Simon Palmer, November 2006 - It is self-evident that a dentist who is able to build rapport will have the greatest chance of repeat business from a patient. However, to focus solely on the dentist’s relationship with the patient is to ignore a significant part of the patient’s experience. This experience begins before and ends after they have seen the dentist.

The patient’s experience at the practice begins and ends at the front office with the front office team. They handle the patient’s first impression (which will influence whether an initial appointment takes place) and the last impression (which will influence whether the patient will come back). If dentists don’t observe and monitor these interactions with the patient, there is every chance that a huge potential for growth in the practice is being ignored.

First impressions
It is important to look at this first impression that your practice is making with the outside world. Make sure that you are putting your best foot forward and thereby maximizing your chances of converting enquiries into patients.

I recently heard from a practice that invested in an expensive machine to offer new tooth whitening services to their patients. They then spent money marketing the new whitening service in their area. When I called the practice I asked if the new service would hurt and what its advantages were over my home whitening kit. The lady who answered the phone said that she knew very little about the service and that she would have to get someone to call me back….no one did.

Many practices engage in expensive campaigns like this one to get new patients and yet don’t prepare for the next step. If a marketing campaign is successful, the results will take the form of enquiries about your services and fees. When you think about it, by the time a non-patient calls the practice to make an enquiry, three quarters of the work getting a new patient is done. The non-patient has seen your marketing (or been referred to you by someone), they are interested and have taken time out of their day to give you a call. All that remains in the equation is the skill with which the enquiry is handled. It will literally determine whether the enquiry is converted into an appointment.

Without training, it is natural for staff to simply respond to patients’ questions and try to get off the phone as quickly as possible. It may be that no-one has taught them that they need to have an agenda with every enquiry and that is: to get an appointment.

Do you realise the dollar amount that front office skills in this area are worth to you? Let’s work it out: Let’s assume that a new patient to the practice can be worth a minimum of $200 per year (two $100 checkups per year) and typically a busy practice can be getting more than one enquiry a day. Let’s assume that the practice only gets one enquiry and that every enquiry is a potential patient (otherwise why are they calling?). This means that up to $1000 a week ($52, 000 per year) is purely up to the effectiveness of the front desk enquiry handling skills. (this is of course conservative – it doesn’t account for any more comprehensive dental treatment)

With that much potential income at stake, can you really afford to just hope that it is being handled correctly? An evolved leader will put some time aside to:

• work together with the front office staff to get a list of frequently asked questions and how to handle them.
• do some skills practice/role playing with the front office team.
• debrief with the front office team regarding any enquiries that didn’t go well, difficult questions or difficult people, and how could they be handled better next time.

Lasting Impressions
The front office team also have the responsibility for the last chance the practice has to make a good last impression. They can reinforce or compromise any goodwill established by the clinician. With this in mind a dentist should look at this last interaction in a bit of detail.

Handling payments
It is not difficult to imagine that asking for and receiving money could be handled in an awkward or inappropriate manner that could reflect negatively on the practice.

To make sure that the interactions are handled as professionally as possible, specific guidance and training should be given on the way that the front desk staff handles:

• Difficult or rude patients
• Requests for payment alternatives that the practice may not accept (Amex,HICAPS)
• Requests for payment alternatives that is against practice protocol (credit, no deposit on big procedures, etc.)
• Requests for extension of invoice payment time
• Complaints about fees

Appointment Protocols
The appointment book dictates everyone’s day in the practice. Patient’s choices of appointment have to be strongly guided by the front desk. In turn, the front desk team needs strong appointment guidelines from the principal dentists. If you hand control of the appointment book over to the front desk without guidelines and protocols, there is a very good chance that many days will be chaotic for the whole practice.

These appointment protocols need to include:

• What procedures go on what days and at what times. Otherwise you could have 12 checkups on any given day, or four extractions, one after the other, or three consecutive root canals. This can be stressful or boring for everybody and cause wild swings in cash flow.
• Guiding the patient’s choices towards empty spaces in the appointment book. Otherwise there will regularly be times where no patients are booked in.
• What procedures need what amount of time?
• The practice and clinician’s available hours
• How much notice the practice requires for cancellations

Communicating these protocols to the patients in the right way takes training and practice. The front desk needs to know how to set up expectations correctly with the patient and how to handle a patient’s disappointment when they can’t come in whenever it is convenient for them.

If the team has good rapport with the patients at this point, there is a much higher chance that the patient will reappoint. If the front office isn’t polished, there is a chance that any doubts that were already in the patient’s mind about the practice and dentist are further cultivated.

If you remain unconvinced of the impact that the front office team make, look at the small service businesses that you frequent and refer clients to over the next few days (the place you buy coffee or get a haircut for example). Recognise how much your loyalty is influenced not just by the product but when communication skills and systems are polished. Often it is the difference between a repeat visit or not.

The same is true of a dental practice. The patient’s experience and loyalty is guided by their whole experience in the practice. Regardless of how good a dentist you are, a disorganised or inappropriate front desk person can undo any goodwill that you have built. From the moment the patients call or come in until the moment they leave, they are forming an opinion of you, your services and your practice. Can you afford to leave significant parts of this experience to chance?