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Learning from orthopedic surgery

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By Columnist
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6 minute read

Perhaps one of the main reasons planning is not a profession is because most advisers do not act as professionals in their dealings with their clients.

Our need to become a profession has never been expressed more eloquently than in the following story Nigel Scott of the Wealth Corporation in South Africa told at a conference in Cape Town earlier this year. It was about his imaginary friend, Clive.

Clive was in his mid-50s and had lived a very active life playing a lot of rugby when he was younger. As he got older, the punishment his body had taken in his younger days was coming back to haunt him. He could not play a full round of golf without developing severe hip pain.

So with a resigned reluctance, he made an appointment to see his GP, who immediately referred him to an orthopedic surgeon, Dr Payne, as a candidate for a hip replacement. The surgeon confirmed the GP's suspicions, and Clive's worst fears, advising him he needed a new hip. Dr Payne then set about explaining to Clive the process he would undergo if he chose to accept his recommendation.

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"We will book you into the XYZ private hospital. Once you are admitted Dr Ether, the anesthetist, will visit you in your room and explain the role that he will play. Next morning early you will be taken to theatre and after Dr Ether has done his thing, I will cut your leg open, remove the top part of your femur and replace it with a prosthetic that is made from ceramic and looks like this [holding up a model that was on his desk]. I will then do a bit of maintenance on your hip socket and put the whole lot back together again. After a few days you will be discharged and a physiotherapist called Bronwyn will visit you and manage an exercise program that should have you playing golf again in about two months. How does that sound?" the doctor explained.

Clive has a decision to make. He can either except the solution offered by Dr Payne or seek an alternative solution that may be less invasive. But let us for a moment assume the script for this scene is different. Let us assume orthopedic surgeons conduct business in the same way as most financial advisers. Let us take this a step further, and assume, as in the world of financial planning, the patients of orthopedic surgeons are inundated with advertising, editorial, advertorial and comment from all types of media all the time about orthopedics. Every weekend Clive would read stories about patients dying under anaesthetic, of failures of different makes of prosthesis and of the mortality rates in hospitals operated by different groups.

In this scene, Clive may find reason to question some of what Dr Payne told him. "Hello, Dr Payne, I have been thinking about your recommendations and want to discuss the following issues with you. You mentioned that I would be admitted to the XYZ Private Hospital to undergo the procedure. In fact, the latest quarterly survey shows that hospital ABC has the lowest mortality rate per patient admitted in the second quarter of 2007 so I would rather use their facilities. I have also researched Dr Ether's practice and notice that they are not listed in the top 10 anesthetic practices in South Africa over the last year. I will only allow someone from one of the top 10 anesthetic firms work on me. When it comes to the prosthetic, I have always had a great affinity for stainless steel and would prefer that you do not use a ceramic prosthetic," he says.

That's where the scene ends, with Dr Payne probably assaulting Clive with his model prosthetic hip, sending him hobbling into the sunset. The reason Dr Payne is unlikely to entertain the discussion in the second scene is because he sees himself as a professional who knows a lot more about the subject under discussion than does Clive. Why then do so many professional financial advisers engage their clients in the kind of discussion scripted in the second scene? The only difference between the orthopedic patient and a client seeking financial advice is that the former is not bombarded by the media on a daily basis with a lot of noise about finance and investments. That simply means one of the first tasks a professional adviser needs to perform is to clearly position for the client what he does and how he does it.

Back in the real world, many bemoan the fact that, notwithstanding the requisite academic and professional qualifications, the profession of financial planning does not exist. Perhaps one of the main reasons is because most financial advisers do not act as professionals in their dealings with their clients. Instead, they act like salesmen following the path of least resistance and engaging in meaningless discussions that add no value. An orthopedic surgeon does not get to do a hip replacement on every patient he consults. In the end he only works with those who accept his advice and follow his recommendations. Years of study and experience have earned him the right to adopt this approach. Professional financial advisers have a lot to learn from orthopedic surgeons.