by Ann-Marie C. DePalma, RDH, BS
Several months ago, I attended the Association of Dental Implant Auxilliaries and Practice Management's dental implant symposium. One of the continuing education programs discussed the habits of highly effective dental implant offices. Although geared towards dental implant offices, I spoke with the program presenter and we felt that it was a great topic to adapt and bring to any office.
What makes a practice effective and team members want to stay and be a long-term part of the practice? Or conversely, what makes offices ineffective and the overall dental experience negative? Some things are out of the hygienist's control, such as salary, overhead costs, and production issues, but there are other issues that the hygienist can be an integral part of. This article will review these "habits" and give ideas to promote the dental experience.
Open to change and new ideas
The first habit of effective dental offices is to be focused on continuing education and not resistant to change. Continuing education for the entire dental team is important, and not just for hygienists. The assistants and the front office staff need to be constantly educated about the practice as a whole and the specific procedures that are offered to patients.
CE programs can vary from formal programs, to in-office presentations by sales representatives, or informal staff presentations informing each other on various issues at a staff meeting. Whatever way CE is obtained, effective offices are constantly learning and evaluating.
This is a transition to the next point: to not resist change. Change is good and healthy, but sometimes change is bad. One has to recognize which is which.
For example, an office tried a new computer software. The program was much different from the previous program and the staff was reluctant to give it a try. But nevertheless, they struggled through the initial break-in period and now love the program more than the previous one and get much more information about the practice than ever was possible before. If they had been resistant to change they would have never benefited from the enhanced capabilities that the program was able to offer.
However, another practice tried to institute a new policy of recording information in the patients' charts using a master "cheat sheet." This sheet had pre-defined areas to be completed by the hygiene staff. The staff initially used it, but then found the sheet to be too limiting for each patient and information was added in other areas of the chart, and therefore the policy was not continued.
On the same page
Another habit of effective offices deals with constant communication. This means both written and non-written communication. It involves communication between the doctor and staff, patients and doctor/staff, and doctor/staff with other dental providers. Everyone needs to be on the same page as to what is expected of him/her in all aspects of treatment.
Staff members need to be aware of the doctor's wants and needs, and patients need to know what is expected of them during and after treatment, including financial obligations. Doctors need to be aware of staff requirements. Referring practitioners or doctors to whom patients are referred to should also have some insight into the patient's needs.
All of this is not accomplished without a formal system of communication — whether it is a letter to patients explaining office policy or their particular situation, or hygiene follow-up letters to referring doctors. Practices where the doctor is in constant communication with all parties involved often have a higher case acceptance. With the advent of the HIPAA regulations, communication is even more important.
Thirdly, an effective practice is one that is patient-centered. From the moment of the initial phone call through all aspects of treatment, the patient is listened to and is respected. When entering the reception area, the patient is welcomed and made to feel at home. Whether drinks are provided for patients, or fresh flowers, or softer lighting, the patient is made to feel that they are special and they are receiving care that is centered on their needs.
Another aspect of an effective office is the staff having excellent phone etiquette. We all know how frustrating it is to be caught in the "voice mail loop." Imagine what it is like for a new patient calling a dental office and to be told immediately they have to be put on hold!
When any patient calls, he/she should be welcomed and asked if they can be put on hold if needed, that in turns relays a sense of being a patient-centered, not production centered practice. Also, all office staff, when answering the most frequently asked questions by patients, can use scripts. However, some offices prefer not to use scripting.
Also, during some practice management programs, consultants like to role-play phone conversations with participants. One such role-play is to have someone answer the phone with "smile" while another answers with a harried voice. The respective results show how an office image can be portrayed over the phone. It is a real eye opener when someone realizes how he/she sounds.
A practice that has a clear, concise office philosophy with a short mission statement is an office that is often highly effective. Everyone from the doctor, to staff, to the patient knows the goals and objectives of the practice. With the advent of many dental practices having Web sites on the Internet, the office philosophy can be precisely stated so all can be aware. Even if an office is not web-enabled, the office philosophy can be written in brochure form. These statements about the office philosophy can easily be done on any of the computer software programs and included with new patient information.
The red carpet
Having an office roll out the red carpet for patients makes that office special in the eyes of the patient. We all know how it feels to be at the Disney theme parks, Nordstrom's, or Bloomingdale's — the level of service is exceptional. We are made to feel special from the moment we arrive. Making a patient feel special even at difficult treatment times conveys volumes about a practice.
Asking how family members are, or the patient's recent trip or other life event, tells the patient you are genuinely interested in them as a person, not just as a patient. Simple things such as noting a patient's trip on the side of the record makes the patient feel special that you remembered them. Similar to the patient centeredness of a practice, the red carpet treatment can also offer patients a variety of "homey" touches and choices in treatment and non-treatment options.
The red carpet treatment not only extends to patients, but to the staff and doctor(s) as well. An reward system established into place by the doctor lets the staff understands that they are respected and an integral part of the dental practice. In turn, the doctor(s) can expect the staff to uphold his or her philosophy of practice. As part of this two-way street of mutual respect and understanding, the roles that all team members play conveys the utmost professionalism within a dental practice.
Having patients who are dentally highly educated also enhances a practice. Patients who ask questions about treatment are responsible consumers. They may or may not like the answers, but they are the ones who most often accept treatment and are the most motivated patients.
Patients who acknowledge treatment options and have pursued appropriate treatment alternatives in the past make for the most responsibly educated dental patients. Patients who only come in when there is a problem likely have little interest in their dental health or the dental practice, and they likely are the least dentally educated of your patients. Education not only applies to formal education, such as higher degrees, but even the least formally educated patient can be your most dentally educated one.
A presence and pride in the community is another hallmark of an effective office. The dental practice is part of the larger community and patients love to see their dentist and staff involved in community activities. It can be as simple as doing programs for local schools or childcare facilities or health fairs, or as elaborate as having a booth at local town/city wide activities or sponsoring community wide events such as a spelling bee.
Anything that enhances the visibility of the practice within the community is important. It also offers an opportunity to provide a dental home for those within the community who may not be seeking care at the time. Putting a name to a face goes a long way in any community.
Insurance is part of dental life. However, the way an office handles insurance matters can be a positive or negative impact for patients. An effective office is one where treatments are dictated by patient's needs not by insurance coverages. An office that is non-insurance focused provides the best available treatment options regardless of what the insurance will pay.
It may mean in-house billing coupons for patients or having some outside source of credit available for cost prohibitive dental treatments, but the effective dental practice does not rely solely on insurance issues. The staff is always open and ready to work with insurance companies, but insurance is not the practice's focus, it is the patient.
Hopefully, this brief overview of effective dental offices has given you something to consider regarding your own office.
Any good dental practice will be willing to look at itself and evaluate the good, the bad, and the ugly about itself and make appropriate changes as needed. Are you employed in such a practice?
Author's note: Information obtained from Habits of Highly Effective Offices Program, Association of Dental Implant Auxiliaries and Practice Management.
Ann-Marie C. DePalma, RDH, BS, is a practicing hygienist in a periodontal-implant practice.She is a graduate of the Forsyth School for Dental Hygienists, is active in the Mass-achusetts Dental Hygienists' Associa-tion, and is a Fellow of the Association of Dental Implant Auxilliaries and Practice Management.Ann-Marie has written articles and presents programs on dental implants, TMD, and developmental delays and can be reached at [email protected].