High Cost of Doing Nothing Part 1: Marketing Basics for Dentists

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Herb’s practice was struggling. His new patient flow had dwindled and after practicing for 30 years, he had become resistant to change. The thought of promoting his practice went against his long-held beliefs that it cheapened the profession. So, he did nothing.

On the other side of town, Sam had built her practice from the ground up. That was two years ago. And while she used her street smarts to market her practice, she wasn’t feeling confident that her time and money were being used in the most effective way.

High cost of doing nothingThe simple truth is, if you don’t tell people who you are and what you do, they will not become your patients. In today’s marketplace, there is a very high cost for doing nothing.

And while marketing is not usually the dentist’s area of expertise, it is essential to have a strategic marketing plan. Here are some basic rules that every dentist should know and use to guide their decisions for implementing a solid marketing plan. Successful marketing comprises of a combination of five key components:

REACH – Target your message to the specific group or groups you wish to attract.
If you are a pediatric or family dentist, you want to focus your efforts on targeting and appealing to young families. On the other hand, if you specialize in exquisite implant-supported dentures, you will want to reach out to affluent seniors. The more specific you can identify your niche in the marketplace, the more targeted your reach.

FREQUENCY – Send messages and send them often.
Each message or “impression” builds on the last. Consumers rarely experience one exposure or message and remember your name or what you do. It requires multiple impressions for a potential patient to connect with who you are and what you offer.

CONSISTENCY – All messages should speak with one voice.
Focus on identifying your niche and brand and tie together your messages with visuals and content that are similar. One logo, one font and color palette, one positioning statement, consistent approach and style.

VARIETY – Send your marketing message through a number of different avenues.
Identify unique opportunities in your community to raise awareness of your practice and cross-promote whenever you can. This will help increase your REACH and FREQUENCY. For instance, sponsor a charity event or a sports team, billboard presence, host a talk radio program, health fairs, personal letter of introduction to new residents, targeted print publications or magazines, collaborative relationships with other businesses, active community involvement such as Rotary and Chamber of Commerce.

TOP-OF-THE-MIND PRESENCE – Connect with patients when they are likely to need you. It is difficult to know or plan for your messages to connect with people at the very moment they decide they need a service that you offer. But if you are committed to a campaign that focuses on REACH, FREQUENCY, CONSISTENCY and VARIETY, you are more likely to connect.
So, when someone is “in the market” for your services and they either search online for or come across your information, they will think, “I know them. They are familiar. They are known for (fill in the blank). I’ll give them a call.” It is familiar to them because of the marketing foundation you have previously laid.

IMPLEMENTATION
You must identify goals, and develop a plan and timeline for your marketing. This will likely require the support of a team member who is fully capable of helping you in this endeavor. Make sure this is included in her job description and she is given the time, tools, and authority to make it happen. If you don’t have the resources on your team, reach out to a local marketing specialist to help you deploy your marketing plans.

EVALUATION
When you are developing your marketing strategy, also plan for evaluating the results of your efforts to insure you are making good use of your investment of time and money. How will you assess the effectiveness? What indicators will you use and at what stage will you review the campaign and make course corrections, if necessary?

CONVERSION
If you spend time, effort and money to implement a solid marketing plan, you better have your internal house in order AHEAD OF TIME.

This is HUGE. You want to make sure that when the target patient you attracted through your marketing, calls and visits your practice, the experience matches what they have come to learn about you. If it isn’t exceptional, you’ve wasted your time and resources. Many practices make the mistake of spending large budgets on marketing their practice only to lose potential patients at the beginning of the relationship because their staff lacks the skills to connect with them in significant and meaningful ways.  In my opinion, this is the most common marketing mistake made!

Contact me to receive a marketing questionnaire to help you clarify what you are doing now and what you should focus on. And if you would like help reviewing your systems, communication skills, practice perception and marketing strategy, I invite you to call me for a more in-depth conversation.

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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.

Change is good

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changeWe may not like it but we are constantly in a state of change.

Some change is hard.   For instance, It’s time to upgrade my iPhone but I have to upgrade my Mac’s operating system first, which I’ve put off because if I do, my database management software isn’t supported and it will need to be upgraded too. That’s not my idea of fun and it doesn’t come easy to me so I’ve avoided it.

But change can also be good.

You see, once I upgrade all my devices, I’ll be able to do things better, quicker and with less effort than I did before. So, I have to embrace change, take the plunge and not fight progress any longer.

Things change in your patient’s lives too.

What might not be a problem for them last month might now be an issue. Their priorities, their job, their perspective can all change quickly and you must be prepared to adjust to those changes as well. The more you adapt, the greater your success.

Change is uncomfortable but necessary

Think about all the changes that have occurred in your practice over the last year or so. Equipment, procedures, staff, your patient base. It’s likely that those changes were met with some level of cynicism or resistance before people realized the benefits. Just like the bad boyfriend or girlfriend, once you make the decision to change the situation and do something different, you probably thought to yourself “I wish I had done it sooner”.

I want to help you embrace change.

To start, ProSynergy has made some changes and we have a brand new web site. I would love for you to check it out and let us know what you think. As an incentive, I’ve posted a link to the home page for you to receive a free two-hour audio program called:

No Two Days are Alike: A Survival Guide for Successful Change

It is my gift to you for taking a look and learning more about how we can help you become more successful in the face of inevitable change.

web site
Click here to visit the web site and access the free program

Top 5 professional habits you should commit to in 2014

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With every new year, comes an overwhelming amount of commentary on new year resolutions and goals. A lot of them are common sense no brainers mixed with an equal amount of recommendations we know are unattainable. Reflecting upon 2013, I would like to shift the conversation to some things I believe have become overlooked.

I have discovered that many people have forgotten the basics. It annoys me when the professionals I work with don’t afford me these common courtesies. If you want to gain respect from your colleagues, patients, customers and employees and you want them to offer you the same respect in return, it is absolutely essential that you follow these very basic rules of business etiquette in 2014.

Here are my TOP 5 No-Brainers every business professional should commit to in the new year:

Number 5: Don’t interrupt.
Of course, there are some exceptions to this rule and if you made it through high school, you can surely figure out what those are. I’m talking about people who cut you off in mid-sentence because they believe what they have to say is more important than what you are expressing. It indicates they are not listening. It comes off as rude, disrespectful and confrontational. If you are guilty of this, listen more, talk less. If someone else violates this rule, let them know you weren’t finished with your thought.

Number 4: Do what you say and say what you do.
If you tell someone you are going to do something, don’t just talk about it. Do it! If you aren’t sure you will follow through, don’t commit to it. How many times have you been disappointed by someone who has said they were going to do something then dropped the ball? And it adds additional insult when they don’t give you the courtesy of letting you know, which leads me to 4a:

4a) If you commit to something then discover it was unrealistic or you can’t follow through, own it.   It’s as simple as saying you’ve discovered you’ve bitten off more than you can chew or your time commitments have gotten the best of you. You will continue to earn respect from your peers, co-workers, and employees when you are honest with them about your shortcomings.

Number 3: If you change your mind, say so.
Everyone has that right. But changing your mind and not telling us is not OK. People will have different expectations and you will inevitably disappoint them – possibly make them angry – if you don’t tell them your thinking has changed. We will continue to think you have your original mindset unless you tell us otherwise.

Number 2: If you are in a meeting or conversation, DO NOT LOOK AT YOUR CELL PHONE!
We’ve all been on the receiving side of someone who shifts their attention from us to their “next-best friend”. Why would anyone think this is appropriate? This is rude and disrespectful. Period. But it is occurring at epic proportions these days. Just because others engage in this behavior doesn’t mean it’s OK. It says they could care less about what’s happening outside the edges of their smartphone screen – so why should we? Business owners and CEOs can often be the biggest violators of this. Regardless of how important someone is, your time is equally important. If someone does this to you, stop talking until they look up and tell them you’d be happy to continue when they aren’t pre-occupied. Let’s shut this behavior down in 2014.

Number 1: Reply to emails. And do it in a timely manner.
Just like the sign in the public bathroom stall that says; “please flush after use”, this is so basic that I shouldn’t have to mention it. That being said, a large percentage of the emails I send out go unanswered. If email isn’t your thing, tell people up front or simply don’t give out your email address. Otherwise, people expect an acknowledgement or reply – THAT’S WHY WE SEND EMAILS! If you don’t reply, it’s the same as saying you don’t care or the sender isn’t worth your time. Your lack of response indicates your lack of interest which erodes your credibility, regardless of your position or role in any business.

Are you starting to see a pattern here? Every one of these has to do with professional courtesy and respect. And if we want people to respect us and behave in a certain way, we have to commit to that behavior ourselves. That is the hallmark of a leader. And yes, these are basic. That’s where we have to begin to build a solid foundation of professionalism, gain respect from others and to further develop our effective communication skills.

Do you have something you would like to add to this list? Let’s start a dialog and spread the word in 2014.

Smile Gallery No-Nos

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What’s a dental web site without good Before and After photos?

But honestly folks, most Smile Galleries, or Results pages or Before and After sections – whatever you call it – they seem to fall short. Most of these pages look like a hot mess and I’ll tell you why.

Most dentists don’t understand why people visit that area of their web site and what those future patients hope to find. I believe it is because most dentists are looking at something entirely different. They are looking at their artistry. Their patients, not so much.  Please understand that what is appealing to you is not necessarily appealing to your patients. Frankly, while the intricate, artistic work you are trying to showcase may impress you and your colleagues, it is lost on most patients. Yes. I said it.

I believe that people look at these pages to imagine what might be possible for them. They want to “dream” and envision how they might look and how their life might be different. They might attract someone and develop a relationship, they may get that promotion, they might develop new-found confidence, maybe begin a whole new career path, or it could be as simple as feeling comfortable enough to smile again, or chew steak, or bite down on an apple. Anything you can do to help them connect with that feeling can encourage them to take that first step.

Here are my Top 3 Before and After No-Nos

No-No #1: Close-ups of just mouths

Detached mouths without faces are not compelling to patients. Besides the teeth, there are other subtle nuances that aren’t so attractive – namely male facial hair. Ugh. It really detracts from the beauty of the dental work. And while the work you’ve performed may be impressive, what they see does little to help patients connect with the benefits. I encourage you to display full faces instead of just mouths. It actually makes the difference even more dramatic and helps bring the humanity to what you do.

No-No #2: Scary Before Images

Clicking on a page and seeing scary Before images may do more to discourage than encourage potential patients – especially those who are fearful. I would prefer seeing beautiful After faces and smiles when I arrive on a Smile Gallery page.

How might they see the Before images to appreciate your work? How cool would it be to “roll over” the beautiful After image to reveal the Before image? I have seen this technique used in the past and it is SO much more impressive! Sadly, I searched my bookmarks and can’t find a single site that features after photos with a before rollover. Why not be the first? If you’ve fashioned your Gallery like this, please, please PLEASE send me a link. I would love to share it with your colleagues.

No-No #3: Anonymous Smiles

Who are these Before and After faces and what are their stories? Think about the impact it would make to include a brief story about their struggles, how they decided to make a change and how, with your help, it has made a difference in their life. This is where the magic can happen for people. Patients are more likely to connect with the quality of life benefits they are hoping to receive with your help. They will read something that makes them think “That’s me!”.  It can give them courage and motivate them to action.

With these three No-Nos in mind, you’ve got roughly a month before the season of self-improvement rolls around: January. Take inventory of your own Smile Gallery and consider if making some changes might better serve your practice and encourage more potential patients to take the next step.

And if you need help coordinating the effort or telling your patient’s stories, give me a call. I can help you make over your smile gallery for greater impact.

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.