High Cost of Doing Nothing Part 2: Underperforming Staff

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All too often, dentists choose to ignore underperforming staff instead of addressing the problem. Why? Because doing nothing seems like a better option than going through the time and hassle of correcting the situation. But ignorance is not bliss.

High cost of doing nothingWhether your employees are texting during work hours, slacking on the little things, stirring you-know-what among staff or committing major errors, your under-performing employees, to put it harshly, are stealing from you. The focus and energy these employees sap from the practice deprive you of much more.

You can not be as effective in your role when you are worrying about whether your staff is doing their job. Add to that the internal conflict that can develop when an employee doesn’t pull her own weight or “gets away” with it and others have to pick up the slack. The rest of the team begin to resent it and factions form. The next thing you know, trust and teamwork has eroded and you have a full blown dysfunctional team.

When all you wanted was to avoid all the hassles, you end up spending more time managing the inefficiencies and conflict.

Enough already. You can no longer afford to work with people who are inefficient, ineffective, and cost your practice time, money and negative energy.

The first step is to admit your role in allowing it to occur, take a big breath, then set out your plan for a course correction.

          Use this step-by-step approach to do away with under-performers

Define your expectations:
Expectations are reasonable only when they are clearly conveyed and that is where you should begin. Before you decide to let anyone go, apologize for your lack of leadership. Then clearly convey your expectations and give your staff the opportunity to demonstrate their ability to change and perform at a higher level.

There are a number of areas that come up often in discussions with dentists and may have been overlooked in your employee manual. While they may seem like a no-brainer, you simply have to spell it out for them. These details have to do with work ethic, performance, code of conduct, and dress code. Bring your group together and discuss them along with other important expectations. Here’s a partial list:

-Dress and personal hygiene
-What is and is not appropriate to discuss with patients
-Cell phone use during work hours and breaks
-What to do when there is down time
-Calling in “sick”: advance notice and when it is appropriate NOT to come to work
-Showing up on time and being prepared before the work day begins
-Unacceptable behavior with fellow team members (ie: non-communication, triangulation, favoritism, tattling, passive-aggressive behavior, raising your voice)
-Responsibility to identify, call attention to, and catch errors before they happen – no matter who’s job it may be

Once these expectations are clear, everyone must agree upon them. You must also outline the consequences if the expectations are not met and emphasize that you will hold each person accountable.

Follow through with consequences:
Whatever your approach, stick to it. For instance, if you establish a one strike rule, one violation equals one strike. That’s it. You formally put them on notice, in writing, and monitor improvement with a specific deadline for a follow up evaluation.

Cut them loose:
Seriously. Fire employees who don’t get with the program. Get rid of the bad energy, increase your chances for a healthy and productive team. Your documentation will provide the support and justification for letting them go and it will demonstrate to the rest of the team that you are committed to a higher standard.

Provide lots of positive feedback and recognition:
Start establishing a culture of excellence by continually recognizing those who are performing at a high level.
-Verbally mention their performance in the moment, in front of patients and co-workers.
-Take time during team meetings to call attention to a team member’s exemplary work.
-Plan on recognizing high performance with unexpected recognition such as a gift card, or one time bonus to show appreciation to the group or individually.

If you aren’t getting your money’s worth, make a change in the way you address staff who aren’t living up to your standards and expectations. Start today because there IS a high cost for doing nothing.

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We Need More Help at the Front Desk!

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We 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!)DISCONNECTED

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:
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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:
Depositphotos_24330021_mThis 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:
Depositphotos_24330067_mEvents 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

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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

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girl full of dreams      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

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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

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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?

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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.