dental
We Need More Help at the Front Desk!
QuoteWe Need More Help at the Front Desk!
Why is it that team members in the non-clinical roles, often referred to as the “front desk staff”, complain about the amount of work they have to do and always seem to be stressed out? Here are a few of the comments we hear all the time:
“The people in the back don’t understand all the stuff we have to do”.
“How can I do the insurance when I keep having to answer the phone?”
“We never get caught up.”
“I’m constantly having to stop what I’m doing to take care of a patient. Then when I come back to it, I forget where I am.”
We have a couple of theories about the traditional front desk configuration and why it sets most teams up for failure.
THEORY 1: The front desk isn’t the area in which the dentist works. He or she doesn’t fully understand the challenges the staff is faced with and is less likely to know how the systems work against them, not to mention the outdated equipment and software challenges. For instance, many practices have only made a partial transition to paperless charts, making the practice dependent on two systems (paper and computer), which makes locating information more difficult, causing duplication and increasing the chance of error. The dentist rarely understands the challenges this poses for the team. (This is a subject in itself!)
THEORY 2: People who work in this arena often develop tunnel vision and have difficulty
seeing new ways to structure their work. The result is that the front desk staff keeps doing the same old things in the same old ways, and not doing any of them at optimal level.
THEORY 3: When the non-clinical staff complains long enough, the dentist usually breaks down and adds another person to the team to do the same things the other team members are doing, creating more confusion, more errors and even less efficiency and effectiveness – not to mention more overhead!
So, what’s the answer? Consider separating the tasks into two areas of specialty and assign the responsibilities to the individual who has the right skill sets. Let’s look at the responsibilities of the non-clinical staff and how those duties break down.
There are three distinct areas of focus in every practice – what we call the A-B-Cs :
A – Administrative:
Responsibilities that support the business of the business. They are related to paper and tasks – not patients. They can occur “behind the scenes” and in most cases, are not ones that must be addressed in the moment.
The key in this role: to be EFFICIENT with THINGS.
Just some of the responsibilities that might fall under this heading are:
– review chart entries at dayʼs end to balance against deposits
-insurance pre-authorization, submissions, review and followup
-opening and sorting mail with distribution to appropriate person
-entering payments from mail and over the counter
-printing receipts for patients
-monthly statements
-daily deposit
-monthly and annual closing and archiving
-organizing invoices and packing slips before matching to statements for payment
-payables entry in accounting system
-preparation of a/p report for dentist review and approval
-preparation of checks for dentistʼs signature
-mailing signed checks
-inventory of office supplies
-purchase of office supplies and patient amenities
-errands as assigned
-correspondence
-maintenance of office equipment and machinery
-computer system oversight and IT
-maintaining patient amenities (ie: coffee station, water, etc)
-hourly upkeep of patient washroom and reception area
-implementation of marketing, promotion
-communication and follow up with the lab
-communication and follow up with vendors
-planning continuing education
-planning meetings
These responsibilities require focus, attention, detail, someone with self-direction and organizational skills -an analytical thinker. This same concept can also be applied in the clinical area of the practice – responsibilities associated with sterilization, operatory preparation, inventory and lab duties. They are all essential to providing patient care but occur independently of patient care.
B – Behavioral:
This arena has to do solely with the business of our patient’s business and is often the most overlooked area. These responsibilities often occur with patients and are focused on patient care, connection and communication. While some of the duties require planning and preparation, events often occur in the moment, can not be predicted and must be responded to in real time. This job requires an individual with big picture thinking. The best people are those with sensibility, grace, maturity, empathy, curiosity, good listening skills, confidence, good command of language, and the ability to think on their feet.
The key in this role: to be effective with PEOPLE.
The responsibilities that most often fall under this heading are:
-working with new patients from initial telephone call through treatment planning
discussion
-supporting patients in the moment whether on the telephone or in person
-urgency triage and establishing clear expectations with urgency patients
-maintaining oversight of patients in process – those for whom treatment has been
recommended but not yet completed
-organizing and managing the “lost souls” project – those for whom treatment has been
recommended and have dropped out of sight
-handling fees and financial arrangement discussions that are not properly handled
elsewhere
-addressing patient complaints and issues in a timely manner
-ensuring that patient interests and concerns are clearly understood by all
-supporting patients by helping them price-test their treatment options
-ensuring that all patient-contact staff are prepared behaviorally for patients before they
arrive
-identifying patterns and trends with patients as they occur
-maintaining oversight of the schedule and making appointments as necessary
-managing patient correspondence and followup
-coordinating non-clinical aspects of care with specialists and referrals
-internal training on communications and patient relations
-connecting with referral sources, public relations, networking
C – Clinical:
Events related to the delivery of care. Commands most of the focus of the practice and is often the most up-to-date area. Requires the attention and oversight of the dentist/business owner. Removes the dentist/owner from constant oversight of the two other areas, making it even more important that self-directed, well-matched, highly-effective people are placed in the non-clinical roles.
As you can see, the non-clinical staff is responsible for two of the three critical areas of the practice. These staff members are often asked to perform both Administrative and Behavioral roles simultaneously while the responsibilities are very different from one another and require different skill sets. It becomes clear that when we ask them to assume both roles, they are split between two very different responsibilities, making them choose in the moment which is more important. This usually creates more problems, and sets them up for failure, making them less effective or efficient in either of these areas.
It is our opinion that when you separate the Administrative from Behavioral roles and hire/assign responsibilities based upon strength in one of these two areas, you encourage deep competency, similar to your competency in the area of dentistry. Each person performs at a higher level when they are focused on only one arena and they become more successful than if they were asked to do everything with less effectiveness.
This is not to say that a person who is assigned administrative responsibilities can’t support the one who is responsible for patient connection by answering the phone, welcoming patients or checking patients out when necessary. There are always exceptions. Some practices opt for a third person to act as a greeter or to handle phone triage and appointment scheduling. Remember, the goal is to encourage deep competency in their skill set and prevent team members from performing in areas where they are not as skilled.
This concept may require you to think differently about the individuals, skill sets and responsibilities in your practice. A good exercise for each of your non-clinical team members is to have them make a list of their duties and determine whether it is administrative or behavioral (we hope you aren’t asking them to also perform clinical roles too!). Ask them to assess how much of their work load is in each of these arenas and discuss how roles might be shifted to better serve this new model.
Take home message: You most likely don’t need more people serving in a non-clinical role – you just need the right people, with the right skill sets, in the right positions, which creates a better, more efficient and effective systems.
A caveat here – you may discover that you have team members who share similar skill sets leaving you with no one to serve an administrative or behavioral role. This may be the eureka moment that explains why certain problems keep occurring in your practice. This process may also cause you to consider restructuring your non-clinical staff altogether. We can help you consider your options and sort through the implications of making changes to better serve the practice and your patients.
Laying Down the Law With Patients
Laying Down the Law With Patients
While it’s clear that our patients have expectations – sometimes valid, sometimes unrealistic – we have expectations too! And how often is it that our patients disappoint us because they don’t do what we expect of them? While this blog article could turn into a full-on gripe session about those darn patients and how they constantly let us down, I believe how we think and what we do or don’t do, have a great impact on how our patients act and if we want them to change, we have to change first.
Here’s the deal; First, there are some things that we don’t get a vote on and there are other things we do. Second, how can we hold our patients to accountable to any expectations if we don’t come right out and have an honest conversation about them? Expectations are reasonable only when they are clearly conveyed, discussed and agreed-to by both parties.
So, what are the valid expectations? In our opinion, we believe there are only four things you can ask of your patients. I think you will strongly agree;
1) SHOW UP – and on time
I could devote a book to this subject. How often does a patient let you down by no-showing, or arriving late (and thinking it’s OK, I might add)? How dare they? First, this is a professional business arrangement. It can’t be treated casually. Having your patient sign a form with your “office policy” is not good enough. (How many people read it anyway?) You must look your patient in the eye and tell her you have reserved this time with “fill-in-the-blank” just for her, you will be fully prepared when she arrives, and ready to get started. “Can I get your commitment to that?” THAT will get their attention.
What doesn’t work? A recall system or any other communication that conveys the message that you “request the courtesy of — hours notice in the event of cancellation”. You’ve, in essence, given them a ticket to reschedule. And putting them in the penalty box by “fining” them for not showing will just put a strain on the relationship without addressing the problem. Instead, speak to the obvious;
“Bob, we were expecting you this morning for your appointment with Dr. Norris and honestly, we are disappointed you didn’t make it. We had that time set aside just for you.”
How can you assure this won’t happen in the future?:
“ I can arrange your next visit in one of two ways; a deposit of $fill-in-the-blank will reserve your time or, I can call you on a day when an opening avails itself to see if that will work with your schedule.”
Same thing with people who habitually show up late. Speak to the obvious;
“Lisa, I’m glad you finally made it. I only have 35 minutes of time left before my next patient arrives so, I promise I will get as much accomplished as I can. It might mean we will need to schedule another time to have you come back to finish what we can’t take care of today.”
Message: you’re late, I run on time. I will not inconvenience my next patient, you will still pay for your full appointment, and you might have to come back again. Reasonable? I think so.
2) PAY AS AGREED
Aside from insurance claims, there should be no reason for you to have any outstanding accounts with patients. Period. How is it that practices get into the accounts receivable business with patients in the first place? Unspoken or unclear understandings about 1) the fee and 2) the terms for paying the fee.
No dentistry should be performed without an actual discussion about the cost associated with the treatment recommendation, what the patient will be expected to pay, how that fee can be made, and a mutual agreement with the patient on the terms. Something as simple as:
“Gentry, the fee for the treatment you have chosen is $fill-in-the-blank and our first preference is that be paid (in full at the first appointment or a % to reserve the appointment and remainder on the first appointment, etc.). Will that arrangement work for you?” If it does, great. You are done. If it doesn’t, you find an alternative that works for both of you.
Remember, it is better to NOT do the dentistry than to do the dentistry and NOT get paid.
3) BE HONEST
What would we want our patients to be honest about?
#1 on the list: Let us know how you are feeling and what you are thinking.
You can’t read your patient’s mind. You need to know if he is apprehensive, if he isn’t sure the treatment you’ve recommended is right, or if finances are an issue. That is why having a dedicated and gifted facilitator on your team can help you connect with patients at a deeper level and help them voice what might otherwise be left unsaid.
#2 Lifestyle, health issues or recreational/prescription meds. These have a huge impact on what your recommendations might be and the outcome.
#3 Don’t make an appointment if you don’t intend to show up, or agree to treatment if you aren’t sure, etc.
These could be uncomfortable conversations. Coming right out and asking your patient to be honest may imply that you think they are lying. So, how do you convey this very important value? You can suggest the ways in which you hope they will tell you the truth. If you use context to frame the idea, it will make the conversation go more smoothly;
“Some people are reluctant to share personal lifestyle information with us such as their recreational drug use or the state of their health but these issues have tremendous impact on how we might treat someone or the outcome of treatment. I want you to encourage you to be as open as you can with us and know that we will respect your honesty and never make judgments based on what you tell us. In exchange, we will never mislead you or withhold information that we believe is in your best interest.”
Or encourage honestly by speaking to the obvious…
“Something tells me you aren’t fully committed to the treatment we have recommended. Before we go any further, please share with me what you are thinking and what concerns you still have.”
4) BE GOOD NATURED
We’ve all had them. The patients who show up on your schedule and you break out in a sweat. You plan a strategy to be in the lab when she arrives. You avoid engaging her in conversation and ignore the terse comments. In my opinion, that is NOT OK. If there are patients in your practice who are bullies, they need to be called on it.
When my kids were little and one of them would come to me complaining, “Mom, Casey’s chasing me”, my reply would always be, “Then stop running”. The same is true with nasty-tempered patients.
Yes, it is uncomfortable to address someone when they are behaving badly but it can be done with grace and one of two things will happen: it will either defuse the situation and she will recognize, apologize or explain herself OR she won’t get it and the relationship will end. Either way, you win.
Here’s the grace part:
“Hilda, I get the sense that you aren’t very happy about something, and if it’s something we’ve done to make you that way, we would want to know about it. What’s going on?”
You will know very soon by her response where to take the conversation next.
“ Goodness, I had no idea. Thank you for being honest with me. Let’s see what we can do to make it right.”
Or
“You know, Hilda, it is becoming clear that despite our best efforts, we may not be able to make you happy. I am more than willing to transfer your records to another provider if you like.”
Conveying your expectations makes such good sense because it prevents a myriad of problems before they occur. And you will find that there are many remedial systems that can be eliminated when you front-end your relationships with a conversation about expectations.
Having direct conversations with patients about these expectations requires team members with courage, confidence and finesse. It requires level thinking, maturity and most important, time. That is a big investment but pays off quickly by eliminating many of the issues that cause us stress.
Great Expectations
It’s prom season! If you or your children have gone through the prom experience, you know there are a lot of expectations about this life event – your date, the friends you will go with, what you will wear, the transportation to get you there, where you will have dinner beforehand and what afterparty you will attend. If you were like me, my expectations for this magical night were not the same as my reality.
What does this have to do with dentistry? While as teens, we gave a lot of thought to prom and we discussed it at length with our friends and our parents, the expectations our patients have may not be as thought-out or clear. BUT THEY DO HAVE EXPECTATIONS.
These expectations aren’t tattooed on their forehead – they are internal. And they are formed over a period of time based on previous experiences. Patients rarely leave a practice and move on if they are happy with their dentist. Consider that most people who call your practice are recycled patients who, with the exception of having just moved to the area or their dentist has retired, have likely not had their needs or expectations met.
In a recent Facilitator Study Club teleconference, we discussed this topic and gathered a list of some expectations patients might typically have:
Time: How much time do they think it will take? Do they want an appointment quickly? Do they want to get in and get out quickly or do they want the dentist to spend a lot of time explaining or answering questions?
Conditions and treatment: What do they believe the dentist will find? What do they hope the dentist will find? What do they believe the solution will be?
Pain or discomfort: Do they think it will hurt? Do they expect it not to hurt? Are they hoping to have sedation?
The practice: Do they expect simply the basics or do they anticipate amenities like refreshments, entertainment options, warm blankets and the like? What about clinical standards?
Communication: How do they expect to be treated? Do they have a certain way they wish to be addressed? Are they accustomed to getting a reminder call, or text, or email about their next appointment? Do they like to interact socially or prefer you cut to the chase? Would they prefer more specifics and detail or just the bottom line?
Fees: How much do they believe it will cost? What are they prepared to pay? What role are they thinking insurance will play in their decision-making? How do they expect to pay for their treatment?
I’m sure you can come up with your own extensive list.
If you don’t know what your patient’s expectations are, how will you ever be able to meet, or better yet, exceed them? You would hate to find out what those expectations are by disappointing them. And more important, if your patient’s expectations are unrealistic, you would want to know sooner rather than later so you can prevent misunderstandings before they occur.
Your patients will tell you their expectations if they believe you:
1) are genuinely interested
2) will do your best to meet or exceed those expectations
How do you find out? The natural answer is YOU ASK. But as simple as this sounds, it is often overlooked and not practiced consistently. We see this play itself out in practices all the time. Team members guess, make things up, base it on assumptions, which are based on previous experiences with patients. Our own personal expectations or preferences may also play into our assumptions.
And because some patients may not be good at expressing their expectations without prompting, it is essential for you to create a curious culture and a framework for finding out. Make time at the onset of the relationship to have a conversation with your patient about what they expect and come to an understanding about what you can and, in some cases, cannot do. Don’t hand them a form to fill out. Instead, you might use a questionnaire as a guide to help you in this process. (If you would like a sample questionnaire, email me). Allocate time in the schedule for these conversations and assign the responsibility to the most behaviorally gifted person on your team. Provide this team member with additional support and training as well as the private space in which to have these conversations with patients.
The fact that you work at understanding your patients in this way sets you apart from most other practices. Through this information-gathering conversation, patients become clearer about what is important to them, you become clearer about how to serve them better and you establish the foundation of a strong relationship with more successful outcomes. Less patients will move on to be recycled again somewhere else.
NEXT TIME: Conveying practice expectations to patients.
Contact me for a copy of our sample questionnaire or to learn more about the Facilitator Study Club,
My Prediction for 2013
Good news! U. S. News and World Report has announced their list of the top jobs (those in greatest demand) for 2013 and topping the list at number one is dentist! Following in the number ten position is dental hygienist! At the risk of angering some of you, I’m going to say it. No more whining! You can position your practice and seize the market. But you must decide to take a good hard look at your practice and make some improvements. Look at these FIVE ELEMENTS and ask whether you are making the most of each opportunity:
1) Your Physical plant
Patients have very little in which to judge your expertise or competence and some will assess you by the appearance of your practice. From the exterior and signage to the decor, wall art and clutter, look at your practice with new eyes or ask a third party or professional to give you their honest opinion. And while you must like and be comfortable in your surroundings, the more important issue is who you are targeting and what will appeal to them.
2) How are patients welcomed?
The best investment you can make is to train the team members entrusted with answering the phone and welcoming new AND existing patients. NO AMOUNT OF ADVERTISING OR EXTERNAL MARKETING WILL BENEFIT YOU until your team members learn how to connect with people in the most effective way. The challenge is that you rarely know how your team members are engaging people because you are focused on doing dentistry. Enlist the help of a professional to both assess and train your team appropriately.
3) Work on building relationships
This may sound like a no-brainer but there is more to building a relationship than learning where your patients work, their children’s names or where they went on their last vacation. Everyone who works in the practice must be capable and willing to learn communication skills that will carry your relationships beyond the superficial. This requires learning why patients come to you, what they are asking and expecting of you, and how you can connect with them in ways that help them get what they want. The end result is more patients authorizing more dentistry sooner!
4) Fostering referrals
It stands to reason that if you manage expectations and give patients what they want, they will be happy and continue to come to your practice. Far too often, we don’t ask our best, most satisfied patients for referrals. Do you and your team know the art of asking for referrals in a genuine way? Do you have a referral program that encourages people to voluntarily share their experience in direct and viral ways? Enlist the help of a professional to AMP UP this highly overlooked goldmine.
5) Marketing
For you old-school guys and gals, WAKE UP! It’s 2013 and if you aren’t getting your business out into the community, you will be left behind. For those of you who have marketing plans in place, now is the time to re-assess their effectiveness. Keep these three essential elements in mind as you craft your campaigns:
Reach – who you are targeting
Frequency – how often you are sending messages out
Top of the Mind Awareness/Familiarity – being in the consumer’s mind when they are in the market or have a need
I encourage you to consider more non-traditional means of promoting your practice with a heavy emphasis on education and good-will marketing. Think creatively and out of the box. Don’t rely on a team member to try to implement your marketing when they “have time”. Instead, hire someone who can focus on it.
I predict that if you tackle all five of these goals this year, your practice will SOAR. I would love to help you with each of these areas to make 2013 your greatest year ever and be poised for success for years to come.
“Confirmation” Calls and Cancellations
I’ve been thinking about some of the systems many dental practices create and considering the high cost of these mostly remedial efforts. We believe that in many cases, the systems we create in our practices are designed to fix problems we created ourselves! If this hypothesis is true for you, you are likely paying huge costs to address situations which might have been avoided in the first place.
The confirmation call is a classic example of this syndrome. When we institutionalize the confirmation call, we create a very expensive remedial system. In many cases, the confirmation call is like the sign on a blue highway:
LAST EXIT BEFORE TOLL
First, let’s examine the word “confirmation”. I wonder how many patients think about an appointment as “tentative” or “penciled in” until it is “confirmed” by a phone call a day or two in advance? If you, indeed, consider the appointment confirmed when made, any call after that is simply a reminder. When you call a patient to “confirm their appointment” on a particular date and time, it equates to giving them the option NOT to come because it implies the appointment was tentative. I wonder whether, upon receiving such a call, a patient might quickly assess her schedule and bank account balance to determine whether she still finds it convenient and affordable to come for her appointment?
So why do you make confirmation calls? My clients tell me it is primarily to insure that patients remember to come for their appointments because open time on the schedule is costly and frustrating. If that’s the case, it seems like the best place to address this issue is at the time the appointment is made and insure you do everything to identify your expectations and ask your patients to honor their agreements with you.
When you make an appointment with (not for) a patient, you have negotiated a contract which must include agreement on the following issues:
1.The procedure to be performed
2.An understanding of why the procedure was recommended and why the patient has asked you to perform it
3.The fee for the procedure and how you and the patient have agreed the fee will be paid
4.The date and time as well as approximate duration of each of the appointments in the sequence
5.That these arrangements are confirmed at the time they are made – you agree to be on time and fully prepared to deliver on your promise and simultaneously the patient agrees to show up on time and fully prepared to deliver on his promise.
When the appointment-making process has been done well, confirmations become unnecessary and far fewer appointments will be changed or canceled for reasons that have to do with unexpressed expectations you have from one another.
So, what is the true cost of confirmations? Certainly more than the high cost of administrative time and energy to make phone calls and handle changes. The cost is in underdeveloped and unclear relationships. These relationships tend to be as unclear about what concerns or problems the patient is asking you to solve, how the practice recommends solving them, and the costs you both will pay to get there.
I hear some of you thinking; “But what if they are forgetful or WANT a reminder?”
Certainly some patients may request a reminder because their lives are hectic and their organizational skills are not great. But only those who specifically request this reminder should be called. Those patients who have control of their lives and keep a personal appointment calendar don’t need a reminder. So, how will you know the difference and how will you change what you are currently doing? You ask.
Let’s examine this a step further.
We’re not suggesting that you drop “reminder” calls if your patients have been trained by you to expect them. You must honor all agreements, implied or explicit. On the other hand, If you choose to make a shift to eliminate the burden and volume of “reminder” calls, you must let every patient know that there will be a change in the way you handle them in the future. There must be a deliberate discussion about what will be different and why you are making the change. Then you must come to an agreement or, in a few cases, agree to honor their special request to handle their situation differently.
You can begin saying something as simple as,
“Rene, I know you have become accustomed to our calling (the evening, two days…whatever) before your appointment, but since we consider this appointment confirmed when made, I’m wondering if there’s any reason you have for wanting us to call and bother you with a reminder. You can be assured that we will be prepared to see you at this time.”
You could go one step further;
“Rene, you are probably used to getting a card in the mail and a reminder call several days before your next hygiene appointment. Well…”
“… we’ve found that sometimes we don’t connect with our patients and then they aren’t sure whether they still have an appointment…”
or
“…we have found that making the calls requires a full time person and we simply don’t want to have to raise our fees when it’s not necessary…”
or
“…we have found that a lot of our patients don’t want to be bothered with a reminder call that interrupts their day…”
“…so, we have chosen to handle our confirmed appointments a little differently in the future. Unless there is some reason why you would need a reminder (email/text/call), I won’t bother you with one. I want to assure you that we are completely committed to this time and we will be prepared and ready for you when you arrive. Will that work for you?”
That doesn’t mean that the tentative or reluctant patient will keep an appointment just because you’ve delivered that message, however. You must come to know your patients more thoroughly and understand all of their expectations, fears, preferences, wants and concerns. Only then will we be able to make appropriate appointments.
Next, how to handle the patient who calls to cancel their appointment…
Practice Perception Part II: What messages might your staff be sending?
In the first installment of Practice Perception, I asked; Does your physical plant represent your practice mission? We looked at the elements that contribute to painting a fuller picture of what your practice is about and is often the primary way patients can assess who you are and your level of professionalism and expertise.
Of course, there are other factors that contribute to your practice image. One of the most powerful influencers is your staff. They can be a primary reason why patients are attracted to or end up leaving your practice.
Inside the practice, you certainly would want your team to be on their best behavior and represent you in a positive light. However, you can’t assume they will behave or act appropriately without being specific about your expectations. Make sure your employee manual contains specific guidelines for things as basic as the following:
PERSONAL APPEARANCE – include specifics on what you will or will not tolerate regarding: jewelry, piercings, tattoos, hair, personal hygiene, oral health, cologne or perfume, or tobacco smoke or smell.
CLOTHING – if you supply uniforms, this should not be an issue. If you don’t, you must be specific about what is and is not appropriate.
CHATTER – quite often, dentists complain that the staff banter gets in the way of patient care. Patients who hear staff talking amongst themselves while they sit idly waiting will feel ignored. The hard and fast rule should be that the content of staff conversations in places outside the staff break room should be focused exclusively on patient care. In addition, remind your staff there should be no bad-mouthing or negative comments to other staff members or patients at any time.
PRIVACY – and of course, any conversations relating to patient care should be private and discussed in a place where they would not risk being overheard by others.
TEXTING, CELL PHONES AND SOCIAL MEDIA – team members gripe all the time about patients who use their phones during their appointments. Imagine how patients feel when a staff member diverts their attention from patients to text or use their phone or check their Facebook. It is rude and inappropriate. Period. Patients should not see or hear a staff member’s personal phone – not even a buzz when it’s placed on silent.
You cannot stop team members from using Facebook or other social media outlets outside of the practice, but you can remind them that what they post about their job or the practice is up for scrutiny. Depending on the comment, it could present the practice in a bad light. Comments can also cross privacy boundaries. In order to protect themselves and the practice, you should request that they refrain from commenting on anything related to the practice.
ATTITUDE – you have probably experienced your share of passive-aggressive behavior by your team. It manifests itself in ways in which you may not be aware until it is brought to your attention by another team member or a patient; being surly or short with someone, slamming doors or banging things, ignoring others, sarcasm and responding in an overly exaggerated sweetness that is “put on”. Patients pick up on these behaviors and it reflects poorly on the practice and you as their leader.
OUTSIDE THE PRACTICE:
How many times have you been in public and seen one of your patients? Whether it’s at the grocery store, gas station, sporting event or the countless other places you might go, you are keenly aware of how you might be perceived by your patients outside the practice. Your staff? Not so much.
When they aren’t working, your staff are probably not thinking about patients seeing them in a less-than-flattering light. And there’s not a whole lot you can do about it. However, you can encourage them to be on their best behavior. Remind them that they can be a powerful influencer to encourage patients to stay active in their dental care by the warm greeting or response they give patients outside the practice.
Enforcing these expectations can be difficult but it is essential that your staff understand how vitally important they are in influencing practice perception. They are a huge part of the equation.
Practice Perception: From the inside out
In my previous post, I mentioned a dying bamboo centerpiece we discovered in a restaurant to illustrate the importance of practice perception. My main point was that patients have no way to judge your clinical abilities and the indicators they will use to determine what your practice is about or gauge your expertise are the physical plant, the environment you create and the way you engage your patients in the process. Let’s take it one step further.
Does your physical plant represent your practice mission and is it in alignment with what you offer?
In this and future posts, I want to focus on the physical plant and environment and shed light on those areas you may want to evaluate in your practice.
For example, for new patients, the most important place in your practice is the reception area. This is where the look and feel of the practice is established and should be congruent with the image and messages you are sending into the marketplace. You want this space to set the stage for what the patient can come to expect from you and your team.
Let’s use a simple exercise and approach this process by using the five senses as a guide. If your practice specializes in working with anxious or fearful patients, how would you want your reception area to look, feel, sound, smell and even taste? Visualize in your mind how a person might enter into and experience the environment.You want to project the image of clean, soft, comforting, soothing, uncluttered space.
Sight
The colors would be blues, greens or violets to calm the mind, provide harmony and balance and encourage meditation. Artwork would be minimal and serene – no generic smiling people portraits. The space would be accented with side tables and you wouldn’t find ratty magazines or stand up displays promoting procedures or electric toothbrushes. Instead, visitors might discover hardcover picture books about photography, travel, animals, or inspirational short stories. Plants would bring in the natural environment and remove the clinical feel. A couple of carefully-placed live flowers might dot the room showing your care and attention.
The lighting would not come from harsh overhead or can lights but instead would be a mixture of floor and table lamps and sconces, providing soft, warm pools of light through the space.
Touch
There would be soft, inviting comfy chairs or loveseats, perhaps with pillows. Massage chairs might be another option. The floor would be carpeted or would have throw rugs, which also softens the sound of footsteps and voices.
Sound
Patients might hear instrumental spa music just loud enough that sounds from the clinical area would be masked. A water feature like a fountain, or a live or virtual aquarium would support the calming environment and add a distraction for anxious patients. No loud phones ringing, no speaker phone, and the volume of voices would be kept low.
Smell
Candles or wall plug-ins would dispense the aroma of lavender, mint or jasmine to aid in calming fearful visitors. No clinical or “staff lunch” smells would be detected.
Taste
A coffee, tea and water station would invite visitors to make themselves at home with an assortment of flavors, including calming camomile.
Can you begin to see and experience this reception area in your mind’s eye? This sets the stage for what they will experience throughout their visit. The physical space and everything you do should be congruent with this.
You may want to gather your staff together and perform this exercise in your own practice. Paint a picture for your team of the way you would like to treat your patients and how you want your practice to be perceived, based on your specialty and mission. Start with the physical plant. Come up with ways you can support the message. Walk through the space and evaluate what is in the space now. What doesn’t belong? What would you want to change or how would you improve the features? Then do this same exercise for each area of the practice:
Entrance
Reception
Front desk
Clinical areas
Business office
Treatment consultation room
Other public areas: hallways, bathroom
I would love to see photos of your reception area to see how you welcome patients.
In my next blog posts, I will look at the following equally important areas of perception: Staff, external messages and marketing messages. Be sure to click on the “Follow” button so you will get notification of the next post.
The Dying Bamboo
StandardRecently, Sandy and I had dinner with a dentist and his wife before we visited their practice for observation. The restaurant was in the airport hotel w
here we were staying. We were greeted and seated immediately and as we settled in, both of us noticed the centerpiece; a trendy looking slate stone vase that held a single bamboo shoot. Sounds like a great concept, right? If only the bamboo wasn’t falling over and the leaves weren’t yellow and wilted. It was downright sad.
Immediately, this symbol of good luck became a depressing sign, so we removed it from the table. It might also have been a sign for the lack of attention the restaurant received from the management and employees. As the dinner progressed, I noticed the bread was stale, the water glasses sat empty without a refill, and the meals were plated with little care. I began to wonder whether the food prep area was sanitary. Was the walk-in refrigerator temperature to “code”? Did the employees wash their hands? I didn’t have high expectations for the meal. Luckily, our server was decent and our food was acceptable but the experience was less than what I expect from this type of restaurant. I left underwhelmed.
What we discovered were telltale signs that no one was paying attention to the details. If those details weren’t being tended to, what about the things that really mattered? In their book,“In Search of Excellence,” Peters and Waterman make the following observation:
“When there are coffee stains on the tray tables, passengers wonder about the quality of the maintenance of the airplane’s engines.“
These signs undermine confidence. The same is true in your practice. For example, on a recent consultation visit to an upscale cosmetic practice, I immediately noticed something that seemed out of place. The sign in front of the building and the landscaping was top notch. The reception area was gorgeous and it was obvious an interior designer was consulted. The environment was warm and the sounds were soothing. Then I saw it. The spot on the carpet. It did not belong. When I asked the group about it later in the day, most of the team had no idea what I was talking about. Two staff members did recall the spot and said that it had been there for as long as they could remember. No one seemed to feel it was a big deal. That spot was as significant as the dying bamboo centerpiece.
Point 1: Patients have no way to judge your clinical abilities and the indicators they will use to gauge your expertise are the physical plant, the environment you create and the way you engage your patients in the process. If the little details aren’t tended to, your patients will wonder if the things that truly matter – proper diagnosis, clinical expertise, sanitation standards – are also being overlooked.
Point 2: Your team must be vigilant all the time. Create a culture where your staff is encouraged to pay attention to the little things – the stain on the carpet, the full trash can in the patient’s bathroom, a patient’s concerned look or the negative comment he or she might make on their way out. Everything matters. Patients notice. You can’t let down your guard.
Over the course of the next several articles, we will review the physical plant and environment and shed light on those areas you may want to pay more attention to in your practice. If there is a specific area you would like for me to address, please comment below or email and let me know.
Occupational Half Life – I don’t think we’re in Kansas anymore!
Recently, regarding his book, The World is Flat, published in 2005, Tom Friedman said; “I looked in the index under F. Facebook wasn’t in it. Facebook didn’t exist. Twitter was a sound, the Cloud was in the sky, 4G was a parking place, LinkedIn was a prison, application is what you sent to college, and for most people Skype was a typo….”
Which brings us to our topic: the world is changing rapidly – to the point where information, innovation and technology is evolving exponentially. It’s a challenge to keep up and requires more time and effort than it did a mere 5 years ago. Essentially, it’s like trying to out-run a tornado!
Photo credit: National Oceanic and Atmospheric Administration/Department of Commerce
Continuous change requires continuous learning. I don’t have to tell the doctors reading this. You get it. You know the importance of staying current in the clinical arena. But what about the team and the other areas of the practice?
Over 13 years ago, Jim Harris, PhD said something that caught Sandy Roth’s attention and it is just as relevant now as it was then:
“Another HR trend is the idea of occupational half-life, which asks the question, ‘How many years does it take for half of your work skills to become obsolete?’ In 1970, it took about 15 years. [That means] by 1985, half of your original skills were no longer useful. Today, the number is 2 1/2 to 3 years. That means in less than 30 months, half of what you’re doing will be obsolete.”
Whoa! This concept of occupational half-life is huge. It has major implications for anyone in almost any profession but it is especially true in the healthcare field. What does this mean for your team? Well, for one thing, change is not an option. And to take that one step further, if one does not adopt a personal commitment to lifelong learning, they will quickly become irrelevant and obsolete.
Here is Sandy’s message to team members:
“Learning cannot occur only within office hours. Academic and conceptual learning occurs outside of office hours. Practical application learning comes with the doing, where your practice is your learning laboratory. Indeed, there is a great deal that can be done during the hours of your employment, but it will never provide enough time to delve into the creative, the new and the innovative. And that is exactly where you must take yourself if you want to stay on the cutting edge and guard your future.
Your value to the practice will go down if your skills don’t go up. What is valuable to your practice right now will be less valuable in the future. Which half of your skills will be obsolete in three years and how will your diminished impact harm the success of the practice? You cannot expect your compensation to rise when your skill-base is stagnant.”
Did you get that last part team members?
So what role do you, the dentist, play in this? Certainly, you lead by example; taking continuing education courses, reading trade publications, learning how to implement new technology into the practice, networking with colleagues, learning from those smarter than yourself (that includes your team), involvement in professional organizations. While some of this may occur during practice hours, a lot of your learning and growth happens outside of the practice and at the expense of spending time with your family. And why do you do it? While you know it will make you a better dentist and keep your practice growing, my guess is you have a curious mind and a strong commitment to lifelong learning.
Can the same be said for your team? Do they understand that their own growth and future potential lies in their own hands? Are they willing to invest in themselves by taking the initiative outside the practice? Are they spending their free time learning something new? Do they have the mindset to “look it up” if they don’t know?
And are you encouraging and supporting them by providing opportunities for learning? Are you sponsoring independent learning, workshops, online courses or distance education?
I hope so. That tornado is looming large in the distance.
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