Th 182020

“Mystery patients”

June 1, 2005
As we approach the warm, summer months when patients are more focused on upcoming vacations than on visiting the dentist, my husband (the dentist) and I (managing officer of the corporation) use this time to re-evaluate the “way we do business.

As we approach the warm, summer months when patients are more focused on upcoming vacations than on visiting the dentist, my husband (the dentist) and I (managing officer of the corporation) use this time to re-evaluate the “way we do business.” As I mentioned in the last article I wrote, we subscribe to the Total Quality Management, or TQM, business model. One of the foundational underpinnings of TQM is the notion of kaizan - continuous improvement. Never has the need to understand paradigm shifts and concomitant economic and societal changes been highlighted more than it is today. Therefore, as proud as we are of our past successes, and no matter how many times thoughts of early retirement dance in our heads, once again we are in the process of formulating key business initiatives that will be implemented in the upcoming months.

As we evaluate the myriad components of the dental practices (we have three locations), we separate the long list into four major categories; 1) processes that are business related; 2) those that are dental related; 3) issues that relate to our internal customers, our employees; and 4) those that relate to our external customers, our patients. The one for which we have the least reliable data is category four - issues related to our patients.

Surely we all vividly recall the demanding, never-satisfied, rude patients who expect you to be grateful that they allow you to be their dentist. And too often we remember the patient on the phone who verbally assaulted us and was so enraged that we had to use the “hold” button to regain our composure. Unfortunately, we tend to remember the patient interactions that resulted in negative feelings well before we recall the pleasant ones that reflect the majority of our workday experiences. It is precisely this inclination that can lead us to make decisions based on skewed data. How then does a dentist or an office manager gather accurate, unbiased, patient-satisfaction data?

In our re-evaluation, we eliminated the idea of distributing a patient-satisfaction survey for numerous reasons. Two of the most obvious reasons are 1) most of us respond to surveys only when we are unhappy with a service or product and, 2) we were perplexed as to how and when to distribute the survey (surely our data would indicate complete patient satisfaction if the surveys were distributed while the patient was in the dental chair awaiting anesthesia). We knew it was imperative that we find out whether the level of patient care matched the gold standard we set forth in our mission statement; but the methodology we needed to employ was still troubling, that is, until I shared the dazzling wizardry I encountered when I read my first Harry Potter novel.

My husband, a much more concrete thinker than me (did I word that delicately enough?), rolled his eyes at my conversation topic. Since we have known each other for more than 35 years, I continued undaunted in my attempt to have him expand the realm of this thinking. While I was explaining that keys have tiny wings and that’s why I lose them so often, he proudly announced his solution to our dilemma - the concept of a “mystery patient!” Of course, I immediately dropped any thoughts I had of verbalizing what I clearly saw as an example of the influence of the world of magic on his inspirational idea. Instead, I guided the conversation toward developing this intriguing concept.

Since our goal was to gather unbiased data that would help us make necessary changes in the way we interact with our patients, why not choose our subject for data-gathering in advance of his or her dental appointment? We decided to select four established patients and four new patients. We felt sure that by asking the established patients to participate and assuring them that their information would be held in confidence, that their responses to our questions would supply us with the information we needed to make data-driven decisions.

Involving the new patients proved to be a less delicate situation than we anticipated. Since we were interested in gaining a clear picture of the alignment of patient interaction with our mission statement from the initial phone call to the exit interview, I called the new patients after they scheduled their initial appointments. I used the same explanation of the mystery patient to each and asked them if they would participate in our survey after their first dental visit. So far, no one has declined my invitation!

We are at the beginning of our action research. We know that tabulating the answers to our questions will be easier than translating the responses into changes which significantly impact the way we interact with our patients. We engage in these sorts of challenges for the same reasons you read dental journals - kaizan.

The concept of a mystery patient can be used to gather information that can enlighten many aspects of your dental practice. In our case, only my husband and I know the identities of the mystery patients. But I wonder, now that I’ve shared this technique with you, has anyone in your office already read this article and designated a patient in today’s schedule as a mystery patient?

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Dr. Alice J. Gish has been a consultant for 10 years. Her success is grounded in the ability to design plans for change that are goal-oriented and sustainable. Using a well-honed technique of carefully listening to the client, accurately assessing the environment, and helping to build the internal capacity to sustain the new initiatives, she provides business expertise that allows dentists to remain chairside throughout the day. Gish currently manages three dental offices - in Danbury, Fairfield, and West Hartford, Conn. - that comprise the practice. Dr. Gish can be reached via e-mail at [email protected] or by calling (203) 743-4770.