some of the differences in our technology.  If you do not feel confident at this time in describing Widex Sound or the differences in our four levels of technology, please contact your sales representative or education manager so you can learn and then feel more confident in knowing why you are making that product recommendation.

Why Widex?

Intelligibility is our biggest focus, because we know that patients come into our office to understand better.  Widex has the most faithful preservation and replication of the external world because we have the highest input dynamic range of any manufacturer.  This allows sounds to come in undistorted, which will provide that patient with the best access to speech.

Widex has the lowest compression threshold of anyone in the industry.  If you are trying to optimize their ability to hear speech, especially at a distance or when the speech is not directed to their face, a low compression threshold will benefit speech intelligibility better than other technologies.

Also, Widex has predominantly slow-acting compression.  This does the best job at preserving the integrity of the speech envelope.  The better we can preserve the peaks and troughs of dynamic speech, the better the speech intelligibility is going to be.

Widex has four different price points, wireless connectivity in all of our devices, and a form factor for every ear.

Niche Features

One of the features that Widex offers is tinnitus management.  Zen was released in 2009 and has been successful for tinnitus patients.  This is now built into every product in our portfolio so you can offer it to any patient.

We have wireless CROS/BiCROS transmitters in two different styles.  One is a receiver-in-the-canal (RIC) and one is a thin-tube behind the ear (BTE).  For patients with single-sided deafness, you can fit either of those transmitter options on the poor ear, with any Dream product in any style and technology level on the other.

We have a power BTE, should you need a power product with strong speech integrity, as well as Audibility Extender, should you need frequency lowering.  Audibility Extender is built into every product and can be activated through programming.

Product Selection

With this said, what is your goal for that patient?  What is the best possible intelligibility and comfort in noise that that patient can receive, and can you give them access to speech at low, comfortable and high intensities?  Will your patient benefit now or in the future from wireless accessories?  Are there any physical limitations that you can see throughout the course of your testing and counseling?  At the end, make one recommendation.


Cost issues should not be addressed until the recommendation for the best solution has been made.  I have had patients who, before the hearing test or recommendation, asked, “What is this going to cost?”  Refrain from answering this question without knowing what your recommendation will be. 

Remember to make that recommendation and say, “Because of X, I recommend Y.”  We cannot assume what the patient can afford.  If we have focused enough on their feelings and where they need the most help, and if we have built up the benefit enough, the cost rebuttal is going to diminish.  This is an emotional purchase, not a rational purchase.


Many clinicians will use lifestyle to make recommendations.  “What is your lifestyle like?  How active are you?  How often are you in noise?”  While this does work, remember to consider the lifestyle that they had previously or their goal lifestyle.  What types of conversations do they want to have, and what kind of situations would they like to see themselves a part of if they can hear again?

Handling Objections after the Yes


What do you do when you have a patient who commits to moving forward and then never comes back?   Perhaps they get buyer’s remorse or their expectation may have exceeded what was possible for them.

That is where you will have to focus on presenting their discrimination scores, not just the audiometric thresholds.  We need to be the ones to set very realistic expectations based on their performance scores.  That way we know our glass ceiling.  It may be wise when we are setting a realistic expectation to under promise and over deliver; that will lead to more patient satisfaction.

When handling objection, the better you have built up that case and the more you have fostered their feelings of why they are in your office, the fewer rebuttals and objections you will experience. The majority of patients come in seeking advice, so ask them openly what they hoped to accomplish with their visit.  That way, you are both on the same page.

The objection that is the most difficult to overcome is motivation, as discussed before.  If they are not motivated, it is a disservice to proceed.

Follow-Up Plan

When will you see the patient again?  What kinds of expectations are you setting for them in the interim?  What are you asking them to do until the next appointment?  How are you tracking their outcome?  Are you documenting the patient’s initial motivation and discussing it again at the follow-up as a way to document progress?

When you start providing this solution, they start to forget how much they were struggling, because they are not struggling anymore.  Some might even think they are doing so well that they do not need the devices anymore.  It is a good idea to have a discussion from time to time to address ongoing concerns and successes.

New and Returning Patients


There will be differences in how you interact and address new patients versus returning patients.  With new patients, you will have to spend more time dealing with denial, building trust, and cultivating that perception of benefit.

With returning patients, trust and denial have already been addressed for the most part.  They may be focused on improved benefit or perhaps upgrading to different technology.  They will be weighing whether they are getting enough help with the technology they have or if there is something else that will reduce their listening effort.  But they are no longer in denial about their hearing issues.


Are you tracking sales in your office?  I recommend all clinicians do this.  How do we know if we are being successful or helping enough people if we cannot quantify who we are seeing and who we could have helped?  Are you tracking how many patients move forward with treatment and what treatment they use?  If so, do you look at the average selling price?  Are you finding that you are moving enough patients forward with the appropriate technology, or are you moving more with lower technology because that is what you are more comfortable doing?

Be honest with yourself about why patients are moving forward with a lower level of technology.  It could be geographic or economic, which is appropriate, but always make sure that you are not the limiting factor to your patients. If money was off the table, what would you recommend every time?  Make sure that patients are aware of what their best possible outcome could be, and let them decide if that is what is appropriate for them.

How effective are you, and how do you measure this?  Are you measuring things like Tested Not Sold and your customer service efforts?   If you are not tracking these kinds of things, I encourage you to start so that you know the numbers in your own practice.


Keep your focus on the patient’s personal reasons of seeing you as a guide to drive your recommendation.  Offer one specific treatment recommendation that is tied specifically to that patient’s expressed desires.  Talk less; listen more.  Make fewer statements, ask more open-ended questions, and encourage the patient to take ownership.

Track your goals and outcomes and make sure that you are not a limiting factor for patients to move forward.  If there is a topic covered today that made you uncomfortable, take time to assess why.  That is something that your local Widex representative can help you with, and I encourage you to reach out and take advantage of that partnership. 

If you have questions, you are welcome to email us at  Thank you for your time and attention.


Cite this Content as:

Hecker, M. (2015, August). Getting the YES! AudiologyOnline, Article 14762. Retrieved from


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melanie hecker

Melanie Hecker, AuD


Dr. Melanie Hecker completed her Bachelor of Arts degree in Communication Sciences and Disorders from the University of Florida, relocating to Maryland to pursue her Doctorate of Audiology at Towson University.

Dr. Hecker most recently was the lead audiologist at a private practice in Laurel, Maryland. Dr. Hecker’s previous clinical experience has been in an array of clinical audiological settings, including participation in the Cleft Lip and Palate team at the Greater Baltimore Medical Center as well as working with cochlear implant and special needs students in the Baltimore City Public School System. Additionally, Dr. Hecker provided services at private practice audiology and otolaryngology settings in the Greater Baltimore/Washington Metro area.

Dr. Hecker is currently a Fellow of the American Academy of Audiology (AAA), an active member and Treasurer of the Maryland Academy of Audiology (MAA) and is licensed in the state of Maryland. 

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