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I know why your patients are leaving. Do you?

Oct. 9, 2019
After reading hundreds of dental office complaints online and listening to them firsthand, Tanya Gold, RDH, has learned that most patient-related problems have something in common.

After reading hundreds of dental office complaints online and listening to them firsthand, I’ve learned that most patient-related problems have something in common. These avoidable issues start and end with poor communication, both verbal and nonverbal. The results are angry and unflattering online reviews and patients who leave your practice. It doesn’t have to be this way. If we improve our communication skills, we can prevent the loss of patients and avoid those embarrassing complaints online. 

The problem we face is multifold. As dental professionals, it’s our job to welcome and work with all of the different types of personalities that walk through our doors. In addition, we have to tailor our speeches or written communication to all individuals to make sure they understand our office policies, procedures, treatments, philosophies, protocols, and more. When we don’t accomplish that, we run the risk of being misunderstood, misleading, or offending patients. In turn, they may air that misunderstanding or disagreement online in public posts,  leave your practice, or both. 

Unfortunately, many of you have already had the experience of reading a negative review about yourselves. Having a complaint out there, whether it’s fair or not, is damaging to your public image. The silver lining of this dark cloud is that at least you know why the patient is upset, and you can learn from that experience. 

According to my online research on Yelp, here are the most common complaints people share publicly.

Diagnosed with unnecessary treatment—This is a big one. Some patients believe, accurately or not, that the recommendation they receive is for something they don’t need.

Long wait time—Time is a valuable commodity. Most people take time away from something else that’s important to them to be in the dental office, and they don’t appreciate feeling that their time is wasted.

Billing problems—This includes both errors and misunderstandings—being billed for procedures not covered by insurance, being billed for procedures not completed, seeing a price that’s different than what was originally quoted, or not even knowing what the bill is for.

A heavy-handed clinician—The patient is physically hurt during his or her procedure.

Aggressive dental sales—Patients may feel that the practice doesn’t have their best interests at heart when they’re pestered with too many advertising emails and sales calls, or if they’re upsold on proposed procedures.

These complaints serve as great catalysts for spurring patients toward finding new dentists. What may surprise you is that most if not all of these online complaints can be prevented with appropriate conversations. It doesn’t matter if the issue is why the doctor takes too long or why a bill doesn’t look right. As long as someone in the office takes ownership of the situation to let patients know that what they’ve encountered is not standard operating procedure, your practice can earn the opportunity to do better next time. 

Why patients leave

What about patients who don’t complain but don’t return to your practice? After years of listening to complaints and stories about patients’ previous dentists, I’ve learned some of the reasons why they leave. 

There is no “cleaning” included with new-patient appointments. Patients do not realize that their appointments do not include a dental “cleaning” and they’re angry they have to revisit your office. Some feel there is a bait and switch involved because this news is a surprise to them. 

Patients do not receive a callback. A patient never hears back from the office after contacting them about making an appointment.

There is confusion about insurance. The office doesn’t accept a patient’s insurance plan, or the patient does not understand his or her portion of the bill or co-pay.

There is a personality conflict or a disagreement. The patient believes the dentist or the staff were rude or condescending.

Patients experiences post-op problems. A patient comes in with no pain and then experiences pain or complications after treatment. 

Patients feel rushed. The dentist or staff doesn’t spend enough time with the patient. 

Patients feel embarrassed or ashamed. A patient may feel belittled by the dentist or staff because of the condition of his or her oral health.

The staff displays a lack of interest. The dentist or staff shows no personal interest in the patient.

There is a lack of professionalism. The staff and dentist speak poorly about other patients or use slang or profanity in front of patients.

Treatment questions are not answered. Patients leave feeling they don’t know why a treatment was recommended or performed, or what problems it was meant to address.

What to do to fix the problems

Some suggestions that I have to help these situations include informing new patients about what their first experience in the dental office will be like, either on the phone or via email. The first conversation is the beginning of your relationship, and making a good impression is important. Use a script as a guideline if you need to, but take your time, ask the patient questions, and maintain a positive tone of voice. Just as you’re gathering information from your prospective patients, they’re gathering information about you and your practice. 

Remember to discuss length of appointment, type of imaging to be done if any (the patient may have current records from his or her previous dentist), any specific concerns the new patient has, insurance or payment information, prior hygiene protocol and history of periodontal disease, and how the person was referred to your office.

Perform an additional consultation prior to extensive treatment. It’s easy for us to forget that visiting the dentist can be nerve-racking and overwhelming for some patients, especially when they’re facing complicated procedures. Some patients like to save face by saying that they understand all of the details of their proposed treatment, or that finances are not a concern, when in fact the opposite is true.

Having a dedicated consultation appointment in a consultation room, rather than explaining next steps with a patient in the dental chair, will put people at ease and level the playing field. This offers a safe space for patients to ask thoughtful questions, and it demonstrates a sense of caring. Use this time to fully explain treatment, cost, and any possible complications.

Patients prefer discussing their treatment needs with the dentist instead of another staff member, so this appointment should start with you. Please have the patient’s x-rays and photos available to review together. It’s much easier to communicate a problem with a picture. Also remember to use terminology that patients will understand. Your treatment coordinator can finish the conversation by arranging finances and scheduling appointments after you’ve finished discussing treatment details. 

It is OK to warn patients about possible discomfort. Many procedures may result in pain, even when everything goes perfectly. Being upfront is the best way to squash any ideas that their pain means you screwed up something. The same principle applies to your hygienist. If the RDH knows a cleaning will be uncomfortable, have him or her address this with the patient in an empathetic way. 

Do not sell! Dental professionals are health-care practitioners and should act accordingly. Rather than creating the perception that you’re “selling” a service or “upselling” a patient from an adequate approach to a fancier one, simply identify the problems and concerns and then present the possible solutions. This approach centers the conversation around patient needs, not money. Yes, this is an issue of semantics, but it’s an important distinction. This approach will not only increase your case acceptance and set aside trust issues, but your patients will be excited to get the help they need. 

These suggestions don’t cover the full gamut of complaints, but they’ll give you a good start in fixing the ways in which poor communication can sabotage relationships with your patients. Making some changes in the way you present your practice, speak to patients, and communicate can right these wrongs. Face it—patients’ experiences are what matter most if you want to retain them and have them post positive feedback online. Taking the time to make sure your communication is clear and comprehensive will give you happier patients and a healthier practice.  

TANYA GOLD, BS, BA, RDH, specializes in public relations, practice enhancement, and communication strategies. She is the founder and director of Gold’s Dental Charm School, which focuses on the training of social graces for the dental professional.

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