Do You Hear What I Hear?


We all know that you never get a second chance to make a first impression. What many people do not realize is what goes into making a positive, lasting first impression and conversely, what makes a negative first impression. Having worked in countless offices nationwide, I have seen both sides of the spectrum. Most troubling were those practices who didn’t make a good first impression and didn’t even seem to try; worse yet, they even seemed not to care.

Somewhere in the middle of the good and bad impressions are the “in betweeners.” When working at the front desk, “in betweeners” often do an adequate job when it comes to creating a favorable impression. They are usually fine until pressure comes from the patient or the clinical team. When pressure is applied, the front desk staff usually feels the squeeze. When this happens, it is easy to get into a front office vs. back office conflict.

I am empathetic because I spent many years working in the business office of a dental practice. Early on, I realized that my attitude reflected upon the whole office—whether deserved or not. I was the first person patients would see and hear. Because my boss, Dr. Kendall Roberts, saw me struggle at times and wasn’t always happy with what he heard, he allowed me to take training classes from Arrowhead Dental Lab in 1994. Dr. Roberts knew this training was vitally important and could help change the tone and sound of the office.

What does your office sound like? What are some issues that your staff may be neglecting? What can be done to improve the overall impression that people have about your practice? Do you hear what your customers are hearing? Some common problems can result in creating a less than favorable impression. Here are a few of the most common ones:

1. The Difference Between Urgent and Important. It took me a while to learn the difference between these two words. The difference is critical. The difference can be summed up in the phrase, “focused attention.” Everything in the business office is important, but not necessarily urgent. When a patient calls or is present, the patient’s needs are definitely urgent. That patient should feel that front desk personnel staff are providing focused attention to that interaction. A patient knows when they are only getting a portion of your the staff’s attention. When that happens, the patient may feel like “just another patient,” which may cause them to think of your office as “just another dental practice.” It is absolutely imperative that you staff give focused attention to patient interactions. When a patient feels that you and your staff are urgently attending to their needs, a powerful connection is made.
2. Chatter. I have seen front office personnel so preoccupied in personal conversation that patients have felt like they are interrupting. This can happen when staff are talking to coworkers or to people on the phone (when the conversation has nothing to do with dentistry). Remember that patients who are waiting nearby can hear almost everything and they are forming opinions about the practice based upon what they hear. Office personnel should be aware that they are a reflection of the dentist. Things discussed within earshot of the patient should never distract patients from a positive image of the office. The staff should sound professional and always remain focused on the patient’s well being. This is an important point that is often forgotten. Do you hear what I hear?
3. Eye Contact. Seventy percent of what we communicate is non-verbal. Not making eye contact when interacting with a patient is tantamount to saying, “You aren’t important enough to demand my full attention.” I recall being in an office where the receptionist would not make eye contact with a disgruntled patient. The patient was angry about something that had happened in the clinical area and felt like they were not given the attention they warranted. Things escalated and ended with the patient saying, “This is why I will never be back!” Not only did they lose a patient, but all of the patients in the reception area heard and saw the entire scenario.
4. Telephone Etiquette. Oftentimes, the simplest things have the greatest impact on impressions. Telephone etiquette is one of those simple things that can have a dramatic affect on a dental practice. I have seen a multitude of mistakes in this area. The most important thing to remember is to keep a calm professional tone with every patient. I have observed staff becoming agitated with a patient on the telephone on numerous occasions. The result is usually a loud, belligerent conversation that patients in the waiting room can hear. The primary problem is that those in-office patients only hear one side of the conversation. They have no idea how difficult or disrespectful the person on the other end of line may have been. The patients can only hear the staff member and see how difficult they are being. Keep your coolcalm. Be mindful of the comments you makemade after you hanghanging up. Even an offhand comment about a patient can leave the wrong impression in a waiting room.
5. Undermining the Dentist’s Credibility. Often, a patient asks a staff member, “Do I really need this?” after the doctor leaves. The staff should be informed as to the treatment objectives so they can encourage and answer any questions from the patient. If the staff is unsure about a course of treatment, it will be evident to the patient. This will leave the patient frustrated, confused and possibly questioning the credibility of the doctor. Credibility is a function of consistency and sincerity and people know it when they hear it.
6. Cancellations. There is a right way and a wrong way to deal with the dreaded “cancellation call.” I recently presented a webinar on this topic, available for download at In it I addressed the pitfalls of causally accepting patientAllowing cancellations. This to occur without putting them in their proper context creates the impression that a dental appointment is not important and it can be easily be rescheduled. so that “more important” things can be done. Staff who do this typically don’t know what to say to help the patient understand the importance and value of their appointments.

Proactive Solutions
Doctors, what are you doing with your staff to ensure that a good impression is made an everyday? Are you hiring the right people for your office? This is vital to the success of your practice. Your business front office is the first and last impression that your office patients leaves with patients. People working for you should be people-oriented and smile, smile, smile! They need to have both active and reflective listening skills. They should also be multitaskers. Once you have the right staff in place, you can address (and avoid) potential pitfalls.

Give Direction.
To handle urgent and important matters, have a morning “huddle.” Everyone can look at the daily schedule and prepare for any new patients. New patients should receive urgent attention. Decide to make new patients feel important. Let them know you and your staff are glad they chose your office. Some personnel may need a “mouth filter.” In my Total Team Training course, we teach how to present information and move on so the patient will never feel insulted.

Focus on the Patients’ Needs.
When it comes to the issue of chatter or personal conversations, you hire your staff and pay them a full day’s wage, so you should expect them to be focused on your patients’ needs. Breaks and lunch hour are appropriate times for social banter and taking care of personal matters. Cell phones are not acceptable at the front desk. The temptation to text, get on Facebook or check messages will easily cause your staff to get sidetracked at the expense of the patient.

Communicate through Eye Contact.
This is the first rule of active listening. Look each patient in the eyes. This helps them feel that they are important to you and that what’s you communicated bears the full weight of you and your staff’s experience and authority.

Learn Telephone Etiquette.
It makes no difference who is right or wrong if you lose a patient. Front desk personnel must learn to diffuse situations. Proper telephone principles are covered in detail at my Total Team Training course.

Improve Credibility. Avoid undermining doctor credibility by understanding the treatment objectives and sincerely motivating the patient to proceed with treatment. Patients who are confused or in doubt do not buy!

Avoid Cancellations.
Finally, learn how to avoid cancellations and keep patients on schedule. Explain to the patient the value of keeping an appointment. Be sure to emphasize the urgency of not experiencing pain.

Start Listening
I often hear doctors say that since they are not in the front office, they don’t know what’s going on there. If you are getting negative feedback, excessive cancellations or even worse, it is time to learn what is happening in the front office. You cannot just assume that your staff knows what to do or say.

Invest in your staff. If you don’t know where to start, I invite you to attend my next Total Team Training course. Your staff will leave with information that will equip them to handle whatever comes their way. In the future, you’ll know that your customers will hear what you want them to hear and nothing else.

I would be remiss to leave out the many offices that are successful—some doctors have hired well. They and their staff use a “structure” that allows them to shape and control the impressions that patients form about the practice. I am grateful to have worked with so many teachable people.

Personally, I want to thank Dr. Kendall Roberts for allowing me to have training some nineteen years ago. Thank you for not remembering so much about the years that I floundered. Thank you for being patient while I implemented what I learned so that we could enhance the “sound” of your practice. Thank you for reflecting on all of the lives that we helped change through the world of dentistry.


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