Mercury Aligns With Mars

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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.

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Help! My Staff is Holding Me Hostage!

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Help! My Staff is Holding Me Hostage!

The voicemail message sounded desperate. Call me back as soon as you can. I need your help right away!”

What caused such distress? What made the situation so urgent?  As it turned out, the dentist was having difficulty keeping a chairside assistant and was faced with hiring for the third time in less than one year. His receptionist had left but he wasn’t happy with the performance of her replacement. Each day brought another drama with the hygienist whose personal life was in total disarray. The practice was totally unstable and he feared losing another employee every day. What would his patients think when every time they came in there were different staff members?

After a short discussion, it was quickly clear his staff was calling the shots:

“My hygienist didn’t show up for our meeting yesterday and didn’t even offer an explanation.  We are constantly bailing her out of personal situations. I know it’s hard for her – she’s a single mother and doing the best she can. Then, my chairside assistant refuses to do things that are part of her job. I end up having to pick up the slack at the end of the day before I leave. I overheard them complaining in the lab today about a continuing ed program I was paying for them to go to on their day off. They joked that  they would just sit in the back and text on their phones. I’m afraid to lose them because our patients seem to love them and I’d have to spend time breaking in new staff but I don’t know how much longer I can go on. I feel like a doormat”.

While this scenario may vary from one specific practice to another, the problem is basically the same in many: dentists who neither know nor enforce their boundaries and expectations because they are afraid they may lose staff. Indeed, their staff is holding them hostage. How does it get to this point?

Let’s examine the factors that contribute to this phenomenon:

1) The dentist’s personal relationship with staff makes it awkward to set and maintain standards and/or fire a low-performing employee

While we all have busy, challenging lives that can effect our professional lives, these issues should never dictate office policy. This is an area in which many dentists confuse their personal relationship with their work relationship. It stands to reason that because you work together closely all week, you might easily develop a strong bond with one another. You may find yourself identifying with your staffs’ personal problems, like managing a home and family and trying to make ends meet. Express your empathy, of course, when appropriate, but as an employer you must establish clear boundaries. Do not advance paychecks, pay rent, loan cars, or pick up kids. Do not make concessions for days off outside a very rare and unavoidable situation. By doing this you will set a very dangerous precedent. Other employees will consider it favoritism and they will expect you to afford them the same concessions.

If you have already “let that horse out of the barn”, you can reverse this trend.  Gather your group together and apologize. Explain that you care about each person on the staff and this has clouded your judgment.  It has created a problem for you and others. You must now establish a new set of boundaries that are in the best interest of the practice and your patients. Then you must outline where you went wrong and what you are no longer willing to sponsor. They may not like it but they will understand.

If you believe your personal relationship with an employee has gone so far that the two of you can no longer be effective working together, give us a call. We can help you sort out what the appropriate next step should be.

2) Even if it’s written down in the manual, not every employee will know what’s expected and will follow through.

Your employee manual means nothing without two things.  First, your staff needs to understand the bigger picture.  It is your job to clearly convey to each person what your practice is there to accomplish and how their efforts are expected to help make that happen. The big picture is crucial. More than the step-by-step guide that a manual provides, your explanation of the practices’ purpose, as well as your beliefs and tangible examples of how this purpose is played out on a daily basis is vital. It will give them a guidepost to follow in their day-to-day challenge of making decisions about what is in the best interest of the practice and the patients.

Second, every employee must be on board with your purpose. Each must be in alignment with your belief system and share the same basic values. And you must have their agreement about their role and responsibility. This can best be accomplished as a group discussion where each staff person has an opportunity to ask questions and gain perspective. Time consuming? You bet. But without this clarity your staff will be working without a clear direction which often works at cross-purposes with the practice goals and will cause a great deal of frustration for everyone.

3) Hiring and training the right way often takes a back seat to retaining under-performing staff.

A good way to think about your problem employees is the bad girlfriend or boyfriend you may have had. You knew long before you broke it off that things weren’t working out but you avoided it hoping things would get better. They rarely do. Then, when you finally got up the nerve to end it, you thought to yourself, “I should have done this a long time ago”.

Your under-performing staff are robbing the practice. Pure and simple.  You simply can’t afford to work with people who are inefficient, ineffective, and cost your practice time, money and resources. The focus and energy these employees sap from your patients and practice deprive you of much more. You can not be as effective in your job when you are worrying about staff doing their job. It stands to reason that the under-achievers aren’t dedicated to your practice purpose and patients are not receiving the same care and attention you strive to provide.

While hiring and training (and doing it right once) requires time and energy, doing it over an over again takes you away from focusing on dentistry. And it’s not a lot of fun. Cutting your losses and embarking on the hiring process can be an opportunity to make a course correction. If you approach this process correctly, you will avoid having to carry dead weight on your team. You will have a solid and stable group of individuals for a longer time. Approaching the hiring process correctly is essential.

You can bring your new hires on with a strategy for success that includes a thoughtful training plan designed to help them succeed. Equally important are periodic evaluations (for everyone) to keep your team performing at a high level, stay motivated and focused on the big picture.

4) Good people are hard to find but not impossible. Now Hiring

There are way too many dentists “making do” with staff because they are afraid they won’t find a better replacement.  While high-performing employees are more rare and difficult to find, they are out there. It is just a matter of knowing where to find them and how to attract them. They may be disenchanted with their current job or looking for a greater challenge or more responsibility. Perhaps they don’t feel they are appreciated or they deserve more compensation for what they do.  Those are your candidates. It just requires more diligence on your part to find them.  It takes a dedicated effort, creativity, and a solid plan to attract that exceptional staff member. It starts with an exceptional ad that is masterfully written and trying new and innovative strategies to distribute your ad. Most practices do a lousy job at this and dread the process.  The pool of candidates often reflects the quality of the ad, which often misses the mark.

Are you being held hostage? Stop letting your staff dictate what happens in your practice and take control. If you believe it is a matter of establishing clear boundaries and re-establishing expectations, start the process today.  You can no longer afford to allow this to go on.  If you know in your heart that there are one or more staff people who would be better off somewhere else, start making plans today to embark on the hiring and training process.

Of course, we can help guide you through this. We can help you clarify where you need to make changes and develop a thoughtful process for implementation.

If you plan to hire, consider calling on us for support or using the tools in our hiring kit. You can learn more by clicking below or calling us at 800-848-8326.

http://www.prosynergy.com/hiring.html

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,

Dental Speed Dating: The Four DOs and DON’Ts of New Patient Calls

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Your first point of contact with a new patient is likely to be by phone. Those few minutes are the most valuable commodity you have to attract someone to your practice and establish a new relationship. Think of it a dentistry’s form of speed dating. If you handle the call appropriately, you can lay the foundation for a meaningful relationship. While people who triage these crucial calls understand this, they often struggle with how to handle them properly.  At some point in the call, things go south and the potential is lost. This has become more obvious lately since I have been helping a number of practices hone their phone skills.  With the assistance of recorded inbound calling, we have had the advantage of listening to some of these calls, analyzing what went well and where the team could improve. It is a valuable coaching tool that I encourage every practice to consider. (Personal Note to Staff: this tool is not designed to “spy” on you – it should be used to help you become better at what you already do.)

Let’s deconstruct the initial phone call and I will introduce you to some ideas that will help you become more successful with those patients looking for a new dental home.

First, it’s important to remember that every call has money attached to it.  People usually find your practice because of some kind of marketing. Be it from a billboard, web site, search engine, the newspaper, a patient referral or some other advertising source, the dentist has invested money in attracting these new patients. Whatever they saw, heard, or read was enough to encourage them to pick up the phone and call you. Keep in mind that when someone calls your practice, she is predisposed to liking you. She wants you to be the right place and she is hoping that you can help her with whatever the reason was that she called. If she has called the right place and you do the right thing, she will easily become your patient. If the call ends without an appointment, the practice has lost money.

There are four things you will want to focus on during each call.

1. Thank them for choosing to call your practice
I’m not talking about your standard salutation; “Thank you for calling Smile Valley, this is Jennie, how may I help you?” That is not a true “Thank you” – it is merely the way in which you choose to identify the practice. I’m talking about the point at which the caller has had an opportunity to share why they called and you respond to that initial information. This may seem obvious but I rarely hear a genuine “thank you” at this stage in the call.  Just remember that they have a choice of who they call and you were that choice. Let them know how much you appreciate it. Believe me, this is rare.

2. Be intentional
Avoid being mediocre or ordinary by devoting 100% of your focus and attention on the caller. When the phone rings and you are available to focus on the call, pick up a pen when you pick up the phone. Listen intently. Take notes verbatim (to transfer to their record later). Find out the caller’s name and address him by his name.  Acknowledge and empathize if you hear emotion (anxiety, frustration, pain, concern). This extra effort quickly becomes obvious to the caller and he will recognize your commitment and desire to help.

3. Find out WHY they are calling now
Why would someone call a dental practice in the first place? When people are well cared-for and everything is fine, they will not have a reason to call or make an appointment to see you. Something happens to shift someone from not wanting to see a dentist to wanting to see a dentist. What might that be? A problem develops that is compelling enough that they have been motivated to contact a dentist. That problem could be many things and sometimes it is not as obvious as we might think. It is your job to suss that out.

For example, if someone calls with a broken tooth and wants to see the dentist, you may assume that the problem is clear: you immediately consider them an urgency patient because you assume there is pain associated with it. However, that condition could create a variety of other problems as well: it might cause pain, but it might also make chewing difficult, or it may be visible and look bad, or the person might not have any of these problems but has a concern that the rest of the tooth might break or it will begin to be painful.

Let that drive where you take the conversation. This is the foundation of triaging a call so you can best determine if you can provide the service they require and you can find the appropriate time in the schedule to help them.

Speak to the obvious – only that which has been said. For instance, if the caller says “I broke a tooth! I need to see the dentist right away!”,  don’t guess about what is happening.   Instead of responding with “Are you having some discomfort?”, try “It sounds like you are concerned…Let me see if I can help. What’s going on? ”

Let them tell you their story then ask appropriate questions to fill in the blanks. If their issue is not so obvious, ask them to “Tell me what’s going on today” or “Tell me what concerns you have and what you will want the doctor to pay attention to”  instead of “What is your chief dental complaint?”.

4. Find out why they called YOUR practice
How did they choose your practice to call? What do they know about you?  Chances are that whatever they learned about you from advertising or a personal referral will be useful information about what they value. For instance, if the reason is because they work in the same office building, proximity and convenience may be important to them. If they heard from a friend that the dentist was gentle, it is likely that is high on their list of priorities. If they aren’t quite sure about another dentist’s diagnosis and recommendation and they learned you provide second opinions, trust is likely an issue. Ask them to clarify or confirm what you have heard. For example, “It sounds like location and convenience is important to you, Hank. Is that the case? Aside from that, are there other things of importance that you would want us to know?”.

What you must NOT do:

1.Don’t make the patient jump through hoops.
Try your best to make it as easy as possible for the caller. Convey to the patient how you can help instead of telling them about the obstacles they must overcome to become your patient.
For example, if you don’t have an appointment on a certain time or date, you might phrase your response by saying “I CAN find you something comparable on a different day – how does Tuesday sound?”

2. Don’t use negative phrases or words. Steer clear of “You have to…” “You need to…” or “Our policy is…” kind of statements. Instead of “No, we don’t take that insurance”, you might say, “Let me tell you what we CAN do for you”.

3. Don’t answer the phone if you are not prepared to devote your full attention. I know. Many dentists get annoyed when they hear the phone ring more than two times but it is sometimes better to go to a carefully-crafted voicemail message than being answered by someone whose focus is on something else. If you would like some suggestions on effective voicemail triage and messages, contact me and request our white paper; VOICEMAIL GUIDELINES

4. Don’t put the caller on hold for long periods of time. While your “voice on hold” recording may be very compelling, no one wants to be on hold for more than 30 seconds. Simply offer to call them back in a timely manner.

There is an art to establishing a relationship with a new caller. It requires your full attention, a curious nature, and a helping spirit. If you devote yourself to taking these steps, you will naturally experience a higher rate of success with new callers. You will also discover that you are more aware of the patient’s needs and more prepared to help address their problems when you meet them for the first time.

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I promised to continue my blog about practice perception – which I will publish next week. In the meantime, I stumbled across this Blog post from a Mom whose child has Juvenile Ideopathic Arthritis and a story about her trip to the dentist. At first I was interested in this because my youngest daughter also has JIA but I discovered this story is also about a dentist who was given the chance to redeem himself. The take home message for me was; always listen, practice humility and you will do the right thing.

JIA Mom's Blog

When your child has arthritis – most doctors’ appointments are more than routine. It’s
usually more than a “regular check-up”. Often, they involve an extra trip to
the lab for a blood draw, or a swing by for some x-rays. Or there may be some
special eye exams, or heart tests. You come armed with notebooks and photos
documenting symptoms, and print-outs from the internet about treatment options.
When things are going well, and arthritis is quiet – appointments are still a
joint by joint exercise in holding your breath and praying that things are
still good. When things are going bad… well, appointments can take a lot out of
you. It’s a little mini-battle in the war on arthritis – whether you are seeing
the rheumatologist, the cardiologist, ophthalmologist, endocrinologist,
pediatrician etc etc.

The dentist however – I always thought would be a pass. A gimme of normal
childhood…

View original post 1,079 more words

Reality Check: A Commentary on 10 Reasons Why Your Dentist Probably Hates You Too

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Reality Check: A Commentary on 10 Reasons Why Your Dentist Probably Hates You Too

This week, a blogger stirred up dentists and patients alike with her most recent entry: 10 Reasons Your Dentists Probably Hates You Too.  It was clever and funny and written tongue in cheek but it had a ring of truth that rang out loudly for some. It is clear from some of the responses that the points she made resonated with dentists who are frustrated with their patients.  A big thank you to Laura, the author, for your wisdom, insight and graciousness! I wanted to dissect her points and comment on them from a behavioral perspective. Here goes:

1) The first thing you say when you sit down in my chair is, “I hate the dentist.”  Really?!?  Did your parents teach you any manners?  Did they ever teach you that it is impolite to tell someone you hate them the moment you greet them?  What I really want to say back is, “aww, I hate you too.”
First of all, it would be easy to take offense. But don’t – it is not about you. When patients make comments like this, don’t assume you know what it’s about. Ask them. Behind the comment lies a whole host of different reasons – some of which the patient might not even be aware of until you take the time to ask. Replacing your judgment with curiosity allows you to truly find out what is holding your patients back and starts the process of behavior change through discovery. Never mind whether the answer makes sense or not. However they respond, it’s a legitimate issue-for them.  Don’t stop there. Find out more. For instance, if they comment that they don’t like the sound of the drill, ask why? Stay in the question – what is it about the sound that bothers them? Are there things we can do to make that less of a problem for them? – you get the idea…keep being curious!!!

2) You come to your appointment, and it’s obvious you haven’t brushed your teeth in days.  I’ve had some people with great hygiene come in and apologize because they’ve just eaten lunch and couldn’t brush.  This is not what I’m talking about.  I mean food and thick plaque everywhere.  After 10 years of seeing blood and rotten teeth and some really nasty things, this is still the 1 thing that makes me dry heave.  You know when you come to us that we have to be in your mouth.  Would you clean your home before having company?  Additionally, I have spent hours literally bending over backwards repairing your teeth.  Could you at least pretend that you are caring for the work that I have struggled to complete for you?
Speak to the obvious. If what you are finding tells you that they don’t spend a lot of time caring for their teeth, make an observation – not a judgement. “There seems to be food and thick plaque throughout your teeth. This tells me that you may not be brushing very often. Tell me about that”.  Then be quiet and listen.  Don’t go into the telling mode. Find out what they know and what they don’t know. Use it as a discussion opener for achieving better oral hygiene.

3) After we have spent hours of meticulously repairing your teeth, you complain about the bill.  Would you walk out of the grocery store with a bag full of groceries and expect not to pay?  I’ve just helped you to continue to smile and eat comfortably, two pretty valuable things that help your quality of life.
Dentistry is a “below the line” expense. After a person pays for all their  “necessities”, they would rather spend what little they have left on something they enjoy. Dentistry is rarely that and they aren’t happy about re-allocating funds or spending their discretionary income for it. This is their way of expressing their unhappiness. Invite them to talk about it, empathize with them, and don’t take it personally.

4) I tell you that you have a cavity and you need a filling, and you wait months or even years to get the necessary work done.  Eventually the tooth starts hurting.  Two weeks of pain go by, and you call me on a Saturday night while I am at dinner with friends because your tooth that needed a filling a year ago and that started hurting 2 weeks ago is suddenly an emergency.
Pain is a great motivator. But patients create the thing they fear the most by not acting until they are in pain. You get to decide whether you accommodate patients who choose not to act until they are in pain. You don’t have to support that behavior if you don’t want to. You know the State Farm commercial  where the guy (Jerry) calls his old agent when he’s in an accident – “Oh Jerry, I’m so sorry. I would love to help but remember you dropped us last month”….Same in the case of an “urgency” (Key word here is urgency because if it was truly an emergency, they would go to the ER). You empathize, offer the options you have and they get to decide. With your support, they could experience a shift in their thinking in the future – ie: “Jerry, you expressed that you wanted to avoid pain at all costs. If you don’t ever want to go through that again, we recommend (fill in the blank).”

5) You come to me so I can help you, but you make it hard for me to do a good job.  You wince and make faces when it’s not hurting.  The idea that I’m hurting you makes me just as uncomfortable and stressed as you are.  If it hurts, please tell me, and I can help you with that.  But if it’s because you don’t like the whole experience, you are only causing me to work in undesirable conditions, making it harder to do my best.  And when you push your tongue in the way, or you don’t open wide enough, it makes it physically impossible to get my work done.  Don’t you want it to be easy for me to do the best job for you?
Those darn patients get in the way of doing dentistry! Being a dentist would be great if people weren’t attached to their teeth but that’s not the case. Sometimes there are things you just have to deal with. As for the hurting, are you SURE you aren’t hurting?   Again, you can speak to the obvious – “Linda, I can’t help but notice that you are wincing. I want to make sure that you aren’t having any discomfort”. Ask them to hold up a hand if they want you to stop at any time.

6) You call and say, “my tooth didn’t hurt before you worked on it.”  You came to me with a cavity.  I did not put it there.  You did.  I am simply fixing a rotten hole that was in your tooth.  To do so, I must use a tiny drill to cut the rot out of your tooth.  If I took a drill, cut a hole in your femur bone, and then filled it in with a foreign material, don’t you think it might be sore for a while?  Same concept.
Great example.  This is where knowing your patient’s expectations and preparing them for what to expect can prevent a lot of issues later in the relationship. You could use a similar analogy and explain they might experience some discomfort, and if they do, explain what they should do about it. If they expect it, it won’t be a surprise. If they don’t, even better!

7) When we try to take an x-ray, you won’t bite down on it.  We have to do this to see what is going on with your tooth.  Without knowing the problem, we can’t properly treat you.  I know, in some cases some people really can’t do it; but some people could and won’t just suck it up for 15 seconds.  I’ve had x-rays too, and they hurt and dig into my gums, but I just do it.
Acknowledge the brief discomfort, move on. If it keeps them from letting you get an xray, let them know that your diagnosis will be based solely on what you are able to see from the outside and it will be incomplete. Their choice.

8 ) You tell me that you bought my car for me after having a crown done.  Contrary to how it seems, you actually didn’t buy me a car.  You bought yourself a crown.  I have spent hundreds of thousands of dollars on an education, and have spent hours making this crown fit precisely in your mouth, so maybe you helped me make a portion of a student loan payment.  But you certainly didn’t buy my car.
Agreed.  Rude comment. Even if they said it to be funny, there is something behind the statement. I believe it’s OK for dentists and their teams to challenge patients on this stuff –  ie: “Wow. What would make you say that, Mr. Smith?” or “Do you believe the fee for your treatment is out of line?” Then be quiet and listen. Yeah, it takes time and skill. By becoming curious, gaining trust and being honest you can change the patient’s perception of the dentist.

By the way, they aren’t buying your “crown”.  They are buying the solution to a problem – something that will make their life better.

9) You no-show an appointment or cancel last-minute.  Some things are unavoidable, but when it’s because your hairdresser got a last-minute cancellation and you had to take that appointment instead, this is just rude.  Not only am I unable to fill the 2 hours of my schedule that I reserved specifically for you, but someone else who wanted to get in had to wait 2 weeks for his/her appointment.  And on that note, when you have the first appointment of the day, and you show up late for your appointment, I am late for every other patient the rest of the day.
This is a two-parter. The no-show or cancel at the last minute issue deserves a blog all it’s own. As for the patient who shows up late, if you are always late, you teach your patients the bad behavior of being late. If you strive to stay on time, your patients will begin to show up on time.  There are occasions where your schedule will be off and when you acknowledge it, apologize and explain how concerned you are for your patient’s time, they appreciate that. If the patient shows up late and it does not allow you to do the procedure in the remaining time, you have two choices – do it and run late or explain that you are unable to complete the procedure and will have to reschedule. Your patient will be annoyed and you will lose revenue for that day but it will be less likely to occur in the future.
There will always be exceptions – patients who are always late – to everything! Again, speak to the obvious. “Betty, it seems like you are always running a bit behind to your appointment. This doesn’t seem to be working very well. If we don’t have adequate time, we aren’t able to provide you with the care we promised. How should we handle it from this point forward?” Have them help solve the problem and hold them to it.

10) When I tell you that you grind your teeth, you deny it, as if I am accusing you of having a horrible disease or being a baby murderer.  It’s not that bad to be a tooth grinder.  I’m just pointing something out and maybe offering a way to prevent more problems in the future.  This observation is concluded from signs or symptoms that are based on real science, not myth.
OK.  I’m beginning to sound like a broken record. Patients believe what they believe – find out WHY.  Replace your assumptions and judgment with curiosity.  Example:
“Helen, the wear I am seeing on your teeth is something I typically see on patients who grind their teeth.”
“Oh, I don’t grind my teeth”.
“OK.  Then we have a mystery.  What else do you think might be causing this wear?”
“I dunno.”
“Well, let’s talk about your lifestyle and see if we can figure this out.”. You can learn more from what THEY tell YOU than from what YOU tell THEM. Help them through the discovery process.

Have you begun to see a pattern in my responses? All of these challenges can be minimized if we apply behavioral principles to the situation.
Here are my TOP TAKE HOME MESSAGES:

1) Patients voluntarily call/walk into your practice with a problem they are hoping you can help them solve.

2) Patients are pre-disposed to liking you. They would not come to your practice if they didn’t or felt like you were incompetent or not a good fit for them.

3) Almost every patient is a recycled one looking for a place that will provide what they haven’t gotten in the past. If you listen closely, patients will tell you how they wish to be treated. It’s how you respond that will make all the difference. If what they are asking for is reasonable, responding with something as simple as “Mrs. Jones, I’m sorry you had that experience. You can be sure that we will do everything we can to make sure that doesn’t happen here” can start you on a long and successful relationship.

4) Patients price-test everything before they buy.  Dentistry is no different than tires for the car, a new dishwasher, groceries for the month or tuition to private school. They believe that it will buy something that will make their life better. Dentists need to present their dentistry with some context. Not “you needa crown” but instead “if you want (fill in the blank) then you need (fill in the blank)”.

5) Almost anyone can afford what they truly want and almost no one wants everything they can afford. Patients get to decide how they allocate their money and what they choose. We can’t want it more than they do. Set your judgement aside. We can only gain their trust and try to influence their thinking.

6) You don’t know what you don’t know. Don’t make it up. Don’t shift into your smart dental telling mode but instead into your curious learning mode. You will learn how to help your patient better.

7) If a dentist wants to stay sane and positive over his or her lifetime in the profession, it requires a commitment to learning behavioral skills. This area is rarely taught in dental school and it is often not considered in many practices but it is one of the most important factors in being successful. Consider surrounding yourself with a behaviorally gifted staff who can work with your patients in a different way. And consider adding a dedicated full time facilitator (patient coordinator) to spend the necessary time getting to learn your patient’s story and how they hope you will make their life better. By learning the patient’s OUTCOME, helping them PRICE TEST, and offering what will make their life better in a way they can understand, you will become more successful with patients and it will enrich your professional career.

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