By Julie Parker, Julie Parker Practice Success

Upset or angry patients can really put you off. You find yourself feeling intimidated and reacting to them rather than being in control and using effective communication.

Because upset patients rarely give you advance notice that they are about to become confrontational, you need to plan now, and have it in your back pocket ready to use when necessary. Become very familiar with your plan through training such as role-playing so you are comfortable with the words you will be saying, your body language, voice tonality and demeanour.

Firstly, let’s understand the patient behaviour.

Why do people become angry?

People become angry when they feel they need to defend themselves against what they believe is being victimised, treated unfairly or being disrespected. Remember, it is their perceptions that you are dealing with, not the facts of the situation. One of your objectives is to effectively communicate the ‘facts’ to each patient (see The 3 Step Plan below).

Angry people have a form of victim mentality: they are expecting others to ‘right’ their perceived wrongs. Their emotional state is driven by thoughts of:

• I am HURT
• I am being IGNORED
• I am being DISRESPECTED
• I have been ‘RIPPED OFF’
• I am UNLOVED or UNCARED for

Ego is usually the basis for someone throwing their weight around. An out-of-control ego is extremely susceptible to the slightest pokes and scratches, and is a common syndrome of angry, upset or confrontational people.

The plan

Step 1 — diffuse the anger

The key is to have calmer patients. They will not hear you, or seek to understand you, if they remain angry. Angry people believe that the best way to solve their problem is to remain obviously upset, and to maintain this level of aggression until they are satisfied that you have heard and understood them.

The way to diffuse the anger is to establish in their minds:

1. I hear you (LISTEN to their version, without interrupting)
2. I understand you (EMPATHISE by stating “I understand why you are upset.”)
3. I am going to help you (ACTION “Thank you for discussing this with me. I am now going to investigate the issues so I can develop a solution for you.”)

Step 2 — gather information

Understand each scenario by gathering facts from all people involved through participation or bearing witness. No one person gives you an accurate account of events because they only offer their personal perception of what occurred.

From the patients:

Initially, you will get the patient’s version. With open and relaxed body language, a caring interested tone of voice and strong eye contact, say to the patient:

“Rest assured that I am here to help you, so share with me the situation from your perspective.” This is a powerful sentence as it tells the patients what they need to hear to calm down, without admitting any fault, or agreeing with the patient’s version of events.

Do not become a participant in their dramatisation of the events. You are to be a calm, non-emotional moderator.

From the staff:

Next ask for others versions. Avoid confrontation: This can distort information through defensiveness. Simply state:

“Patient X has expressed concern about his last session. What do you remember of what occurred?”

Don’t judge what occurred or how people behaved. This is an ‘information gathering’ process only.

Step 3 — resolution

Meet with the principal dentist/owner/manager and communicate the details without bias. Work together on the facts only, not the emotions. Establish the proposed resolution. Recognise the need to see situations from the patients’ perspectives to reach effective solutions for them.

Then communicate the solution:

Communicating the solution to the patient is ideally done in person. Then you can read all of their body and voice language in order to gauge the effectiveness of your proposed solution.

• Reiterate the patients’ reasons for becoming upset
• Inform the patients of the reasoning behind the resolutions, so they appreciate the good intentions of your business
• The proposed solution

Remember, never be afraid of refunding a patient if they are very upset. The cost to your practice in terms of financial, time, upset and reputation is always going to be higher than any refund. The reason many resist refunding patients is that they think this is ‘admitting fault’. It isn’t. It is buying peace and patient satisfaction.

By Julie Parker, Julie Parker Practice Success

Everyone wants happy patients…including the patient! Practices implement many and varied routines to aid in the happy patient, such as fresh coffee, aromatherapy and strong customer service. And I encourage all of it. But THE MOST effective way to make your patient happy is to set their expectations!

We all assess our experiences in accordance to the expectations we have set. If you go along to Pizza Hut for dinner your expectations of food quality and ambiance will be lower to that of an exclusive restaurant. So when your experience is that of a standard meal and noisy surroundings, you are still satisfied. If you were delivered that same standard at the high end restaurant, however, you would be dis-satisfied.

So to if you embarked upon a backpacking holiday over a resort styled vacation. You can imagine that you would be upset to happen upon cheaper accommodation when you were expecting something plush. And your upset wouldn’t necessarily be because you refuse to be comfortable in anything but the best hotel; of course you stay anywhere where there is sturdy shelter, amenities and a bed. You would be upset because you were expecting a different experience.

This is the case with your dental patients. In fact it is quite difficult for your patients to even set their expectations of a dental appointment. Unless it is regular recall visit, dental treatments vary widely in terms of discomfort, appointment length, instruments and equipment to be used, and of course cost. Unless your practice lets the patient know what to prepare for, they will be left to guess. Then the minute they experience something that is their mind averse to what they thought would happen, they will become unhappy.

So where are your opportunities for setting expectations?

If it is a new patient or emergency patient, the initial explanation of what to expect comes from the receptionist. Giving an indication of length of appointment and potential cost is crucial, especially when the patient has not attended your clinic before.

Once the patient is in the treatment room, the dentist and nurse can use this chance to explain to the patient what is included in that appointment. My advice to all dentists is to have the conversation with the patient before they are reclined back in the chair. Sit across from them at the same eye level. In a relaxed manner, explain to the patient what will happen and then ask the patient if they have anything to discuss before starting. Once the dental issue has been examined, sit the patient back up and discuss the details with them so they can more easily understand what is being said and can then make a decision to continue with the elected option for treatment.

Checking in with the patient is such an important step in setting realistic expectations. If the patient is a new patient or has arrived for unplanned treatment, such as a broken tooth, ASK the patient what they are expecting from the appointment. Because they have booked a time with you for a troubling tooth, you assume they also want you to treat it straight away. However it is possible they want an assessment now, and then plan for the treatment for a future date so they can arrange time off work/finances etc.

You must create the environment for the patient to open up in order for you to understand what is in their head.

The expectations for any planned treatment the patient is to return for are to be explained by the clinical team in the surgery and also followed up by reception. We have all experienced the situation of the patient coming out to the front desk and asked whether they need to make a follow-up visit and they say ‘no’ or ‘I don’t know’ when the clinical staff have just explained everything to them. There are many reasons why patients are not fully engaged in the surgery conversations, so it is up to the whole dental team to ensure that there is consistent information about what the patient should expect at their next visit.

Patients expect of their health provider more than just treatment. They also expect advice, support and reassurance. Build all of these elements in to your communication with patients and they will leave HAPPY!

By Julie Parker, Julie Parker Practice Success

We live in this information age, where you don’t need degrees in marketing and business in order to learn how to run highly successful dental practices. We can research online and tap in to other people’s brilliance at the click of a mouse. As a result there are many stylish and sophisticated marketing campaigns being rolled out in many surgeries. I love a good promotion and honour the creativity that goes in to producing them. Although I encourage all small businesses to develop smart marketing and promotional systems to attract new business, it is important to never lose sight of THE MOST effective new business generator of all; and that is REFERRALS.

Most of you are keenly aware that generating referrals from your existing patients is the cheapest form of advertising. However there are even more compelling reasons to encourage referrals. Note in the above graphic that people are four times more likely to come to you if they have been recommended by a friend. When someone you know and trust suggests you try something, it is a compelling offer. There is a ‘transfer of trust’ from the friend to you. You think “If they are happy with it, it is likely I will be too”. Considering that trust plays such an enormous role in treating your dental patients effectively, leveraging off another patient’s trust in you is a smart move.

Dental practices are only viable with repeat business. It is your loyal patient base who return for all of their required dental treatments that are likely to be responsible for around 80% of your turnover. So it is not enough to simply get new patients. You also need to provide them with the service that they will return for, and become part of you5r loyal patient base. The Journal of Marketing states that of all of your new patients, the ones who come from referrals have a 16% higher lifetime value to your practice than those who came through other methods.

The wonderful news is that if you put in the effort to create the ideal environment for your dental patients, if they are indeed satisfied then a whopping 83% are willing to recommend you to their peers! And that’s where the gold lies…they are WILLING to refer. In order to enjoy these referrals make sure your patients are aware that you want these new patients. I suggest to not be shy in this area of your business. Notify patients through promotions, rewards and gifts, signs and website content, and through your conversations with them that you want and appreciate every new patient they bring in to the practice.

By Julie Parker, Julie Parker Practice Success

It has always been obvious that a great receptionist improves the environment of any business and a bad one will be highly likely to have a damaging affect. However our awareness around the high level of influence our receptionists has requires deeper contemplation.

Dental practices know their receptionist plays an important role in creating a calming environment for their dental patients, allowing them to feel confident in their practice of choice, faith in the dental team and comfortable in the knowledge they are receiving a high standard of care in a professional environment. This same positive influence over the practice’s environment also plays an important role for the dental team members, and their level of happiness and effectiveness.

Therefore the role of ‘receptionist’ warrants a closer look. There is a meaningfulness and importance to this role that all engaged receptionists should embrace and feel very proud of.

Whether it is acknowledged by team members or not, the receptionist of a dental practice is THE LINK between the patient being outside the walls of the practice, not addressing their dental health, and those patients being in your practice dental chair receiving treatment.

There are many steps that need to take place before a patient is lying back in the dental chair and many are performed the receptionist.

Think of a patient who is anxious and wavering in their decision to make their follow up appointment. An unengaged receptionist will not have a purpose or goal in this communication with the patient. They know they will be paid whether the patient books the follow up appointment or not. They also know their relevance within the practice will remain the same regardless of whether the patient books their next appointment. The chances of this receptionist achieving consistently high levels of success in their management of the appointment book are very low.

Compare this scenario to one with an engaged receptionist. A receptionist who is keenly aware that their level of communication skills, and effectiveness in providing the patient with the needed support and care, will generate high level results again and again.

An engaged receptionist understands the responsibility they possesses in ensuring a health-compromised patient actually achieves dental treatment. They also honour the role they play in building and maintaining the credibility of each dentist and the practice as a whole. Engaged receptionists will execute their roles with actions and decisions that are based upon a personal philosophy to care about what they do. This impacts situations such as:

• The patient’s adoption and completion of treatment to achieve oral health/li>
• Assisting the dentists’ goal/agenda to build faith in them in the patients and faith in the practice
• Helping nurses and support staff by being mindful of the demands they experience throughout the day and scheduling effectively

But also it is imperative for receptionists to acknowledge their influence extends directly to:

• The dentists’ ability to strengthen their career development, as they are dependent upon the number of new patients being booked in with them and they are reliant upon the bookings of their returning patients
• The business’ success, through their effectiveness in booking patients appropriately, in the most effective and productive way, their successful collection of fees and their support and encouragement of the practice’s policies and values.

Receptionists need to artfully maneuver around what is ‘popular’ or ‘desired’ by unrealistic patient expectations, staff members who will sometimes want to have an ‘easy’ day and bosses who may be inclined to sway from the practice vision and culture due to lack of commitment or tiredness. The receptionist is often quite unconsciously seen as the ‘guide’ of how things are done, how hard to work and how high the standards should be kept.

The dental industry is only a few industries where a support role employee holds such a large influence, and therefore responsibility, over the effectiveness and success of the ‘producers’ (i.e. the dentist and their nurses). For those people attracted to this profession of dental receptionist, for those who choose to perform their role with the care, the attention, the integrity that it requires, They should approach their daily duties with the STRENGTH to make the right decisions regardless of external pressures, with RESPECT for all of those who depend upon them to do the right thing at all times, and with immense PRIDE that, through their commitment to their philosophy and that of the practice, they are enabling the people around them and the business they work for to achieve greater levels of success than if they were not there supporting them.

By Carl Burroughs, Integrated Dental Marketing

When you really impress a patient you often find out about it as they may have written you a note or sent you some flowers or a bottle of something nice or left you a good feedback. Equally, if someone is really unhappy the chances are you will already be aware of this. But most of your patients are somewhere in the middle of these two extremes, and what this group of people think about the services that you are providing is the true test of how healthy your practice is.

Surveying your patients has always been a great idea, but before digital platforms came along conducting surveys was a cumbersome process. Today however, it is as easy as automating an e-mail to be sent directly to every patient after they have attended an appointment with you.

Creating a patient survey is now easy to organise, but in order for this exercise to give you meaningful data, it needs to be the right survey. I think we have all experienced completing a ‘dumb’ on-line survey where all the questions are weighted to give the answers the company conducting the survey wants to receive. When Bill Gates was busy building Microsoft, he was famous for starting every team meeting by just asking for the bad news and problems, as it was his belief that you only build a world class company by working on the issues and not wallowing in the glory of your successes. Your practice surveys should take from this approach.

Don’t get me wrong, it is fantastic to receive great feedback as it confirms the things you are doing well and allows you to congratulate outstanding staff members. However, it is the negative feedback that you receive which truly allows you to improve the services you provide whilst also enabling you to future proof your businesses.

Gaining meaningful feedback also creates opportunities to expand and adds additional income streams. For example, if 30% of your patients state that they would like weekend appointments, it allows you to expand your hours with the knowledge that there is a demand for these additional hours. A favorable response to a question such as ‘would you like to see us add anti-wrinkle treatments to our suite of services?’, means you can add these services with confidence and they will be successful.

Adding a survey function to your marketing is a simple yet effective way of improving your customer service as the public likes having a way of providing feedback that is easy, discreet and at a time that suits them. Also, no patient will be upset if you ask them for their opinion. They will either delete the e-mail if they don’t have time or don’t want to participate, or will undertake the survey in the same way we all do.

So the key is to have an easy to use platform, which asks meaningful questions, is intuitive and not too long.

The team at IDM have been working with one of the major survey providers to create such a platform. The platform had been developed specifically for the Australian and New Zealand dental sectors with the questions developed by a practice management expert in conjunction with a psychologist. Not only are the core questions developed to give you the information you need, but the platform is intuitive, meaning it will ask the additional questions you might want to know from a particular answer to a question. The IDM survey is also totally customisable allowing you to add specific questions that you want to know the answers to.

The platform allows you to login at will to see the results and the IDM service also comes with the option of having the results analysed by a prominent practice management expert, should you want.

If you would like a free demonstration of the IDM dental survey platform, simply email surveydemo@idm.com.au or call Sonia on 02 9211 1477. You can also visit www.idm.com.au to know more about the services offered by IDM.