Diagnosing Sales Issues 

entrepreneurship fix this next ftn for healthcare providers group practice healthcare hierarchy of needs maslow's hierarchy of needs sales level vital need Mar 11, 2021
Female entrepreneur works busily to achieve her sales goals.

“Sales. Sales is what brings us together, today. How do we deal with clients who say, "Frankly, my dear, I don't give a damn... about [healthcare services]" and get them to "Show us the money!" Well, we are going to find out today.

For my die-hard Office fans out there, you’ll have read this nonsense in Michael Scott’s voice (and if you’re really a fan, you’ll also have visualized the scene!). We all know that Michael is a kind of a douche. He’s insensitive, rude, has little to no forethought, and has a way of making situations feel more awkward. He can also be really tender, is hilarious, and he’s a killer salesman. And although we don’t want to be like Michael Scott, we do want to be good at sales.

Why, you ask? Well, let me go on record by first starting the obvious. Sales are a must. Period. We must make sales if we intend to stay in business. If you don’t intend to stay in business, then sales don’t matter and you can stop wasting your time reading this. No hard feelings. 


To Correctly Understand and Run Your Business, You Have to Know Where You Fall On the Hierarchy of Needs

I’m pretty much positive that I’m not alone in this, but have you ever felt like you were trying to figure out the problem in your business and you had no idea where to look or what was going on?

I remember at one point feeling like I was staring at a giant ball of colored wires, seeing smoke coming up from the middle, but clueless as to which wire was smoking and no idea how to fix the problem. It can feel so damn disheartening.

You (and I) just want to build something with integrity and that provides for people, and the thing we end up with is a fahking mess. Those experiences are humbling, to say the least, but they also really leave me feeling lost, agitated, overwhelmed, and a little bit (fine, a lot) hopeless.

It sounds so cheesy, but I reeaallyy just needed something to help me figure out where to start. Some sort of framework or model for the important variables and assessing which variable is going awry. 

I’m a therapist by training, so I place value in having a theoretical groundedness when I work with clients. But that wasn’t something I had when I was assessing my business. I was basically just shooting from the hip and hoping for the best.

And then, just like that, gently falling from the sky on a silver platter was a beautiful framework that made sense, was functional, didn’t require 1000 years of business school to understand, and was able to be rinsed, washed, and repeated ad nauseum.

[Okay, so maybe the true story is that I was force-fed by Kasey because I’m stubborn as hell and she knows it. But once I ‘got it,’ I was sold. Please learn from my hard-headedness.

My purpose in writing all of this is to say, “I get this and I can help. Please trust me enough to keep reading and try it out for yourself.”

Think about it like this. If I said, “Hey, I’ve got a way for you to quickly assess what the bottom-most need is in your business,” would you ignore me or would you say, “ooh, tell me more"? Hopefully, you’d say, “ooh, tell me more.” And even if you didn’t, I would still tell you more (because those closest to me know that I can’t keep my mouth shut about things I love #TooBadForThem #ILoveCoolThings #SorryNotSorry).


What is the HHN and How Does It Connect to Sales?

What you might not know is that we have something called the Healthcare Hierarchy of Needs. It's based on Maslow's Hierarchy of needs and similar to Maslow's, the HHN houses all the core needs that a business has. This is what you should be after. 

The Healthcare Hierarchy of Needs (HHN) is broken down into five levels, just like Maslow’s original hierarchy. The HHN is also similar in that you cannot exceed the lowest level that is missing a core need. 

Let me repeat.

You cannot exceed the lowest level that is missing a core need. 

Got it? Perfect. Let’s move on.

The lowest level is sales. The second level is profit. The third level is order. Stop rushing me — we’ll get to all the levels. But today? 

We’re going to focus on sales.

There are five core needs within the sales level.

Here's how it works:

  • I'll ask you five questions.
  • If you cannot say “yes” with 99.5% accuracy to any of the following questions, then you should say “no.”
  • When you say no to one of the questions, you have identified a vital need.
  • If you’ve said “no” to more than one, that’s okay (happens to the best of us), and all you need to know is that the lowest-numbered question where you’ve said “no” is then the vital need.
  • If you’re saying “no” to a question below, then that means your vital need falls within the sales level, and you’ve got a sales issue.

Boom. First problem solved (that is, we've solved the problem of not knowing what the problem is). And until you solve the real problem, then you can’t move past this level.

Keep in mind, sales level is equivalent to Maslow’s physiological needs, and that’s because sales breathe life into your business. You’ll suffocate without them. 

 The Five Core Needs In SALES

Ask yourself the following five questions. These are the five core needs that fall within the sales level. Don’t answer “yes” automatically without thinking about these. I’d even encourage you to ask yourself, “how do I know this is a yes?” each time you respond yes.

This is an entirely different post I’ll write about, but please know that the point of this isn’t to quickly run through the questions - you should genuinely think about each one as you’re going through them.


1. Lifestyle Congruence

Do you know what your practice’s sales (billable sessions) must be in order to support your personal comfort level?

2. Prospect and Provider Attraction 

Do you attract enough clients to support your level of needed sales for a profitable practice (20% net or higher), and do you attract enough providers to support the sales demand?

3. Client Conversion

Do you convert enough of the right clients to support your level of needed sales?

4. Delivering on Commitments

Do you fully deliver on your commitments to your clients?

5. Collecting on Commitments

Do your clients fully deliver on their commitments to you?


Determining Your Diagnosis

If you answered no to any of these questions, then you’ve got an answer for where you need to start focusing, and you’ve identified your vital need.

If you’ve answered no to two or more questions, then remember that your vital need (and subsequent focus of all your energy) is the lowest-numbered question.

See? We’ve made it simple for you. Maybe hard in that reflecting on the truth hurts, but simple in that it’s simple to put into practice.

Additionally, if you’ve been wondering, “what’s wrong with my business right now? Why aren’t we (fill in the blank)?”, then you now have the idea of what the problem is and where you need to focus your time, attention, and energy.


The Healthcare Hierarchy of Needs Is Your Guide

Here’s what this doesn’t mean.

It doesn’t mean that all of the other levels aren’t functioning.

The HHN just gives you a sense of the specific thing that is going wrong and wreaking havoc; it doesn’t mean that everything else is wrong. If you answered “no” to three of the sales-level questions, that doesn’t mean questions on all the other levels are going to be “no.”

This is a lens for figuring out the issue - it’s a way to diagnose your practice. Further still, it’s a way of having immediate focus and narrowing your energy, time, and attention to the actual issue, rather than all the bullshit that we get caught up in.

Once your vital need gets taken care of, then you might hop all the way up to impact (assuming you can answer “yes” to all the other questions in profit and order). 

This isn’t an answer to solving the vital need problem right this minute, but it’s a guide to figuring out what your problems are. And right now, we’re focusing on sales (with a primer for the HHN), because without sales, or a physiological business need, then we’re screwed. 

We need sales to survive. If we don’t have them, we won’t stay open, we won’t be able to provide jobs for people, and, worst of all, we won’t be able to be of service to clients or patients. Take time to assess your business using the questions above and pinpoint specifically where you need to focus your efforts, and then stay focused until that core need is met and you can move on to the next vital need or, hopefully, level of the HHN. 

It takes hard work, but I know that’s not something you’ve shied away from yet. And I can promise you that being able to recognize that your sales level is out of whack is just one of the many benefits of having the HHN as a diagnostic tool for your business.


Tara Vossenkemper, PhD, is the founder and owner of The Counseling Hub, an accidental group counseling practice in Columbia, Mo. Once the practice took off, she dedicated more time to the admin side and found she loved that equally - creating and tweaking the dashboards, formalizing the structures, cultivating the culture, and thinking about the near-endless possibilities for creative growth. Tara has since stepped into consulting in a more serious capacity, setting out to ensure that practice owners know both what they need to do and how to do it. Tara's favorite consulting-related topics center around tracking, culture, structure, and diagnosing core issues.
Tara is known for her colorful language (#PuttingItNicely), love of The Office (#USVersion), neuroticism around dashboards (#FormulasAreLife), and hashtags (#AllDay). When she's not in the office, Tara can be found hanging out with her husband and two young sons, probably drinking a glass of red and wishing it was quiet enough to read.

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