When Mr. Newbee called last week to make his first appointment at a dental office, a hassled and hurried staff member answered the phone. She barely gave him time to give all seven digits of his phone number, and he found himself stressing to answer questions put to him at a dizzying speed. In a cold and impersonal manner, the staff member jotted down the information, then dismissed him as another tedious chore accomplished, hanging up abruptly to deal with the next nuisance. That encounter formed this patient's first impression of the office of Drs. Fuss, Muss, and Hoocares.
A week later, during what was supposed to be a confirmation call, a deadpan, disembodied voice - who wasted no pleasantries - massacred his name and almost ordered him to appear for his dental appointment the next day. When (against his better judgment) he arrived for his appointment, he was met with a reception room strewn with magazines and tissues. Glum patients sat in their chairs, obviously disenchanted with the long wait. Staff members, bedecked in wrinkled smocks, were engaged in a verbal brawl behind the front desk. "If this is what the office is like, I can imagine the caliber of dentistry done here," he thought. He turned and left the building. Mr. Newbee never saw the dentist, yet he knew he had made a big mistake in selecting that office.
Someone once said, "You only have one chance to make a first impression." Scenarios like Mr. Newbee's are common in dental offices that need the help of a trained professional. Enter the "Certified Image Consultants" - people who take the goals of an office and create a written "treatment plan" for building patient relationships and much more. One such person is Judy Zazzera McDonough.
After practicing hygiene for 18 years, McDonough felt a need to branch out and explore another facet of life in the dental office. While playing in a tennis league, she met Penny C. Pilafas, who had just started a career in image consulting. McDonough asked for guidance in starting her own consulting business, and Pilafas was more than happy to mentor and train her, having recognized her potential and passion for the field.
"She's a natural. I've had Judy assist me on several large projects, including one with US Airways where we trained the new flight attendants on professional image in uniform and first impressions. Judy was instrumental in determining the appropriate make-up to be worn by each flight attendant," Pilafas said. "Through her effective training and communication skills, Judy has created a niche for herself and I am happy to see her accomplishments in the dental/image field."
Learning about color, make-up, and skin care, McDonough soon realized that looks alone were not enough. The whole person needed to be dealt with, so she began to study body language and how to make a good first impression. She soon learned that even subtle gestures from staff members or patients send a message; the trick is to recognize these messages and interpret them. If the message is negative, there is work to be done.
What kind of office utilizes an image consultant? Amazingly, McDonough reports, the ones that need her most are the ones that don't hire her.
"The offices that could use my services the most are very content with the image they already project," she said. "They have decided that they want to be a certain way, and innovative isn't it."
When the first impression is unfavorable, the patient may never get beyond the initial phone call. Mr. Newbee was hesitant about keeping his appointment simply because of the tone of voice projected over the telephone.
"The first impression is based 60 percent on your appearance, 30 percent on your tone of voice, and only 10 percent on your actual words," McDonough said. The receptionist who called Mr. Newbee flunked the test by her tone and her words. She was already down by 40 percent when the appearance of the office and staff - the other 60 percent - finished him off!
McDonough has had experiences like our poor Mr. Newbee.
"I call any encounter an individual has with an office a 'moment of truth,'" she explained. "A 'moment of truth' is any encounter a patient or client may have with your practice that forms an impression. That impression can trigger three possible feelings - that of neutrality, misery, or magic. When I meet with members of a practice, I ask them many questions, but one of the things that must be determined is what image they want to project.
"In other words, if a patient had to use three words to describe their practice to a potential patient, what would they like those three words to be? The first step to any successful image - or anything for that matter - is to define the image and have a clear picture of what they are trying to achieve. It's like the difference between your perception of Godiva chocolate and Hershey chocolate. The next steps are relatively easy once you know the direction in which you are heading. The key is to make a 'moment of truth' into a 'magical moment.' "
How did McDonough acquire this passion for proper presentation and relationship building?
"I grew up in the restaurant business," McDonough explained. "I was one of nine children in an Italian family. We always had a lot of love, a lot of faith, and a lot of food! My mom was responsible for the faith, but working with my dad in the restaurant taught me how to serve people, and not just the daily special. He taught me how to recognize people in need. He was so generous. He also taught me how to nurture relationships. I have been blessed (although I didn't think so when I was younger, working evenings and weekends)."
McDonough attended Broome Community College in Binghamton, N.Y., and received her associate's degree to practice dental hygiene. After 18 years, McDonough was looking for another outlet to reach her full potential in helping people. She trained at AICI (Association of Image Consultants International) and was then able to turn her attentions from treating one patient in her chair to helping the staff explore better ways of communication, establishing a rapport, and presenting a positive image to the entire patient base. AICI defines itself as, "a worldwide nonprofit professional association of men and women specializing in visual appearance, verbal, and non-verbal communication."
Ongoing training in image consulting is comparable to continuing education for hygiene, which McDonough is also doing since she is still practicing hygiene.
"Training is awesome," she said. "It's very similar to hygiene conferences, only here I have to pay big bucks to attend. But it's worth it because I learn so much! People with various backgrounds attend and have been contracted out to teach techniques for 'learning opportunities' for your clients. Different tricks and techniques are taught, and each session is taught by a person at the top of his or her field. In fact, a few years ago, a cosmetic dentist and plastic surgeon teamed up to discuss the importance of a positive image."
When she started her business, McDonough was a patient at Dr. Earle A. King's practice in Wexford, Pa. She did a presentation on "exploring the professional image" for his staff, and they loved it. Dr. King utilized McDonough's expertise for 11/2 years and reports that his practice has become more cohesive with the staff working as a team to serve their patients.
"Her hygiene breakfast, in which she invited all hygienists from our referring offices, was a great success," said Dr. King. "It consisted of a brunch at my office where she (along with my staff) was able to talk on an informal basis about our procedures, patient care, and patient focus. She hosted and coordinated other functions involving our referring doctors, including a wine-tasting event. Judy's strengths involve her ability to enthusiastically take a public-relations idea, develop, and implement it on a very timely basis and in a very professional manner."
McDonough keeps abreast of the latest ideas and systems by attending a monthly study club. An important skill she has learned is "reading people" - hearing what they're saying in words and behavior.
"Two favorite classes I attended were a listening seminar and a seminar on the different types of behaviors people exhibit. We all tend to fall into a certain class. For instance, I know I'm an analytical person. When people start to discuss an idea with me, I'm already thinking of how we can set it up. My husband only wants to know the bottom line, like so many dentists. He doesn't want to be bothered with the details."
Learning these different personality traits can help a consultant coordinate certain tasks with the appropriate staff member. For example, you may not want to send a "bottom-line" person in to console an anxious patient.
McDonough believes realizing one's behavior type is crucial to working together in a dental office. Using the various talents of staff members is critical to an office's success, according to McDonough.
"It's like setting up to succeed! We all know that a person with technical skills who lacks in the knowledge and enthusiasm a front-office person needs would not likely succeed as a receptionist," she explained. "He or she would be bored with that position because they would rather use his or her hands and be more creative. Other people just have a knack for making people feel welcome and comfortable. A receptionist needs to have this talent, along with many other skills."
McDonough is training with Inscape, the former Carlson Learning Company, enhancing her business in relation to the "matching talents with tasks" concept. Inscape is a company that helps people understand themselves so they can have productive relationships and fulfill their own unique potential.
"A healthy image is like a healthy life - there must be a balance," McDonough said. "In my initial questionnaire, I ask a client questions that are divided into three categories - a healthy mental image, a healthy physical image, and a healthy spiritual image. Lastly, we discuss the importance of healthy relationships."
Once these images are defined and agreed upon, specific goals and objectives consistent with these images are pinned down.
Cindy Hall, office manager for the orthodontic office of Dr. Paul E. Shok in Meadville, Pa., has seen the changes that have taken place because of McDonough's guidance and assistance.
"Judy is like a breath of fresh air," Hall said. "She brought our staff together by having us talk more with each other to define our goals. Once those were established, we started what Judy calls a '12-point treatment plan.' It's a marketing program that we use in our professional relations with referring dentists. There's a point for each month of the year. For example, when dentists consistently refer their patients to us for orthodontia, we like to say thank you with a gift of fresh bakery cookies delivered once a month by a staff member. It can add up to $300 each month to cover our 33 referring dentists, but it's certainly worth the cost.
"Another of McDonough's ideas that really caught on with the kids was a 'prophy passport.' If a child's oral hygiene is good at the six-month dental checkup, he or she gets a 'graded' passport to bring back to our office. Each point (up to five per visit) earns the child gifts from our prize case. The more points, the better the prize. It encourages kids to brush and not miss their six-month recare visits, while simultaneously letting the patient know that our office is concerned about his or her oral hygiene."
"One of McDonough's ideas that was particularly well-received was the dental hygienist luncheon," Hall continued. "Our office invited dental hygienists from the surrounding area to a 'lunch and learn,' which allowed them to earn two continuing-education credits. We explained utilization of several orthodontic functional appliances, including their purposes, wear-times, and maintenance. These appliances are seen by hygienists on a regular basis. This training further strengthens the bond between the dental office and the orthodontic office."
As McDonough wrote in her brochure, marketing is building relationships. One referred case is worth a lot of cookies!
McDonough believes the art of communication is crucial to the success of a practice. Not all communication is verbal. Her theory is that people have trouble remembering names because they are busy deciphering an individual.
With the emphasis on nonverball communication, is there a body-language gesture that might mean nothing at all?
"This is a tough question, because all gestures are important to me; nothing is taken for granted," McDonough said. "I think the key to effective communication is to make it a point to look for all the ways people are communicating. Image consultants say that the eyes are the most effective nonverbal communication tools a person possesses.
"I also believe that just the posture of a person can convey his or her demeanor. I think health-care workers must really have a keen sense for this because we can determine all kinds of things by watching our patients. Signals that say 'no' are clenched fists, eyes cast downward, clenched teeth, crossed arms, and hands on hips. Signals that say 'yes' are smiles, open posture, eye contact, and a firm handshake. When a patient is in the chair or when you bring a patient back to your operatory, a quick diagnosis should be done through the visual check."
Telephone skills are also an important part of good communications and the first impression many patients have of an office. McDonough helps the staff project a polished image by sharpening the staff members' telephone manners, perfecting their electronic etiquette, and helping them learn the art of introductions.
Other areas covered that impact the patient's image are professional attire, appropriate make-up, and etiquette. Chaos follows where there is no wardrobe or make-up policy. McDonough does a lot of listening to the staff concerning their needs and desires, then she and the staff formulate a policy that everyone can live with.
"With Judy's help, our staff members agreed to wear a certain kind of scrubs and to wear their hair off their shoulders and necks. This gives a much neater appearance," said Carol Simon, office manager of Sylvania Orthodontic Group near Toledo, Ohio. "We've had consultants before, but the staff seemed to listen more to Judy because she focused on one thing - appearance. With Judy's guidance, they concentrated on their personal presentation to the patient."
McDonough added, "The best way to build lasting patient relationships is to abide by the 'platinum rule' - treat people how they want to be treated.
"It's true, you only get one chance. You can make the first impression more positive by remembering the acronym SOFTEN* (smile, open posture, forward lean, touch (one needs a strong handshake and the ability to touch another's spirit), eye contact, and nod)."
You can learn more about Carlson Learning Company (Inscape Publishing) by logging on to www.carlsonlearning. com. For more information on AICI, visit www.aici.org.
Joanne Iannone Sheehan, RDH, is a frequent contributor to RDH. She is based in Huntsville, Ala.
* Taken from the book, "How to Start a Conversation and Make Friends" by Don Gabor.
Listening to patients
Patient #1: Linda Shirley, Murrieta, Calif.
"I have a gag reflex and they are very patient with me in coaxing and coaching me through X-rays and such."
"I know I'm pathetic, but I like receiving a new toothbrush and floss. Little goodies are a treat for me. Moms need them too."
"I have one of those super-modern dentists here in California. He is a consultant with UCLA. He has an ultra-bright, modern, sunny, glass office. He even has movie headsets so you can watch movies while they're drilling away."
"My dentist has been helpful and even saw me on a half-hour's notice two weeks ago when I couldn't take the pain in my tooth any longer."
"I don't necessarily think a dentist's office has to be like a Martha Stewart living room, but the brighter and homier approach soothes the timid heart."
"One time, I grabbed the dentist's arm because I was choking with my gag reflex and he was busy and not listening to me. Dentists also talk to you and expect answers with your mouth full of hands and whatever. They should stick to questions with 'yes' and 'no' answers, so we can just nod."
McDonough's response: "Doctors and clinicians alike, listen to your patients! Even when they can't talk, they may be trying to tell you something. Remember the 'eyes' have it! They are a very important part of communication. Doctors and clinicians, including myself, love to ask questions when they are working in a patient's mouth. We can't help it, but we must at least give the patient the opportunity to speak!"
"I also hate when the magazines are all over six months old or only about golf. They are obviously the dentist's old throw-outs."
McDonough's response: "Magazines need to be current and of many varieties. Ask yourself, 'Who are the patients that come to my office, and what are some of their interests?' "
"I absolutely hate offices that are so cold because of air conditioning that you begin the shivering while you are waiting for your appointment."
McDonough's response: "Temperature control - I hate that too! Offices need to be very aware of the temperature. If patients are too hot or too cold, what kind of temperament will they be as they sit in the treatment chair?"
"I like friendly, but not Eddie Haskell (the polite but insincere character from Leave it to Beaver TV show).
McDonough's response: "There is definitely a fine line between friendly and too friendly. However, by reading the patient's body language, one can usually determine how the patient likes to be treated. Some patients like to be fussed over' others don't. Know your patients.
Listening to patients
Patient #2: Charles Bosco, Huntsville, Ala.
"I hate an office where all the women are so friendly. I feel like I just arrived at a party rather than a professional office. A smile is fine, but I like competent office personnel. I like my dental people to be pleasant, but business-like."
McDonough's response: "I agree an office where there is too much chatter and giggling can be quite a turn-off. It sends the message that serious work and professionalism is not present. Even though the staff may be the most competent and serious staff when they get down to work, the patient is forming impressions that are not too comfortable. Let's remember that an impression like this one causes the patient to question and lose trust. Trust is so very important in any relationship. Can the trust and confidence ever be restored? Certainly, it just may take a bit more energy to restore it. My feeling is: Why make our work harder?"
"I do not like to wait more than 10 minutes after my appointment time."
McDonough's response: "Waiting more than 10 minutes is rather frustrating, to say the least. Some offices consistently run late with no apology or explanation to the patient. But if the patient is 10 minutes late ... they are often rescheduled. What is wrong with that picture? Common sense tells you that very often the hygienist or the doctor can run beheind schedule. That scenario is to be expected from time to time. Certainly, when that does occur the clinician should inform the receptionist that they are running a bit behind schedule and to please inform the patient that they will be just a few more minutes. The patient deserves the courtesy. Believe me, the patient will be very grateful for the respect you have demonstrated regarding their time. In offices where they consistently run beheind schedule, the first step is to define why this may be happening."
Listening to patients
Patient #3: Vicki Jeffers, Stafford, Va.
"I love my dental office. It's so clean. The receptionist is friendly. They have toys and books in the lobby for the kids. They always try to schedule me and the girls all together, which makes efficient use of my time. They almost never make me wait very long for anything. They absolutely adore my daughter, Kaila. They have tons of photos of kids on the walls, like they are proud of all of them, and they all are smiling. My older daughter, Karen, says she actually likes going to the dentist. She likes the free toy and new toothbrush they give her at the end. The dentist is nice, too, and always tells me we are a 'good tooth family.' "
Listening to patients
Patient #4: Michelle DeFatta, Austin, Texas
"In one dental office, I couldn't stand the smell when I walked into the waiting room. It was musty and dark!"
McDonough's response: "If you can see it, touch it, hear it, taste it, or smell it ... it is a moment of truth ... an encounter that forms an impression. This impression really stinks! Many offices use a service that can control scents in the office environment. It's worth the cost to make this enocunter a breath of fresh air."
Listening to patients
Patient #2: Susan McGuirk, East Hampton, N.Y.
"I don't like going in a doctor's office where the people don't even look at you. If you are a nameless, faceless person to them, I often wonder what they are incapable of doing."
McDonough's response: "It is always important to remember not to treat our jobs as so routine that we do not even give the patient the courtesy of a smile and hello! Hey, we are in the smile business! A smile is a very warm, nonverbal gesture of kindness and comfort. It is a sure way to put the patient at ease before any dental treatment that day. Remember, even though you may have greeted 25 patients that morning, this is the patient's first encounter with you. Make the encounter magical."
Judy Zazzera McDonough spoke at the American Association of Orthodontists in early May. The topic will be the ever-popular "Exploring the Professional Image." She is practicing hygiene two days a week at the offices of Dr. Ralph Affinito in Allison Park, Pa., and Dr. Carol Layton in Mckees Rocks, Pa. She is also still working as a consultant on evenings and weekends. She can be contacted at [email protected] or (724) 934-0120. Her Web site is www.nauticom.net/www/image911.
