Do you promote yourself as a holistic or a mercury-free dentist? If you do, then you know that working with this special group of patients brings a unique set of challenges. Recently, I conducted a Team Teleconference with a group who was struggling with how to best serve these patients.
Their goal: To better understand these patients and learn how to connect with them more successfully. In other words, how can we align with what they want?
Here’s the email they sent me to establish the agenda for our session:
Holistic calls seem to always be the challenging call in our office. The patients are always very detail oriented and can really throw us off with some of the questions asked. Another problem we face is they take so much time on the phone. I immediately guide them to our holistic website and walk them through our holistic approach when removing Amalgam.
There seems to always be a lack of understanding by the patient about what is involved. What I constantly hear from these patients is that they don’t want to have an exam, (don’t want) x rays and just (want to) have their amalgam removed.
How can we efficiently handle these calls? How can we handle these conversations to help the patient better understand why the exam and digital X rays are important? How do I get these patients to understand our process without coming off “rude” or “condescending”?
Keep in mind we do offer the consult as a last resort to help convert the call to a future appointment.
Our session brought about some clarity by breaking down the knowns and unknowns.
To start, the team identified some common themes that emerge when working with these patients:
1) They do a lot of personal research on the Internet.
We know that there is an equal amount of incorrect information as there is accurate information out there and each patient will struggle to discern what is fact and what is fiction. When they call your practice, they already have a set of beliefs which may or may not be correct. If what you tell them goes against what they have begun to believe, they will experience some internal conflict.
2) They self-diagnose or have been told by a trusted authority that the mercury in their mouth is;
1) toxic and 2) may be making them sick.
This may or may not be true in their case but you will not change their belief system in a short phone call. It is what it is. Gaining clarity about what they believe is essential and you must use this as the CONTEXT for which you will begin your relationship with them.
3) They are apprehensive and slow to trust.
They may believe you want to perform other procedures that aren’t necessary or will also be harmful. Some individuals may have had negative experiences with health professionals in the past, which leads to their distrust. They have a story and you must take the time to learn what that is.
4) They are health-focused.
Some of these patients place high importance on their diet and their exercise regimen – sometimes to the point of obsession. On the other hand, they may have a multitude of health issues and their life revolves around illness and doctor appointments. This is a part of the story you will uncover and must understand in order to determine IF you can help them, and if so, HOW you will offer to help them.
Because of these issues, they will consume more time than your typical patient, asking questions and discussing their unique circumstances. There is no way you will change this. If you are going to serve this special group, you MUST be prepared to take the time required to fully understand them.
Also, there is a BIG difference between being efficient, and being effective. Efficiency relates to paper and processes while effectiveness relates to working with people. And effectiveness can’t be measured by whether or not you convert the phone call to an appointment. Not all callers are ones you will want to invite to become your patients. You must know when to cut your losses.
During our session, we broke it down into bite-size pieces to come up with a more effective way to work with these patients when they call.
What do they want?
In quality of life terms, what are these patients hoping you will help them with?
-They want to feel better
-They want peace of mind in knowing the possible toxins are gone
Above anything else, this is what you are providing. The procedure of removing the amalgam fillings will simply be the means by which you will help them get there.
How do they want you to accomplish this?
-They want it done in the least amount of steps necessary
-They want the safest procedure possible
-They want it done for the least amount of money
What don’t they understand?
-They’ve been told or read something they have come to believe that is different from what we tell them.
-Why xrays are necessary.
-Why a thorough exam is both clinically necessary and required by law.
How can you help them get what they want?
Because you don’t know what might be necessary just by talking with them on the phone and the approach requires a thoughtful process considering their unique situation, you will need to provide the context for why this is important in their case. Experiment with the following process and refine it as you get more successful:
1) Find out more about their unique situation – learn their story
When a caller begins the conversation by asking about mercury-free dentistry or removing amalgam, find out why they have an interest. It’s as simple as saying;
“That’s a great question. You’ve called the right place. Tell me a little more about your situation and let’s see how I can help you.”
2) Be quiet, listen, and take notes.
The patient will choose to tell you those things that are most important and can provide you with the foundation for how you will relate what they want with what you offer.
(Sidenote: if the caller begins by telling you every little detail that happened years ago, there are several ways in which to determine whether you must 1) disengage because of red flags, 2) focus the caller, or 3) offer to refer them to a source of reliable information (like your web site), and call them back at a later time. More on this in a separate article.)
3) Use what you have discovered to provide context to the solutions you recommend.
It doesn’t matter that the protocol you use for each person is the same. You must make what you recommend unique to their particular situation. Remember to:
-refer to them by name
-acknowledge what you have heard
-explain what you recommend based on what you have heard
-get their approval
Here’s an example:
“Barbara, because you mentioned you suspect the mercury in your mouth may be causing some of your health issues, Dr. Holistic will want to learn all about those concerns. She will also want to evaluate what other things might be occurring in your mouth that you would want to be aware of and whether they may be contributing to your problem. I would like to suggest we arrange a time for you to come in to discuss your concerns with Dr. Holistic and she can to determine what diagnostic tests may be appropriate to discover the best way to help you. These may likely include xrays to see what the human eye can’t see going on under the surface. How does that sound?”
(Another sidenote: the subject of xrays and some patient’s reluctance to allow them is another layer of the story. You must peel back this layer in order to understand why this is a problem for them. Don’t assume you know what it’s about. Stay curious and relate to what they are telling you. If you would like to know more about how to address this issue, contact me for a primer on the subject.)
The TAKE HOME MESSAGEs:
Stop telling and start listening.
Use what you learn to create the framework for how you will help them.
Make it personal and unique to their situation.
You can use this same approach with ANY patient. It will help you connect more personally to each caller, begin to develop trust and help you establish a strong relationship from the very beginning.
Every year, students compete all over the country in the Rube Goldberg Competition. Named after the American cartoonist, sculptor, author, engineer and inventor, it is now a noun. The process of creating a Rube Goldberg is defined as: doing something very simple in a very complicated way that is not necessary.
We see this every day in all kinds of businesses. The most recent example I witnessed last week at the new BurgerFi restaurant that just opened in my town. If you haven’t heard of this place, it’s a burger joint…plain and simple. And I’m guessing that because there are a lot of burger places, and most of them are less expensive, BurgerFi, which is a franchise, wanted something unique to set them apart from their competitors.
Enter the tracker system they use once you order. The order taker at the counter gave us our tracker and instructed us to place it on the mat on the table so our order could be delivered to us.
Now here’s where it gets tricky.
We find a seat and sure enough, the mat is easy to spot – right in the middle of the table. We placed the tracker on the star in the middle of the mat which has black hole in the middle, which we assumed communicated with some high-tech GPS system so they know where to bring our order.
Sidebar: The BurgerFi logo is on the tracker pad. This is important information for later.
About two minutes go by, then the owner/manager comes over to our table and moves the location of the tracker, explaining we placed it in the wrong spot.
We take a closer look and in small print on the four corners of the mat are the words; Place Table Tracker Here
We missed that. So I called the owner/manager over to ask him how often he has to change the location of the tracker for his customers. He told us “about 40% of the time…”. So, four out of every ten orders, he runs around the restaurant having to “fix the system”. I asked him if there might be a better way to find the right table without all the unnecessary effort. His reply was something along the lines of “Yes. But it’s part of the BurgerFi experience.”
This is a classic Rube Goldberg: doing something very simple in a very complicated way that is not necessary. There are so many other systems for delivering food to the right table that don’t occupy someone’s time trying to fix what isn’t working. Unfortunately, no one wants to abandon the system for a better way because the company has invested so much in the system and has tied it in with their “brand”.
Is your practice guilty of some Rube Goldbergs? Do you have systems that don’t benefit you or your patients? Systems that are outdated? Systems that require remediation? Systems that occupy the time and energy of valuable staff for no payback? The router system? The half the record in the paper chart/half on the computer system? The hygiene post card/phone call/email reply for “confirming” appointments system?
Bring your team together and use this blog post as a conversation starter about the stupid systems in your practice and how you can think smarter, not harder.
1) A call from a dentist wanting help with performance reviews. It’s time for raises and the staff is pressuring the dentist for a review. Or the dentist is panicked because she promised reviews six weeks ago, but has been avoiding it because it takes so much time. Or the dentist feels reviews and raises just create trouble and is tempted to just give everyone an across-the-board raise to get it over with.
2) A call from a team member wanting to know how to get her (or his) dentist to do performance reviews. She might complain that he keeps rescheduling them, and she needs some valuable feedback. She may feel she is entitled to earn more money because she believes she’s carrying a big load. Or the dentist promised a review after six months but she’s been working there ump-teen years without any feedback.
Here are some thoughts from Sandy Roth about this timely topic:
I’ve written several essays on the issue of compensation and performance evaluations. By now you know that we encourage our clients to compensate staff based on merit and work performance, not length of service or time of the year. For that reason, it is essential to establish a system of reviewing the performance of every member of the team at regular intervals. But how do you structure such an evaluation? And how can these evaluations be done without becoming a huge burden for the
The process can be made simple if the preliminary work has been done. We can’t talk about evaluations without mentioning that a Statement of Performance Expectations must be in place for each employee. A Statement of Performance Expectations is quite different from a traditional job description.The job description was a union invention which outlined exactly what the employee was expected to do and thus guarding her from having to do anything more. This mentality makes no sense in dentistry, where each person is expected to grow and change as the needs of the client and practice change.
Whereas a job description outlines the employee’s tasks and limits the scope of her influence, a Statement of Performance Expectation widens her sphere of influence by suggesting ways she might have a greater impact on the success of the practice. When a Statement of Performance Expectations is appropriately in place for each employee, performance evaluations are a breeze.
The next step is to involve each employee in her (or his) own evaluation. The process is amazingly simple and wonderfully healthy. The employee begins by evaluating her own performance, using the Statement of Performance Expectations as a guide. Simultaneously, the dentist (and in more sophisticated teams, other team members) evaluate the team member’s performance, using the same guide. The employee, dentist and other relevant team members all participate in the Performance Review meeting, during which each of the participants contributes his or her perspective on the employee’s impact on the success of the practice. This meeting is held discussion style and everyone gets an opportunity to contribute.
At the conclusion of the meeting, new goals are set, new expectations are identified, new training and learning opportunities are planned, and supportive commitments are made to the employee. Finally, the next Performance Review meeting date is set.
The following structure outlines some of the categories of expectations which you might want to consider. Use this list as a starting point and add your own ideas. For each area, identify first the expectation then the actual level of performance or mastery.
Evaluation of Clinical Effectiveness or Administrative Accuracy/Efficiency
Clinical Acumen – Diagnostic Skills – Clinical Intervention Skills – Clinical Information Skills – Clinical Strategy Skills – Clinical Collaboration – Information Transfer – Administrative Efficiency and Accuracy – Record-keeping and Tracking
Evaluation of Client Relationship Effectiveness
Listening Skills – Questioning and Learning Skills – Other Communications Skills – Ability to focus on the patient – Sensitivity to patients and their issues – Ability to develop and advance healthy relationships – Ability to transfer information to the team – Ability to handle difficult patients – Social skills – Feedback from patients
Evaluation of Team Participation
Listening Skills – Questioning and Learning Skills – Other Communications Skills – Collaborative Skills – Conflict resolution skills – Respect for others – Finesse
Evaluation of Practice Alignment
Alignment with practice vision – Problem-solving skills – Willingness to commit to the success of others – Planning and strategizing skills – Ability to spot trends and stay aware of changes – Growth patterns/Personal commitment to learning
Please note that some evaluation points are duplicated under more than one evaluation category. It is not unusual for a team member to be extremely effective with patients and out of whack with the rest of the team. These differences are worthy of notation.
Obviously, the expectations will be different for each member of the team, depending on her (or his) role and level of responsibility, and, of course, not all team members will have clinical responsibilities. So, you must individualize the Performance Evaluation categories and items to reflect the expectations of the individual team member.
Don’t fall into the trap of believing that every team member should have the same expectations and evaluation criteria. Although they are entitled to equal respect and attention, no two team members are the same, nor will they ever be. For that reason, the Statement of Performance Expectations as well as the evaluations for two team members who occupy essentially the same position will necessarily be different in some significant ways. The important thing is to set a time for evaluations and involve everyone in the process.
If you haven’t yet created Performance Expectation Statements for your employees, it is not too late. ProSynergy’s Hiring Kit is packed with information to help you learn how to create, even remedially, great relationships with your staff.