You’ve experienced it in a retail store. You take your purchase to the salesperson at the counter, who’s on the phone…obviously a personal call. Rather than acknowledge you, she turns her back and leisurely finishes her call. After hanging up, she turns around without a word and rings up the products of the person who approached the counter after you did. To add insult to injury, the other customer says nothing about this inequity.

Rare? Hardly. As a matter of fact, we’ve become used to this kind of treatment in our society, leaving many of us to lament, "Good manners are a thing of the past." But does it have to be that way? Specifically, should you settle for this "society norm" in your practice?

Picture this common scenario: A patient approaches the counter in a physician’s office. The glass window is closed and staff avoids making eye contact with the patient. Numerous signs on the counter instruct the patient on what to do and what not to do. The patient feels like a number in this office. Is it a surprise that patients are beginning to rail at their insignificance in the health care quotient today?

So how do patients feel when they are treated with utmost respect and courtesy in a dental office? You can bet that they notice it, appreciate it and value you and your practice as a result. But why bother? What does the extra effort do for you?

Well, for one, by extending common courtesy, you are more likely to keep patients and earn referrals. In the patient’s mind the line is blurred between courtesy and customer service. Courtesy should be an integral and inseparable part of excellent customer service.

Another by-product of common courtesy may be even more profound: When you and your staff strive to behave more courteously with one another as well as with patients, the workplace becomes a far more enjoyable, harmonious and pleasant place to work.

Every day we are presented with situations that allow us to show common courtesy and consideration to others. But all too often these opportunities pass by unrecognized. The fact that we refer to "random acts of kindness" as rare and special moments of sensitivity to others indicates the level of incivility we have reached in our society. When you change that approach to "common acts of kindness," you elevate yourself and your practice above the norm.

We are not born innately understanding courtesy. Instead we learn it during a lifelong process. So let’s go back to basics and look at how we can make the office a more pleasant place for patients and for teammates. Here are just a few of the places where your manners influence others and say something about you in the process.

Telephone tips
Courtesy extended on the phone paves the way for courtesy expected when the patient enters the office. Offices should place special emphasis on honing the phone skills of each team member. After all, it’s not just the receptionist who influences the public: It’s every person who answers the phone. Here are a few basics of telephone etiquette:

• Don’t leave callers on hold longer than 45 seconds without letting them know they’re not forgotten: "Mrs. Smith, I’m still working on this, can you hold for another minute?"
• Avoid speaking so fast that you sound rushed. Otherwise, you may be perceived as too busy to meet patient needs.
• Avoid rustling papers or whispering to others while on the phone. When callers hear someone doing two things at once it leaves the impression that you’re really not listening because you are preoccupied with something more important.
• Thank callers for holding when you return to the line. If you’ve been gone for a longer-than-usual time, briefly explain the situation and apologize.
• Keep personal phone calls out of earshot of patients. This is especially crucial when the office is busy and personal phone calls can reflect especially negatively on the practice.

Greeting and meeting others
How gracious a person is when meeting others speaks volumes about the individual and the environment. Patients believe that the way they are treated at the front desk represents what is acceptable to the doctor and creates their expectations for the office. Here are some rules of etiquette for meeting and greeting patients:

• Introduce yourself to new patients. Stand and shake hands if possible. This is particularly important if the patient is much older than you; it is a sign of respect that is practiced too infrequently today.
• Acknowledge in some way each person who enters the office, even if only with eye contact and a nod or smile. (This includes service people like postal employees because patients do notice how you treat others!)
• Address the patient using the last name with Mr., Mrs., Ms. or professional designation, unless you are invited to do otherwise. This is particularly important when talking with those who are older than you.
• When shaking hands, it doesn’t matter who extends hand first, man or woman. Give a full, firm handshake equally to men and women. Be sensitive to the degree of pressure you apply in shaking hands with those who may have arthritis or be disabled.
• Introduce patients to other team members when appropriate. Help patients feel a part of the "practice family." Additionally, patients appreciate when team members wear name tags.
• If a person offers you a business card, look at it and read it before putting it away. The card is a paper extension of the person and therefore deserves respect and acknowledgement. The Japanese extend and accept business cards with some degree of ritual, using both hands and carefully reading the card before continuing the conversation.
• Hold doors open for others. Helping a person who has his or her arms full or cannot easily maneuver is appropriate regardless of age or gender.
• Stand to the side before entering an elevator. This allows others to exit without bumping into you. This is crucial in buildings of healthcare providers where patients may be in wheelchairs, on gurneys, infirmed or disabled.

Smoking and eating

Conversation and confidentiality

Communication by mail and technology
With advances in technology, personal niceties are sometimes forgotten. Even when you are not face-to-face, you can still add a personal touch to communication with your patients. Here are some ways to do this:

• Personalize everything sent by mail. Patients in our focus groups have said that even a simple Post-it note attached to a form or brochure helps a mailed piece seem more personal. The patient feels important and more "connected" to your office. Always use the patient’s name when you write the note and sign your name.
• Patients value handwritten thank-you notes (for a referral or kindness). A phone call is meaningful, but an informal note has greater impact. When the note comes from the doctor it carries even greater significance.
• When you send a fax, even if you know it will go directly to the receiver’s desk, include a personalized cover sheet, signed by the sender.
• In e-mail messages, be sure your header (title line of the message) is personalized so that it is not considered to be junk mail. "Information you requested from Dr. Harold Mark’s office" will more likely be opened and read than "Information you need!"
• Don’t let the beeps, rings and buzzes of cell phones interrupt conversations with patients. When possible, turn phones and pagers to the vibrate mode and check messages when out of the patient’s view.

Anticipating needs
This skill, above all others, may speak to patients about the caring attitude and courteous nature of the office. The ability to anticipate patient needs requires the team member to focus more on the patient than on him/herself. This may not come naturally but can certainly be developed.

• Observe the patient for nonverbal clues indicating possible needs.
• Recognize needs patients have had in the past that are similar to the present situation. This may be helpful in anticipating unspoken needs of the present patient.
• Let patients verbalize their needs. Phrase questions in an open-ended manner such as, "Tell me, Mrs. Smith, how can I help you be most comfortable? What do you need that might help you be most comfortable?" Asking, "Are you comfortable?" really calls for a yes/no answer and by comparison seems less caring.
• Treatment rooms tend to be cool. This temperature may seem even cooler than normal to those who have just experienced wintry weather outside the office. Offer a blanket or wrap to the patient. Some patients are cold-natured at any time of the year and they will appreciate your awareness of the body language clues they send.

Courtesy and successful patient relationships
There are direct relationships among patient retention, referrals and courtesy. Fine-tuning the courtesy extended to patients can only strengthen patient respect for your team, as in the old saw, "what goes around comes around." And when patients make comparisons between your office and others, they will want to remain with you and return to the courteous customer service received in your care.

Above all, your efforts to mind your manners must be sincere. Don’t make the mistake I recently encountered: I was in a convenience store where the staff obviously had been schooled to respond with "my pleasure" to any customer request. I heard this phrase repeated three times to different customers in the store. It was said without eye contact and in a hurried vocal tone. The tone turned to one of embarrassment when a staff person felt compelled to respond in this manner to a burly truck driver. The truck driver left the store mumbling "whoopee doo" under his breath.   Courtesy is crucial but it must also be appropriate to the situation and sincere!

Rants and Raves
How patients rate practices on their Ps& Qs