Patients - You can't live with 'em; you can't live without 'em

Sept. 1, 2002
Let's face it - patients are the lifeblood of your dental practice. Without patients, there would be no practice. Unfortunately, they also can be the cause of our discontent. Some patients are absolutely stellar with regard to compliance, treatment acceptance, and attitude; others are not.

by Drs Matt & Ann Bynum

Let's face it - patients are the lifeblood of your dental practice. Without patients, there would be no practice. Unfortunately, they also can be the cause of our discontent. Some patients are absolutely stellar with regard to compliance, treatment acceptance, and attitude; others are not. How do we handle the different personalities? How do we treat all of our patients effectively, while maintaining our profitability? This month, we will explore the aspects of dealing with patients.

Every patient is unique. Regardless of their appearance or personality, they deserve our undivided attention and expertise. As professionals, we may be able to transform them into ideal patients.

Do not let prejudice enter the picture when you welcome new patients into your practice. Looks can be deceiving. Just when you think a patient will not accept your professional advice, he or she will surprise you and do just what you recommend. Not every person who can afford elective dental treatment wears expensive clothing and drives a fancy car. Likewise, not every person who appears outwardly affluent can afford elective dental treatment. Our job is to diagnose the mouth, the condition, and the desire, never what we think the pocketbook contains.

All patients deserve our undivided attention; however, let us qualify this statement. Certainly, we would all agree that there are people with whom we simply do not get along. Furthermore, we would all agree that to subject ourselves to an atmosphere in which dislike abounds may promote a less-than-perfect attitude on our part and compromise treatment. You simply cannot be everybody's dentist! In doctor/patient relationships, there must be respect and trust between the doctor/team and patient.

If there is conflict, let the patient go. An abusive, disrespectful personality should not be tolerated in any office environment. Surround yourself and your team with personalities that match your practice atmosphere. Remember, there are many personality traits out there. It is your practice, and it should be run by you and dictated by your philosophy.

How do we deal with all of these different personalities? One of the best things that happened to our team was the DISC personality-assessment system. The habits that each of the four personality traits categorized by DISC exhibit seem to be fairly consistent from person to person. Mastering the communication skills of each of the personality types simplifies the way in which we interpret and relay necessary information to our patients. There have been many articles written about the DISC system, and it is widely recognized. The system is used in businesses from the health care industry to Fortune 500 companies around the world. Here is a brief summary of the personality types DISC assesses:

  • D is for dominance. These people will tell you what to do and when to do it. They are drivers, because they think they are driving the boat. They are headstrong and don't want any fluff in their descriptive analysis. Give these people the what, the when, and the how much. Everything else will likely be tuned out anyway.

    • I is for influence. These people will do what you say as long as they end up looking good. They look for approval from others and are easily excited about the flashy, the motivational, and the things that enhance. They are very energetic; these are the people-persons. Share with these individuals the benefits of how your treatment will improve their look and/or self-esteem and they will follow your recommendations to the letter.

      • S is for steadfastness. These people are hard to crack. They are almost always on an even keel and may even be perceived as somewhat slow, not because they are inept but because they must analyze everything word by word. They may barely smile at a funny joke, but inside they think it is hysterical. Give these people all of the information possible about your proposed treatment, but do not push; they need time to process the information and make a decision.

        • C is for conscientiousness or cautiousness. These people typically are classified as engineers. They require detailed information. They need the components of the material you are going to use and the process. They are interested in structure and stability. Give these people lots of information, but do not center the discussion on the way the treatment will make them look or feel; they tune this part out.

        While DISC is an important tool in categorizing personalities, there are other effective tools that you can use to gain your patients' approval. Start by portraying yourself as human. While dentists may be perceived as society's elite, putting yourself on your patient's level is key. Greet your patients by name in the reception area. Share a cup of coffee with them. Always make patients feel important and keep them at the center of your attention.

        Subconsciously, subtle body language - like chair positioning - is very effective in communicating with patients. Have you ever thought about where your chair sits in relation to your patient's chair? Is it too close? Is it too far away? Is it too high? These factors influence what patients think about you.

        I always sit in what I call "striking position" - beside the patient, forward in the chair from the hip-against-hip position. This way, I can look the patient in the eye and be close enough to touch his arm comfortably. My chair is always slightly lower than the patient's, so he can look slightly downward at me.

        When discussing treatment, it is important to make patients feel important, as if they have the upper hand. Placing yourself in front of the patient shows respect; you can look the patient directly in the eye. By placing yourself within arms reach, you are able to show empathy through the use of touch. When your chair is lower than the patient's, he feels a sense of control over the situation.

        I also use a technique called mirroring, which simply means placing your body in a position that very closely mimics that of the patient. Don't take this literally to mean playing monkey see, monkey do, but if the patient is sitting with his arms across his chest, then you should do the same. If the patient is sitting back, relaxed, with legs crossed or folded, you do the same. This allows the patient subconsciously to relate to you and sense comfort in what you are doing. It is easier to trust somebody who is like you than someone who is not. Psychology is powerful; it can be used to gain the advantage over a less desirable situation, like being in a dentist's office.

        Now that you have a way to analyze your patients and communicate with them effectively, how do you commit them to treatment? The answer is value. Patients must sense value to want to purchase your services.

        Everyone has a different definition of value. Value to the insurance-conscious patient translates into benefits. If the benefit does not cover the estimated cost of treatment, the patient may see little value in it and feel resentment. While insurance-driven patients do exist, they are not the majority. I believe that the majority of patients want better-than-average treatment because they value themselves.

        Consider the retail industry. If everyone wanted just average, then there would be no high-end stores like Nordstrom, Dillard's, or Saks. These stores cater to a different clientele than that of Wal-Mart, K-Mart, or Target. In fact, those who shop at high-end stores probably shop at Wal-Mart as well. So, why is it that people still continue to shop at Nordstrom and not Wal-Mart exclusively? Again, the answer is value.

        To create value, you must create a buying environment. It is important to make your practice stand out. In the example of retail, we see the concept of a buying environment exemplified in the high-end stores. These stores are well-kept with organized merchandise, excellent customer service, and knowledgeable personnel. If the retail industry has been successful at doing exactly what we dentists strive to do, why reinvent the wheel?

        Getting patients to accept the treatment they need requires dental offices to operate like retail. Your office should be clean, organized, and service-oriented, and your team should be highly knowledgeable. A comfortable office environment speaks volumes about the service you offer. Your service should be over and above that of the best retail store, and your team should be so well-trained that the only thing that would inhibit the running of the office would be your absence.

        Provide some luxuries for your patients to enjoy. Add special touches over and above customer service. Give your guests five-star service - fresh fruit, cookies, magazines in the reception area, massage cushions, aromatherapy, movie glasses in the treatment areas. Give patients what they don't even know to ask for; go above and beyond their expectations.

        What do we do when we encounter people who simply do not fit the mold? As we said, you can't be everybody's dentist! Acknowledging this fact early on will enable you to eliminate the headaches that come with such patients. Sometimes the only solution is to not perform any treatment at all.

        It is impossible to treat every patient, so don't. If there's not a match between you and the patient, don't enter into the relationship. There is nothing wrong with dismissing a patient, and there is nothing wrong with not accepting a patient. Treat patients only under the philosophies and parameters on which you have established your practice.

        Patients are the lifeblood of our profession, but sometimes they can be difficult. They come from all walks of life, have different personalities, and are as difficult to understand as we are. You can't live with 'em, and you can't live without 'em. Stay tuned.

        Coming up …

        Next month, we will explore the profession's supposed loss leader - the hygiene department.

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