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To Maximize Patient Experience, Focus on Before and After


The best way to improve patient experience is to build a relationship that extends beyond the brief appointment time.

Before and After

In the age of "selfies," everyone seems eager to let everyone else know exactly what they’re doing at that exact moment. But our Facebook feeds are also full of a different kind of selfie — the old “before and after” standby. And when it comes to patient experience, the “before and after” is just as important as the time the patient spends in the office.

That’s the message from Robert Brinkerhoff, a professor at Western Michigan University, when he talks about the 40/20/40 Model for High Impact Learning. And it has particular relevance where dentistry and the patient experience are concerned.

Kordell Norton, CSP, author of “Business Charisma — How Great Organizations Engage and Win Customers Again and Again,” explains the model.

“Brinkerhoff’s research shows that only 20% of the impact occurs when the teacher is in front of the students,” Norton says, equating the teacher-student relationship to that of the dentist and patient. “Forty percent of the potential impact occurs before the student even shows up, and 40 percent occurs after they leave.”

In other words, dentists looking to maximize a patient’s experience should take a closer look at what happens before and after the patient encounter.

Expanding Reach

Norton recalls have a bone graft done for a dental implant. When he arrived at home late that night, around 9:30 p.m., his phone rang. It was the oral surgeon herself calling to check up and make sure he was doing well.

“When’s the last time a dentist ever called to follow up on a patient?” Norton asks rhetorically. “There’s a huge opportunity for dentists to impact the lives of their patients before and after they sit down in the chair.”

An orthodontist Norton worked with had an iPad with each patient’s name on it when they walked in the front door. Written on the iPad was, “Welcome, we’ve been waiting for you to arrive …” followed by the patient’s name. Then when the patient’s braces come off, they’re given a magic marker and told to write a testimonial on the wall.

“The walls of this orthodontist’s office are covered with, ‘Thank you Dr. Zach. I love my new teeth, and my new smile,’” Norton says. “Then they take a photo of the patient and the orthodontist, and the dentist signs it. The patient takes home an autographed photo of his orthodontist.

What those actions are saying, Norton explains, is that the orthodontist recognizes the importance of giving the patient a great experience when in the chair. But he also recognizes the importance of involving the entire family in the experience.

“I went to another dentist’s office and they had a jar of Chapstick with the dentist’s logo on it,” Norton explains. “When kids come in they ask, ‘Can I have a Chapstick?’ And they’re told, ‘Only if you take two and give one to a friend.’ Dentists live and die on referrals, and the best referrals are not from other doctors, but from other patients.”

Paying for the Experience

Norton says the research he has conducted indicates that the value of a dentist’s chair-side manner is worth 50% more in the marketplace. In other words, patients are willing to pay up to 50% more for an engaged, charismatic, fascinating experience. And employees at the practice are less likely to call out sick and are more promotable.

“The staff experiences less turnover, which is a cost savings,” Norton says. “They refer more patients, which is a cost savings. In a very real sense there are multiple ways that this approach is hugely profitable for a dental practice.”

Norton recommends that dentists reconsider their competition in today’s marketplace. He says that it’s not another dentist down the street, or another healthcare professional. The dentist’s competition, he says, is Disney, and Apple, and Trader Joe’s and Cirque du Soleil—because that’s what patient experiences should be like.

“When the dentist is the sole creator of value, then that stifles creativity and the application of that creativity, which is called innovation,” Norton explains. “If a dentist says, ‘I’m a professional,’ but doesn’t turn loose the creativity of their own staff, then it’s just a matter of time before they’re going to get run over by somebody with more personality, warmth and charisma.”

Customer satisfaction is critical, Norton says. He points to the HCAHPS Hospital Survey already in place as an instrument for measuring patients’ perceptions of their hospital experience.

“That’s coming to dentists whether they like it or not,” he says. “It’s just a matter of time before malpractice insurance is assigned to the level of patient experience. Why? Because everybody is already doing it.”

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