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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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10 Ways to Get out of Network

May 20, 2013

Filed under: Article,Business of Dentistry,Happiness — Tags: , , — Barry @ 9:40 AM

images-1In previous posts I have promoted the idea of autonomy.  I am big on autonomy for may reasons.  Firstly, I believe most people go into dentistry to be the masters of their own destiny.  I know I did, but that was a long time ago.  I don’t know what motivates people these days.  One thing I do know is that if a dentist wants to be the very best he can be then having autonomy and the ability to make his own decisions is important.

Being in a network takes some of that independence away.  I know dentistry is heading in a direction that will change the way most of us practice, but I do believe there will always be room at the top.

Years ago getting out of network and building an insurance free practice was a lot easier, there was less traffic on the road less traveled.  And more patients looking for a ride.  These days getting out of network will require a bigger commitment.  Here is my list of things you can do to build a career of freedom and autonomy.  You may not get wealthier, but you will be happier.

  1. Become lean and mean.  In other words build the policies and systems in your practice that keep your expenses down.  By not being sub-servant to large monthly expenses, you can get to do the dentistry of your choice.  Don’t be lured into more expense by manufacturers looking to sell you the latest equipment if your practice doesn’t warrant the expense.  Your patients come to you for your care, skills and judgement.  Being hi-tech is only one factor that people judge your service by…dependability, reliability, competence and empathy come way before the expensive toys.  You would be amazed at how many staff members it takes to produce significant dentistry, especially when time management systems and financial policies are in place.

  2. Take more time with your patients.  Once again, building systems for re-care, new patients, treatment planning and scheduling will make you lean and mean.  All of these systems require the dentists to develop and build his communication and leadership skills.  Putting a system in place without being able to carry it out won’t work.  Think about football teams with great schemes.  Without the players executing, nothing matters.

  3. Become an expert in examination, diagnosis, planning and communication.  Take courses in these areas.  Get coached.  Don’t concentrate on the technical…step back and take leadership courses.

  4. Be a doctor not a businessman.  (more…)

How to Interpret a Story

June 18, 2012

Mary Osborne is one of dentistry’s greatest treasures.  She is a wonderful teacher and a master storyteller.  I was recently reading LeeAnn Brady’s blog and came across a video of Mary telling one of her favorite stories.  I had heard the story before but this time it took n new meaning.

That is the power of story.  It touches each of us in a different way each time we hear it.  Take a listen.

This time I was reminded of one of my favorite lessons about why I spend so much time with new patients during my comprehensive examination.  When I teach this principle I usually refer to Stephen Covey’s works on trust.  I love when he says, “With people, fast is slow, and slow is fast.”

When I quote that I usually get a lot of blank stares reflected at me.  Think about case acceptance…when you take your time with patients up front, they make their decisions must faster.  And when you rush people through an exam, it seems they never make a decision.  This is what Mary’s story means to me.

What does it mean to you?

I am in the middle of training a new puppy, Annie.  The same principle works with dogs—so it’s just not with people.

T-A-O – One Definition

February 27, 2010

Filed under: ARTICLES,Uncategorized — Tags: , , — Barry @ 10:58 AM

Check out this 2006 article from the Pankeygram.

The Tao of Dentistry
Contributed by Dr. Barry F. Polansky, Cherry Hill, NJ

In ancient China, the keeper of the Imperial Library, Lao Tzu, was famous for his wisdom. Perceiving the growing corruption of the government, he left for the countryside. On his way, the guard at the city gates asked Lao Tzu to write out the essence of his understanding to benefit future generations. Lao Tzu wrote the Tao Te Ching and was never heard of again. The “Tao Te Ching” (also called “The Tao”) is one of the most influential books in history. It is the source of famous Chinese sayings such a “Even a 1,000 mile journey starts with a single step.”

In the Tao Te Ching, “tao” is generally used to indicate (more…)