Many of my first conversations with potential clients are about adding a new service to the practice. This usually means the need for equipment, training, possibly new staff, and marketing. Looking at the testing, services, and therapies that are being referred out is a good way to determine what ancillary services a practice that is interested in increasing revenue and patient satisfaction should consider. Many value-added services seem like a natural fit but this does not mean they are guaranteed, money makers. Any new service to an existing business carries many of the same risks as a new business, including the need for more capital than expected.

A recent client decided to add a comprehensive hearing center to his ENT and allergy practice in Northern Florida. He successfully integrated allergy testing and treatment to his practice a few years ago and the hearing center seemed like the next obvious way to grow. He expected his patients to appreciate the convenience, to gain new patients, and increase revenue.

Initial capital was needed to incorporate a small office space that was available next to the existing office, purchase equipment, and hire a hearing specialist. The first difficulty was in finding a good hearing specialist. The hiring process took longer than expected while the initial rent and payments kicked in. In a follow-up call a few months later with the practice manager, I learned that sales were not coming in as expected. The doctor expected patients to purchase hearing aids and other devices. He did not expect to be competing with “big box” stores selling these items for much less. Several patients that had testing, came back with hearing aids purchased elsewhere, asking for help in how to use them. Others had family members purchase them online and when they weren’t satisfied, ask to bring them into the practice for help.

I spoke with the doctor and discussed ways to have the hearing aid specialist educate the patient during the visit. It needed to be explained to the patient that these devices are specifically programmed for their ears. Also, these devices are the ones the practice is trained to program and can fix if something goes wrong. The hearing specialist was not trained as a salesperson but had to be comfortable educating the patient and also discussing financial limitations.

Sales picked up moderately but were not close to the doctor’s projections. With a two year commitment on the additional office space, breaking even on the hearing center made sense for the time being. Six months later, the doctor was weighing the risk and potential benefit of replacing the hearing specialist with someone more able to complete the sale as it was clear that potential revenue was not being realized.  As someone with experience in motivating a sales team, I suggested the doctor offer an incentive to the hearing specialist for selling the devices. We came up with a possible commission structure for the practice manager to review.

The practice manager loved the idea of motivating staff through incentives and within a short time, not only implemented an incentive structure for the hearing center, but also for staff charged with appointment setting and re-engaging patients.