Practice Made Perfect

MANAGING PATIENT PERCEPTIONS: THE FIRST FIVE MINUTES

S U Z A N N E BOSWELL

at happens in the first BEING E A R N E S T

S minutes of a patient’s Through surveys we have conductea

EDITORS’ NOTE: Suzanne Boswell is a consultant to dental practices nationally, a professional speaker, and author of the textbook, Suiting the Customer (Prentice Hall, 1993). She conducts surveys of dentists and patients and conducts patient focus groups. As an “under- cover dental patient, ’’ she assists practices in understanding patient perceptions.

appointment with you may influence whether that patient decides to accept or reject your treatment plan. The likelihood of treatment acceptance by the patient is directly linked to the ability of the practi- tioner and staff to build rapport and trust with the patient. Thus, the rapport built in those first few moments is key to continuing suc- cess. Today’s patients are far more critical in their evaluations of how practitioners relate to them than in the past. The media focus on this issue, along with the national focus on health care, has made the health care consumer much more discrimi- nating. Adding fuel to the fire are gender issues that indicate that health care practitioners have paid more attention to men’s issues than to those of women. For the practi- tioner to succeed, in patient’s terms, it is critical to see through the patient’s eyes.

and through focus groups with patients, it is clear that patients frequently use nonclinical means to judge the clinician. As a “mystery patient” who visits dental offices in order to assess them, I understand and relate to this. The average den- tal patient cannot accurately judge clinical excellence, so they use stan dards they do understand. They look for consistency throughout thc office and consider how you and your staff treat them as people, not merely as patients.

In the first moments of visiting you office, patients already have begun to judge you and your competence, even before meeting you. Obviousl; the physical appearance of your office has an enormous impact. A patient who is considering esthetic treatment will be more sensitive to appearances in general. The office dkcor, the grooming and physical appearance of your staff, as well as

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_ _ yoiir own grooming and image signify ivliat the patient thinks you find Licceptable. Patients may readily relntc this to the quality of esthetic results they th ink they will receive while in your care.

Perhaps most important is how you conduct yourself in the first moments of a patient meeting; this can weigh heavily in your patients’ perceptions. Patients want to believe that you sincerely care about them as people, not just as patients. Actual patient responses in surveys and focus groups indicate that trust in the doctor will dissipate when there is a perceived lack of rapport or caring. And per- ceived is the operative word here. You may well care, but if you don’t show it-if it is not clear to the patient-then you may be perceived as an uncaring practitioner, or one in whom placing trust is difficult.

THF PAT IF\^.\ r i c n I K E

While y o u r mind may he on staying on dit.dule, the patient in the next trcmicnt room, or the emergency scheduled to ‘arrive ;any minute, your p.iticnt is busy judging you. And thcy ;arc makiiig decisions based on this short time span. It is critical that the doctor be totally with the patient “ i n that moment.”

01. I11)1 I’K;\C.TITIONEK

While in y o u r otfice, y o u r patient ni.iy lw pliotographcJ tor clinical purpow. f lo\vcvcr. y o u and your statt .arc‘ Iwng phorogr,ipheei too-

by the patient. Patients take a men- tal snapshot of their experiences in the office. It is a sophisticated snap- shot because it incorporates your demeanor, your vocal tone, your words, as well as how the patient feels about sou. If the patient senses that you are totally in “his or her moment” and if you verbally and nonverbally communicate a caring attitude, trust will increase and the likelihood of treatment acceptance will rise. But all too often, the doctor is deeply into his or her own moment. rather than being in the patient’s.

Recently, I visited a well-respected dentist as an undercover “new patient.” The doctor was profession- ally admired by his peers for his clinical excellence and consistently received many referrals from col- leagues, so I had high expecmtions. The day of my appointment, he was running behind schedule due to an early emergency. He had one patient waiting in another treatment room, another waiting in reception, and me in his consultation room. It was clear that hls desii was to stay on schedule and to move on quickly to the next patient.

As we talked, he sat on the front third of his chair, with his legs and feet angled under him l i e a sprinter at the s t d n g block. His breathing was rapid, and his words sac.in1c.d out on each exhalation, whilc hi.; eyes darted toward the reception counter just beyond the door. I had

been in consultation with him about 15 minutes, and the 6 time 1 could see his attention was torn by the events surrounding h. This lack of attention was not accomplishing anything for him! I wanted to say: “Doctor, you can say the same words in the same time, with more relaxed breathing, better eye contact, and a more attentive posture and it would totally change the way you’re coming across.”

As well, he could have explained the situation and apologized for dre rushed atmosphere. Patients are far more understanding when they are treated with respect. Regardless of his reputation, the circumstances that had led ro this moment had taken control of him rather than the reverse. The snapshot he -wit- tingly allowed this patient to take home was ot an mcaringpracdtiavt

POU’ERFUI. INILI!FNCE OF STAFF

The same concept applies to staff members. As patients approach thc counter in reception, they want to be acknowledged. They want to !eel valued. They look for a w.irrn. comfortable, caring attitude. Consistently. I hear from p.iriciits that one reawii they like or J 1 4 k c their dentisr 14 thc mff. Your t ronr line people iii rccc~ptioia .ire in .in

estrenicly po\wrtul po\ition t o iiitluciiic. p u l r l i i pcricpriola\ ot u w ;iiid !our itinipctcvacc*. \Vhcthcr right o r tvroiig. i n thc p.iticiit’< rnlnJ. rlic

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J O l I R h A L O I ESTHhTlC DENTISTRY

perception of a sincerely caring attitude translates to greater clinical competence. Patients comment that those who refer their friends and family to their dentist do so because of a sense of caring by the entire team and the warm feeling of trust that results.

MOMENTS OF TRUTH

The following techniques can help build patients’ confidence during the first moments of a meeting with the dentist:

As you enter the treatment room, remove all extraneous thoughts from your mind in order to con-

centrate fully on the patient. This is easier said than done! Place initial focus on the patient as a person rather than on the clinical issue at hand. The patient wants reassurance that you see him or her as an individual, not as a diastema or malocclusion. The first moments of communica- tion with the patient should be void of clinical symbols such as mask, goggles, gloves. Initial moments of eye contact should be on the patient rather than on file records.

Patients don’t cave how much you know until they know how

much you cave!

Get on the same eye level with the patient-sit with your entire body oriented toward the patient during the first moments of conversation. Listen to the patient, show recep- tivity to the patient’s communica- tion. “Lack of listening” is at the top of the list of patient concerns. Unfortunately, they won’t tell you this; they will switch doctors! This has been spotlighted in the national press recently. Loosen up! Patients say they want their dentist to be less “uptight.” When patients sense tension in the practitioner, they become more tense themselves.

Accurately calibrded. and adJuslable curlng times obviate ‘be00 countlna” at

t - . only one touth of the b r . The alternate d o n tr&=.r can also override any curing cycle g[ving the operator total control.

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