It's OK to say 'goodbye'

Sept. 1, 2002
You have fantasized about it. You have dreamed about it. You have thought about it. You have even had conversations with yourself in your car about it. What is it? Firing patients.

You have fantasized about it. You have dreamed about it. You have thought about it. You have even had conversations with yourself in your car about it. What is it? Firing patients.

Most dentists are scared to death to let a patient leave their practice. We get upset when any patient requests their records to be transferred, probably because it implies a lack of trust. We want our patients to like us, and we worry about our professional image within our communities.

It is very hard in this profession to separate our personal emotions from those of running and operating a business. This is completely understandable.

Dentists are committed to taking care of patients. Therefore, it is baffling when they don't show their appreciation through paying their fees or remaining with the practice.

Difficult patients

We have allowed this fear of losing patients to overlap into areas where it shouldn't. But not every patient is a good patient, and not every patient belongs in every office.

In fact, I am quite certain that most dentists can immediately think of at least three to five patients who should not be in their practices. These people have intractable personalities; their visits give you knots in your stomach, and they are extremely difficult to work with or work on. Yet, you persist. You continue to treat these patients and charge them the usual fees, even though the extra effort needed to satisfy their whims and placate them far exceeds the normal treatment cost.

Take a minute and review the amount of time your most difficult patients require. They complain; they usually have insurance problems; they don't like their appointment times; and are unnecessarily critical of the staff. In short, they are miserable, and they seem to enjoy making others miserable as well. I guarantee that patients like these are costing your practice!

Not all patients are the same

If you insist upon retaining and treating these particular patients, then they deserve to be charged a higher fee. I don't mean a few dollars - I mean 30 or 40 percent more.

Increasing the fee shifts the decision from your shoulders to the patients. If they choose to stay, then the practice is thoroughly compensated for the extra time and effort these patients require. And if they get upset about the fees and leave the practice, it's ultimately to your benefit. Dentists must continuously evaluate who belongs in their practice and who doesn't. Not every patient is a perfect "fit."

Every practice has a few patients that make both dentists and their staffs miserable. Stop wasting time trying to please every patient. Concentrate your efforts on those patients who truly appreciate the superior service and clinical expertise that your practice provides.

Use a patient dismissal letter


Sometimes, it's better - and less confrontational - to dismiss a patient from your practice with a form letter.

Dear Patient:

Unfortunately, our practice will no longer be able to provide dental services for you. If you would like a referral to another practice, please call your county dental association.
We will be available to provide emergency services for you for the next 90 days.
(your name, your practice)

A letter like this example is to the point, yet nonconfrontational. It's short and it gets the job done. Even if this individual is part of a larger family of patients, it's still important to take steps to eliminate the discord they cause.

Roger P. Levin, DDS, MBA, president and CEO of The Levin Group and the Levin Advanced Learning Institute, provides worldwide leadership in dental management for general dentists and specialists. Contact The Levin Group at (410) 654-1234.

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