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How research into colonoscopies can help you create more referrals and recommendations

Research into how patients feel after a colonoscopy can help improve your marketing and the number of recommendations you receive from existing clients.

Every week I listen to The Prof G Show podcast from Scott Galloway. The Monday edition (there’s a second on a Thursday) is called ‘Office Hours’ and answers listener questions. Last week’s show included a question asking how businesses can improve their Net Promoter Score (NPS).

The answer got me thinking about the implications for advice and planning firms.

Using NPS to prove client satisfaction

For those not in the know, NPS measures client experience. It’s calculated by taking the proportion of clients rating the likelihood that they will recommend a company as a nine or ten (out of ten) and deducting the proportion who score the company six or below.

We use client surveys to generate a similar score for the advisers and planners we work with and use the results in their marketing, particularly on their website.

The listener asked Galloway to suggest ways their business’s NPS could be improved. The answer most people will immediately leap to is to deliver a better service. The reality, though, is more complex – and this is where colonoscopies come in.

Avoid a bum rating

On the podcast, Galloway explained how doctors researched patients’ perceptions of their colonoscopy.

Patients were split into two groups. In the first, the procedure (which is invasive and unpleasant) was extended by five minutes, but the probe was left stationary during that time, so it wasn’t as uncomfortable.

In the second group, the procedure lasted for the normal length of time but the probe was removed immediately it was over.

The result?

The first group reported a better experience.


Because even though it lasted longer, the final few minutes were more pleasant for the first group than the second.

So, what does this have to do with improving your NPS and generating more recommendations?


The research shows that the feeling you leave people with at the end of an interaction disproportionately affects their perception of you. Given the number of times you and members of your team interact with both new and existing clients that mean you have many opportunities to impress…or get it wrong.

Why’s this important?

We all know that recommendations from existing clients are the best type of new enquiry. They have the lowest cost of acquisition and the highest conversion rate. That drives efficiencies in your business and means you spend less money on marketing.

In short, recommendations mean you can spend less money with agencies like us. They also improve your bottom line.

There are many ways to improve the number of recommendations you receive from existing clients. They start, though, with a recognition that recommendations are the best way of growing your business and that they should be top of the list of the things you do to generate new enquiries.

That said, they won’t simply fall into your lap. Your strategy should include:

  • Better conversations (note we said conversations and not asking for recommendations, this isn’t 1995!)
  • Being visible online so people checking you out after being recommended to you can find you
  • Being impressive online, so that the same people understand the benefit of working with you
  • Showing gratitude to your existing clients who recommend you to other people.

The list could go on. However, the colonoscopy research shows the importance of focusing on the last few minutes (the back end, if you will) of each interaction.

7 times to end your interactions on a high

We’ve put our thinking caps on and come up with a list of interactions where you and your team should leave your prospects and clients on a high:

  1. The initial telephone call with a new prospect; it’s a cliché, but you never get a second chance to create a first impression.
  2. The follow-up email confirming the arrangements for the first meeting; these are great opportunities to impress the potential client but so often overlooked. For example, how many of your meeting confirmations include social proof showing that you’re experienced in helping people like them?
  3. Each meeting in the advice/planning process; whether the meeting happens in person or virtually, should finish on a high.
  4. Annual review meetings; again, every client should leave on a high. Achieve that, and it’s the perfect time to discuss recommendations and ask for online reviews.
  5. Ad hoc phone calls; even calls into your team about the most mundane of tasks are a great opportunity to leave clients feeling positive about you. Your team needs to understand how to do it though, and why it’s important.
  6. Calls and meetings with professional connections; recommendations from solicitors and accounts are just as valuable as those from existing clients.
  7. Email communications; the sheer volume of emails you will send and receive each day leaves you with the perfect opportunity to end interactions on a high. A simple sign-off, mentioning something that’s important to the client, prospect, or professional connection, shows you care and that you’ve taken the time to remember things that are important to them.

The evidence is clear (and isn’t based on a gut feeling) that firms with a higher NPS generate more recommendations from existing clients.

However, much like generating recommendations, it won’t happen by chance. Leaving clients with a fantastic impression at the end of each interaction takes practice and persistence from you and your team.

It’s worth it though; more recommendations equals greater efficiencies and an improved bottom line!

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