On top of the world

Dr. Michael D. Goldstein outlines nine little things dentists can do that, while costing less than a dollar each, will make your patients feel they are number one.

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by Michael D. Goldstein, DDS, FAGD

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I'm often overwhelmed by the number of ways available to make our patients' visits to our offices as comfortable as possible. Whether you are strolling among the exhibits at a dental meeting, reading a journal, or attending a seminar, you are deluged with suggestions for improving your relationship with patients. Usually, the suggestions are high-tech and high-priced.

Some consultants suggest cable TV and VCRs in each operatory to distract patients from the work being performed. Others promote $900 sunglasses that have a small TV screen built into them. Patients then can slip on the glasses and watch TV while you're working. Still others tout the merits of a cappuccino bar in the waiting room ... er, excuse me, I mean the "reception area."

I was thinking about all of these high-dollar, practice-building tools one day as I returned a long-distance telephone call from another dentist's staff member. I was quickly put on hold. While I waited, I heard about all the high-tech options available at this office, such as an intraoral camera, air-abrasion cavity preparation, implant technology, etc.

After more than four-and-a-half minutes of this, I became impatient and hung up. I wondered how many patients would hold on longer than I did. If I were a new patient, all the high-tech, fancy gadgets and techniques in the world couldn't entice me to call back an office where the courtesy of acknowledging a waiting caller was ignored. The simple things can be really important.

The following nine items are a sampling of the "little things" we do every day in my office for my patients' comfort. Each "patient amenity" costs less than a dollar and makes my patients feel special and pampered. Added together, these little things can make patients feel like providing them with excellent dental care in the utmost of comfort is your most important focus.

Item 1: Vaseline on lips - cost: 5 cents/application

We've been applying Vaseline to the lips of all our patients before treatment for more than 20 years. It amazes me how appreciative they are of this small effort. The older ladies especially enjoy not leaving with cracked and bleeding lips. We now load the Vaseline into the back of a 5cc Monojet syringe that has the tip cut off to allow for easy dispensing. We place a little dab of Vaseline on our patients' lips for every procedure. Once you begin pampering your patients in this manner, they will expect it every time.

Item 2: Individual packs of tissues - cost: 20 cents

Most of our patients are given their own packet of facial tissues before we begin their dental treatment. We don't wait for their noses to run or saliva to drip down their necks. It's a little item, but you'll immediately notice how appreciative your patients are when you give them their own personal packets.

Item 3: Protective sunglasses - cost: 15¢ per use

Many of us provide our patients with protective glasses before we begin a procedure that could result in splashing. By having the glasses tinted, we're further improving our patients' comfort by shielding their eyes from our dental light. If you don't think your dental light can be annoying, just sit in your dental chair and observe the view from down there. For the kids, we have little Mickey and Minnie Mouse sunglasses that fit them better. I bought hundreds of pairs at a really great deal, so we let the kids take the glasses home (after we clean off all the blood and spit, of course).

Item 4: A cover or afghan for our cold-blooded patients - cost: 0¢ (my mother-in-law made the afghan for me)

If your dental office is like mine, your operatories vary in temperature from 87 degrees to 65 degrees. The other day, I sat down to begin a three-hour procedure in Room 1, which was way too warm. After I turned on the fan, my patient, who obviously had zero blood circulation (I probably should have checked her pulse) complained of being too cold. Instead of my assistant and me stripping off layers of clothing to be comfortable, we covered our patient with an afghan. We have several older patients who routinely request the afghan, especially in Room 2, which is 10 degrees cooler than the rest of the office. My assistants are so sharp - they remember the "cold-blooded" patients and offer the afghan before they ask!

Item 5: Valium, 5mg - cost: 15¢

I rate Valium right up there with the papoose board when it comes to patient-behavior management! Seriously, having patients take just one 5mg Valium 30 minutes to an hour before treatment can improve their comfort and cooperation significantly. We routinely dispense Valium to patients undergoing major restorative treatment (two hours or more).

We also give Valium to patients who have difficulty holding their mouths wide open for long periods of time and to patients who are apprehensive. Patients who take Valium almost always comment on how much easier the treatment was than they had expected, and they often require less local anesthetic during treatment.

When we offer the Valium, we say, "We're going to give you a muscle relaxer to make it easier for you to hold your mouth open during your long dental visit." We also ask these patients to arrange alternate transportation, so they don't have to drive themselves home after treatment.

One bit of caution: It can be difficult to predict exactly how a single 5mg dose of Valium will affect a patient. I've had a 220-pound man fall asleep on one pill and a 90-pound elderly woman who was not affected by two pills! After using muscle relaxants hundreds of times with my patients, I have yet to have one patient experience a negative reaction.

Item 6: Stereo with headphones - cost: 25¢

We have some patients who can't stand the sounds of the drill and the suction. For them, we offer a small cassette/radio with headphones or a CD/Walkman. We encourage our patients to bring in the music they like to listen to and even their own players. I've found, however, that once a patient has the Valium in his system and has been painlessly numbed, he really doesn't care about listening to music. For this reason, our stereos get very little use.

Item 7: A plastic rose for my female patients - cost: 40 cents.

For the last 12 years or so, I've been giving most of my female patients a plastic, long-stemmed rose following treatment. We buy the roses by the gross and keep all of our operatories well-stocked with the white, pink, yellow, and red flowers.

After analyzing the tremendous positive response these flowers elicit, I finally came to the conclusion that the way I present the rose is the significant element. Typically, I say, "Mrs. Taylor, this is for you for being such a wonderful patient today." I even go to the trouble of color-coordinating the rose with the patient's outfit. (My wife, Fern, will laugh at this statement because she doesn't believe I could color-coordinate a tuxedo on a penguin.) Even if the patient is a "pain" to work on, I'll say, "Mrs. Taylor, I know that this appointment was difficult for you, and this rose is a thank you for putting up with us and getting through the treatment."

Patients frequently tell me about their large arrangements of these roses at home. They never seem to throw them away! Giving a rose to a patient also makes me feel good, which is a very large bonus.

Item 8: Calling a patient by name - cost: 0 cents

If you're like me, remembering a patient's name and using it is a very difficult task. Just the other week, I was discussing this very matter with my partner, Kit Weathers. Because of my "name-learning disability," my sharp assistants print each of my patient's names in large block letters on the tray cover to remind me to use it.

Item 9: Give your patients more than they expect - cost: 0 cents

One of the greatest books on practice management I've ever read is The $100,000 Practice and How To Build It, written by Robert P. Levoy in 1966. In the book, Bob used the word "potlatch" to mean giving the patient more than they expect. Using some of these "low-budget" patient-pampering techniques will give your patients a feeling of "potlatch" from their dental experience.

If you still feel you must have interactive video games and a juice bar in your office to be successful, I won't argue with you. I only hope that you're already using the personalized patient-comfort suggestions that I've outlined. Sometimes, it's the simple, little things - done with sincerity and concern - that have the biggest impact on our patients.

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