How Patient Perception of Care Affects Practice Growth and Treatment Outcomes

HOW

PAT I E N T P E R C E P T I O N OF CARE AFFECTS PRACTICE GROWTH A N D T R E AT M E N T O U T C O M E S Written by: Adam McWethy, Vice President of Content Strategy, Spear Education

Spear Education provides dental continuing education for striving dentists that are dedicated to the pursuit of clinical excellence in dentistry

H O W PAT I E N T P E R C E P T I O N O F C A R E A F F E C T S P R A C T I C E G R O W T H A N D T R E AT M E N T O U T C O M E S

CONTENTS “When we [began implementing] Spear Team Meetings – I’ll tell you,

10

4

Introduction: It Takes a Team

4

6 The Pillars of Patient Satisfaction

8 Where to Invest and Why

The Pathway to Team Improvement

12 Summary

12 10

that was when the wheels started to turn and [our practice] started to become a well-oiled machine.”

— T I F F A N Y D A L T O N , F. A . A . D . O . M . ,

13

OFFICE MANAGER

References

14 6

8

3

H O W PAT I E N T P E R C E P T I O N O F C A R E A F F E C T S P R A C T I C E G R O W T H A N D T R E AT M E N T O U T C O M E S

INTRODUCTION I T TA K E S A T E A M You have all the latest equipment in your dental practice (and you know how to use it).

Your degrees and certifications are hanging on the wall in your office.

And you keep up with all the latest developments in dentistry through continuing education.

You feel like you’re exuding competence and confidence in your chosen profession, yet for some reason you’re finding your patients have doubts. They are turning down or delaying treatment and, in some cases, seeking second opinions.

W H AT I S G O I N G O N ?

Most dentists know that patient satisfaction affects outcomes in the practice – from case acceptance to referrals.1 However, what they might not realize is patient satisfaction is affected not only by the dentist’s competence, but by the perceived competence of the dental team as well. Unfortunately, even the most skilled dentist and highly trained dental staff can suffer from a perceived lack of competence if no one in the practice is working from the same playbook.

Knowing this, the question now changes from, “How does a practice owner increase patient satisfaction,” to, “How does a practice owner develop organizational cohesion in the practice?”

And that is the question this white paper will answer.

5

H O W PAT I E N T P E R C E P T I O N O F C A R E A F F E C T S P R A C T I C E G R O W T H A N D T R E AT M E N T O U T C O M E S

THE PILLARS OF

PAT I E N T S AT I S FAC T I O N According to successful businessman and author Julian Richer, “Unless the customer is happy the business will not last.”2 Therefore, before digging into the solution for improved organizational cohesion, it is imperative that you first fully understand the end goal: patient satisfaction.

Based on findings in multiple studies, there are four main components that affect a patient’s peace of mind.3

There is a common thread that ties these four components together: financial investment.

However, some clinicians may be surprised to realize that it is not the patient’s financial

Perception of competence

Expectations

investment in question, but the practice’s.4,5

The Pillars of Patient Satisfaction Anchoring of beliefs

Ability to manage or reduce pain

7

H O W PAT I E N T P E R C E P T I O N O F C A R E A F F E C T S P R A C T I C E G R O W T H A N D T R E AT M E N T O U T C O M E S

WHERE TO

INVEST AND WHY

Each person must know what

This brings back the question

equipment is in the practice and

posited at the beginning of this

what it can do, as well as what

white paper: “How does a practice

procedures the dentist and staff can

owner develop organizational

perform or not perform. That is one

cohesion in the practice?”

of the benefits of structured team training; it ensures staff members

The solution, of course, is team

can intelligently explain why the

training. Most dentists who own a

practice has a particular piece of

practice will have tried some type

equipment and how it will benefit

of team training program. And just like the other keys to patient

When it comes to financial investments

Further, as Calnan, et al, showed,

the patient’s treatment. For example,

in patient satisfaction, there are a

pain management is a major factor

if a patient asks about a CEREC

satisfaction listed above, this, too,

couple of low-hanging fruit dentists

in patient satisfaction. However, just

device, a technician could explain

requires an investment of both time

70 percent of patients said they

the benefits of chairside restorative

and money. Unfortunately, this can

felt their dentist made an effort to

dentistry, thus diminishing – or even

begin to feel like money squandered

The first two components of patient

minimize pain. Thus, an investment

eliminating – the perception of that

when team members do not

satisfaction, perception of competence

in products such as IsoDry, which

device being a cost-driver.

implement what they have learned.

and expectations, can be both be at

serves as a bite block among its

can make use of right away.

They watch a video course or

least partly satisfied through marketing

other functions, or Restful Jaw,

Furthermore, staff members who

and advertising. While some dentists

which stabilizes the jaw, can not only

are not knowledgeable about the

the office and go right back to their

balk at the idea of advertising for fear

help with patient comfort and pain

equipment and capabilities of the

former way of doing things.

of sullying their image, research shows

reduction, it also allows the practice

practice may fail to fully meet a

that it is a non-issue for patients. In a

to stand out from most others. This

patient’s needs. For example, if a

How, then, can a practice owner

study on consumer attitudes toward

is also true of in-office scanning

patient tells the front desk employee

ensure his or her team members

advertising, researchers found that

and milling equipment, such as the

that she suffers jaw pain during

retain and implement their training

CEREC, that will work to reduce the

lengthy procedures and the employee

in a manner that is consistent with

advertising, it did not negatively affect

number of appointments for a crown

fails to mention that the practice

practice goals?

the consumer’s view of the physician if

-- and, consequently, the discomfort

has Restful Jaw, then that piece of

it was done correctly.6 The advertising

associated with the procedure.

equipment is not put to use and the

when a physician spent money on

attend a seminar, only to return to

patient’s satisfaction is lowered due

needs to be informative and help the public to better understand the value

One obstacle for an office to

to the practice’s failure to mitigate

of the clinician.

overcome is the perception of

her pain.

technology as a cost-driver in As for the last two components,

dentistry. Anecdotally, this is why

anchoring of beliefs and the ability to

Spear faculty hears many clinicians

“Spear Team Meetings have been helpful for ‘de-programming’

manage or reduce pain, dentists can

say they do not highlight new

satisfy this through an investment in

technology because they often hear,

expectations of what the limits of our jobs are. Rather than the

dental technology. The most obvious

“I see why this costs so much,” from

benefit here is perception of value.

patients. That is why both extensive

When patients walk to and enter the

training and a cohesive message

operatory, their perception of value is

are so important.

in part affected by what they see. If they deem the technology on hand to be less than adequate, the perception of value is diminished, directly affecting patient satisfaction – even before treatment has started.

tunnel vision we had before, now I can see everyone thinking as a team. I think it wasn’t about not caring, but not knowing.”

— J I L L D E R R Y, E X P A N D E D F U N C T I O N S D E N TA L A S S I S TA N T A N D O F F I C E M A N A G E R

9

H O W PAT I E N T P E R C E P T I O N O F C A R E A F F E C T S P R A C T I C E G R O W T H A N D T R E AT M E N T O U T C O M E S

CHANGING TEAM BEHAVIORS

T H E P A T H W AY T O

TEAM IMPROVEMENT In 2002, Anja Kolluss and Julian Agyeman dissected current research on producing pro-environmental behaviors. While their study was the environment’s best interest, there were some parallels to the issue of organizational cohesion. Specifically, they addressed barriers to getting people to behave in a manner that is good for the whole of society even if that behavior did not affect their individual lives significantly. A dental practice may see this in hourly assistants and hygienists who believe they do not benefit from growing the practice as they won’t necessarily

Utilizing this research, Spear revamped the way it approaches its own online

Social norms significantly influence and shape people’s attitudes, which in turn affect behavior.

Normative influence

Training as a group instead of individually helps create the social norm that learning and change is part of the culture of the practice.

courses that would be viewed haphazardly, the goal became creating a product that actually engendered a lasting positive change in the practice.

One of the first steps was to ensure that the team meetings were created with an

This represents an individual’s perception of whether they can bring about change through their own behavior.

Locus of control

intentional focus, packaged as a series

Each team meeting provides concrete actions that staff can take afterward to make changes in the practice. The locus of control back is now back on the individual staff members in the practice.

placed in a specific sequential order to

meeting curricula follow the best practices of

main considerations:

Direct versus indirect experience

providing an assortment of team meeting

So how can a practice owner change

people’s behaviors, there were four

Team Meeting facilitation guides provide a consistent tested framework for getting everyone in the practice involved.

team meeting curriculum. Instead of just

achieve a result. This led to the development

found that when it came to changing

Direct experiences have a stronger influences on people’s behavior than indirect experiences.

T E A M B E H AV I O R S

see a direct benefit.

this mindset? Kolluss and Agyeman

Spear Approach

CHANGING

7

focused on getting people to act in

Considerations

of Team Meeting Pathways. These team Spear clinicians who have seen the multiplier effect of utilizing these team meetings continuously in their practice. Designed to be completed at least twice per month,

The communicated willingness to take action also gave some indication about the person’s willingness to engage in positive behaviors.

Verbal commitment

Team Meeting discussion guides provide the dentist with tools to engage the staff and encourage participation.

these curricula will help the practice achieve a greater goal than might be

Source: Kolluss and Agyeman, 2002

possible through any one meeting.

Following the Pathway development,

Through this structured team training curriculum, dentists should expect to see their

Spear also sought to answer each of the

teams unified around a common practice philosophy, speaking the same language and

considerations presented by Kollmuss and

working toward the same goals. This helps the practice meet the criteria for patient

Agyeman. To do so, Spear’s faculty created

satisfaction discussed earlier: radiating competence, setting proper expectations,

supplementary content as well as suggested

properly utilizing new technologies and skillfully managing patient pain.

approaches to team training.

11

H O W PAT I E N T P E R C E P T I O N O F C A R E A F F E C T S P R A C T I C E G R O W T H A N D T R E AT M E N T O U T C O M E S

SUMMARY Patient satisfaction is the key to the success of all dental practices.

It directly affects retention, case acceptance and referrals, among other things. However, a dentist practice owner alone cannot ensure a patient is happy with the practice.

It literally takes the entire team – from the front desk staff to the

REFERENCES 4 1

operatory team to the dentist –

Zimmerman, RS. The Dental Appointment and Patient Behavior Differences in Patient and Practitioner

consistently working around a

Preferences, Patient Satisfaction, and Adherence.

unified philosophy.

One of the simplest ways to

Medical Care. 1988;26(4):403–414.

6

create this type of lasting cohesion is through a structured team training curriculum, such as Spear’s Team

2

Richer J. The Richer Way. London: Richer; 2009.

3

Busby MC. Measuring success in dental practice using patient feedback: a feasibility study. 2010.

Meeting Pathways. Dentists utilizing this resource can rest assured that

4

their team is receiving the same

service quality, perceived value, overall satisfaction

high-quality training that they

and happiness of outlook for long-term care institution

receive from Spear faculty based

residents. Health Expectations 2012;17(3):311–320.

on the same philosophies and focused on the same outcomes.

5

And while creating organizational

can increase the most important

Calnan M, Dickinson M, Manley G.The quality of general dental care: public and users’ perceptions. Quality and

cohesion can increase patient satisfaction, more importantly, it

Lin J, Hsiao C-T, Glen R, Pai J-Y, Zeng S-H. Perceived

Safety in Health Care 1999;8(3):149–153.

8 6

metric in any practice: the patient’s

Moser HR. An Empirical Analysis of Consumers’ Attitudes Toward Physicians’ Advertising. Health

oral health.

Marketing Quarterly 2008;25(3):270–288.

11 7

Kollmuss A, Agyeman J. Mind the Gap: Why do people act environmentally and what are the barriers to pro- environmental behavior? Env. Educ. Res. Environmental Education Research CEER 2002;8(3):239–260.

13

H O W PAT I E N T P E R C E P T I O N O F C A R E A F F E C T S P R A C T I C E G R O W T H A N D T R E AT M E N T O U T C O M E S

T H E P U R S U I T O F G R E AT D E N T I S T R Y Patients can feel the support in a Spear dental practice. From office managers and front office staff to practice owners and new associates, there is a recognizable cohesion in messaging and precision of care in the operatory.

Everyone is constantly learning – including patients.

LEARN HANDS-ON With little room for error with often-skeptical patients, your team should feel as comfortable addressing any practice management issue. Guide their professional and clinical development with online courses that cover a wide range of everyday dental practice challenges. Study clubs and campus workshops offer a collaborative, small-group learning environment to discover how to consistently achieve your desired clinical outcomes.

LEARN ON YOUR OWN Spear video lessons and other CE multimedia provide doctors and dental professionals of all skill levels with the training to master any clinical or practice management issue. Our faculty have you covered with content you can enjoy at home, from your practice, or from anywhere you are comfortable.

LEARN ALONGSIDE OTHERS Your peers are just a click away with virtual seminars that allow you the flexibility of attending a large event from anywhere — or attend hands-on, lab-based workshops with like-minded dentists at the Spear Campus in scenic Scottsdale, Arizona.

15