Dr Phillip Palmer, July 2005 - In January this year, I received a letter inviting me to speak in Beijing, China about Dental Practice Management. Having always wanted to visit China (and having someone offering to pay my expenses), I gladly accepted the offer.

Caught up in the excitement of my plans to see the Great Wall and my wife’s plans to shop, I didn’t spare much of a thought for the content of my talk. I must have fifty speaking engagements on dental practice management a year to groups, clinics, various companies and private practices, and I just figured I’d be able to piece something together from my resources.

It was only as the talk approached that I realised my predicament. Talking in China wasn’t going to be like talking in any another country. It wasn’t going to be like me talking in New Zealand or England. First of all this audience of dentists probably wouldn’t speak or understand any English, would be coming from a background of healthcare in a communist country and in case that wasn’t enough - I was going to be speaking in a military hospital run by the People’s Liberation Army.

The more I thought about it the more I realised how different dentistry could be over there. The only thing we may have in common may be the part of the body with which we work. I needed to do some research about my audience in order to find out what they would be interested in hearing me talk about. I emailed some questions that I needed answered:

• Is there private dentistry as well as public (yes)
• Were all patients from the army? (no –only 10%)
• Do hygienists work with the dentists?(yes)
• How do the dentists get paid?(wage)
• Is there any reward for working harder, or is every dentist on a wage? (no, only a wage.)
• Can they each set their own fees? (no)
• Was there any benefit in rapport building? (yes- for their personal sense of appropriateness)
• Were they interested in their patients returning for an active maintenance programme? (yes- for their personal sense of appropriateness)
• Are dentists in China supposed to do the best treatment or the quickest, easiest and least expensive?(“a quickest, easiest, and least expensive service is surely needed”)
• Is there any benefit for the dentist to do quality dentistry as opposed to volume dentistry? (Sometimes, if the patient really likes the service, they may give you a little present! I had visions of chickens being passed across).

With few contacts in China and sketchy answers coming from them I was getting increasingly nervous about the talk.

After much deliberation, I figured out a way to hedge my bets. I decided to call my talk “Latest Trends in Dentistry in Australia”. If the audience seemed unreceptive or uninterested in practice management issues I’d prepare clinical trends to fall back on.

When I arrived I was taken practically straight from the airport to the hospital, where I was amazed by what I saw. I don’t really know what I was expecting to see, but it wasn’t the ultra modern, paperless, fully computerised, state of the art practice that awaited me. Everyone was fully gowned; the sterilisation standards were the equal of anything I’ve seen here in Australia. X-rays were digital and any paper was scanned on to computers.

I started my talk on safe ground, talking about the clinical trends in dentistry in Australia; the increase in cosmetic treatment, the movement away from use of metals, and the use of cerecs, invisalign, and implants. So far, so good. I would talk for 30 seconds and my translator would follow with about 2 minutes of Chinese. Whatever my translator was passing on to the 60-70 people in attendance seemed to be of interest.

I nervously approached the subject of practice management issues. I wasn’t sure how much interest it would generate. I asked my audience if they thought they should be paid a wage or commission. I asked what they thought of being judged on:

• the re-appointment rate of their patients
• the attrition rate of their patients
• their new patient conversion rate (new patients who return for active maintenance appointments within a year)
• new patients generated from their patients.

It caused a lot of discussion in the audience in Chinese, but my translator told me that, practically unanimously, they wanted to be judged on most of the areas that I touched on rather than on hours worked. The organisers were thrilled with the result; I found out later that they had wanted to introduce some sort of scheme like this but were not sure what to measure, nor how the dentists would receive it.

Then I spent time talking about the things that influence a patient on deciding who they will go to for treatment. Once again, though, I wasn’t sure of the interest they may have in how to appropriately show empathy, or scarcity or social proof, or the other influencing factors, my audience quickly got very ’into it’. They took notes, asked lots of questions, and requested books, and references, and seemed genuinely fascinated by the concepts.

Four hours went very fast, and I was asked to return to give a further talk about Communication.

I hadn’t realised the universality of the issues. For some reason, I had thought there was a greater cultural divide between China and Australia than there is. As human beings our motivators and influences are essentially the same regardless of political philosophy. As dentists we want the same things for our patients. We want to form trusting relationships; we want to be able to provide long term optimum treatment.

Of course two different cultures will react differently in many areas, but what I walked away from China with was that fundamentally as dentists and as human beings we are more similar than we think. All of us need a practice with good protocols, good management and good communication.

[Published Australasian Dental Practice, July/August 2005]