Using your BRAIN to negotiate with the doctor

Two of my most common refrains on negotiation are these: Much of life is a negotiation, and a negotiator’s success depends on what they do before negotiating. These two conclusions come together in a common negotiation we all face routinely: a trip to the doctor’s office. Simply put, understanding a doctor’s visit as a negotiation and preparing for it accordingly can make life negotiable.

But wait—why’s a doctor’s visit a negotiation? Because anytime we depend on others to achieve our goals, we’re negotiating. Since we surely depend on the doctor to achieve one of our most important goals—our own health—it’s a negotiation. And if a doctor’s visit is a negotiation, then you need to prepare for it for the same reason you’d prepare for any negotiation: because much of the outcome is predetermined by how well you understand the situation beforehand. But here’s the good news: the same acronym you’d use to prepare for any negotiation—BRAIN—applies to a doctor’s visit in spades. To see why, let’s consider each of the five letters in turn:

  • B=BATNA (best alternative): What’s your alternative to this particular doctor if you don’t get a satisfactory diagnosis or treatment? Seek another doctor, thereby spending more money, taking more time, and generating more incomprehensible bills in your mailbox? Unless you’re seeking to solve a serious medical issue, that doesn’t sound like a very attractive BATNA. So you’d better do what you can to achieve your objectives in this visit.
  • R=Reservation price (bottom line): What’s the least satisfactory outcome you’d accept from this doctor before seeking out another? If he or she suggests watchful waiting instead of active treatment, will you consent? If he or she is too busy to offer an adequate answer to your most important question, is that gonna work for you? Either way, you’d better ask beforehand to avoid walking out in a state of severe dissatisfaction.
  • A=Aspiration (goal): What’s the best possible outcome you could hope to obtain from this visit? Are you shooting for a particular medication, referral, or treatment plan? You need to know beforehand because the doctor may not think of it or be motivated to offer it unless you ask.
  • I=Interests (underlying motivations): What do you fundamentally need to achieve from this visit? Is it really the specific medication, referral, or treatment plan, or are you ultimately seeking to fix the aching shoulder, wobbly ankle, or elevated blood pressure? It’s important to keep your focus on the underlying problem rather than the surface-level solutions, as the doctor may well offer an even better solution. If so, you should probably listen rather than sticking slavishly to a suboptimal solution.
  • N=Negotiation counterpart (the doctor): How’s the doctor likely to answer the preceding questions? In particular, what’s their alternative to you? Probably to see the next patient. And what’s their bottom line in response to your requests? They’d probably refuse to offer you something risky, ineffective, or likely to require undue effort on your part or theirs. And what does the doctor hope to achieve in your visit? Probably to reach a quick diagnosis and make a simple recommendation that helps you our immensely. And finally, what’s the doctor’s underlying interest? For good doctors, hopefully to make you as healthy as possible. So you see, by putting these answers together, that the doctor surely wants to help but probably prefers to do so not just effectively but efficiently. And that should you immensely in framing your requests.

So visiting a doctor is not so different from buying a car or negotiating a raise. In all cases, you need something important from someone else. And in all cases, using your BRAIN beforehand is critical to achieving your objectives, be it fancy wheels, a fat salary, or a healthy you.

What they’re asking for vs. what they want

Businesspeople commonly assume that customers’ requests correspond closely to their underlying needs. If he asks for the S version, he must want a sportier (yet costlier) ride. If she asks for a specific species of tree, she must want something beautiful (yet eventually ginormous). The customer is always right! But I’m here to tell you that the correlation between whatever people ask for and whatever they’re actually trying to accomplish—in business and many other arenas of life—is not statistically significant. And appreciating as much can make business (and life) more negotiable.

To see what I mean, imagine a customer in the process of renovating their kitchen—not that I’ve been there. The friendly contractor asks the dutiful customer: Can you please go to this website, take a look, and let me know what type of countertop material you want? Then, the customer dutifully examines the website and comes back to the contractor with a specific request. Quartzite!

Now what will the typical contractor assume? This customer wants something beautiful and durable and doesn’t mind an exorbitant price, not to mention continuous maintenance . But why might that conclusion be mistaken? Consider three reasons:

  1. The customer doesn’t know what they’re trying to accomplish. It’s a fact. Many people just don’t know what they’re really trying to accomplish, especially when considering a complex, multifaceted, and multidimensional problem like the countertop that will best suit their needs in the long run. So they dutifully examine the website and pick a countertop they think will meet their needs, but it won’t because they haven’t identified those needs very accurately in the first place.
  2. The customer knows what they’re trying to accomplish but doesn’t know how to accomplish it. Many customers, confronted with a website detailing thousands of countertop options, each with several thousand attributes, simply go into cognitive arrest. They simply can’t fathom the overwhelming volume of information, much less the time involved in considering it all carefully. So they simply select the first one that seems, at first glance, to minimally satisfy whatever bar they’re trying to clear. This tendency, commonly known as satisficing, can easily lead to a suboptimal request even if the customer knows exactly what they’re trying to accomplish.
  3. The customer knows what they’re trying to accomplish and how to accomplish it but is too afraid to ask. Many customers, facing a busy contractor booked out months in advance, know they would be best served by something cheap. Formica’s what I need! But they’re afraid the contractor will laugh at them, make a haughty snorting noise, or decide the project’s not worth their time. So the customer asks for something better than what they really need. But wait—isn’t that good for the contractor? Any contractor worth their salt knows it won’t be in the long run, when the bills come in or the customer starts talking to friends who really need a contractor to install some quartzite.

So never assume that requests correspond with needs! And don’t think selling is the only context when that assumption falls flat! Spouses, children, and work colleagues have all been known, on occasion, to make requests that correspond loosely with their underlying needs. Anticipating as much can make life negotiable!

Five pernicious assumptions that your service providers make about you

If you’re like me, then virtually every week brings an unexpected fee hike. Take last week, when both my cable bill and cellular bill unexpectedly jumped $20 a month. “How in the world can our service providers have such gall?”, you might ask.

Well, let me tell you how: they make five common, negotiation-related assumptions about me and you and everyone else—assumptions that the average consumer consistently proves correct. But by understanding and disproving these assumptions, you, the non-average consumer, can make life negotiable.

Specifically, your service providers consistently assume that:

  1. You won’t notice the fee increase: Your service providers commonly believe they can slip one by you—that you are one of those people who doesn’t scrutinize their statements or e-bills or direct withdrawals. Prove them wrong by approaching your bills with the mindfulness of a novice operating a power tool.
  2. You won’t have the courage to call: Your service providers commonly believe that, even if you do notice the fee increase, you’ll probably be too wimpy to pick up the phone and call them on it. Prove them wrong by putting their number into your speed dial.
  3. You won’t have the time to call: Your service providers commonly believe that, even if you notice and muster the courage to call, you won’t have the time to. This, I must say, is probably where they get the most people, stretched as we all are. But prove them wrong by thinking not about whether it’s worth your time to dispute the $20, but whether it’s worth your time to dispute the $20 x 12 months. Then multiply that amount by the number of service providers likely to jack up your fees in the near future.
  4. If you do call, a simple no will suffice: Your service providers commonly believe that, even if you notice the fee hike and assemble both the courage and the time to call, they’ll be able to dissuade you with a simple “no.” For example, “No, that pricing promotion has ended, so we can’t put you back on it.” Prove them wrong by asking a different question. For example: “Ok, is there a different active promotion that would bring me back to the same price?” (That exact question eliminated the two $20 fee hikes mentioned above.)
  5. You won’t be willing to walk away: Worst case, your service providers commonly believe that, even if you notice and call and fight for your case, you won’t walk away and go with another provider if you have to. Prove them wrong by calling with a quote from another provider in-hand. Then ask to connect with the cancellation department, which almost always proves more pliable.

In sum, your service providers are banking on your being inattentive, wimpy, busy, gullible, and certain to surrender eventually. If you want to make life negotiable, you have no alternative to proving them wrong. Unlike your service providers, I assume that you can.

Three surprising advantages of negotiating with multiple people





Negotiating while the iron’s hot



Timing matters tremendously, for example…



Don’t let ‘em get you down! Getting past the barriers to customer service negotiations

In many of our negotiations with companies—the fee-charging bank, formidable cable company, irascible airline—our toughest challenge is not the negotiation itself. It’s getting to a negotiation in the first place. The fact is, many companies just don’t want to negotiate with you—the formidable you—because they know they just might lose if they do. So many companies have devised elaborate methods of preventing a negotiation from ever happening. Since overcoming the most common of these barriers is the only way to make customer service negotiable, let’s consider a rundown:

  1. Bottomless email pits: A favorite tactic of the irascible airlines, particularly my old friend “Reunited,” many companies set up elaborate online forms to email them, then seemingly send your email right to the recycling bin. At least it appears that way, since you never get a reply (other than the obligatory “We promise to reply”). Still, getting to a negotiation often requires you to try, perhaps repeatedly.
  2. Buried phone numbers: Another favorite of the irascible airlines relates to the phone number. Put simply, many companies make finding the relevant number just slightly easier than finding the Holy Grail. Getting to a negotiation requires you to look doggedly hard, often clicking down some extremely esoteric paths.
  3. Labyrinthine menus. Once you finally find the phone number, it’s nearly unthinkable to connect with a person directly. The formidable cable company, for example, often sends you into an overwhelming thicket of menu prompts, none of which relate to your need (ever). Getting to a negotiation may require you to hit zero incessantly, shout “representative!” repeatedly, or just wait a very long time. To that point…
  4. Endless wait times: Have you ever called a customer service line and found the call volume to be unusually low? A favorite of the fee-charging bank, I would surmise it’s a tactic to cool your negotiation jets, the hope being that a sizable number of customers will give up and hang up. But you can’t!
  5. Hapless front-line representatives: I’m quite certain I’m not the only person who usually finds the representative who eventually answers the phone either unable or unwilling to negotiate. It could be a coincidence or a lack of training. Or it could be a subtle way of curtailing your negotiable hopes and dreams. Getting to a real negotiation often requires you to get to someone who knows what they’re talking about and/or can do what you’re talking about.

So don’t let them get you down! Chances are you’ll be feeling quite up once you eventually surmount the barriers and find yourself negotiating.

Giving away freebies: An “irrational” business strategy

Business 101: When a customer asks you to do some service or provide some good, find a way to charge them. Right? Wrong. Well, not entirely wrong, but let me tell you about an important set of situations in which giving away freebies can actually make selling more negotiable.

First, a series of stories:

I seem to have a lot of problems with my tires. A front tire was recently deflating constantly, causing me to spend more time at the air pump than the dinner table. I took the car to the local Goodyear, who informed me that the valve wasn’t positioned correctly, causing air to escape. They fixed it, they said, and even replaced the valve just in case. “How much do I owe you?” I said, reaching for my wallet. “Nothing,” they said. “It was quick, and valves don’t cost much.”

Then, about a month later, my hubcap randomly fell off. I went to the same local Goodyear, asking for assistance in installing a new one, as the process seemed about as simple as a differential equation. “Sure,” they said, “We’ll take care of it.” And they did, in about a minute. Then they again insisted on charging me nothing.

Perhaps these stories seem the epitome of stupidity. Goodyear offered their valuable time twice to assist me with some silly tire problems. And each time, they insisted on charging me nada. How could that possibly represent sound strategy?

Because they knew well enough that I was a new customer who would eventually need a very expensive full tire replacement. And they knew that when I did, I’d think of the local Goodyear instead of the slimy local dealer who is more than happy to charge a hundred dollars for a wingnut. And, of course, that’s exactly what happened. I needed a full tire replacement on another car very soon after, and my appreciation for the freebies turned into nearly $600 in revenue.

So what’s the negotiation principle? That people choose to engage with counterparts they trust—and avoid those they don’t. And that people especially choose to engage with those they not only trust but feel beholden to, as I did to the generous Goodyear. So part of any negotiation is eking out the biggest possible profit right now. But another and potentially more important part is generating enough goodwill to keep the counterparts coming in the future.

In sum, to all the rational thinkers who advise us to monetize as much and as often as possible, I’d say this: That may be a smart strategy in the short-term—the very, very short-term. But research on trust and reciprocity would suggest that it’s likely to shoot you in the foot in the medium term, by which I mean anything longer than the very, very short term. The pursuit of self-interest, it seems, may involve at least a short stop at the way-station of generosity.