A few months ago, I was chatting with a new patient. He was a very nice and very accomplished gentleman. After a few minutes of conversation, I felt comfortable enough to ask him (with his permission, of course) if he would share with me why he had left his previous dentist with whom he had had a long-standing standing relationship. He seemed comfortable with the question, so I felt assured that I hadn’t overstepped any boundaries. He proceeded to tell me that, while nothing terrible had happened, he just had the sense that the dentist wasn’t into the treatment or into him; it seemed that it was almost as if the dentist was doing his treatment by rote on a dummy, not on a human being. This was a curious yet revealing thing to hear a patient say. After thinking about this exchange, I thought to paraphrase his experience in the vernacular; his previous dentist just wasn’t “into” him. “What’s Up With That?” This question is the name of a familiar and fabulous skit on the television show Saturday Night Live. It is actually a profound and probing question, if you think about it. I wanted to understand what my new patient was actually saying and what I could learn from this observation.
The dentist whom my new patient left, whether consciously or not, was conveying that he just wasn’t that “into” Jim (not my patient’s actual name). This also reminded me of a movie title that seemed to encapsulate this wonderfully provocative observation. It is entitled He’s Just Not That Into You, starring Jennifer Aniston and Ben Affleck. The movie is certainly not an Academy Award nominee, but the title was teasingly clever, and the movie itself chronicles the challenges that we face when we try to read (often misreading) what motivates human behavior.
THE QUESTION BECOMES...
To the chase with the coaching challenge for you, as the reader and clinician: Are you “into” your patients?
What does that mean? Do you work in such a way that allows you to make authentic contact with all of your patients every time they are in your office, be that for treatment with you or your hygienist? This isn’t a question that is meant to catch or embarrass you. None of us can score 100%.
I guess another path of inquiry is to ask yourself if you are mindful enough to allow to ask one “I am interested in you” question each time you see this person, and if you leave enough time and show enough interest for your patient to respond and felt heard. “How are you?” will either be a throwaway (some might characterize it as simply being polite) or a truly meaningful inquiry.
Here is my point: either you choose an obligatory, some would say efficient, level of dialogue that doesn’t screw up your schedule. Some readers might comment here that busy and successful patients don’t want that kind of intimacy. That is a discussion for another time, but for now you should know that I disagree. Nobody disavows human contact.
SCHEDULING THE TIME NEEDED?
Now, back to the main point: You can be the model of efficiency, or you can schedule your patients in such a way that allows for you to really be into them. Yes, that means not squeezing every last drop of production out of each day, and if your goal in life is perfect efficiency and the highest return on investment and you drool when you hear about colleagues that produce more than $700 an hour, you are one of those who believe that this model will be your ticket to dental heaven. Actually, if you are in that category you, probably have stopped reading several paragraphs ago. Can I welcome you back?
Now, I imagine (hope) that you are curious and will ask how one can tell the difference between authentic and something other than that?
Sometimes you can’t, but other people can.
TEAM MEETINGS ARE REVELANT TO "INTO-IT-NESS"
You might know by now that I am a strong advocate of regular meetings; this includes a daily morning meeting and at least a once-weekly staff (some prefer to use the term “team”) meeting. Morning meetings provide a setting where you can evaluate the level of intimacy and play with this whole notion of “patient-ness.” Here is one way of doing this: set up an imaginary scale of one to 10 for patient intimacy, satisfaction, happiness, or whatever descriptive word you choose that conveys to you and your staff this notion of “into-it-ness.” This should not be so hard to do, even though each office has its own culture and understanding of community; and, every one in that community knows when things are clicking (or not) with patients.
Using a scale of one to 10, review yesterday’s schedule and rate every single patient visit. This must be done with your whole office team since every human being has blind spots. Each person should identify exactly why each visit was rated the way it was. For sure, there will differences of opinion, but over time, a consensus will emerge about what rates a 9 or 10, and, more importantly, what behaviors lead to that level of excellence.
Here are some hints to put help you get your head around this admittedly unusual question.
• The quality of the greeting—Was it warm and friendly, or did the front desk person barely acknowledge the entrance of the patient? Did a conversation take place, and what was the content of it?
• As the patient is escorted to the treatment room and seated by the dental assistant, how warm and friendly was that interaction?
• The actual dental treatment—If using local anesthesia, did you hurt your patient not at all, a little, or a lot? Can your technique be improved? How will you do that? Did your patient feel the empathy of the dentist and the assistant?
• The dental treatment itself—Was it superb, mediocre, or poor, and again, if it was anything less than superb, what are you going to do about it?
• Now I know it may be difficult to imagine this, but could your patients tell how well or poorly the visit went? How do you know? From what they told you, or in their body language? Can you read body language? Everybody can, you know, and we best be especially aware of the body language between the doctor and staff; it conveys a powerful message to our patients. They make judgments about the care they receive based on how the dentist and staff interact.
• The dismissal—The patient is dismissed by the assistant. Does the assistant make sure that no impression material or cement is left on the patient’s face? Sounds silly, but a sure way to have really aware patients leave your practice is by leaving extra stuff around. Once, a patient said he left his dentist because the doctor left all of the “white stuff” (temporary cement) around a tooth and the patient was aware of it for hours. Yes I know, this was a very sensitive patient but shouldn’t every patient be seen as very sensitive?
• And the second dismissal, at the front desk, where fees are paid and new appointments made, the gracious acknowledgement should be made that, “It was nice to see you, and we appreciate your business.” This is not quite the correct language, but this thought should be kept in mind.
This process is the distillation and microscopic examination of the nuances of things that happen dozens of times every day, but I maintain that we rarely examine them in this detail. There are things to learn and improve upon when we do this careful evaluation of each step in the process.
I know this seems time consuming and even perhaps a bit tedious. But in the end, isn’t it critical that your entire staff is calibrated so that there are no misunderstandings about the defining characteristics of what it means, exactly means, for us to be into our patients?
GETTING "INTO" EACH OTHER FIRST
As you follow this along, you will see that for us (staff) to be intimate with our patients, for us to really be into them, we need to really be into each other. There will be no room on your staff for those who just punch a clock, there will be no room on your staff for anyone who says this thing or that is “outside of my job description.” Even that formulation misses some of the more subtle ways that folks may convey their displeasure; it could be simply a look, a roll of the eyes, a change in demeanor or body language. We all know and can recognize these behaviors.
The crafting of an “into our patients” office doesn’t happen overnight. It happens over time and is helped or hindered by the courage of everyone, especially the dentist/leader. And the beauty of all of this internal work is that it is felt, deeply felt, by every single patient. Some may comment on it, others not, but everyone will feel it. Of course, the dentistry will be excellent. Why? This is because, if you are really into your patients, nothing less than a 9 or a 10 will do.
An unintended and very positive consequence of this process is that when you go through staff changes, you and the entire staff will know if this new person is a fit. I’m not talking about technical skills, which of course are critical but teachable, but rather if this candidate has the soul to be part of this very special practice. Yes, I said it, soul. It is why each and every one of us does what we do. It is what nurtures us and creates joy and happiness.
And yes, with work, we can all get there!
Disclosure: Dr. Goldstein reports no disclosures.