Th 321588

Final impression as important as the first

June 1, 2009
Slow down .. shine your shoes front and back, and leave a positive, lasting impression with the patient

by Peter Vanstrom, DDS, FAGD

For more on this topic, go to and search using the following key words: first impressions, last impressions, patient communication, Dr. Peter Vanstrom.

Slow down ...Shine your shoes front and back, and leave a positive, lasting impression with the patient.

In his modern marketing book, “Selling the Invisible,“ author Harry Beckwith highlights a Charles Schulz' “Peanuts“ comic strip as an example of how important first impressions can be. In the comic, Charlie Brown notices that his friend Linus' shoes are very well polished and clean on the front but dirty, worn, and unkempt at the heels. Charlie Brown asks Linus why this is the case. Linus replies, “I care about what people think of me when I enter a room. I don't care what they think when I leave.“

Click here to enlarge image

Mr. Beckwith and I agree that Linus, and indeed Charles Schulz, made a rare mistake. First impressions are very important, but the last impression that we make on our patients as they leave our practice is just as — if not more — important than the first.

A couple of simple systems

There are a couple of simple systems that we need to apply daily to assure our patients feel confident in us and our dental care as they leave our practices. We need to apply the concepts of a debrief and perfect hand-off as the patient is being excused.

In 20 years of practice, there's one thing I have learned: my staff and I always need to remember to slow down. Even in the busiest of moments we have to slow down and focus on the final impressions we make on our patients. We have much greater case acceptances for current and future work when we spend a few precious moments clarifying treatment received and projected before we rush patients out the door, hurrying to fill the chair with the next warm body.

The debrief

Great final impressions all begin with the debrief. Whether the patient is in the dentist's chair or the hygienist's chair, the process is the same. Once the procedure for that appointment is completed, the patient is seated in an upright position and — this is the important part— the dental bib is left on! The bib is a 50-pound weight to the patient. The patient knows the visit is not over until the bib comes off.

A debrief with the hygienist speaking to a patient.
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Now, hygienists and assistants, before you hurry and run the patient to the front desk, throw that chart on the counter, and rush back to turn over your room … STOP and spend a valuable minute or two sitting face to face with your still-bibbed patient.

A hand-off with three people up front —a hygienist, a patient, and the receptionist.
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During this important debrief moment, you simply review everything that was completed for the benefit of your patient. Remind him or her of what the goals were as you began, what was achieved, and what is next.

An example of the debrief would be the hygienist reviewing the benefits (based on the patient's hot buttons and chief concerns) of two quads of SRP. The hygienist reviews the goal of eliminating all sites of infection as well as reminding the patient of the benefits of the medications used in the office.

Finally, he/she reviews the home-care techniques and medications to be used. And, very importantly, we ask if the patient has any questions about today's visit.

Finally, before the bib comes off, it is very important to remind the patient of further necessary treatment. Once again, using hygiene as an example, remind the patient that one-half of his/her mouth has now been treated, and it is imperative for total health to complete the other side, removing all of the infection still present. And ask if the patient has any questions about the next visit.

Once all questions are answered, only then can the bib come off and the patient be escorted by the hygienist or assistant to the front.

The hand-off

But wait, our perfect final impression is not yet complete. We still need to execute the perfect hand-off. Just like the quarterback has to hand off the ball perfectly into the gut of his running back, the hygienist and dental assistant have to complete the perfect hand-off with either the office receptionist or the financial advisor.

An example of a great hand-off from the hygienist to the receptionist after a six-month recare appointment would go something like this:

“Sally, Mrs. Hammerjaw and I just completed her six-month recare appointment. She has already scheduled her next six-month appointment with me. Mrs. Hammerjaw has two areas of concern — her upper right and lower left molar areas. We reviewed her home-care techniques and she is leaving with chlorhexidine for home use. I have reminded Mrs. Hammerjaw of the need to maintain her recare for her overall health, and I'll be anxious to see that those concern areas are healthier. Mrs. Hammerjaw, do you have any final questions for me before Sally handles your charges for today?“

The hand-off with the receptionist also empowers her to handle cancellation calls or rescheduling needs. The receptionist now has a clear understanding of the individual needs and concerns of the patient and hygienist (or dental assistant).

A lasting impression

The above examples of a perfectly executed debrief and hand-off will leave the patient with a warm and confident appreciation of the dental team's professionalism and care. So shine your shoes front and back, as everyone benefits from slowing down and leaving a positive, lasting final impression with the patient.

Peter Vanstrom, DDS, FAGD, serves as a dental expert for CNN and has published articles on topics ranging from cosmetics to current dental technologies. He has lectured throughout the United States, Canada, and Great Britain on oral cancer screening technology, periodontal care, stem cell technologies, and dental practice-management systems. His e-mail address is [email protected].

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