Turning Patients into Missionaries

March 3, 2010
The key to having a relationship-based practice full of missionaries is to be worthy of a referral. Dr. James Kincaid, a member of the associate faculty of The Pankey Institute, tells you how to build a "well-referred" practice.

by Dr. James Kincaid

How nice would it be to have a dental practice that enjoys a steady stream of new patients, and, even better, if these new patients were all “well referred.” A well-referred patient is someone referred by an enthusiastic patient, a missionary, who has given this person a meaningful reason to select your practice for her or his dental care.

I first heard Dr. L.D. Pankey use the words “dental missionary” in 1972 during his philosophy course. He often spoke about the importance of creating missionaries for quality dentistry. Dr. Pankey believed that this would stimulate referrals to our offices and also be good for dentistry. Like many of Dr. Pankey’s intentions, turning patients into missionaries was woven into every aspect of his practice.

From a business perspective, having new patients is too important to leave to chance. Each new patient experience represents an investment of your time, but it can be worth every minute. Practices that see only well-referred patients find that they need fewer patients to be as busy and productive as they want to be. The well-referred patient is usually a discerning buyer who will appreciate your thorough examination and seek the finest care.

Each of us has the potential to develop dental missionaries. No doubt, you are already receiving referrals from “raving fans,” but how do we make it happen more often?

Mutual trust
In a relationship-based practice, a high level of mutual trust already exists. The trust is developed over a period of time and in an environment where the patient felt he or she was heard. The dentist has demonstrated not only the highest professionalism and technical skills, but that his or her recommendations take into consideration the patient’s circumstances, temperament, and objectives.

No one knows your practice better than your patients, so they are uniquely qualified to endorse the way you and your team treat and relate to them. In short, they trust you. Learning to tap into that trust and to turn patients into missionaries is a career-long quest. As with most endeavors, to be successful you need a plan and a practice team that understands its importance. Would it surprise you to know that most of your patients think your practice is full, and that you may not be accepting new patients? Have you ever had a patient ask if you are taking new patients? Be sure to let your patients — and others — know that you welcome new patients.

Be worthy
The key to having a relationship-based practice full of missionaries is being worthy of a referral. It should begin with the initial comprehensive examination because if the right “experience” is created, it will set the tone for everything that follows. When it is done well, your future experiences with that patient will be like swimming downstream. Things will just seem to flow with less effort. The patient perceives that there is something different about your practice. You have taken the time to get to know this patient as a person — you listen! When you describe the needed treatment, the patient is far more likely to understand and proceed with the work.

However, when the new patient experience does not go well (perhaps it was not thorough enough or there was little opportunity for the patient to speak), future experiences with that patient are likely to make you feel as though you are swimming upstream. The patient may lack confidence in your judgment or conclude that you are trying to sell something.

Know your patient
One of the four cornerstones of Dr. Pankey’s philosophy of practice is to know your patient. The four-phase new patient examination he taught began with a preclinical interview to provide the opportunity for the dentist to learn everything possible about the patient’s values, desires, and fears, as well as to understand how to communicate effectively. If the clinical exam that follows is conducted as a codiscovery process, rather than merely data collection, the dentist and the patient will learn even more about each other.

If your patients are not expressing “WOW” at the conclusion of the comprehensive examination, there is room for improvement. For almost 40 years, I have been working on this very thing, and I still learn more every day. Make the new patient exam a unique “experience,” and let it differentiate your practice and become part of your brand.

Skills to master
The patient has accepted treatment, now what? You are still in the “earning” phase of being worthy of a referral. It is time for you and your team to deliver the service with your utmost care, skill, and judgment. You will want to master skills such as touching the patient appropriately and giving a painless injection. Involve your team and coach each other. Your team should be a reflection of your practice philosophy, and mutual respect must be evident. Studies show that patients will judge your worth by seeing you through the eyes of your team.

None of this comes easy, and success will require ongoing workshops. I have found it helpful to bring in a consultant to act as the team coach. Your underlying goal and responsibility are to be worthy of having your patients become missionaries for your practice.

Birds of a feather
Unfortunately, just being worthy may not be enough. Even an enthusiastic patient may need a nudge to become a missionary, but you may not want to nudge every patient. One of Dr. Pankey’s often-repeated phrases was “birds of a feather flock together.” Why not work with your team to identify those very special patients whom you look forward to seeing. At the morning huddle, decide who would be the best team member(s) to look for the right opportunity to ask for a referral. Be sure to note the date in the patient’s chart and which team member made the request. Consider rewarding the team member whose effort results in a referral.

Finding the right opportunity
How do you know when it is a opportune time? One of the best times is in response to a compliment made by the patient. For example, “Mrs. Jones, you are so nice to say that about Dr. Wonderful. We all agree. He does take great pride in his work. He would love to hear that, but if you really want to compliment him, tell your friends about our office. We always welcome new patients.”

Role-play at team workshops until everyone feels comfortable with their own words. During the preclinical interview, make it a point to comment to the new patient about how much you appreciate the thoughtfulness of the person(s) who referred him or her. Be sure to add that you consider it the highest possible compliment.

With the appropriate patient, Dr. Pankey would create the opportunity during a post-treatment consultation. The consultation was always a separate appointment, and he would begin it by reviewing the completed treatment … and then compliment the patient on his or her good judgment in proceeding with the work. Next, he would ask if the work had met the patient’s expectations. Assuming the answer was positive, he would say something like, “I am so pleased to hear that. I hope you will tell you friends what modern dentistry has to offer. Dentistry needs missionaries like you.”

Patient focus group
An idea that I borrowed from a friend, Dr. Tom Dawson, has proven to be an exceptional way to engage a small group of “raving fans.” In a casual, early-evening gathering in our office, consultant Allan Tappe led a discussion designed to bring out the opinions of the patients. We learned that if you give them an opportunity, patients will respond with constructive ideas. The most important thing appears to be just the act of asking for their opinion. You could absolutely feel the energy in the room. The leader can take the group in any direction, including toward becoming dental missionaries.

With effort invested over time, a highly effective system for internal marketing will emerge in which your patients become dental missionaries who serve dentistry as well as your practice.

Dr. James Kincaid graduated with honors from Emory University School of Dentistry in 1970 and maintains a private practice in Atlanta, limited primarily to health-oriented patients in need of restorative or esthetic care. He has been a member of the associate faculty of The Pankey Institute for Advanced Dental Education since 1982, where he leads a five-day educational program focusing on the diagnosis and treatment of patients with complex dental problems. He has made presentations throughout the United States to numerous study groups and dental societies.