“But doctor, you pulled the wrong tooth. You pulled a perfectly good tooth for nothing.”

“No I didn’t. I’m going to charge you for it.”

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Profit should not be the prime motivator in the health-care professions, however, there is nothing wrong with selling medicine as long as the health and welfare of the patient is placed above all else. While we think of the plastic surgeon or the cosmetic dentist as the salesmen of the health-care industry, every doctor is really selling something to someone as ignoble as that sounds. Even the oncologist and cancer surgeon are selling their particular protocol and service. After all, who doesn’t go for the second opinion? Most patients don’t understand the medicine, even after you explain it well. What they do understand are the components of bedside manner. If you are the doctor with the great bedside manner, they come back to you. When you have it, you’ve essentially sold them on you as much as, if not more than, the protocol.

Once the student graduates from one professional school or another, they are exposed to an onslaught of programs and lectures explaining how to make more money, spend less time in the office, and do better quality service. The problem with these promises is that the only one accomplishing these noble goals is the person on the lecture circuit who is spending less time in the office, making a lot of money from all the attendees, and providing better quality in that they are not in the office performing iatrogenics.

The big business of medicine is not all bad. Wherever there is a lot of money, innovation and technology flourish. Once dentists realized that they could sell cosmetics and advertise the procedures, money poured into new materials that never might have been developed without the promise of big profits.

In medicine, there are many technologies that may have never come to pass, and new and exciting drugs could never be developed without the extensive research dollars generated by the pharmaceutical companies. The promise of vast riches will make an artificial heart and the cure of cancer realities.

When you develop your selling philosophies and protocols for elective treatment, it is imperative to make sure you are not pushing unnecessary procedures, or procedures your patients cannot afford. There are many lecturers out there telling you how to help patients find the money for procedures that you convince them they need. You have to ask yourself if they need the service or if you are just pushing it past many other things they may now have to do without because you sold them a bill of goods.

Finding patients easy credit for elective procedures may put them in debt for years. You have to be a compassionate practitioner and make sure you aren’t part of the vehicle that takes the patient to bankruptcy.

Before advertising in the health-care professions, patients and doctors had a different mindset. Patients came in when they had a problem and doctors addressed the problem. Prevention and lifestyle was encouraged, but there was little, if any, selling. Now gurus teach you how to advertise effectively, literally chart monthly production, increase sales of the most lucrative procedures, offer financing for better case acceptance, and encourage staff to sell in order to participate in production goals that have to continually go up. This sounds a lot more like corporate America than the medical profession.

You have to ask yourself what distinguishes you as a professional. Patients aren’t stupid. They can often see through all the hype and recognize a pitchman. Your credibility rapidly fades when the patient perceives you as a salesman. It’s imperative to learn that a big part of being compassionate is not selling your patients things they don’t need and can’t afford.

We have gone from an era where doctors weren’t allowed to make claims of superiority to daily advertising that makes claims, direct or implied, that one hospital and their doctors are better than all others. How does that make a patient feel if he just had a prostate operation at one hospital and hears that another hospital has the best technique and way of treating his problem? Maybe it’s time to rethink professionalism.