Commitment Levels

Nov. 1, 1996
Dental practices want patients to be committed to their appointments, their treatment plans and their financial arrangements. This level of commitment must be developed, not expected. A patient`s level of commitment mirrors the practice`s. Examples include:

Linda L. Miles, CSP, CMC

Dental practices want patients to be committed to their appointments, their treatment plans and their financial arrangements. This level of commitment must be developed, not expected. A patient`s level of commitment mirrors the practice`s. Examples include:


- Patients respect their appointment time exactly how they feel the office respects their time.

- Patients waiting on the telephone because of understaffing at the front desk or improper telephone etiquette indicate time-management problems.

- Patients waiting in the reception room longer than necessary start counting up faults with the office. A patient in the treatment room three hours for a one-hour procedure (because the doctor is trying to monitor patients in five treatment areas), shows a lack of respect for their time.

- The office that habitually moves appointments to another time shows a lack of respect for the patient (unless the patient had requested an earlier appointment).

On a daily basis, some practices have few changed or failed appointments; others have many. Improve your respect for the patient`s time and watch his/her appointment commitment improve. If the office keeps a patient waiting more than 10 minutes, does anyone on the staff acknowledge the delay, or is it hoped that the patient won`t notice? An apology or explanation goes a long way in helping the patient realize that occasional delays can occur. Letting them know that it bothers you not to see each patient on time truly shows respect to the patient who is kept waiting.

Alerting the doctor of an important telephone call should not be announced in front of the patient during the procedure. The notification should be non-verbal by computer-terminal message, a light system or a note placed where the patient cannot see it. If the hygienist needs a patient check while the doctor is treating another patient, she should never announce the examination in front of the doctor`s patient. These interruptions should be smooth and non-obtrusive.

Financial Commitment

Dental practices that have high degrees of treatment acceptance also have dentists and staff who are enthusiastic about patient education. Treatment commitment filters from the dentist to the staff to the patients. If the dentist and staff are in dire need of preventive, restorative and cosmetic care in their own mouths, why are they trying to have patient commitment to treatment they obviously are not committed to?

Financial responsibility levels are often the same from patient to practitioner. I`m not sure if the commitment filters from the doctor to the patients or whether the office that has a problem paying monthly accounts payable has the problem because patients have not paid. It is, however, interesting to see the situation reversed on both levels when the practice becomes more committed to paying the doctor`s bills on time. Within 90 days, we have seen improved written policies, enhanced financial communication from staff to patients and an overall greater commitment from patients to use creative financing, accept treatment plans and keep their appointments.

Just as patients get their commitment level from the office, the staff develop theirs from their work environment. If the doctor is a great communicator, the staff follow suit. If the doctor is prompt, neat, courteous and dedicated to the task at hand, we find the same qualities in the team.

Make a list of all the areas of the practice that require commitment from the doctor, staff and patients. On a scale of 1 to 10, rate the level of commitment you have. Areas within the practice to be monitored include:

- Telephone etiquette. Are patients left on hold so long that they become discouraged and hang up? Is the doctor or staff taking and making personal calls, allowing patients to sit in the reception room or dental chair longer than necessary?

- Seating on time. While patients are waiting in the reception room, are they observing a highly efficient, well-organized business office, or do they hear staff in personal conversation, indicating time is of little value in this practice?

- Handling of the patient`s account. Nothing annoys a patient more than an account balance that is a surprise. Mishandling of their insurance and mistakes on their bills make patients wonder if their dental care is being done as carelessly. Knowledge, empathy and swift correction of balance errors show the patient that a mistake that happened was rare and a concern to the office. Blaming the insurance company or former staff are not responses a patient likes to hear.

- Scheduling of Appointments. An office that constantly moves appointments to accommodate a failing schedule annoys patients. Patients will constantly move their appointments if the office teaches them that this is "routine." If you must move a scheduled patient appointment, place the letters "ABC" behind the patient`s name. This means "already been changed." Under no circumstances should the same appointment be moved twice. Patients will forgive you once, become annoyed twice, and find another dental practice if you change their appointments a third time.

As the commitment improves within the office, it will become apparent that the commitment level of the patient is closely related to the practice`s. Start 1997 with a greater commitment to patients` time, their financial agreements and their treatment needs.

The author is an internationally-recognized consultant and speaker on practice and staff development. She is founder and chief executive officer of Miles and Associates in Virginia Beach, VA, and can be reached at (800) 922-0866.

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