In this column, I want to close out this discussion by covering the second half of the 10 most common forms of miscommunication in dental practices. As with the first installment I’ll provide a brief discussion of each communication scenario and then offer a standard to consider implementing in your practice.
At the end of each scenario, you can rate your practice. As you conclude the exercise, give your practice a score based on the grading system in the box below. This can be a great exercise to share with your team as you strive to improve the interpersonal skills that set truly dynamic practices apart from the crowd.
5 = Great, this is a strong point of ours—we manage it very well.
4 = We’re working on this and are almost where we want to be.
3 = We’re average—similar to many offices in our area. (Remember: being average does not set you apart!)
2 = We need to sharpen up.
1 = This is a prime weakness of ours.
6. Lack of patient education
The scenario (relayed by a doctor in our focus group): The patient had been with the practice for five years. He came in consistently every six months for cleaning and exam. Recall appointments were SOP wherein treatments were performed but there was little patient education. The doctor had been "watching" a problem tooth for a while but had not discussed it at length with the patient. Now the crown should be put off no longer. But the patient did not understand the severity of the condition and he questioned the actual need of a crown. At this point it was difficult to bring the patient to treatment acceptance. Not because of what happened in a singular appointment, but because the patient had not been educated sufficiently up to this point to endorse the proposed treatment when it was needed.
The standard: It is through ongoing solid patient education that the value of the practice increases in the patient’s mind. A patient who is consistently educated by doctor, hygienist, assistant or treatment coordinator will have a higher dental IQ. These are the patients who place higher value on dental care and are more likely to accept treatment. Trust based on genuine care and education form the foundation on which long-term patient relationships are built. And without fail, when asked to describe the excellent practitioner patients always use the term "teacher." How effective are you and your entire team in consistently building the dental IQ’s of your patients?
Grade your practice: _____
7. Focus on the file, not on the patient
The scenario (relayed by patient in focus group): The patient waited in the treatment room for 15 minutes while the doctor finished with an emergency in the next room. The doctor rushed in and apologized briefly without making eye contact. He stood at the counter with back to the patient while he reviewed the chart and offhandedly remarked about pocket depth and bleeding that occurred during the prophy. He then turned and immediately started the clinical exam. Upon completing the exam, he turned back to the counter to make notes on the chart. With back to the patient he said, "Glad to see you today…Jean will schedule you for the next appointment" and then left the room without a final connect with the patient. The patient in our group commented, "He didn’t see me, he only saw my teeth!"
The standard : We hear variations of this in many focus groups, and as a "mystery patient" I’ve experienced it myself. The doctor could be a superb clinician, but from the patient’s perspective he didn’t appear to be a caring one. The focus on the chart made the patient feel like a "case" instead of a person. When you’re with the patient, be with the patient. It doesn’t need to take more time, it does require more awareness of one’s own behavior and how it might be interpreted. And this behavior may just as easily be manifested by staff or be experienced among team members. So how do you relate with patients and with co-workers? How well does your team "stay in the moment" with patients and with each other?
Grade your practice: _____
8. Poor service
The scenario (relayed by patient in focus group): The patient arrived on time for her 2 p.m. prophy. The receptionist made no eye contact. The patient signed in and sat down. The receptionist was on a personal phone call and she was heard putting a patient on hold while finishing her own phone conversation. Two staff members in the next room could be heard excitedly chatting about a People magazine article. By 2:20 the patient had still not been acknowledged and didn’t know if the hygienist was back from lunch. At 2:30 the hygienist merrily greeted her and led her to the hygiene room. The hygienist said nothing about the delay. Fuming, the patient remarked, "I wish I’d known you were running behind, I wouldn’t have raced to get here." The hygienist responded with, "Oh, our birthday lunch for Katy ran overtime and the traffic was terrible getting back."
This kind of inappropriate behavior has become rampant in our society, though that doesn’t mean it’s acceptable! The public has become indignant with poor service and it’s vital that each team member recognizes how individual behavior reflects on the entire team.
The standard: The fee-for-service patient expects just that—service. Many patients in our focus groups comment that if they are going to be treated poorly they can go somewhere else and pay less. It is true that this attitude reflects a lower dental IQ. A patient who believes that all dentists are the same has not been effectively educated to the quality of care being provided. But the result is the same - a patient who leaves one practice to go to another.
How effectively do team members in your office manage the impressions they make on patients? Are they aware that what they do and say and how they come across affects patients' overall impressions of the practice?
Grade your practice: _____
9. Failure to recognize opportunities
The scenario (my own mystery patient experiences): As a patient, I frequently offer "opportunity bait" during appointments. I might say, "I hate going to the dentist…I had horrible experiences as a kid." For the clinician this is an opportunity to increase trust with a fearful patient by briefly discussing how treatment might be managed more effectively than in the past. Usually I get responses like, "Oh, don’t worry, just relax." This is tantamount to saying, "We don’t know what to do to help you so you’ll just have to manage on your own." This response is meaningless to a fearful patient and it represents a lost opportunity for the practice.
The standard : Opportunities abound in each office daily. Sometimes a savvy team member can create an opportunity by asking the right questions. It’s easy to become so focused on tasks that the opportunities float by unseen. Sometimes the lack of recognition is due to poor listening skills. Sometimes it’s because staff doesn’t feel empowered, and that can be a management problem. It’s understandable that a new employee might not yet recognize opportunities due to focusing on new responsibilities. But it’s not unusual when a long-term team member forgets this skill in the throes of burnout. Whatever the cause, missing opportunities can hold the practice back. This is a key topic that should be discussed in team meetings.
How well do you and your co-workers recognize or make opportunities happen? And if you’re not capturing those opportunities, the first step is identifying why.
Grade your practice: _____
10. Lack of team cohesion
The scenario (my own mystery patient experience): I arrived for my "new patient" appointment and there was high tension in the office. They had seen an emergency patient who required extensive treatment and one assistant was out sick. Waiting in reception I overheard two team members whispering about being behind schedule and making negative comments about the absent assistant. A patient came from the treatment area, handed her file to the receptionist and said, "Nancy asked me to give this to you." The receptionist responded, "I can’t believe she asked you to bring that up here…I’ll have to talk to her about that!" The false smile belied her true feelings. While seated in the treatment room I heard someone in the hallway behind me mumble, "He better not chat-up the patients today or we’ll really be up a creek." By the time the doctor entered the room, I was feeling tense too.
The standard : A divisive team is toxic to a practice. No matter how hard you try, it can’t be hidden. And patients don’t feel comfortable being in the care of those who seem unhappy where they work. And this reflects poorly on the dentist.
The offices I see as the most successful with patients and the most productive are those in which the team members understand and respect each other. They value one another’s strengths and accept the weaknesses. They are stronger as a whole than they are as individuals. They support each other and have common goals. They share equally the responsibility to ensure the practice’s success. Team problems are discussed and worked out in private. And the appreciation for each other is genuine; this cannot be faked for the purpose of image. There are no cliques. Many times they are friends outside the office. It’s not something that happens overnight and a new team, or a team with new members must conscientiously work toward this level of understanding. When a team evolves to this point, they enjoy working together and the likelihood of team retention rises. Who benefits? Obviously the team and the practice, but the patient base benefits significantly as well and this will lead to patient retention.
So how "evolved" is your team? What concrete steps do you take in team meetings to value each other and ensure your goals are in concert?
Grade your practice: _____