The Importance of First Impressions in Healthcare

Welcome to the Practice Builders Podcast hosted by Dr. Vince Leone and Dr. Kyle Pankinen, your source for building cash services. Let's dive in. Hello, everybody, and welcome to the Practice Builders Podcast. My name is Dr. Vince Leone.

And I'm Dr. Kyle Pankinen. We're excited to have you with us today. And we think we have a great topic. So, Dr. Leone, I'm gonna let you introduce that topic, and, uh, I think we're gonna— I think you're gonna get a lot out of this today.

Absolutely. So the title of this one roughly is, Do Appearances Matter? Hint, yes. 3 Strategies to Enhance Patient Experience. And, you know, we all know the, the adage, or whatever you want to call it, of, you know, um, don't judge a book by its cover. The problem is everyone judges everything by appearance, right? We judge, you know, if you walk into like a Mercedes showroom or a Honda showroom, you're going to judge, you know, you're going to be a little judgy on that. Wow, I like that Mercedes showroom better. Um, or if you see someone dressed in rags versus someone in a suit, you're going to make assumptions. And so why would it be any different in a doctor's office? And this is honestly, Doc, This is one of the easiest things that we can do to increase patient compliance, increase patient conversion, increase referrals, and it's just so simple. So the, the 3 areas that we're going to cover, uh, is the doctor's appearance, the staff appearance, and the office appearance. So let's dive in. We're going to start with the doctor's appearance. And Dr. Kyle even has research to back us up on this. I love it.

This is really cool. This is actually a brand new study, uh, published, uh, just this year in Chiropractic and Manual Therapies 2025. The title of study is Patient Preferences for Chiropractors' Attire. And they did it at a university-based clinic. And the— just going to read a few tidbits of this, but I'll get to the— I'll get to the meat of it. And this will be very applicable to you doctors listening to this. So it says there's a significant body of research that has examined how the attire of physicians and nurses affects patient perceptions, preferences, and outcomes. Well, this is the first study. where it was specifically addressed to chiropractors and chiropractic patients. And there were 4 different attires that they evaluated in the study: casual, formal, scrub, or white coat.

Now, would casual just be like, you know, like khakis and a polo or And then formal would be essentially like maybe slacks, shirt, and tie, or a suit potentially. Yeah, my dad used to wear a suit back in the '70s. He wore a suit and he had a little red rose here on the left lapel. That's hilarious. Uh, he got known for that, by the way. He was known for his red rose. Interesting little tidbit there. Biggest practice in Washington back in the day. Anyways. Moving on.

Yeah. So, and then of course the scrub, that would be, you know, what a lot of medical facilities, and then the white, the traditional, the white coat.

Right, right.

And, uh, there were 75 new patients that participated in the study. Interesting. So the results, the results indicated a strong preference for scrubs for both male and female chiropractors. Chiropractors in scrubs were also seen as more knowledgeable, trustworthy, competent, professional, and comfortable. This was closely followed by those wearing white coats and formal attire. Notably, this is interesting, notably the white coat worn by the female chiropractor received significantly more positive ratings than when worn by her male counterpart.

Hmm.

Conclusion: our findings suggest that chiropractors' attire influences patient perceptions and should be considered in the development of dress codes for public and private clinics. So, here's where the rubber meets the road, docs, I think. If you're one of those docs that is confident and you exude confidence and you are highly skilled and you can attract patients, probably what you wear doesn't make maybe that big of a deal.

Mm-hmm.

But if you're a little lacking in confidence, you're young in practice, you maybe don't have your clinical skill set as good or as high as it should be, this can really be a game changer. here just by throwing on some scrubs, or in the case of females in the study, wearing the white coat.

Hmm.

Can really up your image amongst your patients, and they're gonna feel, they're gonna feel more confidence in you. They're gonna feel that you're an expert, that you're well trained, you're knowledgeable, competent, all those things just by changing a little bit about your A lot higher. And that can make the difference between, especially in the world of niches like Dr. Vince and I live in, that can mean the difference between a patient saying yes to your recommendations or saying, nah, I think I'm going to think about this. And, uh, that— so that can make a difference between having conversions and non-conversions, which over a course of the year can mean thousands and thousands of dollars of potential lost revenue. All because of your attire.

I, I couldn't agree more. I think this is one of the easiest things under our control to increase conversion and confidence. And, um, I— when I was offering, just starting offering neuropathy, and I was asking for $3,500, that was my care plan price, I wore slacks A button-down shirt, a tie, and a white coat. And I, in my opinion, I wanted to be the best dressed in the room. I didn't want to— I looked young, you know, thank you very much. I'm 52 right now, uh, feeling 45. But regardless, the, the gist of this is it's, it's such a no-brainer to just go get scrubs. Everyone, like, here's the recommendation, just go get scrubs. You get scrubs, get your name initialed on it. Um, and personally, I don't really care where your confidence is, because if you want to look like the doctor and, you know, have that conveyed to your patient, just wear scrubs, right? Then what's also nice is you can wear nice and comfy shoes because you're on your feet all day. So that's kind of a functional aspect of it. And then I would wear the white coat in the ROF, right? When you're adjusting, you don't need to wear the white coat. Throw it in your office, throw it over the back of the seat when you are out adjusting. But in your ROF, scrubs, white coat. Don't get the long butcher coat, you know, get the, get the, you know, either the sport coat one or the one that's slightly longer. And again, get your name and clinic name embroidered on that as well. Make it look professional. And you will See a difference 100%, especially if you're young in practice. But if you're older in practice and say you're offering these niches and, and you're not getting all the conversion that you kind of anticipate, this would be a really easy thing, really easy thing to make a change ASAP, right? Um, and, uh, you know, so that's number one, doctor appearance. We have the data Backing it up anecdotally, I just always thought this is a no-brainer. I mean, what do you think about, about that, Dr. Kyle?

Well, just proves you were cutting edge even before your time, Dr. Vince. The research finally caught up to you, my friend.

Finally. By the way, you can look back in my old training. This is one of the first things I told doctors to do— either scrubs or a white coat and a shirt and tie. So, anyways, it's, again, no-brainer. If you're young in practice, if you're young in niches, if you're having issues with patient compliance or conversion, this is the first thing to change.

Amen. That's a great point. And it kind of leads us into our next area. So, we talked about doctor appearance. Well, staff appearance. Well, one easy thing you could do to enhance staff appearance is to have them wear scrubs as well. And so we sometimes do see that in many offices where the whole team is in scrubs. And like you said, the names embroidered on there, they got their own name, clinic name on there. And basically it just amounts to what color are we gonna wear today? Yeah.

We would have our, our girls would, um, um, you know, obviously all coordinate, right? They all would wear— they all had 4 different colors, right? Uh, there was like a pink, uh, a maroon, blue, and black. And so then they would coordinate the night before. Hey, what color are we wearing tomorrow? We're wearing this. Great. So they should all be in the same color, but your team should be in scrubs, right? Because, well, couple things. It It's going to eliminate and make their mornings easier. Now, if you think that, well, why do I care about their mornings being easier? Well, because their attitude and their mood coming into the clinic— I mean, it's, it's— there's a whole thing called decision fatigue. That's why, like, Steve Jobs wore a black sweater every day, because he didn't want to even have to think about what he would wear that day, because he felt he had better things to think about versus what am I going to wear today. Um, so take that decision out of your staff's, um, hands, right? Make it really easy for them. Get them, you know, 2, 3, 4 different sets of different colored scrubs. I personally don't think that they need to have their names script and, uh, you know, on there. Having the name of the clinic on there, I think, would be good. Um, but I don't really necessarily feel they have to have their name on there. Um, but it certainly Makes it look more professional. You know, you just never know how people are going to dress. Sometimes it's really nice, sometimes it's not so much, sometimes it's a little risqué and you're like, no, no, no, that's not appropriate in a doctor's office. Then you have to do correction. It's like, just simplify, simplify, simplify, um, and get them in scrubs.

Yeah, and it takes out some of the variability because over the years I've had some staff, some of them dress up Very nice, and some of them dress up like, really, that's what you're going to wear to work today? And so it kind of puts everybody on a level playing field.

100%.

And, uh, so I, I like the concept of it. I like the research behind it. And, uh, I certainly think it's something that those listening should give strong consideration to in their own clinics. Which brings us to point number 3.

Point number 3, appearance of the clinic. Now, this is massive, right? And this starts in the parking lot, by the way, because people start making first impressions. They start making first impressions the minute they see your ad or they hear about you, right? So, if their friend refers you to them, they're probably going to go online, look at your website, They may even dig into your social media. Hey, is this guy a creep? Like, you just never know. There's so much available to people, but we're just talking about locally. So your parking lot should be clean. In other words, it shouldn't be cigarette butts and trash and all that junk laying around, right? That's a bad look. So get that, get that corrected. When they come into your office, just start thinking like What do they hear? What do they see? And what do they smell? You know what I'm saying? So why don't you kind of dive in there a little bit, Doc, and give your thoughts on patient perception as they come into the clinic?

Yeah, I think the first thing that most people are going to notice is a lot of people, they've traveled from a ways. Where are they going to go to? Where's your bathroom? And that's true, they come in and, where's your bathroom? And so Your bathroom's got to be immaculate. Amen. Clean as a whistle, almost that you would, uh, you would lick the counter. But no, you wouldn't do that. But, uh, but you know what I mean? They don't, they don't want to see a bathroom that's in any kind of disarray. And, uh, because that might be their first impression. Yeah. And then when they walk into your clinic—

Can I, can I, can I expound on that a little bit, Doc? So I remember when I was an associate and I, um, you know, just started, and I went into our patient bathroom and I was like, yuck, gross. It was— it hadn't been cleaned. My dad hadn't been in that bathroom for years. He had never— probably never even seen it. I'm like, Dad, this has got to change. I mean, if we're trying to portray ourselves as a premium service, and then they go into the bathroom and it looks like it's from McDonald's. I mean, give me a break. So we went to work, we gutted that whole thing, tiled it, um, you know, nice custom, uh, you know, uh, uh, sink. We did hand towels, right? We took out the, you know, the paper towel dispenser and we put Little rolled white hand towels, and then those, you know, obviously got, you know, laundered every week. So you— and then, you know, had some smell like air freshener type of thing. New toilet, fancy toilet, tiled the floor, um, you know, nice artwork. We'll kind of talk about that, but nice artwork on the wall there. But you really should put some time, effort, energy into your bathroom. Dr. Kyle's right. That's sometimes the first thing they do. Go right in your bathroom. And again, very easy to— I mean, look, if you can't dump $5,000 or $10,000 into remodeling your bathroom, that's okay. The first thing is just make it super clean. That's the first thing is just make it super clean. And then you kind of take steps, you know. Hey, next month we're going to do— next month we're going to replace the sink. Month after that, or 2 months after that, we'll replace, you know, the floor or the Or the toilet or, you know, whatever. But the point being is you probably don't go in your patient bathroom enough. And I know, you know, you probably didn't expect to come on this podcast and be thinking, I'm going to talk about bathrooms today, but it makes a difference. It really does. So, address the bathroom. Okay, moving on.

Just the bathroom. Of course, the first thing they're going to see, maybe not the bathroom, but then maybe the next thing or the first thing will be the reception area.

Yep.

Sit, sit in your reception area just like you were a patient and look around and, and see what you see. The artwork and how the cleanliness of the floors, because people sit at those chairs every day. Are they clean? Is there dirt anywhere around those chairs? Make sure that is all cleaned frequently, especially right at the end of every day. That should be cleaned up in that area. And all trash, anywhere, anything that is emptied out. You don't want any appearance that there's a half-full trash can sitting somewhere in the reception area. And your front desk person, that should be your most people-friendly— that should be your schmoozer.

Mm-hmm.

The first person that walks in the door, that the patient is greeted by, that's your schmoozer, is your front desk person. And they should be warmly and enthusiastically greeted when they walk in the door.

Yeah. And if you're doing any type of volume, I would really recommend that that front desk person is not taking phone calls. They are— they should not be having to juggle trying to schedule a new patient, which could be thousands in revenue for the clinic, and also having to greet a patient. Maybe they're having to, you know, schedule another patient that's leaving their, you know, their appointment, you know, for next time. So as your volume increases, start to be thinking like, hey, I want this as our ambassador, and I don't want them, you know, having to worry about the phone. Because being able to schedule properly, pre-qualify on the phone, educate the patients, that's a whole different skill set. It can be learned. 100%, but it really should be. We always had, um, you know, when, when patients called in for new patient appointments, hey, no problem, we're going to put you through to Dr. Leone's personal assistant. And that was the only one that was really allowed to schedule patients. And then she would go through and, you know, it was— they were usually 10-minute phone conversations, right, to schedule a patient. You'd be like, why would it take all that? It's because they're pre-qualifying them. You know, all these doctors talk about, oh, I want I want better quality patients. Improve your phone skills, right? Improve the ability and the questions that your person talking to the patient has. And of course, in our program, we have— in fact, we just did the training, another training on this. But, um, ideally, that ambassador, right? Big smile, just like Dr. Kyle said. They should be bubbly. They should be energetic. They should be, hey, are you Mrs. Smith? I saw you on the schedule. Welcome, blah, blah, blah. I mean, they don't have to jump out of their chair and climb over the desk, but they should, they should be warmly greeted. The worst thing in the world coming into a new doctor's appointment, the head down, they're like scribbling something or they're on the phone or good Lord, they're on social media on their phone. And you're like, I'm here for an appointment. Good luck. Terrible first impression.

Terrible first impression. Or instead of warmly greeting them, Hi, do you have your insurance card? I've heard, I've heard that line a few times over the years, and I've had to correct that one. It's like, no, you don't. That's not your opening line. Do you have your insurance card?

Oh, that's a great one, man. That's, that's not a fireable offense, but that's certainly— you're going to see the doctor at the end of the day offense.

That was like, that is an offense that needs to be corrected. Right now, or very at the end of the day for certain. So there's a few other things you'd want to keep in mind. So I think one of the overlying themes is, is obviously cleanliness. If, if, if you got— if you're doing well enough in practice, then spend the bucks to have a professional come in and thoroughly clean your office at least once. If not, we have a gal, 2 different gals that come. We have ours thoroughly cleaned twice a week.

I love that. I was just gonna ask you, how often do you have them do it twice?

Yeah, normal once, but twice would even be better. Once towards the middle of the week and, or, you know, when once at the end of the week.

Yeah.

So that it's always, it's always clean. In fact, I got a gal outside of my door right now. She's cleaning and I can hardly hear what's going on.

I think that you can't state that enough. It's gotta be cleanly. I, and I think That, you know, one of the, the kind of end-of-day tasks on like, say, your tech, right? Everyone should be responsible for their area first, right? So at the end of the day, hey, clean it up, you know, put the laser back in proper place. Like, you know, your, your workstation shouldn't have, you know, 5,000 Post-it notes on it. I mean, everything should be organized and cleanly. And then, you know, one person's responsible for reception. One person is responsible for the exam rooms, one person is responsible for x-ray room, like, you know what I'm saying? It's just like, hey, they have this little like area that boom, I clean up my station and then I have one more station and then I'm done, right? So that should be their kind of their exit activities. It shouldn't be you. But you should be doing checks. Like, I would walk through your office at the end of the night and just You know, straighten that chair, uh, you know, pick up this little piece of lint, like whatever. It, it should be, it should be darn near perfect at the end of each night.

One thing I've learned that keeps staff very happy over the years too is, is you as the doctor, even though it's, it's, it's not your job, no, but yet you shouldn't be above it. In other words, if there, if you got a little, if your work area is not tidy, take some responsibility and clean up your own work area. Or if you are walking down the hall and you see something is laying there that should not be, or a piece of lint, do not be afraid to bend down and pick it up yourself. And if your staff catch you do that, they will think— they will respect you more. And they will think, oh, Doc does not think he is above me. And, uh, that's a, that's a good— it's a way to show some humility. Even, even if you are an uber successful doctor, don't, don't get such a big head that you're not afraid, that you're afraid to do the work of the common man or woman. And, uh, so that's something I've learned over the years that has served me well.

Yeah, that's a good point. Um, in terms of smell, we've Uh, we cycled through lots of different options, and a lot of the stuff that you can plug in, I found that a lot of patients, or some patients, would be really sensitive to. Um, and then you get, you know, some patients that walk in the office and almost turn around and walk back out. Oh God, what is that? You know, it's like they just really have a strong— so there should be a scent to your office. It should be faint. Um, we ended up In other words, the thing that, you know, gave a nice scent to the office but did not cause any adverse reactions with patients was, uh, I believe it was— it's called Scentsy. I don't know if they still have this, but it's essentially little things. They, they burn wax, right? They heat up the wax and it's, it's, you know, a wax cube that smells like something. Uh, and so when it burns it, it makes the office smell nice. So. I, you know, I don't know, what are your thoughts on that? And by the way, we used to get fresh flowers delivered on Monday, so I always thought that was kind of a cool thing, you know, for $50 a week or $30 a week or something, having fresh flowers. I know the, the, you know, older women always really appreciate that. But just on, on smell, what are your thoughts there, Doc?

Yeah, we use, uh, an essential oil.

There you go.

That's, you know, kind of— it's back behind our main front desk area so that it emits just this nice little Sent to the waiting room area. And, and so that at least that's their one of their first impressions when they come into the clinic. I can't remember what's what essential oil that the gals use in it, but it, it smells good.

Yeah. Um, how about on the walls? What do you think there, Doc? I mean, I'll just, you know, start off with if you have a poster on the wall and it has some type of chiropractic thing and it doesn't— it's at least it's— I mean, I'm not a huge fan of all the chiropractic, you know, all those posters and all that stuff. To me, that's very '80s and '90s. But if you're going to— this was always a rule that my dad had— if you're going to have something on the wall, it needs to be framed.

Yep, that's exactly what I was going to bring up. My 2 points would be is if you got posters, don't just tack it on the wall. And have it just be the paper, have a nice professional looking frame, or do nice artwork. So I have educate, mostly education-based posters, but they usually line up with the niches so that I can use for patient education that shows stuff about like the disc.

Mm-hmm.

And spinal stenosis and things like that. So that when I'm not in the room with the patient at the time, they can look and, oh, is this my condition here, doc? And, and so it's, it's pretty educational-based, but they're all in nice frames and stuff.

Mm-hmm.

And some doctors have gotten away from the educational posters and they're just some type of nice art. And, uh, I think that is also a nice touch also. Or you could have a, a blend where you have maybe a few strategically Place posters, but that's not every room or taking up every wall of the room. But then on another wall, there is a nice piece of art so that the more ones that want to learn something, well, they're going to gravitate to the poster. But then, oh, here we go. We have a nice piece of art that they can just enjoy, and it creates a relaxation, a comfort. It elevates their mood, especially because a lot of these people are in pain. And so if you have something that can create more of a calming effect where it takes their mind away from their pain and onto something more peaceful, that can be a good strategy.

I think that's great advice. My rule of thumb would be art in high-traffic areas and educational material in exam and like X-ray rooms, right? So You know, in the, in the reception area, in a hallway, in— if you're doing open adjusting, maybe in open adjusting I would go art. That's what we did. And then in the rooms themselves for exams and report of findings, then you can go more educational in nature. I know in our ROF we did a lot of— we talked about having our wall of, of kind of social proof where you'd have framed testimonials from patients. I think that's something that could be really nice. So yeah, I think you know just try to be a little bit different. But and and here's the beautiful thing is if you go online to like online artwork type of you know if you search that you'll find you know and I would have a theme to the office like when I I finished my associateship I had no money whatsoever but I started my own clinic and a friend of ours had traveled to Italy and she took these really great photos so I said hey can I get copies? copies of those, and I just blew them up and framed them and put around the office. So that was our theme, just like Italy, right? Um, Italy slash travel slash water. So I would kind of try to, if you could, think about, hey, what's kind of the theme for our office? Um, and, uh, and then that can steer your thought process on the artwork that you choose.

I had never heard of that concept before, developing a theme. That, that really strikes with me that that would be, uh, And then you could, you could change that theme up year to year too. And, uh, yeah. So I think we covered most of the things. Any other input on things that they need to consider in the office as far as attire or, um, the staff or just things around the office, Dr. Vince?

I mean, I think we've, we've hit the highlights and I, what I would encourage doctors to do is, you know, This is your business. And so I would think of it like your palette, right? Your, you know, this is your— like we talk about in the ROF, how, you know, actors have their present, you know, they go on stage and then the ROF is your stage. Well, your, your business is a representation of you. So I would put some time and energy into thinking like, hey, what is the feeling that I want patients to get when they come into my office, right? And so, and then I would have that lead your decision-making on all this thing, all these things that we've talked about, right? The look of it, the feel of it, the smell of it. You know, are you going to do carpet? Are you going to do tile? Are you going to do a blend? You know, so I think it's just a matter of getting First of all, putting, putting some dedicated time, uh, and thinking into it, um, and slowly execute. Again, you don't need to, you know, dump thousands and thousands of dollars into this right away. It's just like, let's start with the basics. Hey, take care of yourself first, right? That's number one. Take care of your team and then start taking care of the presentation of the office. And this is all just an evolution Of going to that next level and being that premier destination that, you know, most doctors that I talk to, that's what they want. They want to be the premium destination. Um, and so when you do things like this and you put concentrated thought into it, whether the patient voices the opinion that they, they recognize it or not, they will, right? Because rarely does anyone do this. So you can immediately set yourself apart. By putting some effort into this.

And I think that's the big thing is setting yourself apart. Some of these might seem like little things, how you dress or the clinic, but to the patients, this can elevate you a notch or 2 or 3 above any other places they've been, whether it's another chiropractic office or any other professional office. If you do these things, it's going to elevate your image and your clinic's image. in their mind, and that's going to lead to greater success. That's the bottom line.

Absolutely. So, I think that's going to put a wrap on this episode. Do appearances matter? Yes, they do. We went through 3 ways to approach that. So, just to wrap up, I want to dedicate this episode to my father. He has decided to retire. So, after 57 years, I think it's 57 years. 57 years in practice. He is hanging up his adjustment. He'll probably always be adjusting, and he's, he's just a doctor through and through. But I wanted to just recognize him for that and his dedication to this profession, to healthcare, and to all the thousands of patients that he has helped in his career. So with that being said, for Dr. Pankinen, I'm Dr. Vince Leone. We'll see you on the next episode.