Practice Management Toolkit Oops - Making Things Right When Things Go Wrong Steven Schwartz, DDS No matter how hard you try to provide superior, mistake-free service to your patients, occasionally you mess up. What you do when this occurs can mean the difference between losing a patient or creating a supporter for your dental practice. In his book How To Win Customers and Keep Them Forever (Berkley Books, 1987), Michael LeBoeuf, Ph.D., identifies reasons customers quit.
LeBoeuf also illustrates the impact of a dissatisfied customer. He says a typical dissatisfied customer will tell eight to ten people about the problem. One in five will tell twenty. On the positive side, LeBoeuf offers hope when he states that seven out of ten complaining customers will do business with you again if you resolve the complaint in their favor. If you resolve it on the spot, 95 percent will do business with you again. On average, a satisfied complainer will tell five people about the problem and how it was satisfactorily resolved. The average dental practice spends six times more to attract new patients than it does to retain current patients. Yet a loyal patient is worth far more than a new patient that has never been to your office. Consider this question: Who is more likely to refer other patients to your practice, a satisfied current patient or a new patient? Holding power is the key to successful practice management and growth. In a dental practice every effort must be made to provide superior and mistake-free service to patients. Regardless of how hard the dentist and staff try, occasionally things go wrong. The problem might be the result of a mistake by the dentist or a staff member. It might be the patient is in error. It might be the result of improper performance by a third party, such as a dental lab. Or, it might be due to an act of nature, such as a snowstorm or hurricane. When things go wrong, you and your staff must take definitive actions to make things right without delay. Placating the patient and taking steps to rectify the situation involve a process called service recovery. In their book Delivering Knock Your Socks Off Service (AMACOM, 1991), Kristin Anderson and Ron Zemke describe six steps to service recovery.
1. Apologize and acknowledge the patient’s problem or complaint. For beginners, you do nothing. You should be busy treating patients. Your staff takes care of the problem. You must empower and train them to take care of situations such as this, without involving you. The rationale behind empowerment and training is stress reduction.
Once the members of your staff are empowered and trained they are ready to initiate the six steps of service recovery. Step 1. Apologize and Acknowledge the Customers Problem. The first response is “I’m sorry.” It is always in the first person. It is never “We’re sorry.” The patient wants one person to take charge and fix the problem. Avoid placing blame. Knowing who is at fault is inconsequential. Customers just want someone to acknowledge that there is a problem and show concern. It is not necessary to give a specific reason for the problem and it is best to avoid blaming the computer, lab, receptionist or the weather. If you assign blame, it gives the patient the impression that someone in the organization, or someone you deal with, does not know their job or how to deal with unusual situations or problems. Simply acknowledge there is a problem and apologize for its existence. Sometimes it is difficult to say, “I’m sorry.” Some people feel that saying, “I’m sorry,” really says, “I failed” or “I’m to blame.” One might have the impression that by accepting blame, one also exposes oneself to legal consequences. This is far from the truth. An apology is just an acceptance that, as far as that patient is concerned, something went amiss. Often, a sincere apology, made in a timely manner, will head off potential legal problems. The following passage illustrates step one of service recovery. Anne turns to Mrs. Smith and says, “I’m sorry this happened.” Anne is careful not to place blame on anyone. It is possible that a receptionist forgot to enter the appointment in the computer. On the other hand, it is possible that Mrs. Smith confused this appointment with another commitment. There is no need to embarrass a staff member in front of a patient or vice versa. It will not rectify the situation and will probably upset the staff member, the patient or both. Step 2. Listen, Ask Open Ended Questions and Empathize. The importance of good listening in service recovery cannot be emphasized enough. Listening serves two purposes. First, it allows the patient to vent frustration and second, it reveals the real problem. Allow patients to express themselves without interruption. After the patient is finished venting about the problem ask questions about possible misunderstandings or areas that need clarification. Use this as an opportunity to discover problems and consequences that have resulted from the mishap. Once the problem and its consequences have been identified and clarified, repeat it back to the patient. This allows the patient to sense that their feelings and concerns are understood. Next it is important to empathize with the patient. Very simply, put yourself in the patient’s shoes. Try to envision how you would feel if you were in the same position. How would you be affected? More important, what would you want done to correct the problem. Being empathetic with the patient shows concern for the patient. Until the patient is convinced that someone cares about the problem it is difficult to find or to suggest a solution. The following passage illustrates step two of service recovery. After Anne says, “I’m sorry” she learns how this situation is affecting Mrs. Smith by remaining silent and listening while Mrs. Smith does all the talking. She allows Mrs. Smith to vent her fears and frustrations about not having her veneers in place for her cruise and her concern that she will not have time to return at another time for placement. After listening to Mrs. Smith express her predicament, Anne expresses her understanding of the problem by repeating it. She says, “As I understand it, Mrs. Smith, you’re leaving for a cruise on Saturday and you are concerned you won’t have an attractive smile for the trip. I certainly would have the same concerns if I were in your position. Let’s see if we can find a solution together." Step 3. Fix the Problem, Quickly and Fairly. Once the staff member has developed empathy for the patient and understands what the patient is feeling, it should not be that difficult to find a solution. If a similar situation was resolved successfully, the same solution might be applied to a new situation. Even if situations are not similar, a solution that was used to resolve a different problem can be adapted to the current situation. The staff member should step into the patient’s shoes and ask, “What would satisfy me in this situation?” It is important to get the patient involved in the resolution of the problem. Forcing a solution on the patient should be avoided. It is best to present several options and ask for the patient’s preferences. If a patient has some control over the situation he or she will be more receptive to resolving the problem in a manner that is fair to both parties. The following passage illustrates step three of service recovery. Anne makes a suggestion and waits for Mrs. Smith’s reaction. “I wouldn’t suggest squeezing you in today because it takes time to do the treatment correctly. It would be to your advantage to return at another time. I understand this is a very hectic week for you so let’s try to accommodate your schedule. Is there any day this week that is good for you? If during the day is inconvenient, we can see you before the first scheduled patient or after the last scheduled patient." Step 4. Offer Atonement If the Patient Has Been or Feels "Injured." Sometimes fixing the actual problem is not enough. Remember the long-term goal of service recovery is to keep the customer, or in this case, the patient in the practice. To rebuild a damaged relationship, and maintain the goodwill of the patient, it may be necessary to take an extra step, to provide a peace offering or symbolic atonement. This extra step says, “We want to make it up to you.” The atonement can be in the form of discounted or courtesy treatment, dinner, flowers or gift certificates. The following passage illustrates step four of service recovery. Anne says to Mrs. Smith “To make up for your inconvenience, in addition to the scheduled treatment, let’s really give you a dazzling smile. After Dr. Jones places the veneers he’ll polish the rest of your teeth at no charge." Step 5. Keep the Promises You Make. Once a promise has been made to fix a problem it is important to follow through. A patient might give you a second chance, but you will not get a third chance. The promise should be recorded in the patient’s chart while the patient is present. It should be read back to the patient so that both parties understand what has been agreed upon. If a special time has been reserved for treatment, the patient should be made aware of this. When a staff member makes an agreement with a patient, it is important that the agreement be communicated to the dentist and any other staff member that might be involved. The staff should take all steps to insure that the treatment goes off as scheduled. If lab work is involved, a special effort must be made to confirm the lab work is in the office and ready for insertion. The dentist’s schedule should be arranged so the problem of running behind schedule is minimized. If an appointment is scheduled before or after regular hours, everyone involved with treatment should make the appropriate adjustments to their personal schedules. The following passage illustrates step five of service recovery. Mrs. Smith chooses to come early Wednesday morning for treatment. Anne not only records the time in the appointment book but also in the chart. There is a notation in highlighted, large letters, showing that there will be no charge for the polishing. She informs all involved with treatment (dentist and staff) of the agreement so they can rearrange their personal schedules. Step 6. Follow Up. After the corrective measures have been taken and treatment has been rendered, the dentist (not the staff) should make a follow-up telephone call. The dentist should ask about the resolution of the problem and the patient’s satisfaction with the treatment received. The dentist should apologize for the problem, emphasize how much the patient’s business is appreciated, and express hope that the patient will continue to patronize the practice. The following passage illustrates step six of service recovery. Mrs. Smith keeps her appointment Wednesday morning. The veneers are cemented and the rest of her teeth are polished. On Wednesday evening or Thursday morning Dr. Jones calls Mrs. Smith to ask, “Are you satisfied with the way we handled the scheduling problem? Are you happy with your new smile.” He concludes the call by saying, “I appreciate your understanding. Have a great vacation, and I will see you when you get back.” Our relationships with our patients need to be in balance. Every time we satisfy a patient we get one point. Unfortunately, every time we mess up we lose ten points. If your goal is patient retention, combined with practice growth, it is vital that you maintain a positive balance with every patient. Action Steps
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