Are you trying to be everyone's dentist?

Dec. 8, 2010

By Hollie Bryant, DA II

Are you the type of dentist who enrolls every person that calls into your practice, from those who “just want a cleaning and do not care about their dental health,” all the way to those “who want the best possible health for their mouth and want to take the most preventive measures possible”?

This is great, but how do you decipher these patients to know who is who and what they want? How do you know what information you should provide them? If you under treatment plan preventive patients, then they will call screaming at you when they have a toothache. But if you over treatment plan patients who do not want preventive care, they will walk out the door if you present them a treatment plan.”

Enrolling every patient that calls the practice will create a headache for you and your team. You will probably drive yourself nuts and maybe even blame your team members for not getting patients on the books for treatment. Does this sound like a scenario you have been involved in?

Wouldn’t it be wonderful if you could enroll only those patients that you wanted in your practice? That would require you as the doctor to step back and create a vision for the dental care that you want to provide your patients.

A standard of care
Many dental professionals support enrolling patients into the exam process and then into the cleaning. By that time they believe they have developed enough of a relationship with patients to discuss their dental health and the associated cost. This is one way to treat new patients. But here are a few questions to consider before enrolling them into your practice in this method.

* Do you want your patients to know up front the benefits of your practice?
* What type of patients are you seeking to enroll into your practice?
* At what point do you decide if a patient meets your practice values?

Another method is to evaluate patients through a consultation interview, listen to understand what they may be seeking, engage them in their dental health through visual photographs and preliminary finding reports, and be up front with them. Do not be afraid of what you provide. Of course there is no possible way to provide patients with exact fees without X-rays and other diagnostic information. The consultation is designed to determine if patients are a good fit for the practice, if you can meet their expectations, and if you and they share similar values about their health. If so, then enroll them into care.

How many patients in your practice have had a comprehensive exam, cleaning, full X-rays, and a treatment plan they have never returned? Is this because you weren’t good enough for them? Is it because you and the patient were not a good fit for each other? Were they not comfortable there? It could be a hundred different things, but ultimately this could have been prevented by a values screening process.

Vision: In order to enroll only the patients who value true comprehensive dental care, you must develop your practice with the result in mind when you start. I’m talking about much more than a few ideas drafted to paper! It requires the entire plan to be written down and mapped out. This includes timelines, goals, budgets, and scenarios. Once you have committed this to paper then you must communicate it to your team and get everyone on the same page. Anyone not in agreement at this point needs to get another job, as you are not a “fix it” dentist anymore. Begin each day with your vision and eliminate everything that is not consistent with it.

Understanding patients:
Ideal patients are very different from average dental patients. They know what they want, they are picky about their choices, they will research you before they make the first appointment, and they demand great service. A highly trained treatment coordinator is needed not only for education, but also for providing special services. We create a “service profile” for all new patients to remind us what they want, how they want it, and what little extras we can provide to make their dental visit a positive event. Spend time trying to understand this “new” type of patient you want to work with. It is not unusual for a new patient to walk in, talk to us for an hour, and write a check for $40K to get started. This happens when our systems align and a new patient intuitively knows that we are the right office for him or her.

Team: You have to have a great team. Invest heavily here. Hire people with the right attitudes and then train them for dental skills. One average player will pull down the whole team. You need to think about being slightly understaffed, because if you are overstaffed, especially in hygiene, there is a tendency for the extra staff to keep all the “C” patients in the practice to justify their existence. I’m not saying to fire people, but when someone moves away don’t replace them.

Skills and systems: Your skills and systems for operation must be seamless. That requires systems to be written down so that there is no confusion about what the process and expectations are. How many times have you presented a new policy or system to implement, and a week or so later, you wonder what happened. Where did the system go? Well, if it isn’t on paper it doesn’t exist. Having systems that are communicated well can make or break a practice. If you do not stay on top of developments and continue to educate yourself and your team, it will be hard to stay at the top. Your time prepping and delivering cases must continue to improve to increase your hourly rate. Spending so much wasted time in treatment because the doctor is on the phone or a team member is in the break room is no longer acceptable when you’re trying to niche out your practice.

When is the right time to stop being a dentist to everyone and start choosing the types of patients you want? If you want to be an emergency dentist, then you should take only patients that call with a broken tooth, toothache, walk in, or cash pay. If you want to be the comprehensive dentist, then treatment plan comprehensively and seek out patients who are looking for quality care.

Trying to force comprehensive treatment on patients that do not want it only causes conflicts in your practice. It creates negative complaints and breeds negative PR in the community. Attract and accept the types of patients that you are seeking. Advertise for the patients that you want and filter them in through the phone interview. It might be time to start reviewing patient’s goals as they come into the practice. If they don’t fit the practice vision then let them filter out by not reappointing them; just send them a recare card the month they’re due. Let them seek you out for service. This will open up your patient books for new clients who are attracted to the services that you provide. It may be time to stop being everyone’s dentist.

Decide what type of practice you want, whether it is an emergency-style practice, a compressive practice, an implant and restorative practice, or even a cosmetic practice. This needs to be defined and your systems need to be created and formed around that vision. Once you decide, it’s ACTION time. Engage your team, your patients, and you. STOP being everyone’s dentist. It’s time to decide whose dentist you want to be!

Hollie Bryant is a graduate of Bowman Gray Dental Assisting Program and is the former chairside assistant for Dr. Ross Nash and clinical instructor and treatment coordinator at the Nash Institute. She is currently a member of the American Academy of Dental Office Managers, American Academy of Cosmetic Dentistry, North Carolina Dental Association, Academy of Comprehensive Esthetics, and the American Dental Assistants Association. She is the former editor-in-chief of Contemporary Dental Assistant magazine and currently serves on the Advisory Board for DentalCompare. She is on the editorial board of Dental Assisting Digest™ and Contemporary Product Solutions, and is a consultant for various dental manufacturers. She has authored numerous manuscripts on clinical assisting and practice-management topics. Hollie lectures for the NICHE Practice Seminars nationally on clinical and management topics, while she travels for her independent consulting firm from practice to practice working with teams to increase customer service, profit, and implement effective systems. You may reach Hollie at [email protected].