If you look at most major problems facing dental practices today, you’ll find that poor communication is usually at the root. For many clinicians, it’s easier to focus on restoring a tooth or completing a major case than it is to improve interpersonal skills.

Although communication skills typically aren’t taught in dental schools, they are crucial to building a healthy practice. Before you can practice the skill and art of dentistry, you first must acknowledge that you’re in the "People Business." And here’s the bottom line: Patients don’t care how much you know until they know how much you care.

How effective are you and your team at communicating? In this and next month’s column, we’ll take a look at 10 areas of communication in which most practices have room to improve. The quiz below focuses on the first five of these key areas. Each point contains a scenario, the standard for solid communication in this area and an opportunity to rate your practice. By honestly evaluating how you are doing in each area, you’ll discover where you need to improve. At the end of each scenario, give your practice a score based on the following five-point system:

5 = Great, this is a strong point of ours—we manage it very well.
4 = We’re working on this and are almost where we want to be.
3 = We’re average—similar to many offices in our area. (Remember: being average does not set you apart!)
2 = We need to sharpen up.
1 = This is a prime weakness of ours.

1. Phone skills
The scenario (from our own research files): A prospective patient calls the office to get some information on the doctor and the practice. The phone is answered breathlessly with, "Doctor’s office, hold please." Three minutes later the receptionist returns to the line, saying, "Sorry, it’s crazy around here today. How can I help you?" This scenario is not uncommon. If you were a patient and had several offices from which to choose, would you lean toward this one? Probably not if the others fared any better answering the phone.

The standard: The phone is typically the "entryway" to your practice and the person who answers your phone is the "ambassador." All too often the phone is viewed as an interruption instead of the lifeline to the practice. Everyone in the office should be able to confidently present the practice to the public. Some of the most glaring weaknesses in this area include:

• Answering the phone with "Doctor’s office" instead of introducing the doctor’s name or practice name
• Poor vocal tone: sounding rushed, indifferent, unresponsive
• Keeping patients on hold too long without letting them know how long the hold might be
• Not returning phone calls in a timely manner
• Inability to answer questions or provide information requested

Grade your practice: _____

2. Introductions
The scenario (relayed by a patient in a focus group): The patient, a 70-year-old man, is new to the practice. When he arrives at the front desk, the receptionist neither introduces herself nor indicates that she had already spoken with him on the phone. The patient is dispatched to the reception area where he waits for his name to be called.

When the assistant calls the patient, she uses his first name, before she has been given permission to do so (mind you, the patient is new to the practice). Furthermore, the assistant does not introduce herself as she takes him to the treatment room. Another team member enters the treatment room and chats with the assistant, leaving the patient feeling ignored. No one wears nametags. The young doctor enters the treatment room and introduces himself as Dr. Jones and then uses the patient’s first name.

The standard: A person’s name is the most elementary facet of a relationship. By introducing yourself to another person and using his or her preferred name, you are showing respect. Introduction of other team members helps patients identify with the practice. It can increase social ease and help to increase the patient’s comfort. It’s pretty hard to develop any type of relationship without an exchange of names. Be careful, however, overuse of a patient’s name may appear patronizing and manipulative.

Grade your practice: _____

3. Collateral material
The scenario (from our own research files): A prospective patient calls a practice to get information about the doctor. The receptionist seems stressed and says she has two calls on hold. The caller asks if there is a practice brochure or printed information that could be mailed. The receptionist hurriedly responds with, "No we don’t have anything like that. If you want a lot of information about a doctor, why don’t you just call 1-800-DENTIST?"  Before you gasp and say, "No one would say that!" Believe it! These were the exact words a receptionist used with us when we were conducting research on marketing materials.

After several months of gathering research on collateral materials, we took samples we collected into focus groups. The offices that had well-designed, well-written promotional pieces were perceived to be of higher quality than those that had nothing. When comparing offices, participants leaned toward those that they learned the most about through these materials.

When thinking about collateral materials for your practice, remember that you are dealing with a "consumer mentality": The more you positively position your practice on paper, the better perception patients with a high dental IQ will hold of your practice.

The standard: A promotional piece that provides tangible information about you helps to increase understanding, instill confidence and communicate stability. It doesn’t have to be expensive: In many cases a flashy piece will work against you. But it must communicate who you are in a professional and practical manner.

Grade your practice: _____

4. Fees
The scenario (relayed by a patient in a focus group): The patient needs two crowns. The doctor doesn’t mention fees and the patient begins squirming in the chair, as he thinks about the cost. Finally the patient asks, "How much is this going to cost me, doc?" The doctor brings in the financial coordinator. As she apologetically quotes the fee, she uncomfortably shifts in her chair, breaks eye contact and picks lint off her skirt. This "financial flinch" undermines fee integrity and reinforces the patient’s perception that it’s not okay to talk about money.

The standard: Don’t project your own negative or doubtful thinking (e.g., "This is expensive and I feel badly/guilty telling the fee to the patient.") onto the patient! Patients want to feel it’s okay to discuss financial matters and they want you to make it okay. The topic has to be approached frankly yet with sensitivity—a narrow path indeed.

This means you:

1. Bring up the topic at the appropriate time.
2. Reinforce the long-term value of the treatment plan.
3. Avoid mixed messages in vocal tone and body language.
4. Carefully observe the patient for nonverbal clues that may help you determine how to direct the conversation.
5. Encourage questions in a nonjudgmental way. ("Tell me your questions/thoughts about…")

Grade your practice: _____

5. One-Way Communication
The scenario (from my own experience as a "mystery patient"): The doctor stands in front of the bibbed, semi-reclined patient who requires a complex treatment plan. In a dictatorial tone the doctor offers, "Here’s the problem and here’s what I’ll do." The patient questioningly asserts what she thought the symptoms meant. The doctor talks louder, interrupts (he’s got to stay on schedule) and says that the assistant will provide the details about the procedure that will be performed. The patient feels belittled. She is less likely to ask questions and is more likely to seek a second opinion or to delay treatment.

The standard: A dogmatic approach in healthcare is not effective today. Wise practitioners have put aside the old model of doctor is to patient as parent is to child. You’re dealing with a more informed healthcare consumer who may seek information on the Internet or from other sources, is less hesitant to get second opinions and wants options presented to him or her. The patient values an exchange in which the doctor actively listens to him and her and encourages two-way dialogue about the condition and treatment options. In medical circles this is referred to as "partnering with the patient" and is an important element in engendering patient loyalty. How well you manage this will influence treatment acceptance, patient loyalty and patient referrals.

Grade your practice: _____

How did you do?
After reviewing your five grades, how do you evaluate your management of these matters? Each of these issues deserves discussion among the entire team to ensure that the practice manages the impressions it makes on the public. And in these instances, it’s not the dental impressions, but the mental impressions that matter.

Be sure to tune in next month when we’ll investigate five more key scenarios for team discussion. WEB VISITORS: Find PART 2 here