Up-sell, Cross-sell
Jay Abraham tells a story about a doctor that increased profits by $4,000 per month simply by offering discount flu shots when patients came in
for any reason. This is something people may think about when at home, but will not prompt a visit to the doctor’s office for this sole reason.
Plastic Surgeon: When someone gets a face-lift they affirm their commitment to looking their best, haven’t they? What else might this person do
to improve their appearance? Perhaps they will want a breast enhancement or eye tuck or thigh treatment?
In addition to “enhancements” the plastic surgeon does, these patients may also want their teeth whitened. The doctor can suggest a great
dentist to their loyal patients. How about their spouse, does he need a tuck here and there?
Referrals
Letter
Dear Mr. Johnson,
Mary Smith has been a customer of ours for the last 3 years, and she suggested that we offer you our free comprehensive eye exam on
her behalf so you could see for yourself how different we are. (self serving benefit headline).
We currently have a minimal number of openings in our practice (scarcity). Rather than advertise to unknown people, we have asked our
clients for the names of some high quality people we would be proud to make part of our family of clients (reason why) (specific benefit-
special service).
Enclosed you will find a certificate for a “Free Comprehensive Eye Exam” for one member of your family (self-serving benefit).
Simply present this certificate at the time of exam and you won’t pay a dime. (specific action they must take) It is our belief and conviction
that once you experience the level of service we provide, you will want to bring in the rest of your family and refer us to others as well.
(why)
Our services include a one-day turnaround on your glasses or contacts. We even deliver them right to your home or office. We have over
500 styles in stock and have access to over 2,000 more that we can get within 2 days. (benefits)
Dr. Smith is one of only 6 Chicago area optometrist to be certified in” laser optic vision correction” a technique that immediately corrects
most patient’s vision so they no longer need to wear corrective eye wear. (specific outcome/services) (disclaimer)
To take advantage of our Free Exam, simply call us at 555-1212 to schedule an appointment. (specific action they must take)
We look forward to seeing you soon.
With warm regards,
Smith Optometry.
PS If you are already committed to another eye care professional, please pass this certificate on to a friend, neighbor or family member
that you feel would appreciate the gift. (Leverage the referral)
You can dramatically add to the effectiveness of the letter if you ask for one personal note about person your client is referring – this
enables you to really personalize the communication.
By the way, since you are dealing with people that your clients referred, and especially if you are offering an incentive, it can be very
powerful to say this on the outside of the envelope.
• “ Bill, a gift from Mary Jones. An $85, no obligation, comprehensive eye exam for you or a family member”.
Letter/Postcard
You may decide to elicit referrals from your clients in a direct mailing. Especially if they come in infrequently. In this case, the offer can be
quite short, something like this:
“Get Your Next Set of Glasses for FREE” (self serving headline)
Simply refer us to a few of your friends, neighbors and relatives and for each one that becomes a client we will take 25% off you next set
of glasses, including the exam. Just refer four families and your next pair of glasses are absolutely FREE!” (Specific benefit and action
you will take).
Simply fill out the information below and drop it in the mail – the postage is on us! (Specific action they must take)
We will include a “Free First Exam ($85 value)”, on your behalf, for each person you refer! (The reason why)
PS We will send your 25% savings certificate when one of your referrals becomes a patient. (PS – reiterates compelling offer)
Of course the “why” you use is obvious and the risk elimination is built into the fact that it is free.
Referrals Cont.
So what is the financial impact of implementing this strategy? Let’s go back to the dentist example I gave earlier. He had acquired 4 of the 49
families that live in my neighborhood – really just the ones that talk most often. Therefore, the potential clients in the neighborhood are
incredible.
Let’s use this illustration to determine the marginal profitability of implementing a Neighborhood Referral Program in just this one neighborhood.
• We said that this dentist’s Lifetime Value for the average patient was $6,000.
• Let’s further say that the dentist has 500 patients and he “guesses” that 20% will give a testimonial or agree to write an endorsement letter to
send to their neighbors.
• And of those 100-willing patients, 50% live in the same neighborhoods, so we don’t want to count them multiple times. This leaves about 50
neighborhoods to implement the program within
• O.K., going back to my neighborhood of 49 homes, let’s say that out of the 44 non-patient neighbors only three try the dentist and two become
patients.
• Note, currently he has 100% of our cul-de-sac so it is not inconceivable that the number of families in our neighborhood could reach 15-20
• Those 2 clients will generate = $12,000 in Lifetime Value
Expanding this success to the 50 neighborhoods in this dentist’s service area will generate over $600,000 in profit over the next 5 years! And
what did it cost per neighborhood? Perhaps $100 or so for the series of letters he will send, and some incidental costs involved in doing the free
check-ups.
Expanding Customer Purchases
A Wellness Physician I know has over 3,000 patients; some come on a preventative health basis, and the balance come only when they are ill.
This doctor stocks a premium line of vitamins and minerals, which he prescribes only for specific patient concerns. He may reach 10% of his
patients in this way. This means 90% of his patients are completely unaware of the incredible benefits of these vitamins. Unaware of the fact that
they are five times more absorbent and have a molecular structure that binds them to the cells 80% more effectively than standard vitamins–
something like that. I don’t remember the specific “techno” benefits.
The point is that this doctor is really passionate about the benefits of these vitamins – to the point of getting intense when he talks about the
“garbage vitamins” that companies sell at the local stores – including health stores. What if he wrote a letter to the 90% who don’t buy these
vitamins? Passionately educating them on the benefits, more energy, better memory, less disease, and offered them a special introductory price
and 100% guarantee – would a large number of these patients buy? You bet!
These patients have already shown that they are into alternative health, so they are the perfect audience. And more importantly, and this is
critical, they trust the doctor! Many of them probably are currently buying the “garbage vitamins” he described and spending similar money. If
only 5% of his patients purchased just $40 per month in vitamins, he would generate $75,000 per year in revenue and $25,000 in profit - over
five years these profits reach $125,000!
Now, let me ask you a question, would these patients be open to other such health-oriented items that the doctor recommended? – Absolutely.
Especially if each item he recommended was of good value and delivered the benefits he promised.
And here is the critical part. Are his patients better off because he made these vitamins available – Yes! Are they endeared to him even greater
- Yes! Are they more prone to refer him – Yes! Are the inactive patients more apt to come back to him -Yes!
An Orthodontist can educate his patients (the parents or adults) on having their children come in at a younger age to get preventive work done.
He can offer to put braces on the parents – even educating them on the “invisible braces” that are available. He can also tell his patients about
other appearance enhancements – decorative eyewear, teeth whitening and plastic surgery, and recommend other health care professionals to
his trusted patients as well.
Going back to the Wellness Doctor that we discussed earlier, if he tracks his patients by specific ailment (back pain, arthritis, headaches etc.},
he can recommend specific vitamin and mineral supplements to specific ailment groups.
Example Letter: For your clients that you are reactivating
Dear Bill,
It has been almost two years since your last physical. With your history of heart challenges, we recommend a complete evaluation every
two years to ensure we keep you in perfect health. (A specific self-serving benefit headline, reason they should get service, and specific
outcome.)
The exam will cover a general physical, a stress test, a chest x-ray and complete blood work. (The specific actions you will take.)
As the process will require two visits of about an hour, I suggest you call us now to ensure availability that works best for you. (The
specific action they are to take.) If you want to bring Mary in for a check-up as well, I will waive the $20 co-payment. (Price incentive.) In
addition, I just came across the best low-fat cookbook I have ever seen. The dishes are really tasty, what a concept, and quick to make as
well. Remind me when you come in and I’ll give you one as a gift. (Bonus)
Let me take this time to share with you how much I appreciate your and Mary’s business and the continual referrals you have provided
over the years.
To your health,
Dr. Raymond Johnson
PS Are you still staying with that exercise program we set you up on?
This letter is very personal. Don’t you agree that this would motivate action? One Critical Distinction I want to mention. This follow up
process is not time consuming! The doctor can write a template letter designed to be sent at the appropriate times to the group of
patients that have heart conditions. Then he can simply modify the personal remarks, by using a tape recorder to add a personal note to
each patient’s letter. The clerical staff can then prepare the letters. If the doctor can personalize 20 patients’ letters in an hour, and if this
results in just 2 patients coming in for a $1,000 evaluation, that’s $2,000 per hour (and I will spare you the cumulative effect of the
expanded referrals etc.).
For example, a doctor may have a monthly health letter that reminds patients of the upcoming flu season. They can also send a
newsletter that promotes “Preventative Health” actions such as cookbooks, vitamins, wellness classes and so on.
Orthodontists: Often patients will want their teeth bleached after their braces will come off. If you don't set them up ahead of time to have this
done, they may leave your office and look to have it done elsewhere. You can lock in this extra business by informing the patient at the initial
consultation and again before the braces come off that you offer a bleaching service and because they are already in the office, they can have
it done at a less expensive price than another office will be able to do it for. Do some research and show the price comparisons. Expect a patient
acceptance of about 80%.
Strategic Endorsements (a.k.a. JVs)
Orthodontist -- Since he is really an “Appearance Enhancer”, as he straightens people teeth, his clientele will probably be interested in dental
services -teeth whitening, caps, general dentistry, and also these people are high users of other appearance enhancements, plastic surgery,
cosmetics, hair, etc. The Orthodontist can endorse a host of other “appearance specialists” to his clients and have them reciprocate as well.
For the Wellness Physician that offered his patients the premium vitamins, she can also include a special travel pack and a 30-day money back
guarantee if the patient doesn’t feel more energetic and healthier. Once again, we are stacking the deck. In this case the physician should insist
on the manufacturer extending the warranty so it really cost her nothing.
Letter
The physician offering the premium vitamins might write a letter as follows:
Dear Bill:
I have seldom been so utterly impressed with a product for improving health and vitality that I felt compelled to recommend it
wholeheartedly to my patients. (Self-serving headline – who doesn’t want health and vitality)
Over the last year I have been recommending state of the art nutritional supplements to my patients that have had specific health related
conditions. It recently occurred to me that I am doing a disservice to all my other patients that want to improve their general health.
These supplements represent a scientific breakthrough in my opinion. Why? Because typical vitamins, including most you find in the
health food stores, only have an absorbency rate of 20%. That means 80% of the benefit is lost. However the Supplements 2000 line
achieves a remarkable 50%-85%. In addition, they are coated so they are easy to take and have no bad taste. (Specific benefits of the
product-reason to buy) These supplements are available only through physicians – so you can’t buy them in a store – which by the way I
feel is ridiculous. Therefore I have gotten the folks at Supplements 2000 to agree to let me offer them to all my patients. (The reason they
should purchase the item and why from you)
In addition, so they are affordable to you that I have gotten them to allow me to offer them to you at 25% off. (Incentive-benefit from
ordering from you)
Although, from the results I have experienced with other patients I have the utmost confidence that you will be thrilled with these
supplements, I insisted that the company unconditionally guarantee 100% of your money back if you don’t feel noticeably more energetic
and just plain healthier. (Risk avoidance)
Enclosed is an order form for you to fill out and send back to us. We will then order these for you so you get the full 25% discount. You
will receive your order in about two weeks. (The specific actions they should take and the actions you will take)
Plus, for the first 100 of our patients that order the company will throw in a $25 travel supplement pack for free. (Value added bonus)
Let me take this time to share with you how much I value your business and hope my discovery can help you and your family live a
healthier life.
To your health,
Dr. Raymond Johnson
PS. The incredible thing about these supplements is the fact that they are so much more effective and yet cost less than the premium
supplements you find at the health food store.
Now, I am making up this letter on the fly and the facts and circumstances are purely fictitious – but I want you to get the gist of the letter –
you will embellish the benefits you listed about your product or service. If you are delivering the offer at the point of sale or via
communicating by phone, you will need to crunch down this script so it is shorter but hits all the same points.
Let’s continue with or physician example. The first thing she must do is to determine at what price she will offer the supplements to her patients.
This first involves determining how much profit she will be satisfied with per patient. Once this is established she then must negotiate with the
supplier for the best price based on projected revenue. The combination of these two dictates the price. For example, let’s say the Doctor
wanted to earn $10 per month per patient. If the monthly cost of the supplements were $50 retail, and she had a $30 cost basis, then she could
offer them for $40 and earn the $10 profit.
Now if she could get the company to reduce her cost to $25 due to volume, then she could either lower the price to $35 or pack the offer with $5
in value added bonuses.
If a dentist is sending five families a month to the orthodontist, then he ought to handle the braces for that dentist family or extended family for
free as long as it is justified. Now in reverse, the dentist may only get one family per month from the orthodontist. So the dentist may provide free
dentistry for only one family member based on this volume.
Medical Specialist: If you are a medical specialist of any type, write a small brochure to educate people on how to cure/treat your area of
specialty. Place these brochures in the waiting rooms of other doctors. You can also offer the brochure on the radio or on talk shows.
Laser Marketing
Let me use a story I heard at a Jay Abraham marketing seminar to illustrate the impact of changing from mass to target marketing: A Cosmetic
Surgeon ran costly ads in the Los Angeles Times. Of the almost 1,000,000 reader, only about 1,000 represented his targeted customer. He
decided to more closely target his specific demographic group by advertising in the upscale LA Magazine. The ads were focused on the benefits
the client would derive -i.e. how they would look and feel and offered a Free Tape that included actual patient endorsements. The result was a
300% increase in business with half the investment!
If a dentist knew which families were new to the area, and therefore needed to find a dentist, she could easily justify providing a “Free first dental
visit” – since the likelihood that they will remain a customer are very high. In contrast, she would get overwhelmed with families that would take
advantage of her offer, with no intent of coming back, if she made such an offer to the general public (mass marketing).
Other Ideas
1. Joint venture with businesses that also focus on helping people become more beautiful. Look for to plastic surgeons, then to optometrists and
dermatologists. Agree to put each other's brochures on the reception counter. Finally, you can go further afield and do the same with beauty
parlors and even jewelry stores.
Dentists
2. Help your patients get into a continuity program that promises them a better, whiter smile. Give them a risk-free offer; for example, if they are
unhappy with the program for any reason, they can get an additional year for free. If you can sell people on a continuity program, then you
make money every month.
3. Take service to a whole new level.
- See the patients on time
- Offer stationary for people to write letters if they have to wait
- Offer a menu of drinks (water, juice, tea (hot or ice), wine (red, rose or white)
- Put turkish cotton hand towels in the bathroom and change them frequently.
- Provide diapers in the bathrooms, or let the parents know that you have extra if needed.
4. Pay your staff a percentage of actual collections, taking into account service/ employment, the number of employees' multiplier, number of
hours worked, etc. They will be more driven to help the business succeed and you will have created a win-win situation.
5. Don't be afraid to be a little outrageous. For example, buy a giant tooth balloon and put in on your roof. You need something to stand out.
6. Offer local schools a free seminar for their students on how to keep your teeth for life. Make it really fun. Give a prize for the student with the
best teeth ... and ... the least number of teeth. Make it memorable. For example, you could give a free toothbrush to every student (with your
name and address on it).
7. Doctors: This is a small idea but works well to generate some "pocket money" for you. Send your patients a newsletter every month and
create a "Community Board" in your office. Perhaps there are 1,000 patients in your database. Approach local businesses and tell them that
you have a monthly newsletter that goes out to 1,000 people every month. Tell them that it will also be going out to the local businesses in your
geographic area (them included). Offer them the chance to have exclusive placement in your newsletter for just $25/month. If you sign up 24
business, you will generate an additional $600 per month. It may not seem like much, but it will help with a couple car payments. (You can hire a
college student to make these sales for you and compensate him accordingly.)
Dentist, Physician, Plastic Surgeon,
Optometrist, Orthodontist