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How to Control the Dental Experience

July 9, 2013



A very good patient of mine told me a disconcerting story about her daughter.  Her daughter used to be my patient, but she told me she won’t come back because I scared her.  This was quite bothersome to me, not because the practice lost a patient, but because dentistry may have lost a patient.

We do our best not to frighten anyone.  I think we really try hard to be nice.  But my answer to my patient was really lame…I told her, “I’m a dentist, sometimes that happens.”  It was lame because it is my responsibility to manage the patient’s experience.

In the words of author Antonio Porchia (Voices),   “I know what I have given you. I do not know what you have received.”

In the classic book, The Experience Economy, authors Pine and Gilmore describe experiences in terms of explicit and implicit outcomes.  In a dental practice the explicit outcomes would be the quality of our work, things we can easily judge.  But the implicit outcomes or the subjective experiences of our patients are rarely measured.

Many times we don’t even know how the patients perceived the experience, or they can’t find the words to describe the experience.  Sometimes, years later…they might say…”he hurt me, I don’t like him, I’m not going back.”

I guess that’s how it came down with my patient.  If she’s reading this…”I am truly sorry”

But a great screenwriter once wrote, “Love is never having to say you’re sorry.”  And if your practice is one that claims they “love their patients,”  maybe it’s time to take better control of the implicit outcomes.

Think about your last experience with any service provider.  How did you feel when it was over?  How did you feel when you walked away from the ticket counter at the airport?  Or from the clerk at the convenience store.  I know I have stayed away from restaurants…forever…because of bad service and how it made me feel, rather than because the food was bad ( I just had a horrible Father’s Day experience—and the fish was good).

Feelings and emotions rule. 

The difficulty most of us have is to systematize these subjective emotional experiences.  The dentist must become, what I call, a master of the intangibles.  And that is not easy.

I have found the key to creating great dental experiences is to control the environment.  Companies likes Disney and Apple spend fortunes keeping their environments “happy.”

The best advice I ever heard on this comes from the late positive psychologist Chris Peterson who said:

“Positive institutions facilitate the development and display of positive traits, which in turn facilitate positive subjective experiences.”

In other words…It’s the culture.

In a new book, The Customer Service Solution, authors Sriram Dasu and Richard Chase actually use an example from a dental practice to make their point about subjective experiences.  I certainly wasn’t surprised that they chose a dental practice considering how we do as an industry.

I don’t think that’s our fault when you consider the amount of sharp objects we work with.

In their example a hygienist is cleaning a six-year old’s teeth.  At one point the hygienist inadvertently hits a sensitive spot on a tooth.  She could either stop the cleaning or continue on with less discomfort.  If you’re a dentist I know what you’re thinking.

But, this moment of truth can effect the child’s subsequent visits, and the hygienist realized this.

Dasu and Chase actually site research in behavioral science that suggests that continuing the treatment at lower levels of pain may actually cause people to have a less negative recall of the experience.

 The principle is that the patient will only remember that the “pain wasn’t so bad, in the end.”  Endings matter.

This blog concerns it self with many of the softer, subjective feelings that go into the patient experience.  Understanding human behavior and cognitive psychology is a big part of dentistry.  The books mentioned above go a long way in explaining what every dental practice should know about people and their experiences…after all sometimes it’s not about the teeth.



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Travis and Louie Teach Me The One Thing for Success

July 2, 2012

Filed under: Book Reviews,Philosophy,Uncategorized — Tags: , — Barry @ 10:57 PM

When I speak I tell the story of “The One Thing” from the movie City Slickers.  Remember the scene where Curly (Jack Palance), tells Billy Crystal that the meaning of life is just “one thing,” and everything else don’t mean shit.  Well, I have been looking for that one thing that will make my practice successful.

A few years later, Marcus Buckingham wrote a book, The One Thing.  He wrote about the one thing successful people do.   (more…)

10 Things Your Dentist Doesn’t Want You to Know

January 5, 2012

About a month ago there was a blog post that got a lot of attention.  It was titled 10 Reasons Your Dentist Probably Hates You Too.  It created quite a stir and wrote a post that I called 10 Reasons Why My Patients Love Me, in response.  The author of the first post wrote it with her tongue firmly planted in her cheek, and I wrote my response to sho

English: Street dentist in Bangalore with a pa...

Wild Wild West Dentistry

w that our profession needs more relationship building in an age where the professions have tipped toward business rather than health car

What is the truth about dentistry these days?

There are many ways to practice dentistry.  Every dentist is faced with the problem of balancing the paradox between duty and desire...the desire to live a great life and the duty to be a great dentist.  We live in a material world and as much as we claim that less is more…so many of us still want more.  Yet I truly believe we also want to to find meaning in our dentistry.

It gets confusing for the dentist as he tries to earn his daily bread in an age where the business of dentistry is like the Wild Wild West.

I try to practice in a manner that helps balance the paradox…some might call it “business ethics.”  I am truly bothered when I see the breakdown of ethics in our profession…so I give you these things that I see some of our colleagues doing on a fairly regular basis…that I think patients, and the powers that be should know about.

  1. Your  dentist sees you as a profit center rather than a patient.  Everyone gets the business thing.  Football players tell us this all the time…but this is health care and an ethical dentist MUST put the patient first.  That is the real definition of professional.  Dentists who do this usually relate everything to the “time is money” philosophy.  They usually run behind and are over-scheduled.
  2. Your dentist just took a weekend course in an advanced surgical technique—-and you (more…)

A Dynamic Duo-2 Books to Guide You

March 15, 2010

Filed under: ARTICLES,Book Reviews,Uncategorized — Tags: , — Barry @ 5:21 PM

When I wrote The Art of the Examination a few years ago, one of my better references was a book called The Cluetrain Manifesto.  That book was an early predictor of the future.  The authors used phrases like, “business is a conversation.”  They predicted how Web 2.0 would work.  They predicted the transparency that is so required on today’s social media platforms.  The Cluetrain Manifesto is still the go-to book on the inner workings of the web these days.

I used that book as a reference because the authors were extending real human values in using the newer tools that were coming into vogue.  They have just updated that book because the tools have changed, and are still changing on a daily basis.  And everyone wants in.

I can’t help but notice a recent trend in dental courses.  Dental seminars, institutes, consultants and coaches are all teaching some form of social media curriculum…and dentists are buying in.  I am not sure if we’re not dealing with snake-oil salesmen.  It’s been done before in dentistry you know.  We’;re still learning about the web.  No one really KNOWS where it’s going.  But one thing for sure…the lessons taught in the Cluetrain Manifesto still work.  Trust, participation, attention, transparency, reputation, are the currency of the new web as expert Chris Brogan tells us in his book Trust Agents.  How you use the tools is another matter.  The values and the principles will rule the day in the end…not the tools.
Just like dentistry eh?