The Art of Confusing a Customer

This week I had to go to the tire shop to get a little puncture in my tire repaired.  While I was hanging out waiting on the work, I overheard one of the salesmen explaining tire options to a lady. 

Apparently her Mercedes sedan used 225/45-17s on the front and 245/40-17s on the rear wheels.  But if she wanted, she could go with the 225/45-18s on the front with 245/35-18s on the back.  But then she would have to get eighteen inch wheels, which shouldn’t be a big deal if she traded in her 17s.  The Yokahamas were studless winter tires, but cost about $50 more than BFGoodrich’s speed rated tires.  Did she know about speed rated tires?  No?  Don’t worry about it.  Anyway, the Bridgestones had a longer warranty, but cost $20 more per tire and would need different wheel-mounted pressure sensors.  There was a cheaper Bridgestone tire, but it wouldn’t work on the eighteens they were talking about.

Something like that.  The dude went on offering confusing options for about fifteen minutes.  I quickly became confused by all of the jargon and choices.  Apparently the customer did, too.  (You did too, I bet.  Didn’t read all of that paragraph, did you?)  She extricated herself from the salesman, saying something about needing to sleep on it.  I bet she just went to another shop where someone competent helped her.

This salesman offered her too many choices, based on technical information that she didn’t understand.  There is no way for her to understand the relative benefits, costs, risks, and sizes in all the different combinations.  Nor did she need to understand all of that.  Do you know why she doesn’t need to understand all of that?  She isn’t a tire salesman!  That’s what we pay tire salesmen for!

I’m not a tire expert.  The last time I had to buy tires, the salesman asked what kind of tire I wanted.  I said, “Black ones.”  My knowledge was exhausted at that point.

Dude, I don't even know.  Is that the right size for a Honda Civic?  I mean, at least it's black and all...
By Greencolander, via Wikimedia Commons

The salesman should have learned what the customer needed and then offered his recommendation.  Did she drive long distances at highway speeds, how much winter driving did she expect to do, that kind of thing.  Using that information, he (the expert) could know the two or three best options for the customer.  The customer still gets a choice, cheaper with short warranty or more expensive with long warranty, that kind of thing.  But the lady wouldn’t have been overwhelmed.  If the two or three options he offered didn’t work, move to the fourth one.  He shouldn’t have shotgunned choices at her.

The same thing happens in EMS.

We need to inform people of technical information all the time.  But most of our patients are not medical experts. It is difficult for a non-expert to accurately weigh the risks and benefits of a given choice, multiplied by the relative odds that condition such-and-such is even what they have going on.  When you add in fear, uncertainty, embarrassment, and pain, the ability to make complicated choices becomes nearly impossible. 

People get confused.  Experts need to de-confuse people by giving them simple information. 

I use this phrase all the time: “If it were me…”  Repeat after me: “If it were me…”

“If it were me, I would stay home, rest, and take some ibuprofen.  There is always a slim chance that something terrible is going on, like a one in a million broken neck.  But in my opinion, based on everything I see here, the risk of that is really low.  It is common to be sore after a jolt like this and it usually better after a day or two of rest, ice, and ibuprofen.  How’s that sound?”

“If it were me, I would send him to the hospital in the ambulance.  This could be something minor like a breath holding spell, but I don’t like to mess around with breathing.  Breathing is important, right?  If you let me take your son, I can keep an eye on how he is breathing and intervene if it comes to it.  How’s that sound?”

“If it were me, I would probably get my wife or a friend to drive me to an urgent care.  They can shoot an x-ray and take care of it if it is broken.  It would be a lot cheaper that way, too.  But if you want come with me to an ED, it is probably more expensive but I can give you some painkillers to help you feel better on the way.  It’s up to you, based on how much pain you are in.  But one way or the other, you need to get to a joint with an x-ray.  What do you think?”

Give people your honest opinion.  You are an expert.  Work in their best interest.  You have an opinion.  Let them know that it is your opinion by using the phrase “If it were me.”  But you have to give people your expert opinion of what is going on.  Tell people what they should do.  If you don’t know something, tell them that you don’t know. 

Base your opinions on what would be in the best interest of that patient.

People still make choices opposite my opinion all the time.   I’m actually okay with that.  Information is what patients deserve, so that they can make decisions.  Give the information, show them the best path based on your training, knowledge, and experience, and let them make their choice.  Don’t be the tire salesman, spreading confusion in your wake.