Managing caries and motivating change, part 2: Motivational interviewing
How do you motivate your patients? Discover how caries risk assessments and motivational interviewing tactics can help you connect with…
Hospitality isn’t only for hotels! Discover how applying some key hospitality principles in your dental practice could help you build stronger connections with patients and staff, improve patient treatment acceptance, and foster a successful culture for everyone.
While the word “hospitality” may bring to mind visions of room service and complimentary breakfast, the word’s origins are actually based on the concept of hosts providing kindness and safety to guests – and it isn’t limited to the hotel industry. In the context of dentistry, hospitality has everything to do with building trust and an emotional connection between patients and staff. From booking the appointment to taking a seat in the dentists’ chair, we can take a more holistic approach to dental care by meeting patients where they are and treating the whole person in front of us, not just their smile. When we succeed in creating a hospitable environment in our dental practice, we earn the loyalty and advocacy of our patients, while simultaneously building a strong and dedicated staff.
Before diving into the finer points of hospitality, the first and most important thing to keep in mind is something that can be easy to forget: no one walks into a dentist’s office wanting to be a patient. When we see them as a person, and not just a patient, we build meaningful connections. Human beings respond more to hospitality than to dentistry – dentistry is not the patients’ field, but it is their need. If we don’t have that in mind from the beginning, we can miss an early chance to build that human connection. Sometimes we miss the boat right off the bat by looking in the lobby and saying, “there’s my next patient.” There is a person with a need, and they aren’t comfortable in the role of a patient. So how do we get off on the right foot? Choose to approach each person with hospitality at every step and you’ll find you hold the key to unlocking that relationship.
When defining dental care through the lens of hospitality, I like to break the concept down into two distinct components: “Care, the noun” and “Care, the verb.” Care the noun is comprised of all the things people already expect as a baseline when they visit a dentist — technical skill and training, high quality products, hygienic practices, etc. Care the verb, on the other hand, is all about the act of taking care of others. Do we value the fact that a patient trusts us with their time and health? Do we value them as a person, and not just as another case to treat? As dental professionals, we tend to get caught up in the noun side of care — filling a cavity, installing a crown, providing a tangible service — but in fact the verb side of care is just as important. Yes, care is the service we deliver, but it’s also how we deliver it. When you deliver the noun and the verb with equal intention, you deliver the essence of hospitality. This does not mean we treat someone like a hotel guest — it simply means we make them feel comfortable and at ease in our presence.
Like the word hospitality, many people may have a preconception of the term luxury. Luxury may conjure images of designer clothes, sports cars, or flying first class — in short, fancy things. But at its core, luxury refers to something in short supply. In the dental office, patients often have a healthy supply of anxiety; what they lack is peace of mind. In this context, luxury is the absence of worry: you are trying to create that sense of ease for each patient who sits in your chair. Your patients already have plenty to worry about – everyone has stress about health, finances, work or relationships – and your goal is to subtract from that list, not add to it.
Once in the dentist’s office, the focus should be on how you can take worry away for those in your care. I like to encourage providers to ask patients, “What’s the most important thing I can do for you today?” Surprisingly, they rarely answer with the obvious (your treatment of their need is expected). Instead, they may tell you something along the lines of, “I’m nervous, put me at ease,” or “help me attend my daughter’s wedding with confidence.” There is a cerebral side of meeting their immediate need, but it’s the emotional connection that leads to a patient’s loyalty. When you ask them in this way, patients often open up emotionally, giving you a way to quickly address their deeper need and create that human connection.
When we start to view hospitality within the whole experience of visiting the dentist, the first touchpoints start before the patient even walks in the door. How was the scheduling process, or finding contact information on the website? How about arriving at the clinic — was it easy or stressful to find parking or follow signage to your office? Take the time to consider those pre-arrival elements and see if practical things can be improved. A small change to your website, a smoother payment system, even larger, clearer signs can all contribute to a more hospitable experience, allowing patients to arrive in the right state of mind and heart.
The next opportunity comes after your patients have walked in but before they sit down for treatment: now is the time to show patients that your whole staff is there on purpose and with purpose. Even on a busy day, a personal touch and a smile convey a sense of confidence that can go a long way in reminding a patient they’re in good hands. And even behind a mask, people can tell when you have a genuine smile on your face.
Why does it matter so much? It’s easy, especially on a busy day, to treat the next patient like a number. But if you greet someone by name and make a bit of small talk, you’ve done more to put that person at ease for the next hour than you can imagine. On the other hand, if the arrival experience is not quite right, patients may sit down cautiously and see you as somewhat of an opponent from the beginning. When you start out by putting yourself on their side, patients are more likely to open up to you – and to be more open to treatment suggestions. They will in turn trust that you are their partner, that you’re there to give them everything you’ve got – then sit down in the chair in partnership with you, ready to work with you.
I do observe some common behaviors in clinics that should be avoided. One that happens frequently is providers having conversations among themselves. During treatment, patients in the chair mostly don’t have the ability to talk, and so those conversations among staff may leave them feeling forgotten or unseen — in a word, excluded. Or worse yet, providers may make comments that inadvertently damage a patient’s confidence or trust, such as mentioning offhandedly how they didn’t sleep well the night before, or that they’re stressed or hurried. Avoid these types of interactions that exclude or worry the patient, and instead engage your patient. Make sure to give them time to respond, and actively listen to their responses. Make it a dialogue rather than a lecture – and try to keep things positive!
Another frequent problem can be providers or staff commiserating with patients. While this may feel like you are empathizing with the patient, it ultimately has more negative consequences than benefits. When a patient expresses frustration, commiserating with them can communicate that you are resigned to the problem rather than motivated to resolve it. I call it the “Caregiver Rule:” as a caregiver, you can’t commiserate with those you care for. Here’s an example of a common situation: a patient may say to you, “Gosh, 2020 hurt me and my finances.” You say, “It did the same to me.” Then the patient gets the bill – and possibly wonders, “Is this really what it cost, or is this because your business is hurting?” Solution: be a role model. Let the patient say what they want to say, and then exemplify the right response. I want to say, “trust me, I get it,” but instead I’ll say, “I felt that for a while, but I’m so grateful to be back pursuing my calling.” It builds the bond we mistakenly think we are building when we commiserate, while also building confidence. Take the high road: you’ll get the same bond, but in a much stronger, lasting way. Give the same uplifting response you would like to hear if you were in their position.
Sometimes, even with our best efforts, things can go south, and a patient can have feelings of disappointment, frustration, or even anger. How we address these negative moments can make all the difference. The first thing to keep in mind is that almost all anger is rooted in fear – even the most upset patient is often fundamentally scared about something. It could be about the expense of dental care and how it will deplete their savings, or travel plans that they might now have to change, or experiencing pain they didn’t expect.
A common kneejerk reaction is to quickly placate patients by compensating for the perceived problem. But time and again what I witness is that most people value being heard over a resolution in the practical sense. You have the power to make patients feel validated and seen. “I get it,” I would say. “You trusted us with your time, and a few things haven’t gone the way you expected them to. I see and respect that.” An empathetic response does not mean you’re accepting fault, it’s letting the patient know that you understand their feeling in that moment.
There are also going to be times when you might not learn about a negative patient experience until it pops up online. The last thing any practice wants to see is a negative review, but these comments are actually an opportunity to learn and demonstrate your commitment to care. Here are some tips specific to online reviews. The first is to stay away from projecting a tone onto written reviews or comments. We sometimes hear a tone that isn’t there. Online, we lack key information like body language, tone of voice and facial expressions, and so people assign an intent. Instead, give the patient the benefit of the doubt. If someone takes time to say “hey, it wasn’t the best,” dive into it with appreciation — it’s free coaching! To respond to it as anything else is to fall back into third place. First place is hard work.
My second piece of advice is to avoid “copy and paste” responses online. I pay attention to responses more than reviews on websites. If I see the same response every time, it’s like a machine; I don’t trust that a person is truly listening on the other end. Let me see heart in your response. Just as for an in-person interaction, offer the person the chance to be heard. Consider the patient’s mindset and ask, “how can we respond in a respectful manner?” At the core of it, they are expressing fear and frustration and asking whether you understand. If you acknowledge you understand them, you restore their trust and regain their loyalty.
The final follow-through for challenging or negative interactions is to debrief with your staff. Don’t let a bad interaction disappear and hope it never comes back! Learn from it, make yourself comfortable addressing it, and help that team member work through it too so they can move on from disappointment, fear or frustration so they don’t carry it forward to the next interaction. When you gather at the beginning of the shift and talk about the day, make time to address things from the day before. Avoid a cycle of fear or frustration towards patients. Sometimes I hear comments like, “Remember that guy who sent that note.” Don’t let that attitude spread. Everyone deserves a fresh start. Every time there is a negative or frustrating interaction, guide the staff through a debrief and remember these principles: anger is rooted in fear, and everyone just wants to be heard.
When it comes to staff, a strong company culture is as important as the quality of the service that patients receive. Whether it’s a patient or a staff member, my philosophy is simple: whoever I encounter next is the human who needs the best version of me. If approaching an individual with hospitality works for patients, it works the same way for staff. When you treat your staff the same way as you do patients, you show them, “I’m invested in your care, too.” By showing your team the same care you give your patients, you earn a loyal and emotionally connected staff – which in turn translates directly to a better patient experience and, ultimately, patient loyalty.
I can’t emphasize enough how much your entire team matters in creating an overall impression. Sometimes, staff members don’t realize how visible they are to people in the lobby. Patients interact with whoever greets them and gives them paperwork, yes – but they also watch the way your staff interacts with each other. Words matter, but you can counter positive words if your body language and tone don’t match what you say. We have all experienced a “Hello, can I help you?” delivered with body language and tone that do anything but convey a sense of desire to truly assist. If I come into an office on a busy day but I still see a smile on your face as you work and interact, it tells me you are confident. I see that the whole team is really good at what they do, that my anxiety of walking into a busy dental office can still be allayed, because the team is calm and confident and in control. Don’t let patients see a team that’s surviving, let them see a team that’s thriving.
In the big picture, a staff working together with hospitality at the center of their intention will also perpetuate a sense of purpose. When you build a great, hospitable relationship and treat someone like a human being first and foremost, it renews the caregiver’s passion for their work. A happy staff means happy patients, and happy patients feed back into that cycle. I’ve had providers say to me, “Not only was the patient relaxed, but that partnership felt good. It renewed my Why. It felt good to have a patient thank me for going into this profession – that’s really rewarding.” Results refuel providers.
When it comes to hiring team members, again for me it comes back to care, the verb. I’d rather you run lean and short-staffed with the right people than quickly hire someone who doesn’t contribute positively to the company culture of emotional care. I look at a candidate’s ability to connect and build relationships with the same focus as I do on clinical skills. In respect to Care, if someone is 100% on the noun side and only 60% on the verb side, I promise you the patients will notice. They measure the verb more than the noun. Don’t just take what you can get. Make caring a necessary skillset.
Unlike the clinical success of a dental procedure, the patient experience is difficult to evaluate and measure. But just because some things are difficult to quantify doesn’t mean they don’t have value. We know that there are so many things that can’t be measured that truly matter. The things we value most can be felt with every cell in our body – and in every interaction. Compare it with your life outside of work. You don’t work on “retaining” your spouse, or on a “satisfaction score” with your kids. If you ask me, “how much do you love your son?” I will never respond with, “This year I’m aiming for 72%.” Yet in many organizations, people go to work and try to quantify human relationships!
Instead of focusing on employee retention or patient satisfaction scores, try changing your mindset. It all comes down to practicing hospitality at the heart of everything: patient experience, employee experience, turnover, recruitment, doctor resiliency – you can either dive into each area, or you can move upstream and focus on hospitality in a way that affects all those areas simultaneously. Bring out the best version of yourself for each person you interact with – it has a huge impact. This approach also creates a sense of gratitude towards patients. Patient loyalty hinges on that feeling. The entire reason you’re here as a provider is to serve them, and you couldn’t do that if they hadn’t chosen you. That sense of gratitude translates to patients spreading the word about you— and you’ll be amazed at how fast good news travels. I’ve had providers tell me, “More and more patients are saying they heard about me based on stories of hospitable moments.”
A discussion of providing care wouldn’t be complete without addressing how the past two years have really leveled the playing field by changing the way we create success. The pandemic has truly put a spotlight on the need for the soft skills, like kindness and empathy, in dentistry. After coming through something traumatic, many of us have asked ourselves: what have we not valued that we should have? The culture-building efforts that have stayed afloat throughout COVID – focusing on care, compassion, respect, gratitude – are the soft skills strong enough to hold true during a difficult time.
No one can say “Oh, because of COVID, we can’t have compassion anymore.” Just the opposite: because of COVID, the true importance of hospitality is highlighted everywhere we go. We’re looking for those emotional, unmeasurable connections more than ever. Anyone who doesn’t value that will be left behind as we enter this post-COVID culture.
Hospitality is so much more than a reception desk. It’s being the best version of yourself for each person you encounter, whether it’s a new patient or a veteran staff member. It’s creating an atmosphere that matches high quality dental care to an equally high level of caring for people. It’s validating a frustrated person’s feelings gracefully, and learning from those interactions. It is embodying gratitude while removing worry. All of these things are the essence of hospitality.
Ensuring the best care for your patients isn’t just about your clinical skillset – it’s about making honest, human connections with the people in front of you. By emphasizing empathy and hospitality in your practice, you create trust, forge patient relationships, strengthen your staff, foster loyalty – and set yourself up for long-term success.
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