You are 40 minutes behind, your next two patients are waiting in your reception area, likely getting irritated at this point, and this one won’t stop talking. Why do some people feel the need to give us minute details of every single thing that led up to this one toothache, when we can so easily tell from a 3 second look and a simple x-ray what it is, how it got there, and what to do about it. But this woman can’t stop talking. She feels the need to tell me about how every single food she has tried over the last two weeks specifically effects her tooth. And then she has to describe the way she prepared that food! OMG, I don’t need to know that a strawberry when simply washed and eaten causes feeling A, but when she puts it in her smoothie, she experiences feeling B! But feeling A and feeling B are pretty much the same things anyways, and I want to scream and yell: I GOT IT!!! EVERYTHING HURTS!!! But I can’t because, let’s face it, professionalism aside, we can’t be a$%holes to our patients. They are looking to us to help them and some of them believe that the more detail they provide, the better we can help them. So I sit in silence as she rambles on and I still have to go through the rest of her mouth with her, and it’s going to be intense.

I think any dentist can relate to this and I am sure you have, at one point in time or another, fallen into the deep well of the “Chatty Cathy”. But more often than not, even without this type of patient, we are running around, rushing through and still feel like we wish we had more time. There are many ways I tried to manage all types of occurrences in the past. We would move patients around in the schedule, we apologize for running late, we ask the patient to come back another day, we reschedule the consult, we pass them on to someone else who is able to finish the discussion… all ways to manage the problem currently happening, but none of this really fixes it long-term. And then there was the pissy patient who was mad or complaining, be it cost, or unexpected outcome, discomfort after a procedure, any number of issues we deal with on a daily basis.

When COVID shut us all down for three months, I began to go through different stages of emotions and resolutions. The first, like for many of you, was fear, denial, sadness, boredom, and then acceptance. When I got to acceptance of what was going on, and knowing that everyone else was in the same position, it allowed me to clear my mind and think. Really think. And for the first time since I can remember, I had endless time and no interruptions. Nobody was waiting for me in the reception area, there were no patients in other rooms waiting for me to come in and check them, there was no staff members asking me questions, and the phone and emails were silent. I had calm like I’ve never had before. So I sat down one morning in my favourite spot where I always sit to be alone with my coffee, and wrote down in a freshly opened Pages doc, on my laptop:

What is the one thing that I could do in my business when we re-open, that would give me more of this feeling: CALM?

I wanted calm the most. I wanted to reduce the chaos, the stress, the running around, the constant putting out of fires, and build calm. But how? Since I already knew the WHY behind this, I asked myself: how can I achieve this, or at least work on achieving it some of the time? And so I started to break it down by categories, based on the types of events, triggers, or personalities, that resulted in creating the chaos and stress. And once broken down, I began to see a pattern emerge. I found out that the reason I was constantly stressed, constantly pushed and pulled in all directions, constantly managing and putting out fires, all these things that led me to hate doing what I do so many times, were due to one simple element:

lack of clearly managed expectations

You are probably reading this going: WHAT??? What the he!! does that mean? Let me explain. When a patient is pissed about something, say the cost of treatment, it’s likely because you (or someone in your office) didn’t explain it properly. When a patient is waiting for you in reception and you are running behind, they get mad because nobody properly communicated to them early on what’s happening and given them the option to reschedule. And when something goes wrong after a procedure and the patient calls or emails you a nasty message, or gives you a crappy google review, it’s likely because you didn’t properly inform them of this possibly happening and what you would do about it if it did. Managing expectations does not mean managing patient behaviour. It means that you have clearly outlined (verbally as well as written) what it is that is going to happen in the future. So this is about how you communicate BEFORE you do something, not during or after.

I have created my own package of information, how I want things done, step by step, and ways to communicate with patients so that we manage expectations and do things well rather than doing them fast. We have written documents that are sent to each patient for every procedure they are scheduled for, as soon as they schedule the appointment and we go through the information again on the date of the appointment prior to doing anything so that they have had the information at least 2 times before I start. This gives them a chance to ask questions and gain clarity. We send written documents with specific post-op instructions and what to expect, and what to do when the unexpected happens, and we also do this verbally at the end of the appointment, so again they get this information twice. We do written estimates as soon as they schedule an appointment, we do written financial arrangements that get signed and uploaded into the patient chart, and all financial aspects of their scheduled treatment are discussed in detail before they come back in for their appointment. Everything is emailed to the patient so they have full clarity of costs associated with each appointment. If I am running late, either I or one of my staff, will communicate this to the next patient and if they haven’t arrived yet and I know I am going to run behind, we call/email/text to let them know and offer the option to come later, or reschedule with an explanation and apology. These are just some basic examples of the massive step-by-step Program I built to create CALM in my office.

But my favourite part that I built for my CALM Program is the New Patient Protocol. There is so much to this one but the main and most important aspect is the way I present treatment. And the way I build value, urgency to go ahead, and a huge desire for the patient to accept a comprehensive plan rather than a “one crown per year” plan. By changing a few simple things and focusing on the ‘important’ rather than ‘urgent’, I have been able to shift many of my patients to accept the optimal solution for themselves, (often a full mouth rehabilitation or multiple teeth at a time to improve aesthetics or bite position) rather than dealing with the one urgent issue they came in with. And yes, it does start out with their Chief Complaint. But it takes them, step by step, into a place of understanding why if all I do is fix the one thing and not ALL the others, they will just be back her in a few months with another and another and another. And the way I finish the presentation, the specific obscure yet incredibly effective statement is the key to that entire presentation. And that key, I can teach you when we meet because the way you use the key is dependent of the type of personality you yourself are.

If you would like to learn more about the CALM Program, send me a message and ideally, share with me a bit about what you want to achieve in your practice.