Exceptional Dental Practice Management

Patient, or Victim?

Let's face it, we've all heard the line, "Sorry, I'd rather be anyplace but here."  When we hear it we all think, "Wow, I haven't heard that before.", right?  It's universal because it's true.  Patients usually don't want to be in our chairs.  When you get one that says, "I must be weird because I like coming to the dentist.", we tend to agree.  People hate coming to the dentist because they feel that once they warm up the seat a little, they start to lose any control over what is going to happen to them.  Things can be going along just fine and all of a sudden, the bur hits a sensitive spot.  Since they're just waiting for it, their perception of the pain and reaction to it tends to be magnified.  Now you've got a victim clutching the armrest or putting a thumbnail into the back of her hand, and it's all your fault.  At least that's how it feels to your victim.

I noticed the other day that patients tend to become either helpless or angry when they are in the chair, especially adults.  If you gently retract their cheek, you'll feel like a gorilla who just pawed the poor person's cheek out of your way so you could get to their teeth.  Their whole head will swing in your direction and even if you ever so gently urge them to turn straight, it's just too much.  They've already given in to the helplessness and you'll spend the rest of the appointment wondering if you are just approaching the whole thing much rougher than you feel like you are.  You might even ask your assistant, "Is it me, am I really that rough?"  No, you probably aren't, you're just dealing with the past. 

You can change the past for some people, but it takes time and awareness.  The patient has to be open to learning to expect a different experience, and you and your staff have to be constantly aware that everything you do, every nuance in your words and actions will either aid in making the change happen, or reinforce their long-standing perceptions.  Some patients are open about their fear, but others just come off as gruff or unpleasant.  Getting them to open up is a challenge, but very satisfying if you can get there with them.  You can be successful faster if the patient is up front about their fear right from the start.  That will allow you to form a partnership with that patient in creating a new expectation.  They have to do their part and tell you how it's going for them.  You have to keep asking and working to find their comfort zone.  Between all of you, you can create a new reality for them, at least dentally.

The best thing is to start out with a great experience.  That is a gift you can give to the children in your practice that will benefit them for a lifetime.  Children who are not afraid of the dentist, become adults who do not avoid dental care.  If you can't develop a great manner in treating children, please don't treat them at all.  I've seen both sides.  I once worked with a dentist who was fine with well-behaved children, but who lost it with children who were fearful or difficult.  You could actually see the child decide that going to the dentist was scary and just plain terrible.  It was sad, and shouldn't have been that way.  I finally convinced that dentist to refer most children to the pedodontist.  My current boss, Dr. Nigel Morgan, is absolutely amazing with children.  First of all, he takes time to let them get comfortable with him.  He talks to them and jokes with them until he's got them giggling and excited to see what's going to happen next.  I'm smiling as I type this, just at the memory of how cute it all it.  If you look over at the parent, you can see that they're enjoying it just as much as the child.  Parents love to see someone care that much about their kid.  Dr. Morgan lets the child know what he's going to do in kid-friendly terms and before you know it you have child giggling through their injection at the thought of a tooth bug pulling out his sleeping bag to take a nap.  The adventure continues as the sleeping tooth bug wakes up and realizes he's about to be chased out of his home, and finally packs up to find a different mouth to inhabit.  The child leaves with a smile, a toy and a healthy outlook on dentistry.  No victim here. 

Whether you're facing a phobic adult or an anxious child, you can make a difference.  Encourage open communication, allow requests and try to honor them, and be patient.  Victims aren't much fun to work on, and you certainly don't want to become the victim of an anxious, angry patient yourself.  Work with intention, not reaction and you and you're patient will both benefit.

The Way You Make Me Feel

    I've been writing about my favorite restaurants, and what makes them so great, quite a bit lately.  Now I want to write about one of my favorite shops.  Rabbit & Company!  It makes me smile just to think about it.  That's what it's all about, creating pleasant anticipation in your customers, clients or patients.    Why do I love Rabbit & Company so much?  It's a wonderful specialty cooking shop owned by the delightful Katy Kistler.  Let's start with Katy.  She's a little southern mensch.  When you walk in you feel like she's just been waiting for you to arrive.  When she sees you her face lights up and her whole body just says she's thrilled to see you.  If she's talking to someone else, she'll very naturally work you into that conversation.  She remembers everything you tell her and will ask about it the next time she sees you.  But, the thing that makes it all very genuine is her interest in you.  She asks about you, she listens and she responds with warmth, delight, laughter or commiseration.  She basically draws you in to the warmth of her shop and her own personality and makes you a part of it all.    Now, how in the world does she create all that warmth in a building that, if empty, would resemble a warehouse?  Well, of course, there's Katy, greeting you as you walk in.  Then there are the thoughtful displays that grab your attention and make you want to investigate.  Everything is wonderful, I'm not exaggerating.  She uses her space wisely and pays attention to detail.  Nothing is ever out of place, yet you feel invited to pick things up and examine them.  Everywhere you turn, there's something you haven't seen before.   Katy knows her stuff, too.  She can tell you about everything she sells and usually has some funny or interesting experience to go along with it.  I recently bought a mandolin and she strongly warned me about being careful, lest I lose a fingertip.  She then went on to tell me about a customer that I know that did just that.  I left with the promise to always use the pusher thing and then saw the fingertipless individual in the grocery store.  I smiled and said, "I just bought a mandolin."  He laughed and said, "Katy told you, didn't she?"  She creates community from her little corner of town.  That creates goodwill and good feeling toward her business.  It makes me feel a little smug about being known in Rabbit & Company. 
    Ok, so what does this have to do with dental practices, you may wonder?  Everything.  Let's look at the reasons that Rabbit & Company makes me feel so great.  First, there's Katy herself.  Imagine if a patient walks into your practice anticipating the great feeling she knows is waiting for her inside.  Each and every team member is responsible for creating that feeling.  It can't just be the front desk person, everyone has to carry it through or it will die with the first grumpy face or careless greeting.  It has to be consistent or it will feel phony.  Every time, every person.  Once you get past the greeting, there has to be interest in the patient.  Talk about yourself a little, but talk and ask about them a lot.  Give advice, it shows you really care.  Follow up later if warranted.  Draw them in with warmth, concern and your personality.    Develop your skill.  Develop your personality.  Check your and your team's attitude and appearance.  Nothing makes me feel worse than a healthcare provider that doesn't seem to care.  Sometimes it seems that people in health care think that seeming indifferent makes them come across as competent.  It just really makes them seem uncaring.  Have you ever had someone prepare to take blood from you who acted nonchalant and flat?  You're sitting there anxious and dreading it and for them it's business as usual.  That may well be the case, but if they just acted like they cared about your experience it would change everything.  Next time your preparing a patient for extraction, try to think about what they may be feeling and thinking.  I guarantee, from personal experience, it's anything but business as usual.  They are feeling loss, fear and anticipation of pain.  Let them know you understand and support them.  That's how you create the magic that Katy creates in her shop.  That's wrapping your arms around them and bringing them into a warm, comfortable place where they feel like someone cares and is for them.  Know your stuff, just like Katy does.  If you bring a new service or product into the practice, learn everything about it.  Don't wait for instructions, do your own homework.  When you recommend something for a patient, be prepared to answer questions intelligently.

    How about the physical surroundings?  Make things cheerful and welcoming.  That adds to the anticipation.  Katy is always changing her central display and that adds to the fun.  Find some area of your office that you can create a seasonal display and keep it interesting.  I just decorated our office for fall and it adds so much warmth when patients walk in the front door.  There's nothing worse than a dental office that is just dental.  Add some interest to the decor to relax patients and make them feel that someone is trying to delight their senses as well as care for their teeth.  Light scented candles to detract from the smell of eugenol, have some items that ease the anticipation of the drill, have a good supply of up to date, interesting magazines available and offer some kind of refreshment while they are waiting.  Look around as if you are a patient entering your office and see where you could make things more cheerful and welcoming.  You'll be surprised when you look at it from their point of view.    How do you want to make your patients feel when they are coming to see you?  Do you want them to smile, the way I do when I think about going to Rabbit & Company, or do you want them to have that sinking feeling of dread that so many associate with a dental visit?  I want the Katy factor in our practice.  I want patients to smile when they think of us, just like I've smiled through this whole post thinking about Katy.  You can do it, you just have to want to do it.

Here's Rabbit & Company's info.  If you are in Hendersonville, check them out.  You'll see what I mean about Katy and find something you didn't know you needed at the same time.

124 Fourth Ave. East, Hendersonville, NC, 28792,  828-692-6100

Service Joy

“I slept and dreamed that life was joy. I awoke and saw that life was service. I acted and, behold, service was joy.” R. Tagore

I just read this quote on Twitter and it was tweeted by none other than someone I have the utmost respect for, Tom Morris.  The word service is one of those words that make people feel something.  Some feel inspired to act, but others feel almost victimized when they think of serving.  I think it helps to think about where you're coming from when you are considering serving another.

If we think of serving as something we are forced to do or have no choice about, we may feel somehow less than the person we are serving.  But, if we look at serving as something that we offer, something which is accepted from us by another, we may see the honor in that.  We are taking an ability that we have, offering it to another, and being accepted.  In the process we make their life or experience better and find meaning in our ability. 

When we serve our patients we not only affect their oral health, which in turn affects their physical health, we have the opportunity to enhance their psychological health.  In turn, when someone accepts our service, they allow us to be of use to them.  That makes us feel pride, accomplishment, and yes, joy.

Whenever a patient feels compelled to hug a staff member before leaving, you can be sure that both the staff member and the patient experience a symbiosis and pleasure in what has happened between them during the interaction.

The best thing is that this joy is available at most any time of the day, any day of the week.  It's right on the tip of your tongue, just open your mouth and say a kind word, offer good advice, thank someone else and you will inspire joy.  The power is in you.  Every moment you have the chance to give someone else what they need whether it is supporting a team member, holding a hand, or just listening.  Yes, even listening is service if it is what someone needs from you.  Allowing others to serve you is also a form of service in itself.  Sometimes people want to do something for you to gain your trust or admiration.  Having the self-discipline to accept their service, even though you could do a thing for yourself, is generous. 

If you want to experience true joy, give.  If you want to share true joy, accept what others want to give.

Well Seasoned Service

    I really want to continue to focus on service for a while.  After all, in this time of economic unhappiness, it may be the only thing that sets us apart.  Good service will surely be a bright spot in a stressful day and an often unexpected but very welcome pleasure in the midst of a growing tendency toward casual inattentiveness on the part of service providers.

    It seems that some people don't even realize they are supposed to be providing service.  Fortunately there are others out there who knock themselves out providing fabulous service.  In my enthusiasm for praising 131 Main, I almost took the excellent care I receive at Rezaz  in Asheville, for granted.  I say care because the kindness with which our last server attended to us goes beyond the duty of service.  Let me tell you why.  I had just sat down to dinner with my husband and was happy to be in one of my very favortie restaurants.  I was wearing a new necklace and caught it on the table and broke it.  Since I felt that the necklace made my outfit I was pretty unhappy.  As my sweetie-pie husband struggled to fix it with no luck, our server came to take our order.  Well, I was too wrapped up in the necklace disaster to think about the menu and he patiently waited until I was past the disaster.  Now I'm sure he wanted to move on because undoubtedly that table was booked all through the night, but he acted like he had all the time in the world.    When I finally got over my obsession with the darn necklace, which breaks every time I wear it by the way, he came back to take our drink order.  Since I'm am somewhat on a diet, I asked if the bartender could make me a Skinny Girl Margarita.  He was sure the bartender would be happy to try.  I was delighted to look up from my first sip to see the bartender watching.  He gave me a questioning look and a tentative thumbs up which I happily returned.  I've been in other places where they won't even try, but this guy not only made it, he really cared about whether I liked it.  So, they've got it all figured out.  Great food, fantastic funky atmosphere, personable, caring service, what more could I want?  Well, I could want to get in to their Argentinian Wine Tasting but we were too late, not surprisingly they are sold out already.  I'll just have to react faster next time.

    So you're probably thinking, what's this got to do with dentistry?  Nothing, it has to do with service and service is important in all areas of life.  Money doesn't have to change hands to make service important.  Think about the difference that could be made in a life when someone shows genuine human caring.  Whether it's in a soup kitchen, a homeless shelter, Buckingham Palace, the White House, or your own home, doing something with care for another makes an impact and affects how they will treat the next person.  Service is good.  Adding care to that same service in the seasoning that makes it memorable and important.  I'm going to continue talking about great and not so great service I receive around town because I'd love to see Hendersonville become known as the little town with great, caring service. 

About Respect

   

I've been following a discussion on Dentaltown about how to have a successful practice.  As a practice manager, I'm always listening for new ideas and I know you are, too.  There is a regular poster on DT from Australia who has a very enjoyable sense of humor. Most of his posts have some element of humor in them along with a lot of good information.  Often there is some self-deprecation or a hint of teasing in them.  Yesterday he made a post about respect that I found to be profound and undeniably true.  And he was dead serious about it, too, which gave the statement all that much more impact for me.

"We must always treat people with respect no matter how humble.  I love the scene in Breakfast at Tiffany's, where they tell the man they only have a few dollars to spend, and he graciously shows them a tiny brooch that they can afford.  I love the grace and deep respect he shows them.   You just know that if they ever had enough money to buy something expensive, they would go back to that man."

    If you begin every encounter with every patient keeping that principle in mind, you will have a successful practice.  Let people have their dignity.  When we make people feel small, they never forget you for it.  Likewise, when we honor their dignity, they always remember us for that.  Which would you rather be remembered for?

    Often patients come to us with a sense of shame.  They seem astonished that they've let their mouth deteriorate to such a condition.  It happens.  Time goes by while other challenges that seem, and honestly for them, may be, more important at the time. Let's face it, there are strollers to push, soccer cleats to buy and college tuition to pay.  And let's not forget about vaccinations, ortho, summer camp and the latest pair of sneakers that everyone else has.  When they finally have the time and resources to turn their attention to themselves and their own oral health, a lot of damage may have taken place and years of neglect may have taken their toll.

So now that they have the time and money, they have to summon up the courage to face not only the treatment they will need, but also, the judgment of the dental profession.  Or, they may still not have the resources to accept optimal treatment, but want to do something.  We have to know when to stop promoting what may be optimal, and listen to them so we can guide them to treatment they can afford.  When we offer them a less optimal treatment with "grace and deep respect", we allow them to feel good about, and proud of what they are doing. 

    How we treat people passively, through our attitudes and words, is just as important as how we treat them actively, during treatment.  If we mess it up passively, we may never get the chance to treat them actively.  The thing is, it's so easy to be kind and respectful.  You get back as much, or more, than you give them.  It feels good to do good.  Treat all your patients with respect and courtesy and you will be successful and happy with yourself, and they will love you for it.

The Patient Is Always Right?

   

The patient is always right.  Right?  Not so fast, the patient is always the patient and you can't win an argument with a patient, but that doesn't make them right all the time.  Did I just hear an army of dental professionals rise up and cheer?  Go ahead, you deserve it, but then get over it and listen.
  
     I'm reading a book titled Delivering Knock Your Socks Off Service, which is put out by Amacom.  I'm loving it so much that I'm putting together a staff meeting built around it.  I'll be posting a PDF file that you can download if you'd like to use it with your staff, when I'm done.  There are a series of Knock You Socks Off books and, glutton that I am, I've bought three of them.

    Dental offices all offer the same basic thing.  The only things that will make you stand out from all the other offices in town are skill and service.  The only thing that will make your service stand out is really caring.  I'll get into that in another post, but right now I want to talk about the revelation that the patient is not always right.

    Before you get too excited, realize this, just because the patient can be wrong, it doesn't mean you get to say, "Ha!  You're wrong."  What you have to do is acknowledge that your patient may be misinformed and use education and information to steer them to being right.  That's correct, you have to use all your knowledge and professionalism to make the patient right. 

    One point that is made in the book is that by thinking that the patient is always right, we put ourselves in a one-down position.  When we force our staff to do whatever the patient says to do, even when we know they are dead wrong, we are telling our staff not to think or ask questions and this can make service feel like servitude.  This will quickly demotivate the staff and make them dissatisfied.

    When we insist that the staff must always consider the patient to be right, we cripple their ability to use their knowledge and empathy to educate the patient and help bring them to a position of actually understanding and making good decisions for themselves.  We can use what we know to help a patient become right without embarrassing or shaming them.  That's what will keep our patients coming back again and again, and what will make them refer their friends and family to us.

Still Thinking About Service

   

I can't get the subject of service out of my mind.  Chris Creamer from the Mastery Program remarked that he  had read my article about 131 Main, the restaurant whose service I've been so impressed with and said that he'd just read a book titled Setting The Table by Danny Myer, a NYC restaurant owner.  If restaurant managers realize how important service is, shouldn't we?  Let's face it, the one thing we have in common is the fact that we all offer something that is useless unless someone else wants it.  Lot's of other people offer basically the same service.  The two factors that make some decide to come to you and stay loyal to you are quality and service.  Thankfully, both are completely within our control.
    It's not as easy as it sounds, though.  You can't wave a magic wand over your staff and make them great technically and give them a desire to provide outstanding service.  You, and they, have to work at it consistently.  People tend to like to get to a certain point and say, "Enough, this is as good as I get."  People get tired, I know that.  It's ok to rest and look back over how far you've come and even enjoy a plateau now and then.  That rest should be short though, you should always be looking ahead to see where you want to go next and checking that you haven't lost any of the ground you've gained.
    Yesterday I went to buy some tomatoes at a local farmer's market.  The place is always busy and the stand I wanted to buy tomatoes from was being manned by a nice gentleman and his 8 year old granddaughter.  When I walked up she jumped up and said, "We're getting busy!" and asked me what she could get for me.  I asked her to pick out 2 lbs. of nice tomatoes and she very seriously picked out the best tomatoes and weighed them.  She took the task seriously and thanked me very sincerely.  You could see that she wanted to do a great job and was proud of helping me.  When do we lose that enthusiasm and desire to serve?  When does service change from something we're excited to be trusted with, to something that we avoid or resent?  Trust is the thing that made what she was doing so important to that little girl.  Her grandfather had decided she was trustworthy enough to handle the responsibility and she knew that and valued it. 
    Do we realize that our dentists are trusting us with an important responsibility?  As a manager, I am sometimes awed by the amount of trust Dr. Morgan places in me.  He trusts me with his livelihood and that of the staff.  He and I trust the staff to deliver not only excellent care, but also fantastic service to our patients.  The key is keeping that enthusiasm alive.  It's instilling pride in performance.  It means we have to constantly and consistently notice and acknowledge our staff's efforts and achievements.  Don't take anything for granted on either end.  Uphold standards, do not accept less than required and be very verbal about acknowledging great performance.  It's also fun and appreciated to surprise the staff with special treats now and then, too.  Soon enough, that desire to serve well will return and the childhood thrill of living up to the trust that is placed will return.  Don't we all experience that inner "Yes!" when we know we've done well?  Imagine what having your staff experience the "Yes!" on a daily basis will do for the culture of your practice. 
    Maybe the title of this post should really be, Always Thinking About Service, because that's how it is for me.  How about you?

How They Do It All Right

   

If you remember, about 2 weeks ago I wrote about a great new restaurant nearby called 131 Main.  I was completely impressed with their customer service.  I was so impressed, in fact, that I called the General Manager, John Perkinson to ask him how they did it.  John was very generous with his time and information.  Ninety minutes passed before I knew it and I was impressed with John's enthusiasm for leading his team.  No wonder they're so great, it starts at the top.
    He started talking about the interview process, which is where I think a lot of us in dentistry make our first mistakes.  The problem is, if you make mistakes here, it's very unlikely to have a successful outcome.  Prospective employees go through 3 interviews.  By the time they get to John, they've been narrowed down to some very good candidates. When an applicant makes it through to him who shouldn't have, he goes back to the previous interviewers and asks why they passed them through.  Often, the interviewers liked the candidate as a person and didn't want to hurt their feelings.  How many times have you hired someone because they were nice and ignored the little voice in your head that was saying, "Yeah, but..."? 
    Once an employee is hired they go through 5 scripted days, always with an experienced staff member.  Each day is planned so that the trainee is exposed to the standards of the restaurant and understands what is expected.  In our offices, it's sometimes hard to do that because we often are running thin on employees as it is, but is it fair to expect someone to just pick things up as they go?  John or another manager talks to the trainee every day and gives them immediate feedback.  Don't wait for the 90 day probation period to end before giving feedback, give it daily to help ensure success.
    John suggested giving an applicant situational problems that they will encounter and that other have struggled with, and seeing how they'd handle them.  He feels that the culture that you have built in your practice will help lead you to the questions to ask a new applicant.  Don't be embarrassed or think something sounds silly.  If something is important to the culture of the practice it is imperative to ask questions that help you determine whether the applicant will fit into that culture. 
    "Be tough on standards, not on people."  I told John I was going to quote him on that because it's such an important point.  People don't come to work hoping to do poorly, so don't beat them up when they make mistakes.  Instead, focus on correcting mistakes or behaviors and reinforce that as needed.  As John says, "If they can't take constructive criticism, they don't need to be here."  I know I've often felt hesitant to give feedback for fear of an employee walking out.  I worry about turmoil in the practice and patient perception.  Patients often don't realize there's more that goes on behind the scenes and that the person who is so nice, may be struggling to perform even simple tasks correctly.  Often, a person who does not have the ability to handle feedback would rather just leave.  John talks about the fact that the new employee will often push back when criticized, but says that being consistent will often get good results. 
    He says that everyone on the team challenges each other and that if someone just doesn't perform, they will often leave because the staff will pressure them to improve.  That is so important in our practices.  I always remind our staff that the practice culture requires their participation if it is to remain intact.  If they see a new employee struggling or doing something incorrectly, they should help her and show her how to do it right.  I also expect them to spend time teaching the employee about what they do and how they can help and enhance each other's care of our patients. 
    Finally, reward good performance.  Be on the lookout for it to increase dedication and loyalty to the practice.  It doesn't take much.  Just knowing that someone noticed extra effort will help ensure that it's repeated.  I'm planning to make up some WOW cards to hand out to staff whenever I catch them doing something good or when someone comments on something outstanding that they've done.  When they have five cards they can turn them in for a reward.  I've already got some nice soaps and Marble Slab gift certificates ready and waiting. 
    Talking to John made me realize that it takes effort and preparation on the part of management to help our employees excel.  That's what we are here for.  Serve by leading well so that you can increase service to patients and make your practice a practice of excellence.

Doing It All Right

    Who would have thought I'd find the best example of great service for a dental office in a restaurant?  My husband and I went to 131 Main, a new restaurant in Biltmore Park in Asheville last night night.  I was blown away by the great service and wonderful food.  I sat there amazed at the fantastic service given to us by multiple employees in the restaurant.  Our main server explained that everyone works as a team and that the person closest to any server will always take care of whatever need presents itself at any given moment.  Not only that, I noticed that if a server was holding a plate that a diner had finished with while they were explaining something to the diner, any passing server would notice and take the empty dish as they walked by.
    I was thrilled to hear another server explaining that he had come up from the Charlotte restaurant to help train the new servers in the recently opened 131 Main.  He explained that they had a culture in their restaurants and he wanted to help the new servers understand and develop that culture in this new restaurant.  Wow!  I found myself wanting to beg them to give me just one of their employees for our office.  We have a great staff, but could use one more to help fill out the group.  I just find it hard to find people who are willing to accept constructive criticizm or who can last through the frustration that sometimes comes with learning and adapting to a new job. 
    I asked to speak to the manager because I want to know how they do it.  He explained that they have a very definite and intensive training regimine that each new employee must go through.  It works.  Every single person working in that restaurant was watching, ready to fill any need before it was even recognized as such by the customer. 
    The service set you up to want to love the food.  We weren't disappointed.  Everything was fresh, delicious and perfectly prepared and presented.  Everything was a delight, right down to the cup of tea I finished off my meal with. 
    Attention was paid to every single detail.  Even the soap in the rest room smelled wonderful and the place was immaculate.  I felt like the intention of everyone in the restaurant was to make it an exceptional experience that would keep us coming back again and again.  That is how regular customers are born.
    This is what we need to do in our practices.  We need to make every visit an experience.  We need to leave our patients feeling that we strive to meet their every need.  We need to figure out how to develop our teams the way 131 Main does. 
    I have the managers card and I'm hoping to interview him in the near future and find out how he does it.  If he gives me any insight, I'll post his tips here so keep watching.  In the meantime, call 828-651-0131 and make a reservation.  It's my new favorite restaurant.  Hmm, maybe I shouldn't be telling you all this.  It'll probably make it harder to get a table.  Imagine having that problem in your practice.  Now, that's a problem everyone would like to have.

Treat Me Like Dirt

   

And I'll tell everyone who will listen.  And then they'll tell everyone who will listen.  And it quickly goes viral.  Here's what made me write this:
    A few weeks ago a co-worker and I ate lunch at a place that has a buffet.  We like their food in general and like the idea that it's a buffet, so supposedly no waiting will be involved.  We hate the fact that they never seem to have much ready on the buffet. As we were being seated, I mentioned to her that it would be good if they had more ready.  I also asked the server to prepare a to-go order for my boss.  A few minutes later she came to our table and berated me for the comment I had made to my friend and said that they only take 20 minutes to prepare more food.  I told her that defeats the purpose of a buffet.  We only had 40 minutes, that's why we came to a place with a buffet.  She made another snippy comment and flounced away without taking our drink order.  We had to call it to her as she stormed by again.  Near the end of our lunch she came by and tossed my boss's lunch on the table and said that we probably wouldn't be able to get it again as it's not on the menu.  If she had said that when I asked for it, I'd have ordered something else.  All in all, horrendous service.  I asked if the manager/owner was in and she said she'd be in at 3 and I could call her then.  She obviously wasn't at all concerned with our dissatisfaction.
    When I called back, the owner said the server had told her what happened and defended her as her best employee.  I hadn't even told her my concern yet.  I told her that we used to like going there for lunch, but if that was going to continue to be what we could expect, we'd go elsewhere.  She did not care.
    A few days ago a patient came in and told us that he had eaten there and his food was somewhat burned.  It had happened before and he'd mentioned it to the server.  When the server came over and asked how their food was on this day, he said that it was burned.  She took his name and number and said the owner would call.  Well, the owner did call and left a message on his machine informing him that since he'd complained twice, she was banning him from the restaurant.  He was no longer welcome to come and pay for burned food.
    Now, think about it.  The patient bothered to mention this incident to his hygienist during a recall visit.  This is a small town.  She immediately told me about it because of our previous experience.  This patient is an extremely nice man.  The combination of such rude treatment and such a nice man makes it twice as bad.  There are six of us in the office who will now never eat at this restaurant again.  We will probably mention it to anyone who brings up the place.  God only knows how many people our patient has mentioned it to if he's telling his hygienist. 
    What it comes down to is this, people want to feel good about themselves.  The way others treat us influences our feelings about ourselves or about them.  Treat a patron badly and they might eventually forgive you, but they'll rarely forget or trust you again.  Treat them badly and don't extend an apology and they are going to talk because they want reassurance that they did nothing wrong and confirmation that yes, you were treated horribly. 
    Bad news travels faster than good news when it occurs in dental practices.  Think about it, if you promise to treat your patients well, make it your "thing", and consistently deliver great service.  Patients expect nothing less and become accustomed to it.  It's not news anymore and they don't leave and tell their friends, "Oh, you can't believe what a great dental visit I just had!".  But, when someone asks for the name of a good dentist, they'll rave about you.  So good gets less press, but it gets referrals, so keep it up.  Give a patient poor, unkind, or uncaring treatment however, and you are in for it.  They will tell the first person they see after the visit.  Someone calls them on the phone, they will get an earful, even if the patient remains a patient and comes back, they've still panned you to at least 5 people.  Those 5 will never give you a chance.  You can't afford to chalk it up to a bad day, bad news, cramps or a sick family member.  You have to deliver good, caring treatment.  If you can't put whatever is bugging you aside, then you really should stay home.  Nothing destroys a business or practice faster that bad word of mouth that quickly goes viral. 
    It's too bad for the restaurant.  It's got a lot of good things going for it, but the bad outweighs that.  I doubt that they will turn it around and that's a shame.  No one opens a business intending to fail.  That's not enough though.  You have to have a vision for how to succeed and this place missed that step.  Make sure that you have your vision firmly in place and consistently followed.
Listen to your patients and follow up on their concerns, don't just dismiss them.  If a problem occurs, deal with it appropriately.  It may just be a misunderstanding so follow through to a win-win conclusion.  You can guide the word of mouth if you care enough to listen to complaints and deal with them.  I remember in grade school, hearing a teacher compare gossip to scattering the feathers from a pillow on a windy day.  It's impossible to run around gathering them all back.  Once it's out there, it's out of your grasp.  It's the same with bad word of mouth,  you can't undo the damage, so do everything you can to make sure the feathers that get out there are working for you, not against you. 

Who Cares?

  

  Hopefully, you do.  Whether you're an owner or a staff member, if you don't care about what you're doing and how you're doing it, you'll just be wasting your time and languishing in mediocrity.  You can be smart, you can have a beautiful office, great looking staff and fantastic skills, but if you don't care, your patients will think you're just ok. 
    Here's the thing, and it's a good thing, it's not hard to show you care.  It takes a little bit of thought, insight and oh yeah, caring.  Think about it, your patient comes to your office, sits in your chair with their mouth open for an hour and a half while you introduce sharp, spinning, whining instruments that sometimes hurt and at the least make them bleed or drool.  They trust you with that.  So, isn't it a good idea to take three minutes at the end of the day to call them to see how they're feeling?  Believe me, that small investment of your time will pay big dividends in loyalty and word of mouth advertising.  You are always making impressions on your patients.  You are guaranteed to make a good one when you call to see how they're feeling.  Even if they are having discomfort, they'll still think you're great for caring about that.
    Show you care in any way that you can think of.  Send flowers to a patient who's had surgery, a card to a patient who misses an appointment because of the flu, a plant to a patient who's lost a spouse.  Make them feel your caring and you'll have a loyal patient.  The bonus to all this caring is that you'll likely find that you really do care and that will make what you do very satisfying. 
    I see lots of dentists trying to be the best, or trying to win patients by adding spa amenities and running glossy ads.  I remember going to a new dentist and being handed a rose on the way out.  The problem was that from the word go, I had a very negative feeling from the staff and dentist.  No one seemed to enjoy what they were doing and there was absolutely no connection.  The rose almost seemed like an insult to my ability to discern whether or not I'd received caring treatment.  I'd have been much more impressed to have been treated warmly.  As it was the beauty of the rose could not wipe out the thorny indifference of the staff and dentist. 
    I'll leave you with a compliment we received from a patient today.  Yes, I know it's Saturday, but this patient had called yesterday to ask about some pain he'd experienced after biting on something hard with an implant crown.  I called to see if he had experienced any more problems.  He was fine, but his comment made my day.  He said, "Dr. Morgan and all of you are outstanding because you understand that you are dealing with human beings.  You can have all the skill in the world but it doesn't matter if you can't figure that out.  You consistently show me that you care."  There's the secret formula for successs.  CARE.  Even if you don't really feel it, fake it at first.  Before you know it you'll find yourself hooked on caring.  Who cares?  You must, after all you're reading this aren't you?

A Gift

    My boss and I are attending a Turbyfill prosthetic course and if you ever have the chance to attend, do it.  Dr. T. is 76 years old and absolutely delightful.  He brings a patient in who is having problems with a denture and remakes the denture during the three day course.  It's really something to see.
    The patient today was a very sweet 68 year old woman named Mary.  Her full upper and lower dentures fit so poorly that she said she takes them out to eat.  Now, where's the logic in that?  When she started talking about how it affects her, it was an eye-opener. 
    She is very mild mannered, but when she began talking about her journey with these dentures she became agitated, upset and somehow seemed almost ashamed because she had gone to a "discount" denture clinic since she couldn't afford her dentist's fee.  Her general dentist was there and had been asked if he could supply a patient for the course.  He was obviously very grateful to have her getting some help.  As she told us about her denture I realized that denture patients may often feel like a lesser class of denture patient.
    As Dr. Turbyfill stated, we need to be very compassionate and caring with our denture patients and make them feel good about what we are doing for them.  So often these days, we are classifying dental IQ's and feeling that patients who accept implants must have high IQ's because they are choosing optimal treatment.  Being able to afford something better doesn't make a patient smarter than someone who has to choose within the limits of their budget. 
    After listening to Mary, I gained new insight into the feelings and experiences of a denture patient.  Thanks to her, I think I have more empathy for what our denture patients may experience.  Dr. T. has assured us that Mary will not only join us for lunch tommorrow, she'll keep her dentures in her mouth to eat it.  I can't wait.  What a gift for her and what a satisfaction it must be for Dr. Turbyfill to be able to give that gift.

Just Satisfied (Yawn)

    Ok, our staff is back on track, so back to business here on this blog.  Sorry for the diversion, but I hope you gleaned something from my travails. 
    So, are your patients satisfied?  Are you satisfied with that?  Great, open your mouth and let loose with a big yawn, that's probably what your patients are doing. Because satisfaction is boring.  It's just enough and not much more.  It's basically fulfilling an obligation, but not more than that.

    What's wrong with just enough?  Nothing if being mediocre is what you're aiming for.  If you want your practice to be more than that you have to make each appointment memorable in some way.  It's not hard and it doesn't cost a lot of money.  It takes time, it takes training and it takes a team that believes it's worthwhile.

    I'm reading a book titled Customer Satisfaction Is Worthless - Customer Loyalty Is Priceless by Jeffrey Gitomer.  Books like this make me realize that we always have to keep paying attention to what we're doing.  We can't think we're good enough as we are because complacency is just another way of saying we're done.

     Have you ever wondered why patients leave your practice when you feel that you are satisfying their needs?  It's probably because someone told them about the great Wow! experience they had at their dental visit.  Satisfied patients will be fine with you until they hear about something better.  Then you better watch out, they're going to want that.  Because they know their worth it and they may wonder why you don't see that, too.  After all, if Dr. Jones can give his patients fantastic service, why can't you and your staff?  They won't tell you about it, they'll just leave and leave you wondering.

    What can you do to give your patients a great experience at their next visit?  There are a dozen easy little changes that you and your staff can make.  If you'd like the staff meeting outline I've worked up that I based on this book, just email me and it's yours.  Email me at: lindaz@mchsi.com

The Last Five Minutes

Whew, it's the time your patient likes best.  The last five minutes of their dental appointment.  The anxiety is over, they can close their mouth and go on with their life.  Most patients would like nothing better than to jump up and rush out.  Try to slow things down a little.  First of all, they've been lying supine for a while and they need to sit up and get used to the posture change for a minute.  You need to get their info into their chart.  Check their face and help them neaten up a little.  Wipe their face and clean their glasses.  Check out the back of their hair.  No one likes finding out that they've been walking around with chair hair for a hour after their appointment. 
If you're the doctor, don't rush right out.  Let the patient know how you feel the procedure went and what they can expect.  If you want to make a really lasting impression, make a quick phone call to your operative patients in the evening after work to see how they're doing.  It really doesn't have to take long and they appreciate it.
Assistant or hygienist, talk to your patient about home care and congratulate them for their wisdom in keeping regular appointments and taking care of problems in a timely manner.  Find a way to compliment the care they've received from the dentist and let them know that you appreciate having them as a patient. 
At the front desk, make sure they have all the information they need and that they understand their fees for what has been done and for any upcoming treatment.  Be prepared with any x-rays or narratives that they may need to submit with their insurance claim.  Pay attention to them all the way through this last part of their visit.  It doesn't end until the door closes behind them.  If the first five minutes is a great opportunity to make a good first impression, then the last five minutes seals the visit.  A happy patient leaving a dental appointment will tell the next person she sees all about how special you are.

The First Five Minutes With The Dentist

If the first five minutes with various staff members opens the door for a great patient experience in your practice, the first five minutes with the dentist ushers the patient completely into the heart of the practice.  The staff can relax the patient and make the practice feel special.  They can build you up as they go so that the patient can't wait to meet you, but only you, the dentist, can confirm all that for the patient.

I think the best thing you can do is to be "yourself", just make sure that "yourself" is a good way to be.  You can only fake being kind, caring or compassionate for so long.  Then a situation will come up like a patient being overly anxious or a crown occlusion being ridiculously high and the real you will seep through.  One time and the patient will chalk it up to "Oh, Dr. Usuallynice is having a bad day."  More than that and they'll realize they're seeing the real you. 

I think that listening is the key to the first five minutes.  So many dentists enter the room and ask how the patient is doing while washing their hands with their back to the patient.  If so, the patient has to reply to the dentist's back and try to talk over the sound of the running water or rustling paper towel.  Often the dentist is glancing over the patient's head at the x-rays or chart on the computer screen behind the patient.  By this time, the patient may be wondering if the question really required an answer.  The best I've seen shake the patient's hand while inquiring as to their well-being, pull up a chair to listen, mention something that either happened or was discussed at the last appointment (staff, you can help with this at morning huddle),  and finally, ask the patient if they're ready to get started.

Once the patient is positioned, if they need anesthetic, the best technique I've seen is slow.  Slowing down makes the patient feel that the dentist and assistant really wants this part to be as painless as possible.  Don't just slap the topical on, gently massage it in with the swab.  My boss injects just a small amount of anesthetic and waits one minute, explaining to the patient that he wants to let that start to work before he goes further.  Then his injection seems painless to me and the patients often mention that it is indeed, painless. 

You may think you don't have time for all this, but taking the first five minutes slow, builds trust.  That trust makes it easier for patients to accept treatment that you recommend and to relax in the chair.  They will also be more likely to sing your praises to their friends and that's the best first 5 minutes you can get.

The First Five Minutes In The Operatory

It all starts with the way the assistant or hygienist retrieves the patient from the reception area.  The usual way is to push the door open, prop it with a foot and call the patient's name.  Now, the long trek down the hallway begins, with the patient trailing behind the staff member.  One in the room, the patient is bibbed, laid back and smeared with topical.  There may be a half interested question about the patient's weekend as the staff member washes her hands and wonders who is calling her on her vibrating cell phone.  Not such a great first five.

Here's what I like to see.  The staff member goes to the patient in the reception area and warmly greets the patient and invites them back to the operatory.  They walk side by side and the staff member, having reviewed notes on the patient, asks for updates on events that were discussed with the patient at a previous appointment.  It's so easy to jot down a few notes about the wedding, graduation or vacation that the patient was looking forward to at the last appointment so that it can be mentioned at a future appointment.  It's one of the things that distinguishes a practice and lifts it out of the ordinary.

Once in the operatory, the staff member should go over the treatment to be accomplished that day and answer any questions the patient may have.  Any special items that the patient appreciates such as a neck pillow or head phones and music will be waiting because, again, a staff member has noted the patient's preference so that any staff member working with that patient can offer exceptional service.  When it's time to place topical or begin the prophy, the staff member will let the patient know that the chair will be reclining rather than just pushing the button without warning the patient.

It's all about consideration for the patient's sensibilities.  These are the things the patient remembers and tells her friends and family about.  These are the things that make you stand apart from other practices.  These are the things that make the first five minutes work.

The First Five Minutes On The Phone

We talked about how important the first five minutes with a patient can be.  Let's break it down a little.  Let's think about the first five minutes on the phone with any patient.  I say any patient because every contact with a patient either builds up or breaks down their opinion of our practice. 

I called a practice the other day and after receiving a cursory greeting, I was asked if I minded being put on hold.  Before I got a chance to respond, I found myself listening to the BeeGees singing "Staying Alive."  I immediately looked at my watch and 90 seconds later, the BeeGees were cut off by a very rushed sounding person asking how she could help me.  I felt like I better state my business quickly or risk a rendition of Billy Joel's Uptown Girl.  My feeling was, "This office is too busy to care about what I need." 

The first thing a patient wants to feel during that first five minutes is that they have found a practice that will have time to care about them.  When they are immediately put on hold the message is, "There is something more important going on here than your phone call.  You'll have to wait."  It's impersonal and disconnected.  It's usually a sign of what the patient can expect if they wait through the hold time and actually make an appointment.  I have a physician who is wonderful, once I get through the uncaring, detached staff that work in her office.  She's part of a group practice and probably feels like she has to put up with it.  If she herself wasn't so caring and interested in me as a patient, I'd probably find another doctor. 

I'd rather see a practice that can't keep up with their phone have a warm friendly answering machine message that let's the caller know that everyone is attending to patients and that they will return the patient's call within 5 minutes if they leave a message.  Then they should do just that and give the caller their full attention.  The practice should also consider hiring more staff at the front desk to give the proper attention to answering the phone. 

So, what makes a great first five minutes on the phone?  Answer by the second ring and smile while you are talking.  The smile comes through in your voice and the caller can hear it.  Be warm, professional and interested in why the patient is calling.  Listen for unspoken messages such as fear, embarrassment and pain and try to address those in a caring, reassuring way.  Try to find point of interest about the patient and tell them something about you that will establish a connection.  Let them know that you look forward to seeing them and that they can expect a pleasant welcome from everyone. 

The main way to make a great impression in the first five minutes is to think.  Think about how you like to be treated.  Think about what you can do to make this contact special.  Think that this patient is the most important patient in the practice, because truthfully the patient you are involved with at them moment is the most important one for you.  It's the only one you are affecting in that moment.  Make it count.

The No Blame Game

    Did you ever notice that when something goes wrong, people seem to spend more time trying to figure out who to blame than they spend trying to make it right?  It's as if making someone else wrong makes us feel better and somehow vindicated.  It doesn't have to be that way.  Situations can be fixed without finding a fall guy.

    We had a patient who I felt was being pretty unreasonable.  He wanted to blame his hygienist for the fact that one of his teeth under a stainless steel crown had developed decay and needed a new crown.  He felt that we owed him a new crown.  My first inclination was to talk to him about accepting responsibility for his own oral health, but I knew that if I did, I'd only make him mad and probably lose him and his wife as patients.  I decided to listen to him and then asked him what we he felt the hygienist did wrong.  He said she should have seen the decay. I told him that an x-ray wouldn't have shown it and that there was no decay at the gumline.  Basically, I led him through a co-discovery of the whole scenario.  By the end of the conversation he came to realize it was a blameless, though unfortunate, situation.  We went on to talk about ways to avoid further decay problems and by the time we hung up he was satisfied and pleasant.  He lost his desire to blame once he understood that I cared enough to listen to him.

    It's the same with staff members.  People don't make mistakes on purpose.  Nobody wants to do a bad job.  So, when things go wrong, aim for solutions, not blame.  When people see that you will work with them to fix things rather than against them to affix blame, they respond.  They remember.  You've got them working with you then. 

    If you've been playing the blame game, switch things up.  Pay attention and you'll enjoy seeing the look of surprise on the faces of the people you interact with.  The atmosphere will lighten up and and people work better in that environment.  And after all, that's what you really want, isn't it?

Raving Patients

    Everyone wants raving patients; as long as they're raving about the great treatment and exceptional service they received at your office.  Let them rave all they want.  Because, rave they will, whether it's good or bad is up to you and your team. 
    It's been proven that a disappointed patient often won't bother telling you about the problem.  But they will tell everyone else.  Nothing spreads as fast as news so make sure all news about your office is good news.  People also like to be the one who finds something great.  Let it be you.  They'll tell their friends all about the great new dental practice they've found and they'll want them to go and see for themselves how smart they are.  What impeccable taste to be discerning enough to find this wonderful dental practice.
    So, how do you plug your practice's name into that?  You begin by taking a good look at yourselves.  What are your strengths and weaknesses as a team?  As individuals?  Build on the strengths in a way that benefits your patients and enhances the care you provide and the manner in which you provide it.  Assess the weaknesses. Can they be improved enough to make them neutral?  Can they be eliminated?  Can people who are weak in one area apply their strengths somewhere else and let someone who is strong where they are weak take over something? 
    Can great customer service be taught.  Definitely.  Sometimes just becoming more aware of providing better service will start a great idea inspiring discussion.  There are great books about customer service that can help.  Think Disney, who better demonstrates the benefit of paying attention to the customer experience.  When your team starts paying attention to the patient experience, great things may happen when they see that it benefits everyone and makes the day much more pleasant.   And those raving patients make life in the practice so great, everyone will want more and more of them.  Once you get started, you'll wonder what you were waiting for. 

Why Wait?

    Ian Furst, an Oral Surgeon from Cambridge, Ontario Canada contacted me to tell me about his blog, Wait Time and Delayed Care.  His blog encompasses other types of healthcare and focuses on how to improve patient waiting times.  That's something we all deal with in our practices.  He has a good post about block scheduling.  Click on over there and see what you think. 

It's Not About You

    If you don't believe anything I say, believe this.  It's not about you.  Really, get used to it.  A few days ago I wrote about some bad service we got at the end of my daughter's wedding reception.  The person who caused it wasn't out to get us.  She didn't hate us or want to make us unhappy.  She just couldn't unwrap herself from the problem we were having.  We couldn't locate the bride and groom's car keys, so they not only didn't have a car, they didn't have access to their luggage which was in the car.  We asked for help and got defensiveness and combativeness, but no help.  The result is that we will never give the place a good reference. 
    The person we were dealing with was a young woman so I tried to give her the benefit of the doubt and help her see that we weren't accusing her of anything, we just needed someone to help us unlock the car at the least, or find the keys at best.  She would have none of it.  I asked her to take herself out of the equation and think of herself as a representative of the establishment and do what would make them look good.  She couldn't do it.  We all lost.  My daughter and her husband didn't get their car keys and I believe the young woman was terminated. 
    When something in your dental practice is not going the way it should, do you think about how it affects the practice and the patients, or do you examine yourself for hurt feelings or insult?  If you can just focus on the event and take the time to think of what response will give you a result that will satisfy the patient, then the practice will be ok, and so will you.  When a patient is standing in front of you ranting about their insurance, it's about their frustration with the insurance company.  You may feel disrespected, but that's probably not their intent.  They're mad, and you're there. 
    I had an elderly patient come in a few weeks ago.  She has dementia and needed an extraction.  She's pretty feisty and tends to imagine we've done all sorts of diabolical things to her teeth.  She'll usually give me a lengthy lecture about how terrible we are and then let me settle her into the chair.  When my boss walks in she is sweet and complimentary.  If I try to hold her hand during an injection she'll slap me away and tell me not to touch her.  If I let it be about me, I'd feel pretty bad and dread seeing her.  I know it's not about me, how could it be?  I'm always nice to her.  If she didn't suffer from dementia, she'd love me.  It's about her and her disability.  That's all.  I can deal with it. 
    When you stop taking everything personally, you give yourself freedom.  You don't have to wonder what you did, what is wrong with the other person or what it is about you that makes people treat you that way.  If it's not about you, you just deal with whatever happens and go on.  It's all about thinking outside of the box.  Instead of doing what you always do the next time a problem or stressful situation arises, try to stop and think in a different way.  You may find that you enjoy the challenge. In the end you earn the respect of your co-workers and the self-confidence to know that you can handle whatever happens.

It's Not All About You

When you're in a healthcare occupation, you have to accept the fact that it's really not always about you.  As a matter of fact, it rarely is.  There are more important things than how you feel about what's happening.  Everybody wants to feel good about their job and how they're treated, but there are times that you have to look beyond yourself and do the right thing for the patient.
    This really hit home for me this weekend.  My daughter is getting married next month and we went for a fitting for her wedding gown.  We were excited and looking forward to a special time together.  She put on the gown and the seamstress asked her how she liked it.  She loved it except for one small detail and the seamstress quickly fixed it.  Everything was going wonderfully until the shop manager asked the seamstress what she'd like for lunch.  Then it all fell apart.  The seamstress did not want to take lunch and complained to us about the fact that she had to clock out for 30 minutes.  Then her daughter came into the room and started complaining very dramatically about the manager.  They both started telling us about every slight they'd ever felt from the manager.  We felt uncomfortable and it got worse when the seamstress grabbed her scissors and started hacking away at the netting under the dress.  Even though she needed to cut some away to shorten the dress, we both would have felt better if she had done it calmly.  All in all, it changed what should have been a nice memory into aggravation.  She then charged what I thought was an exorbitant fee and suggested that we give her a tip.  My daughter didn't want me to say anything because she has to have another fitting and doesn't want to feel uncomfortable.  Her comfort and happiness should have been the concern of the staff.  She shouldn't have had to stand and listen to this lady complain.  To be honest, we didn't care about the whole lunch scenario and now I have such a bad feeling about the place, I'll never refer anyone there.
    Have you ever shown your stress to a patient?  Did you ever grumble about anything to them?  If you did, make a vow never to do it again.  They have their own problems and their immediate problem is the injection they're about to get or the extraction that is about to be performed.  You are there to make it easier for them.  You can look at your time in the office as a chance to put your own cares aside for 8 hours.  Give of yourself and you may forget everything else.  Take 3 seconds to ask yourself if what you're about to say or do will enhance the patient's experience in the office.  Then you'll know what you should do.

Tugging At Heartstrings

     I've been talking about attitude toward patients the last couple of days.  Last night I came right up against some really poor customer service.  I went to two large, nationally known department stores.  I was looking for some star necklaces to give to the staff to complete our Energy Bus series.  At the first store no one asked if they could help me and I couldn't find a soul to ask.  Same deal at the second store.  I went back to the first store and stopped at the cosmetic counter to buy some make-up.  Two employees were standing chatting.  When I asked if they could help me, one raised her finger, indicating I should wait till they finished their conversation.  I waited what I felt was much too long, and left.  As I walked away she called out, "I would have been with you in a minute!" 
     Finally, I went back to the jewelry counter and chose a gift for our new dental assistant who is graduating this week.  I took it to the counter and the two ladies there were having a conversation as well.  One of them carried out the entire transaction without ever pausing in her discussion with her friend.  It was as if I was a nusiance that was getting in the way.  She slid my purchase toward me and continued her dialogue.  I walked away angry and wishing I could tell her what I thought.  I'll go back if I have to, but I'll try to shop online if I can. 
     I think online shopping will eventually kill department stores because people would rather have the cold mechanics of the computer than face the cold mechanics of a human being.  The computer doesn't have a choice, it's a machine, but the human being is choosing to treat you with disregard. 
     How does your staff stack up against a computer?  Do they treat patients warmly and with caring or do they choose to grimly work like disinterested robots?  In our practice, many patients hug the staff members before they leave.  We have a lot of older patients and they need people who show interest in them and make them feel cared for. They can't resist hugging them for treating them so well.  Our staff fusses over our nursing home patients and they love it.  That caring touch and attitude gives the patients that feeling in the chest that is referred to as "tugging at heartstrings."  It's that satisfied, sated feeling that eases the hunger we all have for someone to care about us.  We really have no idea to what extent our actions affect another person.  So make sure it's a positive effect and, you may notice that when you treat another person well your heartstring gets a little tug, too.

A Little Bird Told Me...

    ...about what she looks for in a dental practice.  Susan Bird posted an article on her Bird's Eye View weblog in response to a comment I made about an article she wrote about hospitality.  When Susan talks I sit up and pay attention.  Not only is she a communication expert, she cuts to the chase and says things clearly and makes a lot of sense. 

    Susan's dentist is located in Manhattan and has some ideas I hadn't thought of.  He has a section of his reception area set up with a table and chairs with computer access.  I bet a lot of people love that.  Susan makes the point that all the niceties in the world don't matter if the dentist and staff aren't top notch.  I think it quickly becomes apparent to patients that the staff thinks the world of their dentist or, unfortunately, if the staff thinks very little of the dentist.  My boss, Dr. Jeff Price, is absolutely the best dentist I've ever worked with.  Our entire staff speaks with pride when we talk to our patients about what he can do to help them.  That is one of the most important patient services you can provide; a sense of profound security in the skill and character of the dentist and his staff.  When a team admires and respects each other it comes through loud and clear in the way they relate to each other, the way they carry themselves and the way they treat their patients. 

    Spa treatments and theme rooms are gaining popularity these days, but no amount of add-ons can divert attention away from a team that doesn't function well together or a dentist who isn't meticulous and caring in his/her treatment.  I can remember moving here 20 years ago and going to a dentist for a new patient exam.  I was seated in an operatory and left to linger for 20 minutes.  When the dentist finally arrived he was stand-offish and did a cursory exam and said, "Make an appointment with the hygienist." and left.  That's it.  On the way out the receptionist presented me with a rose.  What a weird dichotomy.  Ice cold treatment topped off with an insincere gesture of caring.  I wanted to suggest, "Show me you care about me as a patient and a person and you won't have to waste your money on a bunch of roses every day."  So I think I would suggest that you make sure you've got your basics covered and then find out what your patients will value in the extra creature comforts that you'd like to provide.  Thanks for the great post to bounce off of Susan.  You made my job easy today.

Be With Your Patient

    Even though my first passion in dentistry was and still often is dental assisting, I realized that I don't write much about it.  Well, today I will.  Friday is a day that we reserve for our more complicated cases.  It's usually just my boss, the patient and I in the office.  Sometimes another staff member comes in to handle the front desk.  We do our most intense dentistry on Fridays and really get in the zone.
    Our first patient was a gentleman who needed four extractions.  He had some health complications and was extremely apprehensive.  His gingival tissue was still inflamed despite being on antibiotics for a week so the delivery of local anesthetic was uncomfortable.  I generally comfort patients in some way at times like that and I was rubbing his arm during the injection.  When my boss was finished the patient said, "Thanks for the arm rub, it felt like someone was in it with me."  Basically he felt seen, heard, understood and comforted.  The extractions went well and he went home thankful and relieved.
    The second procedure was an implant placement on a very healthy middle-aged woman.  Again, our patient was apprehensive.  I suggested nitrous oxide which took the level of her tension down very nicely.  She needed a sinus elevation and when my boss started tapping the osteotome with the mallet she came very close to panic.  I've had a sinus elevation.  I knew just how she felt. I could empathize with her completely. Her knees drew up and her hands started grasping for anything.  It doesn't hurt, it's just really creepy and sounds ridiculously loud in your head.  I held her hand and kept telling her that everything was going just as it should and that I had had the same procedure and she would be fine.  She got through it and again was thankful for the reassurance. 

    The dentist has his hands full during these procedures just trying to perform dentistry.  The assistant can be his second pair of hands, eyes and ears.  It is up to her to keep in tune with what is happening emotionally with the patient.  The difference a caring assistant can make is huge.  I hear dentists talking about their assistants peeking in their pockets at their cell phones while they're working and I wonder what is missing that makes them care about that.  First of all, expectations from the dentist must be clear.  Cell phones should be put away during patient care hours.  That benefits the employee and the patient.  The patient gets the full attention of the person caring for them.  The employee gets to be fully in the moment with the patient.  There is a lot of satisfaction in that.  It is what makes the difference between a professional and a worker.  Another important aspect that is sometimes missing is communication from the dentist to the staff about the impact they have on the dentist and the patients.  Good, caring staff allow the dentist to feel confident about what is happening with the patients and can make a world of difference in the patient's experience during treatment.  By letting the staff know that, the dentist will encourage the staff to continue to serve the patients well. We all owe it to ourselves and our patients to really be there with them.  Dentists should accept nothing less from their staff members and staff members should remember that they are in a privileged position of trust from both the dentist and the patient.

Who Can Argue With An Angel?

    We had a patient scheduled for an extraction today.  She's a school teacher.  I brought her back to the operatory and she said, "I really don't want to have an extraction today, I have to give end of grade tests tomorrow, I'll be talking all day and I just hate extractions. Can't we just do a filling instead?" She was the last patient of a long day.  Now, this could have gone two different ways, basically, and it all depended on me. 
    If you remember, I'm fond of saying that you have choices in how you react to whatever is presented to you.  I had two choices.  1. I could have sighed deeply and said, "Well, OK, but you'll have to wait till I take all this out of here and set the room up for a filling instead." Or, 2. I could say, "Well, sounds like this is a bad time for this procedure.  Let me just switch things around quickly and we'll do the filling today and the extraction next month when you'll be out of school."  The devil on my left shoulder was pulling strongly for reaction 1 and I was leaning that way.  Hey, I was tired.  Then, the angel of mercy on my right shoulder whispered, "You really don't want to do what he says.  You'll just look like a crank and you won't serve the patient's needs.  When you think about it later, you'll wish you chose me." 
    Who could argue with an angel?  I'm glad I didn't.  There have been times when I've gone with the devil and it got me nowhere.  It ends up being a tense situation with the hapless dentist trying to cajole everyone, the patient effusively apologizing for being a nuisance and me being petulant, but not so much that it deserved a reprimand, but just enough to satisfy my urge to sulk.  Then seeing another staff member laugh off an inconvenience would lead to a good round of self-recrimination and guilt.  Who's got time for all that.  So, yeah, it was slightly inconvenient, but not so that you'd notice and the patient got what she wanted.  She left feeling good about us and asking me if she would end up on my blog tonight.  Hey, I have to have my fun somehow, don't I?

Keep The Customer Service Ball Rolling

  Ed Horrell's weekly advice reminds us to constantly focus on customer service:

The best way to keep customer service alive includes making sure that it is at the cornerstone of everything you do.  It should be as close to everywhere as you can make it. 

It is the most important thing that you do.

Put it on coffee mugs, e-mails, posters, and cards.  Put it on desks and in break rooms.

Remember, customer service is not a result of seminars and reading books.  It is the result of constantly focusing on the purpose of providing the very best in service. 

Try it. Keep it alive in your company.  You'll see the difference and you'll own your customers.

Ed

    Keeping customer service first and foremost in the minds of your staff reinforces the importance of top quality service to our patients.  If they see that you mean it, day in and day out, it will become something they see as a normal part of what they do.  Constantly recognize outstanding service and new ideas.  What gets recognized gets repeated.  If you hear a staff member say something especially kind or insightful to a patient, write it on the white board, in quotes with credit to the staff member.  Have a part of your regular staff meetings dedicated to recognizing outstanding service that took place since the last staff meeting.  Let the team members talk about what they saw each other doing that impressed them.  Recognition by peers is particularly gratifying.  Keep the customer service ball rolling and your entire practice will pick up speed.  Just becoming great at customer service doesn't guarantee that you'll stay great.  You have to continue to focus and work on it.

Is It Time For a New Look?

    Have you taken a critical look around your office lately?  You may think everything looks fine, but it may just look dull.  It's a good idea to freshen things up every now and then.  Start where your patients start.  Walk in your own front door.  What's the first impression you get?  You hear that the receptionist is the first impression your patient gets of the practice, but it actually starts at the front door.  Is the entryway warm and inviting?  Do you smell that dentist office smell right away?  I did this today and I noticed that our foyer looked boring.  We have a great world map but it's on the wrong wall.  The map takes up more than half the wall and there is an electric outlet under it.  We can move the map to the opposite wall and put a table with a lamp opposite it.  I'd like to get some of the new reeds that you stick in a vase of scented oil, too.  Anything to make it have a nice warm glow and a pleasant scent.  We have an all-purpose type mat on the floor, too.  I'd rather see something more interesting in it's place.  It doesn't have to be expensive so that if it gets too worn we can replace it without feeling bad about the cost.
    One look around the reception area told me it was too cluttered and we're advertising too much stuff.  We have great magazines that we keep up to date and a fantastic children's play area.  We also have about 15 straight back chairs lined up around the room.  It would be great for musical chairs but it's not inviting.  I'd like to see a sofa and some easy chairs.  I hope we'd never have 15 people waiting in the reception area anyway.  I plan to bring in some cookbooks that patients can browse through and some books that I'm done with that they can borrow if they'd like to.  My boss is a map lover and we have some really great ones as well as Audubon prints, but I'd like to see something that says who we are and what we do. 
    The reception side of the front desk is too cluttered with business cards, candles, a dried flower arrangement and brochures.  Lose the old dried flowers and replace it with a bud vase with a single rose.  The candle can stay, but light it for Pete's sake so it helps get rid of the dental office smell.  The patient bathroom is OK, but a weak attempt at pampering the patients.  We have hand lotion, toothbrushes, mouthrinse and cups, even some potpourri, but it's displayed so unimaginatively.  We can do better. 
    The back office side of the reception desk is utilitarian.  It's neat but there are charts, folders, paper and envelopes stored in their original boxes in plain sight.  It's great to keep them where they are, but better to transfer them to attractive, inexpensive bins. 
    My own office is a pig-sty.  I admit it.  It's just like my teenage bedroom.  Stuff everywhere.  I didn't get any further than that today.  I cleaned it up.  Actually, just like my teenage bedroom, I stuffed things in drawers.  If I had a bed in there I'd have shoved things underneath it.  But, it looks better now to patients who come in.  So, tomorrow I plan to move down the hall.  I also plan to involve the rest of the staff.  I'll have everyone take a notepad and look around the operatories and jot down a few things that have to go and whatever they think would look just great.  I know I'd like to get some fantastic before and after pics to hang.  My boss does has had some beautiful results (I know, I'm biased, but he does fabulous work) and I think we need to show it off. 
    The important thing to remember is that the office has to reflect something about the dentist, the staff and the people we treat.  One of our patients make beautiful, natural furniture, so maybe we'll get a piece from him for the foyer.  We read so many books as a staff, we may just put some of them out for the patients to borrow.  If the office doesn't say something about us, then no matter what we do, how much we spend, or how pretty it is, it will leave our patients cold.  We want them to feel like welcomed guests every time they enter the door.

If Everyone Cared

     I guess you noticed that I have figured out how to put videos in my posts.  I promise not to get too carried away, but I saw this one last night and loved it.      Most of the things that happened in this video really turned into major events and affected hundreds of thousands of people.  You're probably wondering how I think this applies to this blog or to anyone reading it.  If it reaches only one reader and they do something with it, even that could have a long ripple.       Think about any given day in the practice that you are a part of.  How much of the day do you spend thinking about how you feel about what's happening around and to you?  What if you took that and applied it to your patients and co-workers?  Sometimes the view from inside ourselves becomes narrow and focused to a small frame that always comes back around to us.  Try to imagine what would happen if you spent one whole day really caring about how you affected everyone else.       Let's take a young, frightened child as an example.  Really think about what that kid is going through.  They are making them self sit in a chair that is way too big for them, opening their mouth and letting someone give them an injection.  It probably takes every ounce of courage for them to do that.  Now imagine yourself really empathizing with them and helping them find a little more courage.  You may become a lasting memory for them.  How about the little elderly woman that the nursing home brings over because she's got denture sores.  When you look in her mouth and see how poorly her oral health is attended to do you recoil in disgust?  Blame the nursing home for not caring?  Or do you do something to make her feel cared for by you?  Do you talk to the attendant about ways to help the residents with their care?  Do you offer to go to the home and talk to the staff?  Do you care enough to do any one of those things?  We had a lovely lady that would come to our office and worry over the fact that her fingernails were unkempt.  From that day on, whenever she came in, one of us would file her nails while her anesthetic took effect.  Her daughter came in one day and saw that and was so grateful that someone cared.       When you see a co-worker struggling to keep up, learn a new skill or just keep it together, how do you respond?  Do you care enough to help?  An even more difficult situation is dealing with an unpleasant patient or co-worker.  They may be someone you'd prefer to steer clear of, but they may just benefit the most from everyone caring.  I've said it before; what you do to the people you encounter at work does not just affect them, it affects everyone they encounter as well.  That's how the ripple builds.  The quote at the end of the video is powerful:                                

                                                     Never doubt that a small group of committed people                                                                                             Can change the world.

                                                        Indeed,it's the only thing that ever has.

                                                                        Margaret Mead                                  

  Dental practices are made up of small groups of committed people.  Yes, I think we can make a change in the world.  Change starts small and it has to start somewhere.  Don't think you can't reach outside your immediate surroundings and affect change in the world.  You may never be celebrated like Nelson Mandela but you may be celebrated by a young child or an elderly woman's daughter at the dinner table  tonight.  They may remember what you did and how it made them feel and that may influence the care they show others.  And on it goes.

Let Them Be Right

    I've said it before and I'm saying it again.  Never argue with a patient.  You just can't win.  Even if you end up proving that you're right, you lose.  Why?  Because you let it become personal, and it's not.  At least the right and wrong part isn't.  You are there to serve their needs and if they need to be right, yes, you must serve that as well.
    I had to call a patient at the end of the day today to appoint him to have his crown cemented.  We had tried to seat the crown last week, but due to an open contact, we had to return it to the lab.  So he left with his provisional in place and we told him we'd call him when it came back.  He swore that we had cemented the crown the week before and that we were really screwed up.  I asked him to look in the mirror to see that the provisional was white and his new permanent crown was gold.  Yes, he saw it, but he still wasn't convinced.  Now, we could have gone back and forth for quite a while, he was just warming up and had nowhere to go.  Then I remembered what my boss always says, "Never argue with a patient, you can't win."  I immediately apologized for not remembering to tell him that we had re-cemented his provisional and for the inconvenience of having to return.  He was quite forgiving and the appointment was made.  I lost nothing.  It didn't bother me to miss out on the debate and I certainly wasn't going to let something so minor upset me.  As a matter of fact I chose not only to see the humor in the situation, but to find some compassion for the poor guy.  He's an older man who's wife is in the beginning stages of Alzheimer's.  If he needs to give someone a hard time now and then, well I can serve that need, too.   I get paid when they're nice and I get paid when they're not.  It's not personal if I don't let it be.  So, let them be right, it won't hurt you, and you get to go home a lot sooner.

Give A Little Bit More

When we were children, we used to think that when we were grown-up we would no longer be vulnerable.  But to grow up is to accept vulnerability...To be alive is to be vulnerable.

Madeline L'Engle

   

What do you think about your elderly patients?  You do think about them, don't you?  It can be easy to overlook your older patients or write them off as slow, doddering or boring.  That would be a mistake, and both you and they would be missing out on some great conversations.  It can be tempting to just push these patients through their treatment time.  We're busy. There is so much to do and so many patients to take care of, not to mention all the behind the scenes work to be done. 
    Right now we are a little short staffed.  I'm trying to cover too many bases and my boss pointed out that although it is admirable to be able to multi-task and he knows I'm working hard, the patients are missing out on the attention they should be getting.  I needed to slow down, even though everything inside me was shouting, "Hurry, hurry, hurry!"  So, I did.  The work didn't go away, but amazingly, my day instantly became less stressful.  Last week I was running from room to room trying to get ahead while waiting for anesthetic to take effect in room 2.  Do you see what I'm saying?  The most important person in the practice, the patient, had become the anesthetic waiting to happen in room 2 for me.  That's not good.  This week I sat and conversed with the patient; the living, breathing, thinking person, who was waiting for treatment.  That's better.
      We live in a retirement area and have a lot of older patients.  I noticed a few things about them.  1. They are tough.  They sit through a mandibular block like it's nothing.  They stay open through root canal treatment and don't complain.  2. They're open-minded.  We have two 85 year olds who recently had implants placed.  They're not worried about getting their money's worth out of them, they wanted the best tooth replacement available.  3. They're fascinating.  One patient has written a book about his experiences in World War II.  Another is journaling about her life experiences so that  generations of family to come will know who she was.  She's doing it on the computer.  Another patient in her 80's told me that her son and grandson bought her a computer and she is determined to learn how to use it so she can e-mail them.  4. They are vulnerable.  We all are, but they are more vulnerable because things are getting out of their control.  The mind may be willing, but many of the bodies are getting beyond the scope of their will.  But, they handle it with grace.  It must be frightening sometimes. They lose so much.  Their friends, family members and spouses may be passing on and their own mortality is suddenly within reach.  They lose their ability to see well, hear well, drive or live on their own.  They don't want those things to happen, but they do.  They realize that some people don't understand or care about how much they have and want to give.  Can you imagine how that feels?  5.  They need someone to talk to.  Many of them live alone.  Believe it or not, going to the dentist may be an event they look forward to because they'll have someone to visit with.  Don't let them down.
    I'll admit that when my boss first made his comment about not giving the patients the attention they deserve I was a little put out.  Didn't he see how much extra work I had to do?  Then I realized it was I who wasn't seeing.  I was blind to the opportunity I had to serve our patients well.  Getting the sterilization done was important, but making the patients feel cared for was crucial.  Crucial trumps important.  It's all a matter of prioritizing.  The patients are our priority.  Once I stopped worrying about the work and started focusing on the patients things were better.  The work still got done and I was able to enjoy our patients and give them what they needed; a little bit more of me.

 

Your Patients - Do You Own Them Or Are You Just Renting?

    Last Sunday I passed along Ed Horrell's weekly newsletter to you.  It looks like it will probably be something you can count on every Sunday.  Here is this week's newsletter:

This week I want to discuss customer's expectations when they deal with us....and the importance of knowing what they expect and meeting or exceeding those expectations.

Most of us have a mental image of what we are going to experience in virtually everything we do.  Surprises are the results of happenings which are not consistent with what we expect.

Same way with customers...they come to expect a level of service from the companies that they patronize. They find a "water mark" service level and come to accept that level, whether the service be good or not.  It just is what it is, and we come to expect it.

Let me give you a couple of examples.

I use the services of quite a few entertainment companies, such as cable TV, broadband Internet access, music software programs, etc.  I enjoy the services when they work enough to tolerate the pain I expect to receive when I experience a service problem requiring me to speak to someone. The result is that I have a relatively high level of expectations regarding the services working and a pretty low expectation of service when it comes to solving problems.  They don't "own"me...they more like "rent" me until someone better comes along.

They could own me...if they'd offer a little kindness and make me feel important on those occasions when I do need some help. 

SONY owns me...here's why.

I bought a SONY PDA about a year ago.  I brought it home, hooked it up to my PC, loaded the software, and none of the right stuff happened.  I had messed with it for a half hour of so and had seen enough.  I unhooked everything and was packing the box to take it back to the retail store from which I had bought it. 

As I packed the last part, I noticed the SONY help desk number and decided to make one quick attempt at a call, expecting to get a long delay and indifferent rep on the line.

I got a quick response and a kind, friendly rep who said "Mr. Horrell, we can get this fixed and I'll walk you through step by step."

I reconnected everything, got a helpful explanation as to why I was having problems, and now am a happy SONY user. 

And as a result, I'll be shopping SONY for a long time...they own me.

    So do you own your patients?  Are you do something different and better than any practice in your area?  Is your whole team on board?  One bad apple might actually spoil the whole bunch when it comes to customer service.  Think about it.  You go to nice Dr. Jones' office and the receptionist greets you with a sincere smile and offers you something to drink.  She might even come around the desk and help you off with your coat and hang it up.  The assistant comes to the door and disinterestedly calls your name.  As soon as you reach the door she mumbles something and starts walking to the back.  Along the way the other staff you pass are cheerful and happy to see you.  You reach the room and the assistant sullenly puts the napkin on and gets you positioned.  The dentist comes in and has the same great attitude as the rest of the staff.  You can't stop wondering about that assistant.  Maybe something happened, or maybe she just doesn't like you.  If it keeps happening it won't matter how nice everyone else is.  You won't enjoy the overall experience because of one person.  So they won't own you.  If your friend tells you about Dr. Smith's office, where everyone is always upbeat, you will be interested and may decide to give them a try. You may regret leaving Dr. Jones, he is so nice after all and a great dentist, but you want the total package.
    Set the stage to make the total package possible in your practice.  Treat your employees well and give them what they need to present the total package.  Make them know that they are important to the success of the practice and to patient satisfaction.  Talk about customer service often, daily if possible.  Take time during your morning huddle to talk about anything outstanding from the day before and ideas for the upcoming day.  Practice what you preach.  Let the staff see you help an elderly patient put her coat on, give compliments to your staff in front of the patients and each other.  Spread it around so everyone can feel good about each other's success.  Staff, compliment the dentist in front of the patients.  Our patients often comment about the respect and regard we all exhibit toward one another.  It works.  It's notable.  Do it often.

    So take a realistic look at what you are doing.  Watch and listen to your staff.  Are you doing the things that will let you own your patients or are you renting them till someone else comes along who will give them the experience they want?

Get 'Er Done

    I get an e-mail about customer service from Ed Horrell  every week.  Ed is the author of The Kindness Revolution. This week's tip is one that Ed feels may be the most important of all:

The tip is this....solve the customer's problem.  Period.

"Solve it quickly.  Solve it calmly and without regard for the mood of the customer.

Solve it without being concerned about what caused it.

What happens too often, however, is that the customer contact becomes more interested in either calming down an upset customer or dealing with how the problem got caused.

Next time you have a problem, listen to whether the rep assisting you is more interested in solving the problem than either explaining or defending it. Then make sure YOUR company is focussed on problem solving.

You'll own your customers if you practice this."

eh      

 I've never thought of it that way, but I think Ed's right.  We tend to see the patient's upset state as the first order of business.  "If I can just get this guy calmed down, then I can get the bottom of this."  You already are at the bottom of it, you have to get back to the top.  Start solving the problem and the will result be a happy patient.  Your initial response will determine which way his mood will go.  It may take a minute and he may berate you or vent during that minute, but when he sees you remain calm and professional he'll start to anticipate a satisfactory result and he will become calmer.  He just still has little fight/flight adrenaline to work off.
    Employees would also do well to use this response when receiving critical performance comments.  Don't start immediately explaining or making excuses.  Just listen and ask questions that will let the speaker know that you want to understand the problem and fix it.  Managers usually don't enjoy telling a staff member that their performance is unsatisfactory, so don't make it harder by dragging it into the emotional arena.  Knock it out by listening and learning. 

       I plan to print Ed's tip and read it at our morning huddle.  I learned from it and I want to share it with the rest of our staff.  If you want to receive tips from Ed just click here and sign up for his weekly tips.  I like them because they are concise and easy to apply.  It's all part of his "Kindness Revolution." 

It's A Big Deal To Me!

    We've been talking about great customer/patient service the last few days.  Let me tell you about some patient service I experienced that was not so good.  I had to have some rather invasive tests done on Friday.  Prior to this I had to go to the specialist's office to fill out some paperwork.  When I arrived, I went to the window.  The three people behind the window ignored me for 2 minutes.  When the window was finally opened I said my name and that I was instructed to come in to do the paperwork.  Three people stared at me like I was out of my mind and then looked at each other the same way.  A supervisor came over and found the papers and handed them to me.  When I was done, I gave them back and asked if anyone could answer some questions about the procedures.  Another 5 minutes to find someone and then very rushed answers. It was obviously an inconvenience.  "Well, how much will this cost?"  The crazy lady stare again and nobody  could answer that question.  "But, the paperwork said I had to pay in full the day of the procedure."  After a few phone calls during the week I was told to wait and see.  The procedure has been completed and I still don't know.  There are more tests to be run and I don't know what they'll cost either.  Maybe they think it's not a big deal to me.  They're wrong.
    OK, so the day for the procedure is here.  This will require general anesthetic so I'm a little apprehensive.  A nurse comes back and tells me she will be my nurse.  She never cracked a smile, she performed her duties very perfunctorily and got away as fast as possible.  She then proceeded to spend the time until I was taken into the operatory walking through the pre-surgical area trying to order a toy on her cell phone.  This went on for at least 15 minutes and she never spoke to me again until everything was over. Then the same detached manner removing the IV and giving post-procedural instructions.  At that point I didn't want her near me. I was sick of feeling like I didn't matter to her.  Obviously this was a very routine procedure for her, one she participated in a million times, but it was a first for me, and it was a big deal to me.  I was left wondering what ever made her want to go into a caring profession in the first place.  Was it the hours, the benefits, the setting?  It surely wasn't concern for people.  At least not as far as I could see.  The doctor and anesthesiologist were very nice but I spent about 5 waking minutes with them.  The person I spent the most time with seemed disconnected, distant and like she couldn't have cared less.
    When you have a patient come in for an extraction or root canal treatment do you ever think about what they may be feeling?  We may look at it as a procedure that we enjoy assisting with, hate setting up for, or know like the back of our hand.  For the patient, it's probably a different story.  They may be filled with anxiety, fear or dread. If it's an extraction, they are losing a piece of what God gave them and it may seem more valuable to them than it ever did.  A root canal may be the unknown if it's their first.  They may be sure it will be excruciating.   Maybe you can diffuse that by talking to them.  Most people have been misinformed by friends who have had a bad experience.  For some reason, friends like to share horror stories with patients who are about to undergo a procedure for the first time.  You can show children the instruments you will be using and explain their use.  You can even involve them by letting them hold a cotton roll to hand to the dentist. By taking the time to tell them all about what is going to happen, you may keep one patient from growing up to tell about the terrible experiences they had at the dentist.  Be sure to tell them the truth if something will sting, like an injection. I let them know it may hurt a little, but that if they count to 20 it will be over.  You will let them know they can trust you to be honest with them.  Your good, caring attitude can help them maintain good oral health for their lifetime because they won't look at the operatory as a torture chamber.
    An experience like I had always reminds me of what a great staff and dentist we have in our practice.  They don't have to act like they care because they truly do care.  The patients know it and appreciate it.  They tell their friends.  That nurse probably wouldn't even be able to think back to me or that day because it and I didn't matter to her. People tell their friends about bad experiences, too.  I feel fortunate to work with people who do care.  That's a big deal to me!

The Habit Of Like

    How do you think about problems?  Can you see a problem coming and start formulating a solution before it ever really blows up?  Can you think on your feet?  Do you believe that for every problem there is a positive response?  Or do you blank out when anything out of the ordinary happens? 
    When dealing with patients, it is our job to make what they need, our pleasure to provide.  We need to be willing to think outside the box and find a solution that may be outside the normal operating scope.  Part of making things happen is having good relationships with everyone you do business with.  Be polite to the people at the lab, courteous to the service and supply reps, and build relationships with the staff in other offices.  Then, when you need that crown delivered in two weeks because your patient just told you they are leaving for Florida for three months, you'll get it.  Your autoclave dies?  No problem, the service guy will get in today because you're always so nice to him.  How about when your patient needs a root canal on that molar and the endodontist is booked out three weeks?  He's booked out for everyone but you, his receptionist loves you because you're always so nice and you ask about her grandchildren when you call.  She'll work your patient in.
    This isn't manipulative.  You have to really feel good toward all these people or they'll spot you as a phony.  Get in the habit of like.  Like your patients, like your boss, like your co-workers, like everybody you deal with each day.  Once you get in the habit of like the payoff is so great, you won't want to break the habit.  You'll put that feeling out there and people will be happy to help you.  When you like people you'll find that you want to go out of your way to help them.  That will make you stand out in your position.  Adopt the attitude that it is you pleasure and goal to give exceptional service to your patients and to be kind to everyone you deal with.
    Take a look a the practice you work in and your attitude toward it.  If you don't feel strongly about being a great advocate for the practice, try to figure out why and what you can do to make that happen.  Maybe it's time to sit down with your boss and ask him/her if they'd like to explore ways to really get the team going.  There is nothing professionally as satisfying as working with a goal oriented team that likes and supports each other.  Get your team into the habit of like in 2007.  It could be your best year ever.

Indifference Or Enthusiasm

    Will you serve your patients with enthusiasm or indifference?  Seems like a no-brainer, but then why is there so much indifference?  If you've read this weblog, you know that I hate to hear "That's good enough".  When it comes to customer service, if it isn't great, it's just mediocre to me.  Every interaction you have with patients gives you an opportunity to achieve greatness;  for yourself and your practice. 
    Let me give you an example of how being treated with indifference, or worse yet open hostility, by a person whose job is to offer service can influence your expectations of the entire organization in the future.  There is an upscale grocery store that I shop at about once a week.  It is set up to attract a more affluent clientele and the atmosphere of the physical space is very nice.  It's clean, the displays are pleasing and classical music plays over the sound system.  They even offer samples of special items.  But the employees ruin the effect for me quite often.  They seem irritated to have to leave their conversations with each other to take care of customers. They seem to begrudge handing over the free samples. I have witnessed downright rudeness and meanness.  I have complained to management frequently.  I was ordering from the deli counter the other day and the person waiting on me had terrible teeth.  Strike one.  She had poor grammar.  Strike two.  She started preparing the wrong item.  Strike three, she's out, right?  Just as I expected, lousy service by a person who doesn't care about themself and isn't even careful enough to get a simple order right.  But wait a minute.  She started asking me how I was doing.  I replied that I didn't feel well that day.  She commiserated and said a lot of customers were saying the same thing.  She handed me my order, smiled with her pitiful teeth and looked me in the eye and said "I really hope you feel better soon".  She meant it.  She cared. I forgot about the teeth, the grammar, the mistake.  She won me back. 
    I bet you are starting to ask yourself why I keep going back there.  It obviously drives me nuts sometimes.  It gets bad enough to make me seek out the manager to complain.  Why do I bother?  Why do I complain?  Because the place has potential.  They have some really nice employees too, like the one I talked about here.  I just want the manager to find more like that.  I want him to light a fire under his staff.  If they won't warm up, I want him to set them free to find a place that doesn't require interaction with customers. 
    So you see, a bad experience with an indifferent employee not only ruins that interaction, it puts the other people in the organization at a disadvantage for their next interaction with that customer.  They have to win the customer back.  They have to deliver extraordinary care and concern to override the negative opinion that was formed because of previous poor service.  It is in your best interest to encourage your employees or co-workers to be enthusiastic about your patients.  It sets you up for the interactions you will have with the patients.  It's so much easier to have patients walking into the office expecting nothing but the best.  It's easier to deliver that, than to clean up the mess left behind by someone else before you can even get started.  Besides, indifference is dull.  It's boring.  It's indifferent.  Enthusiasm is fun.  It's lively.  It's the way to be.

Send Out Your Servants

     Where does great customer service come from?  Great servants.  But that word, servant, it bothers some people.  Maybe some people see it as belittling or putting yourself beneath the person you are serving.  I think they are seeing it all wrong. 
    When you serve you are filling a need.  You have the power to fulfill that need. Service is defined as an act of helpful activity, being useful.  You have the power of deciding whether or not to provide for another.  You have what they need or want.  I see the decision to provide for others as deciding to use the strength that you possess. 
    Deciding to serve means deciding to pursue self-actualization.  Self-actualization is at the top of the pyramid of Abraham Maslow's hierarchy of needs.  The needs under self-actualization are 1. The physiological needs - air, water, sleep, the basics.  2.  The safety and security needs - the need for structure, stability, order.  3.  The love and belonging needs - the need for friends, love, a sense of community.  4. The esteem needs - respect from others and respect of self. 
    If you look at this hierarchy of needs and then apply the act of service to others to those needs, do you see how serving will be self-actualizing?  By serving you will be able to succeed at your job and provide your basic needs and have structure and stability in your life.  When you help others, you develop friendships and love relationships and become part of a community.  All of this gives others a reason to have respect for you and you can respect yourself as well.  You are achieving self-actualization by using the talents that you have to make a difference for others and yourself.
    So, you could say, when you choose to serve others you are serving yourself as well.  You are giving yourself opportunities for friendship, love, respect and fulfillment.   You are becoming part of a bigger, reciprocal picture.  It is reciprocal because by helping another achieve, you achieve with them.  You are part of that achievement.  When you teach someone else what you know, you do not lose your edge, you gain an ally.  Together you go forward to use that knowledge squared. 
    When you treat the people you manage well, you are showing them how to treat the patients that you serve.  People who feel good about how they are treated go on to treat others well and see service as something to aspire to.  People who are angry about how they are treated will pass that anger on to others and no one gets served.  By recognizing this you can now analyze your approach with the people you lead.  Are you supportive and careful in your criticism and generous with your praise?  People flourish under kindness, appreciation and encouragement.  They are better able to focus on what they have to give when their needs are fulfilled.  It takes very little from a leader to provide that and the rewards benefit everyone.  If you are a kind and generous leader keep it up, it works, doesn't it?  If you are cringing a little reading this or if you just realize that you've been on auto-pilot for a while, make some changes.  The great part about it is that people respond quickly to a better environment and are quick and eager to get over the past.  But...just like the old saying "God doesn't close a door without opening a window", you have to give people something new to go to so they can leave the past behind.
    If you can see the reality of the situation that you are in and had a hand in creating, you can begin to empower and enlighten your staff so that they can provide fantastic customer service.  You can be the best dentist on the planet, but, if your staff is unmotivated to serve the patient, you may never get the chance to prove it.  People are impressed first by how they are treated; then they can appreciate the treatment they receive.  It all starts with the leader, no matter how you look at it.  Like a waterfall shapes all the rocks below it as the water falls upon them and forms it's patterns, the leader at the top impresses the person below her and she flows onto the people she guides and pretty soon everyone is surrounded by whatever it is you put out there to begin with. 
    Servant leaders give the people they lead what they need to serve others.  They acknowledge their abilities, praise their best efforts, encourage them in their struggles and applaud their successes.  The gift for the servant leader is in the self-actualization.  It is watching the seed you plant take root and grow.  It is seeing the staff member take the extra step that makes their service to the patient special and beyond what they have to do.  The success is that they want to do better because you have shown them how good it feels to be well served.

Don't Tell Me Your Problems

     Today we were done a little early so we were able to have a longer lunch break than usual.  We decided to go to a new pizza place and have a nice relaxing meal.  When we placed our orders we mentioned that we were on our lunch hour.  We were told our food would be ready in fifteen minutes.  Twenty-five minutes later we still didn't have our salads.  After asking a different waitress to help move things along, our original waitress came and told us that someone else had gotten most of our order and they would have to start all over.  We couldn't wait so we all shared one small pizza. 

     Mistakes happen, the situation could have been saved with an apology.  That didn't happen.  Instead the waitress continually dumped her problems and excuses on us.  Even though we were visibly annoyed her demeanor remained the same, unconcerned.  I finally asked for the manager and told her about our experience.  Her remark was that she was giving us the meal for free so could we at least be happy about that.  Not really.  We went in fully  expecting to pay for our food. We just wanted to get it in time to eat it. When we finally got some, it was delicious. But, the service was horrible and the food just can't make up for that.  It is aggravating to feel that the person responsible for your needs doesn't care about the outcome of your encounter. 

     You can relate this experience to your interactions with you patients.  Be sure to listen and hear what they are saying they need from you.  Then do your best to make it happen.  Don't make excuses, don't blame the receptionist, don't complain and don't lose your cool. If something goes wrong apologize and do what you can to correct it or make up for it.   Sometimes you have to put more effort into something but make sure they know it is your pleasure to do it.  You have two choices, you can give outstanding customer service or you can't.  Anything in between is poor to average.  Who wants to be poor to average?  You don't or you wouldn't bother reading a dental weblog.

     When you have a tough patient or a procedure that is difficult be sure to maintain a pleasant disposition.  We had a patient who was extremely nervous today.  She needed two root canals in teeth that were very inflamed and difficult to anesthetize.  My boss was the picture of patience and perseverance.  I'm sure he was getting frustrated and wishing the patient would just stop squirming and that the canal was easier to access.  He never let her (or me) see him sweat.  That is what makes him stand out among his colleagues.  Sure, after the procedure was completed we commented about how tough it was but the patient never had to worry about it.  That is the key to outstanding service.  Keep the problems to yourself and make it all seem effortless and as if the pleasure is all yours.  That will set you apart from the crowd.

What Is A Patient?

    My boss has this essay hanging on the bulletin board at the office.  We pass it every day and don't notice it.  It's been there a long time and looks pretty worse for wear.  It's as timeless and pertinent now as it was whenever he first hung it there.  You might want to share it with your staff, too.

 

What Is A Patient?

 

A patient is the most important person ever in this office, either in person or otherwise.

 A patient is not dependent on us. We are dependent on him.

 A patient is not an interruption of our work; he is the purpose of it. We are not doing him a favor by serving him; he is doing us a favor by giving us the opportunity to do so.

 A patient is not an outsider to our practice; he is part of it.

 A patient is not a cold statistic – a name on a chart or ledger. He is a flesh and blood human being, with biases, prejudices, feelings and emotions like our own.

 A patient is not someone to argue with – nobody ever won an argument with a patient.

 A patient is a person who brings us his needs. It’s our job to fill them with tender loving care and to do so profitably – to him and to ourselves.

 

                                  Author Unknown

Any questions?

   

 

It's All About The Patient

   

How well do you serve your patients?  In a busy dental practice sometimes the purpose for being there at all can be forgotten or at least undermined.  We are there to serve the patient.  Numero uno reason.  If you don't do that, you might as well learn to do something else, because sooner or later that's what you'll be doing. 
    Why do we forget about serving the patient?  Other concerns get in the way.  It's difficult to put concerns for ourselves and what we want to do aside sometimes.  If you can resist self-interest in the short term, you will benefit in the long term.  In that respect, it's a character and integrity issue.  You must integrate all the reasons for any action you can take until they steer you toward what most benefits the patient. 
    Sometimes dedication to the practice itself becomes the problem.  It can be aggravating to deal with patients who don't seem to value their scheduled appointment time and who don't seem to respect the doctor's time.  It can be hard to remember that they just really don't understand what a cancellation costs the practice or that sometimes a demand in their life seems more urgent to them. They're not usually inconsiderate people, they just don't know what you know.  You can help them by treating each patient individually.  Get a handle on their previous track record and work around it.  If they're always late, confirm 10 minutes earlier than appointed.  If they forget a lot of appointments, find out what confirming method is best for them.  E-mail, call two days before, whatever it takes.  Dedication to the practice is great so show that by making the patients happy and don't take what they do personally.
    Some patients want more special treatment than others.  Provide what you can without detriment to other patients.  Make unusual requests sound like a piece of cake.  Act like you're thrilled they asked.  If you can't provide something at the current appointment, try to be sure you can at subsequent appointments. Remember what they like and have it ready next time.  Anticipate needs.  If they are rubbing their neck, bring out the neck pillow.  If you've noticed that their lips are dry, offer some lip balm.  That's what makes you stand out.  Susan Bird posted a good article on her website  .  Most of her articles are great for dental professionals to take a look at.  I recently discovered her website and I am now an avid visitor. 
    Just always keep in mind, the reason we all go to work everyday is to serve the patient.  The practice and the doctor deserve our best effort too, but without the patient there is nothing to go to work for. 

That Guy's Fun

    I had a great patient today.  He's one of my all-time favorites.  When he first started coming to us he was pretty phobic about dentistry.  I found out he had a great sense of humor.  That's how we got him!  We make it fun for him to come to the office. 
    I send him a funny e-mail card before and after his appointments.  Today he got a talking monkey telling him how much we loved seeing him.  He brings out the comedian in us.  We're never as funny as when he comes in.  There's just something about him. 
    The best compliment we've gotten from him is that he now enjoys going to the dentist.  "I didn't know that going to the dentist could be so much fun!"  That's a great testimonial.  So, what do we learn from that?
    We learn that we have to find out what is unique and special about each of our patients.  Once you do, you can cater to that and build a great relationship with them.  Our first patient today wasn't what I'd call a fun patient.  Not everybody's fun, that's OK.  She likes to be cared for and pampered.  We had the warmed neck roll ready, lip balm and headphones with classical music.  It was "nirvana", as she put it.  Whenever she got the chance to close her mouth I gave her a mini TMJ massage.  She loves it and it takes very little effort on our part. 
    So the best thing you can do is to discover that special thing about each patient and give them the star treatment.  Why not?  You can provide adequate care or you can provide exceptional care.  Which sounds better to you?

Ain't Nothin' Like The Real Thing

    Since we've been discussing the impact we have on others, let's talk about the impact stress has on us and our patients.  Let's face it stress gets things going.  A certain amount of stress keeps us on top of our game, so certain types in small amounts are good.  That is what I'd call positive, natural stress.  It's the stress that makes us want to reach our goals and improve our performance.  It's not urgent, just a little thrill running under the surface of things.
    Then there's the kind of stress that gets our heart rates zipping, our adrenaline pumping and our concentration scattered.  That's what I'd call negative, intrusive stress.  It distracts us from our focus, disturbs our peace of mind and if it goes on long enough, it can affect our health. 
    Patients can sense both types of stress.  They both give off vibes. There's no faking it and no fooling them.   When a patient feels the positive kind they are left thinking, "Wow, these people really are go-getters who want to do their best."  When we're exuding the negative kind of stress the patients thoughts go more like this, "What in the world is wrong?  Everybody seems distracted and upset.  I wonder is something bad happened.  I wonder if they don't like me.  I wonder if they'll be able to concentrate on my treatment." 
    Figure out ways to keep a good level of positive stress running in your office and to minimize or almost eliminate negative stress.  I say almost eliminate negative stress because people are not perfect so there'll always be some of that.  Decide how you'll deal with it and keep it away from your patients.   They have enough of their own problems. 
    The best way to deal with problems is to develop high levels of trust between staff members.  If people work in a trusting environment, they know that any problems they face in the course of the day can be addressed and settled later.  Then people can relax and avoid turning molehills into mountains.  Trust, honesty and acceptance all work together to ensure smoother problem solving and to minimize conflict.  That keeps the staff happy and patients happy, too.  And keeping patients happy and healthy is what it's all about.  Keep stress levels low and attitudes high.  You need the real thing.

WHO CARES?!

    Who cares?  About your patients?  About their fears and concerns?  About what they really want?  About how they experience you and your team and their treatment and time spent in your office?  You should, and if you're reading this, I'm sure you do!  Your staff should care.  Do they?  If they don't can you make them?  Yes, you can, sometimes. 
    How do you show your patients that you care?  You can't fake it, no matter how hard you try.  Insincerity is the most transparent of all attitudes.  Sincerity is a state of mind that can be developed by deeper thinking. 
    Put yourself in your patients place.  How would you like to be treated?  How do you want your patients to describe their experience in your office?  Just as it takes more muscles to frown than to smile, it takes more time and energy to reverse a bad impression than to create a good first impression.
    Make sure that the person who answers your phone cares and has the time to give their attention to the new caller who wants to become a patient or to the existing patient with a question about their bill or a toothache that has kept them awake all night.
     Patients recognize it when the person who is responding to their call is also trying to mouth thank you to the person checking out and hello to the patient walking in the door.  Not to mention the fact that the unsupervised child in the reception area just winged a block through the room that just whacked the beleaguered receptionist in the temple.  A valiant effort on the part of the receptionist, maybe, but the stress and distraction travels right through the phone line and into the patient's awareness.  A chance to make a good impression is lost. 
    What would make this experience better?  Enough front desk staff so that once engaged in a phone call, the receptionist can give the caller her full attention and really pay attention to what the caller needs.  And of course, she must care about what the caller needs.
    In the operatory or hygiene room, is the patient given the chance to understand what today's procedure will entail and are they able to ask questions and express their feelings about what is to be done or is the patient napkin stuck on, topical slapped in and the patient left supine with a wad of gauze and a cotton tip applicator sticking out of their mouth for a indeterminate period of time until the dentist darts in to give them their injection and disappear for another indeterminate period of time? 
    Or.....does your assistant go out to the reception area and warmly greet your patient and walk to the operatory with them and explain what the planned treatment is, what it will entail and how long the patient can expect to be in the office?  Does she have the knowledge to explain procedures and the discretion to know when the dentist is needed to answer questions?  Does she offer the patient a pillow for her neck or headphones and a selection of Cd's to choose from?  When treatment is completed does she escort the patient to the front desk or figure she knew how to get in, she'll find her way out even faster?
    Does your hygienist talk to her patients about conditions she is seeing in their mouth and how to remedy or improve those conditions.  Does she give helpful tips about hard to reach areas and educate patients about toothbrushing techniques and new products.  Does she ask them about their diet and clue them in to foods that seem harmless or even fairly healthy that can cause decay?
    How about you, Doctor?  Your attitude sets the stage for everyone else's.  You have to walk the walk.  If you get annoyed or insulted because a patient questions your treatment recommendation, it won't matter what everyone else does.  And sooner or later, everyone else will sink to the level you establish as the leader of the practice.  Even if you have a practice manager, you are the leader and you set the tone and determine the level of caring in your practice. 
    I have given you just a few ideas about customer service.  I will continue to post more specific practices you can incorporate into your team's performance philosophy that will not only make your patients feel good about you and your team, but will increase your level of satisfaction with what you are providing.

Coming soon:  How to raise the level of care and caring in your practice.