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More than ever, dental practices are paying attention to what patients think and say about their care. Reps can help.

FI-Dec15Cover-StoryAnthony Vastardis’s father, George, was a chef at Pappas in midtown Manhattan. “He’d say, ‘The customer may not be qualified to judge our food, because they don’t know good food,’” says Vastardis, CEO of Milwaukee, Wisc.-based Dental Associates. “Then he would add, ‘But it’s the customer who pays to eat the food, so we have to make it so they like it.’”

So it is with dental care today.

In years past, the dentist was king of the lair. His staff recognized it. So did his patients, who came to expect very little in terms of decorum, office comforts (except the occasional ragged Highlights magazine for the kids), or even pain control.

Today is a different story. “Consumerism has become an industry-changing thing, not only in dentistry, but anywhere the consumer is involved,” says Vastardis, whose firm has 12 dental locations in Wisconsin and will open two more next year.

In such an age, listening to the patient is all-important. Monitoring his or her perceptions of the practice, quantifying that data when possible, and responding to issues raised on social media, are considered necessary for successful practice management.

Anything sales reps can do to further the cause will be appreciated, according to those with whom First Impressions spoke.

The real competitors
Successful dental practices today recognize that “patients are more likely to pay for dentistry they want than what they need,” says Naomi Cooper, president, Minoa Marketing, and CEO of Doctor Distillery, Marina Del Rey, Calif.

Consumers may have a limited budget for what they might regard as traditional dentistry, but they will spend money on goods and services that make them feel or look good…and young. “As dentists start to think of themselves as being more in the wellness and beauty category, they begin to understand their competition is not MDs, but spas, plastic surgeons and dermatologists,” says Cooper.

“I hear from dentists all the time who tell me, ‘Patients come in with perfect manicures, but complain about a $30 copay for their prophy. So when they are doing something as comprehensive as a full mouth rehab, understanding that the dental practice is competing with those discretionary dollars helps them understand the importance of patient satisfaction.”

Patient satisfaction begins with the little things, says Cooper. For example, when answering the phone, does the staff tacitly acknowledge that pursuing oral health care is the patient’s choice, rather than treating the patient’s visit as a foregone conclusion? Does the office smell fresh? Is the waiting room (“call it a reception area,” says Cooper) comfortable and clean? Does the front desk welcome visitors, or do they give them the typical doctors’ office experience – glass window, the clipboard over the counter, etc.?

Pay attention to the senses – touch, smell, feel and first impressions, she says. How about the ceiling tiles? That’s something patients notice as they recline in the operatory. “The doctor pays attention to fancy equipment and clinical details, and meanwhile, the tiles are nasty.”

Most important is the staff’s attitude. “They shouldn’t regard patients as a disturbance in their day, but rather, as the reason they’re all there, and they should treat them accordingly,” says Cooper.

The good news is, today’s dentists are focusing more on providing comfort-conscious, patient-centric dentistry, and less on doctor-centric care, she says. Successful doctors are emphasizing things like crowns in an hour, laser dentistry as a way to eliminate drilling, digital radiography as a way of reducing radiation exposure, and technologies for faster numbing and less time spent in the office. “These are things that address what people want vs. what they need,” says Cooper.

Traditionally, many dentists have been wary of elective areas of dentistry; they didn’t want to appear to be overtreating. “But it’s the regular preventive maintenance which patients resent, not cosmetic dentistry,” says Cooper. “It’s a matter of teaching patients that we’re not just here to treat toothaches, but to help them look and feel better for life.”

Of course, clinical skill and technique is important. But that is the price of entry, she says.

“In the end, patients have no way to judge a doctor’s clinical ability; they assume you’re qualified. They don’t care which dental school is ranked highest, or how many dental societies you’re a member of. They’re more interested in, ‘Are you nice? Are you caring?’”

Reps can help by presenting to the staff technologies that are patient-centric or comfort-conscious, “whether it’s a bite block that is softer or a radiographic sensor that is smaller,” says Cooper. “These are types of things doctors are more cognizant of and paying more attention to today.”

Good business
Patient satisfaction is simply good business.

“When a patient perceives that their needs and desires have been met in a reasonable fashion, they communicate their experience to those around them,” says David Schirmer, DDS, a practicing dentist in New York and a member of the American Dental Association Council on Access, Prevention and Interprofessional Relations. “They tell family, friends, neighbors, and co-workers, especially if their expectations have been exceeded. As a result, more interest in the practice develops, which directly relates to more patient traffic.

“If the practice is able to maintain, improve and evolve this patient satisfaction, a growing network of positive momentum develops. This momentum drives the practice to ever higher levels of success.”

Patient satisfaction is largely related to the degree to which patients perceive their interaction with the dental office is patient-centered, says Schirmer. “Most people are reasonable in their expectations of dental treatment. However, there will always be primary components that can be a positive or negative part of the dental experience. These include timeliness of appointment, the office environment, personality and demeanor of dentist and staff, pain management, technical clinical results, esthetic results, and finances and billing.”

While it’s true that smiles and laughs might be good indicators of patient satisfaction, today’s dental professionals are looking for more objective indicators.

“There has developed a paradigm shift toward data-based measurement of the patient experience,” says Schirmer. “Increasingly, practice management software and its adjuncts allow a practice to monitor ‘on time’ performance and other aspects of the patient experience. Those more sophisticated practices can use this data to their advantage in their quest for quality assessment and improvement.”

The best measures are standardized, validated, tested, then endorsed by a recognized accreditation organization and reviewed regularly, says Schirmer. “This is the process that is followed in most industries, including healthcare, and is appropriate for dentistry as well. In fact, it is already the process followed by the Dental Quality Alliance (DQA), which develops quality measures and educates those in the dental arena.”

“Credibility is the key to consumerism,” says Vastardis. Most people today research the Web to help determine the quality of organizations or professionals with whom they might interact or conduct business. Successful dental practices are paying attention.

Angie’s List and Yelp are popular stopping-off points, says Vastardis. But Dental Associates believes that by conducting scientific patient satisfaction surveys, the practice can more clearly hear the voice of the patient and then use that information to plan for the future and figure out how to meet – and exceed – patients’ expectations.

Since 2003, Dental Associates has conducted ongoing patient surveys with the help of patient-experience, firm Press Ganey. In 2014, Dental Associates began posting patient evaluations of its dentists and clinics on its website, based on the Press Ganey surveys. In fact, each dentist has a profile page on the company’s websites, which includes a five-point rating for the doctor and patient comments from the preceding 18 months.

“The key issue comes down to this: The provider is listening to the patient, and the provider is communicating back to the patient,” says Vastardis. “What is it that the patient wants to accomplish? What would they like to see happening that day? That’s especially important for the new patient, some of whom haven’t gone to a dentist in years. They might have had a bad experience some time ago, and memories are long. You need to know why the patient is there.”

How do the doctors feel about the transparency?

“Our doctors have come a long way,” says Vastardis. Still, it took some upfront work to gain their trust in the Press Ganey survey process.

One specialist who is highly regarded in the field complained that the patient was in no position to judge his work, explains Vastardis. “I said, ‘It’s not whether the patient is qualified; it’s about the patient making the decision whether to refer others to you, or even to continue his or her treatment with you.’

“The expectation of your paying customer should be the driving principle of what you need to do in your business.”

The patient survey process and resulting transparency on the website have stirred competitive instincts, says Vastardis. “Nobody wants to be known as the doctor who gets bad comments,” he says. “Everyone wants to be the best.” What’s more, doctors are aware that their family, friends and acquaintances can easily read the online reviews. “That’s what transparency is all about,” he says. “It’s not a matter of you telling someone how wonderful you are, but having someone else saying how wonderful you are.”

Focusing on patient satisfaction pays dividends in many ways.

“What this has done – and this is very important – is take away some of the heaviness of the work day,” says Vastardis. “When you have unhappy customers, your day is long. But if patients love coming to the dentist, everybody is smiling. They listen to you because they trust you. It’s an easier day. That’s the payback.”

Vastardis also believes in giving a more practical expression of a job well done.

“Everybody talks about quality and how important it is to the organization,” he says. “But there’s another thing I believe in: You need to have compensation systems that reward the right behaviors.” He cites a 1985 book, The Greatest Management Principle in the World, by Michael LeBoeuf, which says that people don’t do what you tell them to do, they do what you pay them to do. “It really is pay for performance,” says Vastardis.

Sales reps can help dental practices exceed patients’ expectations by promoting products that focus on efficiency and patient comfort, he says. “Sell us what we need to have in order to further the patient experience.”

Follow the leader
Meeting and exceeding patients’ expectations is all about communication, education, and making sure patients know all that you’re doing for them, says Cooper. The mindset must be apparent on the website, social media and, of course, in the office.

“Look at your online reviews,” she says. “Be aware of what patients are saying about you, or what is being said in the Web sphere. And we’re not just talking about patient satisfaction. That’s Step 1. Rather, it’s, ‘Are they thrilled?’ At the end of the day, it’s the difference between ‘My dentist is alright’ vs. ‘I love my dentist, and I’m willing to post that on Facebook.’ That’s when it becomes viral-positive instead of viral-negative.

“I always tell my clients to fish for compliments,” she continues. “Ask, ‘How was your visit today?’ And don’t be afraid of the answer. If they’re not happy, better to find out then, when you still have a chance to address it, rather than seeing a negative review online.”

Cooper also encourages clients to take advantage of the post-appointment-survey feature of many dental practice management systems. Surveys help the practice learn where improvement is needed and are a great way to collect testimonials and encourage positive online reviews.

“Doctors have to recognize that, yes, they are professionals. But dentistry is a service-oriented retail business. It doesn’t matter if your clinical ability is 100 out of 100, if your customer service is only rated 50.”

The payoff
“If used to its full potential, social media gives practices a dynamic, online and mobile method of interacting with patients on an almost unlimited basis,” says Schirmer. “They can use this unlimited interaction to communicate patient satisfaction or manage dissatisfaction. Online reputation management is important today, and social media offers a somewhat more personalized approach. Tools and applications that utilize social media can capture a patient or potential patient’s attention in a manner that was almost unthinkable 20 years ago. It will most likely become a staple of dental marketing.

“From the standpoint of the patient, social media can be fun and engaging,” he continues. “The more engaged a patient becomes, the more likely they will feel connected to the practice. This enhances patient experience, and in turn, patient satisfaction.”

Publisher’s Letter

Patient Satisfaction = Dental Practice Satisfaction = Your Satisfaction

As salespeople, we often get caught up giving our customers what they want, but we don’t always look past that initial customer need. I am not telling you not to pay attention to what the office (your customer) is asking for. What I am asking you to do is look deeper and try and help your offices give their customers – the patients – what they want. For example, you may tend to look at the dentist, assistant or the hygienist in the office and what their needs are when you are selling them a product or service. This is natural, but what if you took a step beyond the needs of the dental office and helped your customer focus on what their patients really wanted? A novel idea? Maybe. Yes, the dentist knows best, but the patient knows what they really want.

Please read our cover story on patient satisfaction. This is a story you are going to want to share with your offices. Find out what successful practices are doing and what reps can do to help their offices give patients what they want while providing them the care they need. We interview the CEO of Dental Associates who gives us insight into DAs successful customer-centric model. We also take a look at how social media and online tools like Yelp and Angie’s List have put the patient in control of not just their own destiny, but also your dental customers’ destiny and reputation. Naomi Cooper of Minoa Marketing talks about today’s dentists becoming more focused on providing comfort-conscious, patient-centric dentistry, and less on doctor-centric care. Dentistry is no longer about the dentist, but about the patient.

Now that we know what the patient wants, let’s make sure we are up to date on everything else a sales rep needs to know. Take time to review the results of Futuredontics’ dental office manager survey . Many times the office managers are the decision makers when it comes to products, as well as which distributor an office uses. Also review Benco’s Third CenterPoint Showroom  that recently opened up in Texas. Follow up your thirst for knowledge with OSAP’s Safest Office column highlighting the silent epidemic.

Thank you to all of our advertisers and readers for a successful 2015,

Bill Neumann

Serving the Endodontist

Just like successful endodontists, successful sales reps come from a place of generosity and abundance

Your endodontist customer can be much more than the outsourced “root canal guy.” Instead, he or she can be a thought leader to the local GP community as well as to patients. To do so, he or she must come from a place of generosity and abundance rather than scarcity. And sales reps can help.

FI_Aug15_SpecialtySelling“There’s often a sense of territorialism underlying the relationship between the GP and the endodontist – or any specialist,” says dental marketing consultant Naomi Cooper, president and founder, Minoa Marketing, and chief marketing consultant, Pride Institute. “And it doesn’t have to be that way.” Cooper gave a presentation at the American Association of Endondontists’ AAE15 conference on “Marketing the endodontic practice to GPs and patients.”

Just because a GP is doing a few simple endo procedures, for example, does not preclude that GP from continuing to be a good referral source, she says. By doing a few such procedures, the GP may gain a better understanding of his or her limitations, and a more keen sense of the circumstances under which it is better to call a specialist. “When the GP truly understands what the specialist does and why it is so unique, that serves to reinforce the referral rather than erode it.”

The successful endodontist – or, again, any specialist – chooses to act as a teacher, a mentor and a subject matter expert – rather than merely serving as the outsourced resource for especially tough cases, says Cooper.

It’s as true today as always, that “the more knowledge you share, the more people will respect the knowledge base you have,” says Cooper. The generalist will never know as much as the specialist about any given specialty, but the specialist can share enough knowledge for the generalist to feel, “Wow, I have really learned something from that person,” she says. In the process, the specialist not only earns that GP’s future referral business, but his or her respect as well. “It becomes a cycle of positive referral energy rather than a vicious cycle of scarcity.”

It’s a paradigm shift. Particularly among specialists, the sense of territoriality is strong. Orthodontists, for example, resisted Invisalign in the early years, she recalls. “But one could argue that Invisalign is one of the major trends that brought adult orthodontics into the forefront,” ultimately expanding the market for the orthodontist.

“It’s eye-opening for specialists to think of GPs as partners,” says Cooper. But today’s economy is no longer on the shaky ground of 2008, 2009 or 2010. “That scarcity mentality – the feeling that there’s not enough work to go around – isn’t [appropriate anymore]. And it was never the right mentality anyway.”

Two customers
Endodontists, like other specialists, have two sets of customers – GPs and patients. In order to market to both, the specialist must understand the mindset and needs of each. “But it’s important not to think of this just as marketing, but as better communication, and really fostering relationships,” says Cooper.

“When stepping into shoes of GPs, [the specialist] has to think about the fact that they are hungry for knowledge; they’re thirsty for it; they want to learn more,” says Cooper. “There’s a reason dentists do so much CE, and it’s not just because they have to. They love learning new techniques, ways to add revenue streams, ways to do more cool dentistry. And the more [the endodontist] can provide them in terms of knowledge, maybe by hosting a study club or meeting with them on a regular basis, the more value he or she offers them.”

In fact, specialists should ditch the Thanksgiving turkey or ham, and instead, offer their GPs something of real value – knowledge. And those specialists need to think beyond reaching the dentist. After all, many referrals are suggested at the GP’s front desk. “They might have a couple of endodontists’ cards for their patients, but it’s the front desk person who will say, ‘This is the guy or gal you really should call,’” says Cooper.

When dealing with patients, endodontists need to turn off their “dental brain” and instead turn on their “human brain,” says Cooper. “That’s difficult for GPs, and it’s almost impossible for specialists.” Specialists spend so much time talking to GPs and their peers, they almost forget how to communicate to patients.

Patients aren’t looking for in-depth information about endodontic technique, says Cooper. They know their limitations in judging the clinical expertise of the specialist. In fact, they assume competence on the part of the specialist to whom they have been referred.

Rather, patients are more concerned about, “Is she nice? Gentle? Is the staff friendly? Will I be treated like a human being?” Many patients today – particularly younger ones — consult Google prior to calling the specialist, to learn about the practice, read patients’ reviews, and get answers to some of those questions.

By also operating from a place of abundance, sales reps can help their endodontist customers thrive, says Cooper. For example, reps should consider Googling the practice prior to calling on it, reviewing its website and reading any reviews about the doctor and his or her staff.

If the practice has only four or five positive Yelp reviews, the rep can encourage the front desk to solicit more from patients who love the work of the endodontist and staff. Or, if the practice’s website looks dated, or if it hasn’t been optimized for mobile devices, the rep can point the staff to resources that can help.

“If you as a rep are helping the dentist create abundance in their practice, you are becoming a teacher to them, and how much more are they going to trust all your other recommendations?” says Cooper. “Because you recommended something from which you had nothing to gain, they will look at you with a fresh eye.”

Marketing upgrades for the specialist

At AAE15, Naomi Cooper, president and founder, Minoa Marketing, and chief marketing consultant, Pride Institute, offered endodontists three marketing upgrades. She shared them with First Impressions.

  1. Adopt a brand and logo. Give your practice an identity. Many dentists and endodontists, particularly those who have been in practice 20 or 30 years or more, have a common name for their practice: First name, middle initial, last name, DDS or DMD. “Even if they have an associate or are planning to retire, or are thinking about running away to Europe to become a concert pianist, they still invest all of that affinity in their own names.” Sometimes, name does matter, such as a father/daughter or mother/daughter combo; a third-, fourth- or fifth-generation practice; a husband/wife team, etc. But in most cases, the doctor’s name isn’t necessarily the best route to go. Assuming the doctor does come up with a catchy or revealing name for the practice, he or she has to make sure that brand is consistent – on the website, business cards, signage, e-mail communications, etc. “It’s a matter of making sure you’re not sending a mixed or confusing message,” says Cooper.
  1. Create a website, and keep it current. A sharp, well-designed, well-maintained website demonstrates the practice is modern. More fundamentally, “it communicates you exist,” says Cooper. If the practice lacks a website or has failed to update it for months or even years, visitors will wonder if the doctor has retired or has simply refused to keep up with the times. Visitors want to see an up-to-date website; so does Google, which controls the lion’s share of web searches today. In fact, the company penalizes websites that haven’t been touched for awhile, by making them more difficult to find with its search engine.
    One more word about websites: Make sure the site has been optimized for mobile devices, says Cooper. “In today’s world, the majority of web traffic is on mobile devices, whether it’s a tablet or mobile phone.” When searching for information, people today are more likely to be in an elevator, at their kid’s baseball game or in line at the supermarket than they are sitting at their laptop. A mobile-optimized site is one with a responsive design, that is, one that transforms and changes shape based on the size of the browser used to access it.
  1. Solicit online reviews from satisfied patients. Online reviews can validate a practice. Failure to ask patients to post good reviews is wasted opportunity.

Editor’s note: Reps can steer their customers to a Google site to help customers gauge the “mobile-friendliness” of their websites. The URL is