Years ago, I had a powerful experience when traveling with my family in London, England. I was with my 19-year-old son, Craig, and we were looking for a cigar store to buy an after-dinner cigar to celebrate his perfect semester at the University of Texas. We entered the Davidoff Cigar Store on St. James Court. The store was closing, and we asked for an after-dinner cigar to celebrate Craig’s 4.0 grades. The owner, Edward Sahakian, took us into the walk-in humidor containing hundreds of expensive, limited, one-of-a-kind cigars from Cuba, Honduras, and the Dominican Republic. Mr Sahakian asked, “Where are you going for dinner? What time is your dinner? What are you planning to eat? Will you be smoking after dinner or in your hotel? What kind of cigars have you smoked before?” as well as several other probing questions that homed in on our needs and wants. He then provided us with a choice of 3 cigars that might be appropriate for our time of day, restaurant, and food selection.

Neither my son nor I is a connoisseur of cigars, as we only smoke cigars 2 or 3 times a year. We asked questions about how cigars are wrapped, how the size of the cigar is determined, how to light the cigar, and how to preserve the moisture in the tobacco.

With the skill of a master salesman, Mr Sahakian gave us a 15-minute lecture on cigar selection. I was concerned about our choice as we didn’t have a cigar cutter. Mr Sahakian said he would provide us with a cutter and a disposable butane lighter at no charge.

After careful deliberation, we made the decision about our cigars. Mr Sahakian took our cigars and carefully boxed them so they wouldn’t be damaged before we enjoyed these very special stogies.

I gave Mr Sahakian my credit card, and he gave me the receipt to sign, and I noted it was for only 1 cigar. Before I could question the mistake, Mr Sahakian said, “The bill is only for your cigar. The other is a present to Craig for his stellar accomplishments in his first year of college.”

So, what 10 lessons for the medical profession can be learned from my experience at the Davidoff Cigar Store?

1. Begin each encounter with the patient on a nonclinical topic. This might include inquiring about their work, hobbies, or a recent vacation. Treat the patient as a human being and not an organ system.
2. Identify the needs and wants of your patients. Some patients are only interested in the diagnosis and treatment. Others may want to hear about medication, side effects, and the cost of the drug. Others may be bottom-line oriented and want to receive their prescription and be on their way. You will know their needs and desires if you try to identify them.
3. Ask probing questions. Query the patient about how they have been treated and the effectiveness of previous treatments.
4. Offer something extra. Go out of your way to do something kind for the patient. This may include medication samples or an FAQ sheet on the medication. These extra efforts will be remembered long after the patient leaves the doctor’s office.
5. Acknowledge their children or family whenever possible. Nothing feels as good as hearing positive comments about your family. When you hear a kudo about the family, mention it or send them a note. It will probably be the only note they receive.
6. Provide more service than is expected. Remember the baker’s dozen or service after the sale. Create a memorable experience on every patient’s visit.
7. Exceed expectations. Exceed your patient’s expectations, and you will be rewarded by having your name and your practice on the tip of the patient’s tongue whenever they need your services. The patient is likely to recommend your practice to family and friends.
8. Make the patient look forward to their next visit. Smile, be enthusiastic, and provide outstanding service; the patient will be delighted that they chose you as their doctor.
9. Use the patient’s name whenever possible. The minimum customization needed is to use the patient’s name at least once during the meeting. It’s best to use it upon first meeting the patient and at the end of the doctor-patient encounter.
10. Make the experience memorable. Think outside the box. Be creative. Use humor if it is appropriate. Try to differentiate yourself from other physicians who might be providing care for the patient.

First, I have told this story to dozens of cigar-smoking colleagues and friends. Several have indicated they plan to visit Mr Sahakian on their next trip to London. Second, my son, Craig, was interested in working at the cigar store one summer, so he might escalate his selling skills like the master, Mr Sahakian. If physicians emulate the skills used by Mr Sahakian, they will be rewarded with an enhanced relationship with their patients, improve their communication, and ultimately increase their bottom line.

P.S. The cigars were Partagas!