Jonathan Hoffsuemmer

You think you know why you choose. The stock you bought. The brand you wear. The doctor you trust. But you can't tell if any of them is good. Nobody can. So you judge what's standing in front of them: who called back, how the name sounded, how it felt to walk in. And everyone who has ever chosen you did the same. Your clients. Your customers. None of them could judge how good you are. They judged a phone that rang four times, a price they had to ask for, a name they couldn't repeat at dinner. I learned this inside a hospital. I spent my first ten years in healthcare ops, leading teams of more than seventy people and implementing a version of the Toyota Production System across an eleven hospital system. Then I helped open a clinic for the most chronically ill patients a health system has. Good doctors. Real time with every patient. Everything those patients needed. It filled slower than the plan said it would. Nothing was wrong with the medicine. The people who needed us most never got close enough to see the medicine. They saw a referral that went cold somewhere between their doctor's office and our door. So we left the medicine alone, left the marketing alone, and fixed the handoffs: what the referring doctor said, how fast we called, whether a person answered, whether the visit was booked before anyone hung up. The panels filled. The cost of care fell by nearly a third. I've spent the last ten years in marketing, 80+ engagements across MedTech, healthcare, SaaS, legal and consumer brands, testing that one idea anywhere I could and writing two books about it. It's held every time. A practice with better medicine loses to the one that calls back. The brand a friend can explain in one sentence outsells the better one she can't. A company changes what it calls itself, and the stock reprices before anything in the business has changed. What you sell still matters. It's just not what anyone judges first. You'll choose something this week without knowing if it's good. So will the people choosing you. I write about that moment, with one longer story every Sunday at nobodywantsadoctor.com/sunda…

Tonight is the biggest night of the year for candy, and $HSY makes more of it than anyone. Almost none of it is bought by the person who eats it. The buyer is paying for how the bowl looks when the door opens.

When a price feels wrong, the word in front of it is usually what’s wrong.

The lobby with the water feature impresses for a week. The desk that remembers the dog’s name, and that the dog was sick, matters for a decade; so does the call after a scary result that nobody asked for. Impressive can be bought by any competitor with a budget. Remembered has to be done one person at a time, for years, and it is the only thing on the list a member will repeat at dinner.

The best thing a medical practice can do for its reputation is answer when it’s closed.

Your quietest customers are either your happiest or already gone. From the outside they look the same. No complaints, no replies, invoices paid on time. The unhappy will always be heard. The grateful you have to find, because gratitude doesn't file a complaint. So most businesses spend the year answering the loud, and never learn who was about to leave, or who would have sent three friends if anyone had asked. Once a quarter, call five who haven't said a word. Not to sell. To find out which kind of quiet it is.

$TDOC reported last night. The lines to read are visits per member and how many members came back for a second year. Telehealth solved the Tuesday-night problem: a doctor in twelve minutes, from the couch. What it hasn’t solved is the second year. A fast visit with a stranger is a transaction. It gets repeated when someone needs another one, and it builds nothing for the year after. The practices that hold a panel for a decade sell the opposite thing: the same person every time, who remembers the last visit.

At fifteen minutes, someone comes out and says the doctor is running behind, and offers a time. Those few words are the difference between a late visit and a bad one.

When $GOOGL reports tonight, the numbers will be read inside a frame that was set eleven years ago. In 2015, Google asked to be judged by a different set of neighbors. The market said yes. It renamed itself Alphabet, and most people shrugged. The search engine kept working. The ads kept selling. Nothing a user could see changed. What changed was the shelf. A search company gets compared with other search companies. A holding company of bets, with search as the cash engine, gets compared with something else entirely, and gets permission to lose money on moonshots without the core being punished for it. One word moved the company to a different shelf, and the shelf set the price.

Three things people say about a membership fee, and what each one is asking. 1. “I already pay for insurance.” What does this buy that insurance doesn’t. 2. “I hardly ever go.” What am I paying for in a year when nothing happens. 3. “What if I need a specialist.” Will you still be my doctor once I leave the building. Answer all three on the fee page, before anyone has to ask.

Twelve free tools for concierge and DPC practices, one page each. 1. Call your own office. 2. Draw your relay. 3. Write the fee sentence. 4. Answer the five questions. 5. Say it at dinner. 6. Listen first. 7. Find the last straw. 8. Make it easy to recommend. 9. Read the words. 10. Make the nothing visible. 11. Find their word. 12. Beat doing nothing. Start with where you need help. nobodywantsadoctor.com/tools

Write down the name of your practice. Count how many of these four words are in it. Family. Wellness. Personal. Health.

A virtual chronic-care company, billed through insurance, recently posted a list of what concierge medicine offers. Then it promised that same level of access, virtually. Expect more of this. Patients can't judge the medicine, so they judge the name. Once a word carries status, everyone borrows it. From the outside, a $2,000-a-year physician who answers her own phone and an app with a rotating care team now sound the same. The borrower gets the word for free. The owner keeps paying for it, because the word that used to do the explaining stops doing it, and the explaining comes back to the practice. So say what a borrower can't copy. Who answers when you call. How fast. Whose cell number you get. How many patients the doctor carries. When everyone is concierge, nobody is. Say what you actually do.

Practices think loyal patients are happy patients. Mostly they're patients for whom leaving would be work. The records. The new forms. Telling your whole history to a stranger again. So they stay for years, not thrilled, and from the inside it looks exactly like devotion. Then one afternoon the cost of leaving drops below the cost of staying, and a decade ends in a parking lot. Loyalty in medicine is mostly friction. Mistake it for love and you'll never see the exit coming.

The Timber Association of California was losing. Protests, a ballot initiative, and a public that had decided what they were. Research turned up why. People think of trees as a family. Saplings in a nursery are babies. Old growth is the grandparents. And the word timber, to that public, meant a family falling down. They couldn't change the work. They changed the word. Timber became forestry. Clear-cutting became forest management. The lumberjack with the chainsaw left the ads, and a woman tending seedlings in a nursery took his place. Then the chairs, the cribs, the kitchen tables, all the places wood ends up in a home. The initiative failed. I put that story in Message Market Fit because it's the cleanest case I know of a category word doing the work the product couldn't. People weren't voting on forestry practice. They were voting on a picture, and the picture came with the word.

Anne had never called her own office. Eleven years in, she had rewritten the website herself. Time with every patient. A doctor who calls you back. She had read every line of it twice. Then one day she finished rounds late, with a phone that wouldn't turn on, and needed the front desk to push her one o'clock. So she borrowed the phone at the nurses' station and dialed the number on the sign. The one on the website. The one everyone else has to use. It rang. She counted, because there was nothing else to do. Seven rings. Then a recording. "Thank you for calling. Our office is closed for lunch from noon to one. If this is a medical emergency, hang up and dial 911. For prescription refills, press two. To leave a message for the nurse, press three. Our fax number is..." She hung up before the fax number. She had never heard that greeting. Her calls went to the back line. So did everyone's, everyone who already belonged. That afternoon she asked Dana at the front desk what happens at lunch. "The phones go to the recording. We get a lot of hang-ups. Most people don't wait for the beep." "How many." Dana pulled up the log. Anne looked at it for a long time. It was a list of numbers she didn't recognize. Each one was a person who had decided, at 12:20 on a weekday, to call a doctor they had never met. Some of them had been carrying her name around for weeks. Somebody's sister had said "call mine." And at the moment they finally did, the practice said: noon to one, press two. She thought about the website. The paragraph about time with every patient. The line about calling you back. All of it true. None of it reached the person on the other end of seven rings. What reached them was the rings. A stranger can't judge your work. That's why they're calling. What they can judge is everything around it: how many times it rings, whether the voice sounds glad to hear from them or finished for the day, how long it takes anyone to call back. And the clock decides more than you'd like. A person with a problem isn't shopping. They're trying to make the problem stop. The first place that picks up, with a person who knows what to say, ends the search. Not the best place. The first one that answered. The practice down the road doesn't have better medicine. It has a phone that gets picked up at 12:20. Anne didn't buy a phone system. She made a decision and wrote it on a card taped beside the front desk: a person answers, every time, by the third ring, and that person knows what to say to someone who is scared. If you need a menu, keep it. Put the stranger first: "If this is your first time calling us, press one," and a person picks up. Everything you promise, you promise on a website, a sign, a friend's word. The phone is where you keep it. Monday Call your own number three times: a few minutes after you open, in the middle of lunch, and a few minutes before you close. Use a phone the desk won't recognize. Count the rings. Listen to the greeting as someone who has never heard of you and has a problem today. Then decide what should happen by the third ring, write it down, and tape it where the phone gets answered. One of these every Sunday, free, at nobodywantsadoctor.com/story

Tropicana changed its carton in 2009 and sales fell within weeks. The juice was the same. The old carton had an orange with a straw in it. The new one had a glass of juice and a clean typeface, the kind a design team is proud of. Shoppers walked past it. They weren't looking for orange juice. They were looking for the straw. The company put the old carton back in under two months. A brand is whatever the customer uses to find you without reading. Change that, and you've asked every one of them to decide again, in an aisle, in four seconds, with the competitor's carton right there. Most rebrands are a gift to the shelf next door.

Native wrote "Deodorant that isn't a chemistry experiment" next to shelves saying Clinical Strength and MotionSense Technology. $PG bought them for $100 million. Plain words are a position.

Look up what sector your biggest holding is filed under. Then look at what it actually sells. The gap between those two is your risk, and it's on no statement you'll ever get.