“Superior listening skills are also required for positive empathy,” Landram adds. “This includes the skill of asking good questions, and patience in waiting for your client’s answers.
“And, developing and nurturing authentic relationships – regardless of the business – really comes down to care,” Landram adds. “How can you most effectively show others you truly care about them, their needs and well-being, and their success?”
Building a “one star” practice
Dr. Mariano’s career has taken her around the world – aboard Navy ships and Air Force One, no less. Today, her practice is nested in a comfortable, almost home-like setting in Scottsdale.
When she retired from her military career and White House duties in 2001, Dr. Mariano joined the Mayo Clinic Scottsdale’s Executive Health Program.
“I was there for four years, and I met some amazing people,” Dr. Mariano says. “I provided all aspects of care in a 24/7 environment,” she adds, “and what I discovered was patients wanted to see me for more than just their annual physical or once-in-awhile treatment.
“Fortunately, I was able to leave Mayo on very good terms…and start to build the Center for Executive Medicine,” she adds. Mariano’s practice now involves providing presidential-level care to member patients. “I tell everyone we treat patients as if they were the president of the United States.” Dr. Mariano has branded her care with a reference to her military stripes: STAR – an acronym for service, trust, access and relationship.
“I try to provide an environment where anxiety is reduced…an environment that is safe…an environment where patients feel completely at ease talking with me about their health and wellness, any concerns they have, and goals they have,” Dr. Mariano explains.
Her practice has grown completely by word of mouth.
“I don’t do any advertising. I have patients telling other people about their experience and our relationship,” Dr. Mariano says. “They tell the ‘wow’ stories: ‘a human answers the phone; there’s no after-hours recording; you don’t wait when you come in.’ My patients don’t have to fill out paperwork; we prepare everything in advance of their appointment. They’re greeted as they might be walking into someone’s home. We try to make everything comfortable – and easy.
“We strive to deliver the best that medical care can be,” Dr. Mariano adds.
The majority of Dr. Mariano’s patients are retired CEOs. Half are women. Her youngest patient is just 20, and her oldest is 93. To all, Dr. Mariano becomes their health care partner.
“Some of my patients say, ‘You’re like a therapist…’ – and I think it’s because of the questions I ask. I try to engage people in conversation. I try to determine the things that are most important to them. It’s the only way I know how to develop a very comprehensive, overall care plan for them,” Dr. Mariano says. She also doesn’t rush anyone through an appointment. Most visits take around two hours.
“Spending this amount of time with patients enables me to really develop a relationship with them,” she adds.
“I always ask patients: ‘What would make life better?’ I think it’s an interesting and revealing question,” Dr. Mariano explains. “Most of my patients enjoy a very comfortable life in terms of having money. They have the resources to live where they want. They’ve enjoyed business success. But, everyone can identify more they’d like to do, ways they’d like to contribute, things they’d like to improve in their lifestyles.
“I guess I get to do a little life coaching during these conversations,” she adds.
According to Mariano, she’s delivering medical care in the most fulfilling of ways…but not every day is stress-free for her.
“It takes discipline and the ability to be very organized,” she relates. “Establishing my own practice is a challenge. I’ve really had to learn a lot about business, and understand the skills I have as a physician aren’t necessarily the skills required to build a successful business. It involves finding people who are experts in other areas who you can trust,” she adds.
“And, you really have to be a salesperson.”
“I think the biggest reward is when a patient says ‘Thank you’,” Dr. Mariano adds. “I also feel so lucky being able to develop relationships with patients. I feel very close to my patients. I usually hug them when they leave.
