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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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.

Do Your Patients Deserve an Upgrade?

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First Class Status!

While skimming the Facebook statuses on my Home page, I noticed a colleague’s comment about how excited she was to get an upgrade to First Class on her flight. She went on to say it was the “simple” things in life that make her day.  Another friend commented that it isn’t a “simple” thing – “it is what we deserve but seldom get”.

With first class status, you get priority check-in. You get to board early. The seats are roomy and usually a buttery leather with lumbar support. You are greeted immediately and get to choose from a wide selection of complimentary pre-flight beverages. There’s exceptional meal service (love those warm towels!). Some feature individual media players and personal amenities. You leave the plane feeling refreshed and a little more special than when you entered. Is it likely that my friend will think of this moment the next time she books a flight? Absolutely.

In fact, this JetBlue TV Commercial from 2006 took the concept of First Class and applied it to every passenger across the board.

It made me wonder what patients think when they arrive at a dental practice.  What have they come to expect?  Do they expect an outdated or less than appealing reception area?  Have they come to expect to wait for an extended period of time?  Are they accustomed to being rushed through? Do they expect to be lectured on their home care? Is it their expectation that they will be “hassled” about doing the treatment they’ve put off? Do they expect to hear dental-speak that doesn’t make much sense to them? In other words, do they expect to fly coach class?

What if your patients came to your practice expecting coach but instead, receive first class treatment? Imagine how they might be thinking as they leave the practice? What would it take to provide each and every patient an upgrade – to provide them with what they “deserve but seldom get”?

As you embark on a new year, why not make this a team project?  Each team member could review their own performance and area of responsibility and ask the question; How can I make this a first class experience for my patients?. What additional effort would it require? Think outside the box of dentistry. Think five-star hotel. Think red carpet treatment. Bring the ideas to a group meeting.  Brainstorm as a team and experiment with your ideas.

Make sure your patients feel more special when they leave. After all, you want them to book their next flight with you.