"I'm not really sure patients are brutally honest when asked in the office about their visit and the service they received. Do you know of a good way to get a truly honest response from patients in terms of their satisfaction with a dental practice?"

It is very easy to become complacent in routines. With the day-in, day-out doldrums of work, it is effortless to take things for granted, with the thought that the status quo works.

However, as in any service industry, consumers run dentistry, and oftentimes the consumers see things in a different light compared to the workers. Since patients are out of their element or routine, they become more aware of the environment around them; astute clarity of the goings-on in your office is monitored and internalized.

Hopefully, the environment and service provided leaves a lasting, pleasing effect on the patients. However, when was the last time you stepped back and tried to view the makings of the workplace as a consumer rather than the worker?

Not only should one think about doing a self-performance review, but also think of giving every aspect in the office a "performance" review.  After becoming satisfied with any changes or improvements that you could institute, take the performance review one step further, ask the patients. 

Most likely, if an appointment was truly unpleasant, for any reason, a patient would be more apt to verbalize a complaint. However, if a patient was asked how a visit went when the appointment was mediocre, do you think an honest response would be given?

Many times, patients could come up with an answer that would benefit the way the office was run, but this opinion is not voiced. The patient may fear retaliation by an employee if a complaint regarding his or her behavior was brought up, the patient may be too shy to be truthful, or the patient would be forthright with critical analysis of a problem, even giving possible solutions, if only given the chance to do so, anonymously.

In order to bridge the communication gap, a lot of weight should be given in building relationships with patients . Care, compassion, and great communication skills more often than not bring out honest dialogue that are able to resolve most issues. Unfortunately, if we’re missing on some of these elements, we could miss out on learning from our patients the very things that will help us solve problems.

The question is always debated, “How do I get a patient (customer) to give me the honest truth about how they feel about our practice (company)?”

In my experiences with dental practices, the way to accomplish this is to combine the compassionate approach with a patient survey. There are a few key elements to the survey that I’d like to elaborate on in this article to be sure it is done correctly.

To begin, write an opening paragraph that is friendly and encourages people to respond openly to the questions. Here’s an example:

·        We sincerely hope your experience in our office was exceptional. Because your satisfaction is extremely important, would you assist us in improving our service by taking a moment to evaluate your experience today? Please answer the following survey questions and drop this in the mail. Thank you for your assistance.

Next, develop questions that will address a handful of service matters you wish to evaluate. Following are some examples.

• How would you rate your service overall?
• Are we exceeding, meeting, or not meeting, your expectations?
• When you contact our office, are you treated in a timely, courteous, & professional manner?
• Have you recommended our dental office to anyone?
• If so, thank you! If not, why not?
• If you’d like to comment on a team member, whether satisfied or dissatisfied, please note their name and your opinions here.
• We appreciate and take your advice seriously. What would be your suggestions to help make a patient’s visit more pleasant?

Leave space enough for comments so that people who wish to elaborate can write a few comments.

Construct the survey so that it can be printed on one page, put them in envelopes with a postage stamp attached. Alternatively, you may elect to print these on 4x6 postcards.

The key point to a patient satisfaction survey is to have the responses sent to an independent 3^rd party, or alternate address other than the office, if at all possible. Here’s the thought; people are more apt to give an honest response if they believe the surveys are being sent to an objective 3^rd party. Response rates for unsolicited customer satisfaction surveys usually range from four to eight percent. In my experience, when patient surveys have been implemented in practices under my guidance, we see anywhere from 75 to 83% response. The reason being, we’re handing them out directly to the patient, encouraging them to respond confidentially, and incorporating the system intelligently.

It is helpful to keep a ledger of all the patients who were in the office and that each of these patients was given a survey.  In addition, it would beneficial to always have more than one employee responsible in handing out and double checking that the patient did indeed get a survey.  Not only does the survey help to enlighten you as to the patient visit, it also could be a potential spotlight on a specific employee.  If there was a conflict with an employee during the patient's visit, and the employee in question felt responsible for poor actions or behaviors, this same employee may be more apt to "forget" to give the patient a survey. 

Here are suggestions for how to orchestrate the distribution of surveys in the office. Modify them to suite your practice’s particular style.

Place the surveys in each of the office's operatories and at the front desk. Give one survey to each patient after the office visit. Keep in mind the advantages of the survey when getting ready to release it to the patient: Confidentiality breeds honest response, so stress to the patients that it is being mailed to an independent 3^rd party.

Present the patient survey in a positive light:

“We’re always interested in learning if there is any way we can improve the service we provide our patients. Would you please help us by completing this confidential questionnaire? This is returned to an independent 3^rd party who will compile all the information for us. It’s more important to us to know what we need to do, rather than who is providing the feedback. Thanks for your help.”

It is best that the surveys are collected off site, by an independent 3rd party, rather than the dentist’s home or an employee's home, and that either the 3rd party or the dentist are the first to see the answers given in the survey.  In being the first to review the surveys, all the information can be accounted for. If the dentist chooses to use an employee's home for collection, be sure that the employee hands over the surveys unopened. In this way, there is no shredding of evidence implicating either the employee collecting the information, or the protection of a fellow employee.

The survey results should be tabulated off site, and should never be viewed in the office in front of patients. Any comments that merit immediate discussion or action should be delivered to the office quickly.  If any negative patterns are apparent from the survey results, action steps to improve the problem should be implemented as soon as possible. The survey results should be discussed frequently during the morning huddle or at the regularly scheduled office meeting.

More often than not, the surveys reveal what the office is doing right, and also specific employees are positively recognized for actions taken during a visit. Discussing the results, including a specific employee who was listed can boost morale for the entire team, while also improving performance. An employee may go the extra mile hoping that a patient will individually recognize him or her!

The final steps of the management process, when incorporating a patient survey, are to mold the feedback into management action steps and explain to the team how to solve some of the issues presented during a regularly scheduled team/office meeting. Try not to find blame with any one individual, rather find the fault in the practice management system. Fix the system rather than singling out the person. However, if a significant negative incident involving a single employee is brought to light, have a private meeting, one-on-one, with this employee to gather more information regarding the incident.

Here are some examples of what I mean:

A comment by a patient was made that she heard side conversations by the staff about subjects not connected with dentistry, and was offended. Or, a patient commented that he was in the treatment room near the front desk, and overheard the staff discussing how difficult a patient was being on the other end of the phone.

Use this feedback to suggest that these comments are not appropriate and we must be on our best behavior during each moment of the day. Patients can hear more than what we think; it’s important to be aware of how our voices carry. Re-affirm that being patient and respectful to all who come to the office is vital in excelling in patient services.

Another example is a response that indicated a patient waited for some time for a scheduled appointment. In addition, when she arrived at the office, no one acknowledged her. Again, provide feedback to the team and suggest ways to be aware at all times of the schedule and patients in the office. On-time performance is important for people coming to the dental office, as their time is valuable. Know that a reason why patients are late or change their appointments is that we may run late or we may contact the patient to change appointments for some reason. Is turnabout fair play? No. Patients may very well respect your time as much as you respect theirs; but remember, patients are the consumers.

We discuss often in Practice Pointers the importance of patient services. Keeping this portion of the practice operating at peak efficiency is a keystone in practice success. Make sure you know what your patients are really thinking and conduct a survey so that you know for sure. Don’t become complacent in the day-to-day activities of running your business. Be sharp, be aware, and be successful!