We find ourselves living in a world of e-mail and texts and tweets filled with contracted words, symbols, and abbreviations. Whether you are on the subway, or out for dinner, or at a ballgame, all you see are people glued to their smart phones. It seems that we have forgotten the art of interpersonal communication. One of my favorite journalists recently wrote “Did you ever think you’d see the day when handwriting seems like an endangered species?”

One of the major keys to success in life and in business is making people feel special. And in my opinion, nothing does that better than sending a handwritten note. I advise all of my clients to write two handwritten notes at the end of every single workday before they leave to go home. Here are the logistics of how to make this happen.

Your dental practice is a huge gossip center where happy occurrences or tragic events and everything in between are discussed every day. The people who answer the telephone at your office often have to reschedule appointments based on these events: births, deaths, business situations, etc. Life as we all know it is complicated and ever-changing. Unless the change occurs on the doctor’s schedule that day, he or she may not be privy to or informed of that information. There are also many patients who are processed through Hygiene that the doctor may not be scheduled to examine. So again, important social information will not be heard by the doctor.

The goal is to channel all this information to the doctor so that he/she can respond. I suggest the creation of a position in the office called the “PR person”. This is the name for the designated staff person in charge of public relations to whom everyone who works in the practice reports all significant information that they might hear during the course of the day. The PR person’s job is to accumulate the information, along with the name and address of the patient, and leave it on the doctor’s desk.

From the list that has been prepared, the doctor chooses who will receive notes. Using personalized stationary, the note is written in your “prescription” handwriting. This is not a term paper–just two or three lines at the most.

“Dear Mary–I was so sorry to learn that your Mom had passed away. Please accept my deepest sympathies at this difficult time. Sincerely”

“Dear Robert–I was so excited to learn that you were accepted to the University of Pennsylvania. Congratulations on all of your hard work. Please send my best to your proud parents. Sincerely”

A number of wonderful things happen with this note writing program.

1. People are very surprised to get a personal note from their busy dentist. It is so totally not expected that it gets talked about–to many many people – all over town.
2. It shows great inter-office communication. The information that might have been discussed with someone at the front desk or a hygienist or an assistant somehow was made available to the doctor.
3. It makes people feel special. You took the time to write a note. How often does that happen? Usually, the only correspondence one gets from a dental practice is a bill!

So please try this strategy of writing notes to your patients. You might be skeptical about the time this will take. But so many clients have told me the joy they experience by staying in close touch with their patients. And they certainly get a lot of positive feedback. Two notes per day soon becomes thirty-five per month. If you commit to this effort, it doesn’t take long for a huge buzz to spread around your community recognizing you as a caring and compassionate professional.

The dental profession was dealt a major black eye two weeks ago with the astonishing revelation that Dr. Wayne Harrington, a Tulsa, Oklahoma oral surgeon, had potentially placed 7000 of his patients at risk by exposing them to Hepatitis B and HIV from poor sterilization procedures. In a complaint filed by the Tulsa Health Department, Harrington allegedly reused needles and was working with instruments that were rusty and porous and could not be properly sterilized.

I received many calls from clients wondering about a proper response. Some were considering sending an e-mail blast to their patient base reassuring them. Others were thinking about a newsletter piece. I discouraged this approach feeling it was going to just add fuel to the fire. My advice was to meet immediately as a team and write out “the script” for the proper response when any patient inquired. Something like “Thank you for calling Mrs. Smith. Your concerns are certainly justified. We want you to know that our practice is 100% compliant with the highest standards of recommended patient protection, and that you and your family are totally safe.” It is an absolute necessity for the message to be consistent and perfect when delivered by any member of the team.

This deplorable situation triggered unpleasant memories of another outlier event that occurred in the late 1980s, when Dr. David Acer–a Florida dentist who himself was HIV positive–infected three of his patients with the deadly AIDS virus. This was the first recorded case of patients becoming infected during dental care. The Acer event entirely changed the way that modern dentistry is practiced. The Centers for Disease Control and Prevention in 1988 recommended the OSHA standard for occupational exposure to blood borne pathogens which included the use of gloves in a dental setting where there is contact with saliva or blood. I sure wish I had bought stock in latex gloves!

The take away message from this unfortunate incident in Tulsa is that our patients are VERY concerned with their safety. I have always been a big advocate for an impressive well designed Stericenter. It should be hospital quality – nothing less. And it must always be immaculately clean. The major dental supply companies all have their own version, and I think this is a wonderful and worthwhile investment. Be sure to point out the sterilization area in your practice–especially to new patients–as they are being escorted to a treatment room. Let’s go out of our way to make every single patient feel safe and secure.

Studies over the years have shown that–believe it or not–what staff want more than sex and money are two things: one is acknowledgment and sincere appreciation by the boss for a job well done, and two is the opportunity to influence and/or participate in management decisions that affect the practice and their jobs. My feeling is that in the times in which we currently live, both of those desires are superceded by the necessity for healthcare insurance.

We all know that it is not possible to attract quality staff members without providing healthcare as a benefit of employment. But the cost of medical coverage is skyrocketing! Ten years ago the premium for single person healthcare was in the neighborhood of $300/month. Currently that cost–even with higher deductibles and larger co-pays–is closer to $600/month. As a dentist owner, there is no other overhead item that is rising faster and with apparently no end in sight than the cost of health insurance. Supplies, staff salaries, lab, occupancy–nothing else has even come close to doubling in that same time period.

There are many reasons for these continuous cost increases. Physicians are forced to practice medicine defensively, necessitating the ordering of every test under the sun because of the litigious society in which we live here in the United States. So until limits are placed on malpractice judgments–or a change in our legal system occurs that will prevent an attorney from taking a case on contingency– I don’t see costs going down. Another contributing factor to escalating healthcare premiums are the heroic costly hospitalizations of terminally ill patients. End of life medical costs need to be controlled in some humane fashion with greater integration of hospice care.

Unfortunately, we as dentists have little control over these issues. So much of the discussion about health care is political, and a lot of smart people have failed in their attempt to make improvements. Meanwhile we dentists as employers just continue to pay increasing premiums for health care. So what to do? My recommendation is to cap the dollar allotment that you pay as a benefit. Whatever you are currently paying for single person coverage–whether that is a percentage or a dollar amount–announce to your staff that as of January 2014–that dollar amount is the maximum that you will pay, and staff members will be required to pay the increase. Give your staff the better part of the year to prepare–you don’t want to announce this new policy in November.

Staff surely understand this dynamic of continuous rising costs of health coverage. In many dental practices, staff have been affected with no or minimal salary increases because of this upward pressure on medical costs. Unfortunately, you as the doctor cannot continue on this path. It is time to take a stand.

I constantly hear clients complaining about how they don’t have enough time to go to the bathroom – let alone all the other substantive things they want to accomplish – both in their professional lives and their personal lives. Doctors these days just seem flat out overwhelmed. Yet I continue to observe other doctors – albeit a much smaller segment – who seem to have figured out how to achieve the balance we are all seeking. These are very successful, creative and innovative professionals who have achieved– or are on their way to achieving –
their dreams.

I believe these doctors have mastered the art of delegation. They are the polar opposite of the micromanager. They revel in the old saying “if you want to get something done ask a busy person.” They allow competent staff to take responsibility for tasks or projects and then let them run with them. These successful doctors are also smart enough to know what NOT to delegate. As someone once said, “I can give you the sheet music for Blowin’ In The Wind, but you ain’t gonna be Bob Dylan.”

Of course, this means you need to have trusted, responsible, talented and motivated people working for you. During my monthly meetings and telephone calls, I am always hearing about staff issues – immature behavior, lack of appreciation, always asking for more, not understanding the concept of team, etc. The list is endless. In fact, I’ve said repeatedly that the most significant roadblock to success in any dental practice is the failure to assemble and retain a great team. So why do we continue to employ ineffectual people? Why do we continue to tolerate mediocrity when there are so many talented people available?

I think it may be the ultimate catch-22: you are so stressed and so busy that you don’t have the time or energy to solve the problem. Unfortunately it seems easier to just live with what you’ve got. Seth Godin eloquently discussed this very problem a few days ago. So you need to re-define your vision. Almost like a New Year’s resolution – even if it is already March. Simply stated, identify the areas that only you can do – the areas that create the most value in your life – and agree to assign or delegate everything else. Obviously this is easier said than done – or I wouldn’t be writing this post.

John Wooden, the iconic basketball coach of UCLA, might have said it best. He attributed his coaching success to “getting my players to do what they don’t want to do in order to get the results they want”. I couldn’t offer better advice.

My wife and I and two other couples recently went out for dinner. The dining experience was horrendous. 7:30 reservation–seated at 7:50. Another 15 minutes before we got drinks. Our server finally takes our order. We obviously had plenty of time to study the menu! Someone requested  swordfish blackened. The waiter says “not possible.” But right above the swordfish on the menu, there is a selection of mackerel blackened. “Sorry–that is the way the chef serves it.” I wanted garlic mashed with my tuna rare. Sorry–there is no replacement for the fries which come with the tuna, even though mashed are clearly available with other selections. You get the picture.  No one ordered an appetizer, yet our meals were not served until 9 PM! At that point, nobody enjoyed the meal. The food was decent, but nothing to write home about.

The manager finally came over to apologize as we were eating, and offered all kinds of excuses. We certainly expected some kind of courtesy discount on the bill to mollify our obvious displeasure with the restaurant. Unfortunately, that was the next disappointment. On the way out of the restaurant we saw the manager, and let him know in no uncertain terms that we would never return because he had missed his opportunity to at least do some kind of damage control–some complimentary offer to get us to come back–to show off his restaurant in a more favorable light. Later that night I wrote a blistering Yelp review–it was all true.

What has this story got to do with dentistry? Hopefully a great deal. This restaurant failed miserably to make me feel special. The customer service was abysmal. Hopefully your dental practice never has a bad day like this. But in my consulting experience, I often see so many examples of behavior that are guaranteed to turn patients off:

1. A potential new patient calls asking for an appointment for a teeth cleaning, and finds out that they must come in first for a separate appointment to see the doctor before they can make the cleaning visit. Why not give the patient what they requested?
2.  The phone is not answered over lunch. Why not rotate staff so the phone is always answered during the business day? For many people, lunch time may be their only opportunity to call.
3.  The phone is not answered by a person but by a very complicated message machine–press one–then press two, etc. So it takes you forever to get to speak to a real person. Very frustrating – very impersonal.
4.  There is a  lack of  customer friendly business hours. 8:30 to 5 – Monday through Thursday – just won’t work for a big part of the population.
5.  There are very rigid financial arrangements. If you wish to do more comprehensive dental treatment plans, you need to offer user friendly payment options.
6.  The doctor runs behind schedule on a regular basis. This is flat out unacceptable. Patients will respect your time in direct proportion to the way you respect theirs.  If you are running late, at least do something concrete to apologize – like free movie tickets or a Starbucks card.
7.  The “wrong” person is answering your telephone. She doesn’t smile–often says “no” to requests–and may actually even be uninformed and certainly not helpful. The person answering your telephone is the “face” of your practice – and may in fact be the most important person in your employ.

People today tend to be more demanding, so you have to be up to the test and the task. But if treated with exemplary, consistent, over the top “the customer is always right” service,  people will really respond and make it a point to go out of their way to tell others about their positive experience. And that, of course,  is what you want to happen. Motto -do everything possible to avoid fish stories.

Those of you who have been following my posts for a while know that I have written frequently about the importance of accumulating quality reviews from your happy and loyal patients. There is an unquestioned and direct correlation between the quality and volume of patient reviews and how your practice ranks on the local Google business map. Since studies show that something approaching 70% of people choose from the top two listings, you certainly want to take advantage of this proven SEO strategy.

The easiest way to get a patient to write a review was to have that patient go to your Google Place Page–sign in with a Gmail account–and publish the review.  To make this process more user friendly, I have recommended that you install a Google button on your website  (you can see what I have done) where someone can click the button and in one step  be directed to your Page and write the Google review.  That process was working just fine until to my dismay, seven months ago, Google Pages changed to something called Google+Local. Click here to read how this change became a major disaster. Google’s efforts to control spam or false reviews resulted in a situation where it was virtually impossible for anyone to post a review on your Page.

Whether this was Google changing their filtering algorithms to become very aggressive, or whether it was some other mechanical issue, nobody will ever know. But no worries–I am writing today to tell you that Google must have actually read my blog post of October 24 and decided to fix the problem!

About ten days ago–when checking my own Google+Local Page–I discovered something amazing.  As if by magic – five or six reviews for my services that had been written during the past six months – but  had never been published on my Page – were now suddenly  showing up. I quickly checked the Google Place Pages for several of my clients to excitedly find similar results. The following day, just because I had become so paranoid about all of this, I had someone else write a review for me, and it was published instantly–just like the old days.

So don’t wait any longer. The Google review process for the moment is alive, well, and functioning.

In my last post, I discussed some strategies to help dentists overcome stress and burnout. One of my suggestions was to find a mentor, and I would like to expand on that idea.

My younger son Andrew worked for a number of years in marketing and advertising for a large publicly traded pharmaceutical company before eventually starting his own business. He was fortunate early on in his career to find someone  three or four rungs up the corporate ladder who took a liking to him. This guy  was senior enough to him not to feel at all threatened – and was very helpful in steering my son in the right direction by providing invaluable political and strategic advice. Andrew thus avoided a lot of the pitfalls that can circumvent or derail a career and instead,  he advanced quite nicely. This senior person was around for three years before he was promoted to a major management position in Europe. Shortly thereafter my son left this company, realizing at that point how important an advantage it had been and how fortunate he had been to have had a mentor.

Corporate America of course is very different from a dental practice. But there are some parallels in this story that can apply to your situation.

1. Find a mentor who practices in your overall geographic area, but certainly not in the next block. This person shouldn’t think of you as the competition because he/she would then be unlikely to share the important and relevant information you are seeking.
2. Choose a mentor who might be 10-15 years older. Those years of practical experience are invaluable. And it is easy and natural to be deferential and respectful of a more senior person. Again – there must be no feeling of competition.
3. Keep in mind that mentoring a younger colleague can be a bit of an ego trip – so the relationship is usually fun and satisfying for the mentor.

My good friend Dr. Peter St Clair has a very successful general practice in Rowley, Massachusetts, and writes a weekly column on dental topics for his local newspaper. He shared his thoughts with me about mentoring. “A mentor is someone with whom you have a connection – someone to share and discuss standards and life goals. A mentor is someone who works with you to lead a more balanced and happy life – someone you look up to – someone to inspire and guide you. But most of all, a mentor will hold you accountable for implementation.”

The information you will receive from a mentor is going to be truthful. There is no reason for exaggeration or hyperbole. Compare this with the experience we have all had at one time or another. You go to a district dental society meeting and are chatting with a bunch of your peers – and hearing fish stories about how they are hitting it out of the park and getting 75 new non- insurance patients every month!

So gather your courage and identify some potential candidates for mentors – and then approach them. Do your research – know where they went to school – what continuing education courses they took – what professional accolades they might have received.  Even if they don’t know you very well or at all , more than likely they will be flattered to be approached. I’ll bet that the rest will be easy.

I am beginning my 17^th year of providing management consulting to the dental profession, and during that period of time, I have worked closely with over 580 different dental offices. One immutable fact remains constant – it takes a lot of hard work and requires a lot of talent to run a successful and profitable dental practice. According to The American Dental Association, 75% of all dentists in America are sole proprietors. Thus they are responsible not only for providing clinical care – what they were trained for – but also for managing a significant business entity – with NO formal training.

Maybe this is why I am definitely seeing an increase in stressed out dentists. I am seeing dentists – twenty years into their careers – late 40’s, early 50’s – experiencing burn out. And if you looked at the take home pay of these dentists, you might be envious. But they are overwhelmed with staying ahead of the game and keeping up with the demands of family life and a professional career. One of my clients with four kids recently shared with me that he has been having recurring fantasies of being on a deserted island – by himself – for a month!

As dentists, we get good at solving day to day problems and putting out fires, but unfortunately many of the solutions are of the band-aid variety. There is no luxury of working “on” the practice when you are so intently working “in” the practice. These observations have prompted me to offer some ideas that might be helpful if you are experiencing some of the feelings I describe.

1. Better time management – As dentists we are overly consumed with being productive clinically every hour of every day. Try blocking out an entire afternoon once a month – not to go to the beach – but to have dedicated time for thinking and strategizing. You might want to include key staff members. You will be amazed at how beneficial this time will be.

2. Find a mentor – Identify a few dentists in your area that from your perception are eminently successful.  Ask them if they would be willing to share their secrets for success. Successful people – in my experience – are flattered when asked – and are often quite generous with their responses and their time.

3. Evaluate your current professional advisors – For example, how many other dentists does your current accountant advise? Ask around – who are the super stars? It is probably worth paying for that kind of comparative analysis and expertise.

4. Continuous team building – I have written repeatedly on the importance and advantages of assembling a great team. Sports franchises do this all the time.  Obviously, there are no draft days in dentistry!  But I would encourage you to take a really hard look at any weaknesses in your current staff – and then commit to improvement.

5. Continuing education – Probably the best way to combat burnout is by increasing your knowledge and perhaps learning different procedures. Same old/same old gets boring. I see a lot of general dentists adding services like short term orthodontics and basic implantology.

6. Marketing – Most dentists learn next to nothing about marketing while in school. Instead, their education in this area comes from trial and error – and that strategy often turns out poorly. It is imperative to find someone very experienced to guide you because the choices and options are mindboggling and confusing. I am recommending a marketing budget in the range of 3-4% of annual collections.

It is human nature that business decisions are driven by concerns about money. It is of course necessary to be prudent on expenditures, but lately I am feeling that in order to be successful, you can’t afford NOT to spend the money. I encourage you to at least take the time to consider some of these longer term strategies that in the end may be a great return on investment.

According to Forrester Research, the growth in mobile demand is explosive. In the United States alone, the forecast is for 159 million smart phones to be in use by 2015. More people use smart phones for Internet search than traditional Web (full screen laptops and desktops with browsers). The problem is that your dental website is almost unreadable on a mobile device. So the forward thinking strategy until now had been to develop a separate mobile website that better fits a smaller screen.

Responsive design is a new technique that enables web pages to dynamically adjust depending on the device being used and the amount of screen real estate available. TNT Dental is the only company that I know of that is building responsive design websites in the dental space right now.

An adaptive website thus replaces the need for a separate mobile version of your website. Your TNT website morphs and optimizes with the device you view it on. This enables your mobile site to load faster without the need of a separate site or application. The website identifies the device and its capabilities and decides what is best to load, optimize and change. Because it responds to the device you are using, it is smarter than your average website.

Unlike traditional mobile versions of websites which can be somewhat drab by comparison, the colors and graphics that are part of your regular website are retained and used, so all the work that has gone into creating your unique website are carried throughout the responsive mobile version of your site. It also includes all the optimization from your website which means that all of your on-page SEO remains in place as well.

Since a picture is worth a thousand words, my good friends at TNT have created two screen shots to demonstrate how this works. The first shows my website as it would appear on a laptop or desktop computer, an iPad, and a smart phone. In fact the version on the smart phone shows the difference when held horizontally or vertically, demonstrating the ability of responsive design to adapt and optimize to the screen. The second screen shot shows my old (pre-responsive design) basic two page mobile website compared to the new responsive design version.

I think this is SO amazing. You might want to give TNT a call and see if this could work for you. Tim Healy can be reached at 877-868-4932.