The letter came at the perfect moment. It lifted me up, reminding me of the important work that we do and filling me with joy during a time I was feeling down. My down moment: We had several miscommunications with a husband and wife, both patients. Lovely people, but there was a cultural and language barrier. She’s a fearful patient who braves her way through treatment. He was also nervous and needed extensive dentistry.
Money was not a problem for this couple. But still, the issue was financial. They had previously had a 5-percent cash courtesy, but when they obtained dental insurance, the courtesy wasn’t given to them. Not only was it withheld; the wife, who’s in charge of finances, said she wasn’t told about the change.
In addition, in our practice, sedation patients pre-pay and sign consent forms two weeks prior to treatment. Because the payment was due, the couple drove quite a distance, while she was ill, with two little children, to pay so her husband could keep the appointment. They paid by check not knowing they didn’t get the cash discount. When she brought her husband to the surgical appointment, she questioned the front office about the courtesy. It didn’t go well.
The patients felt we didn’t trust them. The wife felt that she was talked down to by my front office, as if she couldn’t understand. What the situation taught us, as a team, is that we need to first apologize for how the person feels and then listen carefully. Anytime a patient is frustrated or feels a dental practice lacks customer service, it typically involves money. He said, “If I’d known we weren’t getting the cash courtesy, I would’ve paid with a credit card. We wouldn’t have driven across town when my wife was ill, and I would’ve gotten my airline miles.”
I personally apologized to both patients individually and together, listened intently and said, “I’m so sorry. It was never our intention to have made you upset or unhappy. Here’s what I’d like to do for you, if it’s OK with you: We can write you a refund check today, and you can pay when you’re ready with your credit card, to get your airline miles; or we’ll honor the 5-percent courtesy for this treatment, the past treatment and future treatment.” I felt it was the right thing to do. In these times, it’s best to listen to our gut, our instincts. As this was happening, the letter arrived:
Greetings, Dr. Savage,
I doubt you remember me, but you helped me so much when I was in the Navy. See, I was terrified of dentists, but you listened and helped me through my treatment. You were kind, encouraging and gentle. Here I was, in a senior enlisted status, and my teeth were horrible. How could I lead my men and make them realize how important their health was, if I didn’t take care of myself. My breath was awful. I could tell by how people would step away from me when I was talking. My teeth had big, black cavities and I had gaps in my mouth from having to have teeth pulled when they hurt. The Navy didn’t have laughing gas and wouldn’t let me have sedation. But you made the shots so easy; they barely hurt at all. One step at a time, by the time I retired, you had my mouth looking great! I’m writing now, after 14 years, to tell you that you made a difference in my life. My wife and I are now living in Las Vegas. If there’s anything we can ever do for you, please drop us a line.
Thank you so much.
Chief Petty Officer Tim …… U.S. Navy Retired
What we do is tough. We’re providing a very personal service to sensitive, often nervous patients. For many, we’re changing their lives, just as they can change ours. Tim, the Chief Petty Officer, didn’t need to pay for his services. But how he felt came through in his letter. How people feel in your office is important; listening carefully and not interrupting is critical.
Let’s talk about the value of building authentic relationships that keep patients coming and also help keep team members on board.
When you engage patients in the decision-making process, they don’t feel sold. Your team also appreciates being engaged in the dental practice decision-making process because they then feel that their voices matter. If there was one phrase I’d like you to remember and focus upon, it’s this: “No one likes to function in a void or absence of communication.” To that end, I’d like to discuss the patient first and then the employee second.
Patients appreciate knowing their options, presented in a way that’s simple, easy to understand and clear. Patients don’t understand our dental jargon. There’s a book written on this topic, in a general sense, entitled The Art of Explanation. The author states: “We let our vernacular, our phrases, our professional jargon, get in the way of people understanding your products, ideas and services.”
To illustrate this, please pull out a blank sheet of paper and do the following exercise:
• Draw a small house
• With a front door
• Two windows on each side of the door
• Smoke coming out of the chimney
• The sun is shining
• There’s a nice sidewalk
• A tree
• A dub
• A bird
• A chimney
Wait! What’s a “dub?” Did your hand or mind stop and not move on? A dub is a pond or a small body of water. If your assistant tells the patient, “We need to take an FMX,” the patient’s mind stops; everything turns into blah, blah, blah as he or she tries to figure out what you’re saying. Keep your words simple unless you receive a complex question.
Secondly, there’s a huge value in a complimentary consultation appointment for patients with complex needs. What I’ll do is first connect on a personal level. Prior to going into the operatory, my team will give me a few personal bits of information, so I can easily connect on common ground. This can be about sports, travel, hobbies, work, children, grandchildren, etc. I can easily walk in and say, “Hi Tina. It’s very nice to meet you. Thanks for coming in today. I understand you have a daughter who plays soccer. What position does she play?” Then I’ll share a bit about my daughter, Kaitlyn, who’s had a career as an international soccer goalie.
I recommend that the dental assistant, the hygienist and the dentist have two or three personal connections prior to sticking their hands in the patient’s mouth. Remember, there’s no other more personal service than OBGYN and proctology!
I’ll review the health history and x-rays, and my hygienist will obtain periodontal charting. After looking in the patient’s mouth briefly, I’ll simply chart clinical decay. I don’t identify the need for a crown, implant, denture, etc. Instead, I’ll say, “Tina, I know you realize you have a number of dental needs. If it’s OK with you, what I’d like to do is ask my dental assistant to take some impressions of your mouth to create study models.
“With your models, I’ll spend some time and think about a few different treatment options that would be best for you. Then we’ll have you back for a chance to talk about your options. We will have researched your insurance and put together treatment estimates. There’s no fee for all of this; I’d just like to have time with you to explore options that can best fit your needs, your time and your family’s budget. Will that work for you?” Rarely do they fail this appointment. They may proceed slowly with treatment, but the patient understands, from models and our discussion, what the end result will be.
Clear communication, honesty, empathy and concern for feelings builds strong relationships. The same is true within your team relationships. I recommend you clearly define your values as a doctor. A job description is one thing; clear values are another.
My values include timeliness, hard work, honesty and integrity, which means doing the right thing, even when no one is looking. Have you defined your values? Are you holding effective, dynamic team meetings, performance reviews and merit reviews? Do you have clear expectations of behavior?
Mine are simple. I let my team members know that they don’t have to be friends, but they have to be nice, friendly, respectful and responsive. Exploding in anger, the silent treatment, gossipping and negativity have no place in my practice. Most importantly, these values have to apply to me, as well. Patients and staff members are attracted to a practice where they feel valued, important and cared for, and where communication skills are strong. No one likes to function in a void or a vacuum of information.