Building Friendships
As a consequence of the recent increase in professional liability insurance premiums, professional conferences are beginning to sponsor speakers who are addressing the problem of malpractice avoidance. One of the themes that keeps emerging from these conferences is that people don't ordinarily sue people they like. In light of this, any time spent developing friendships with our patients and their families is time well spent. Theodore Levitt calls this "relationship management".
It isn't difficult to establish rapport with our patients. We see them often and-- provided we do not totally delegate their treatment to assistants-- we can come to know them and develop mutual admiration. But we need to treat them like worthwhile human beings; show an interest in them; share their interests; help them to achieve a winning smile with as little pain, discomfort, and trauma in the course of treatment as possible; show respect for their time by keeping appointments on time; finish their treatment on schedule; and communicate our friendship throughout treatment and beyond.
Parents of child patients present a different problem. Traditionally, orthodontists haven't been comfortable with parents and, for this reason and to save time, have often taken unusual precautions to keep parents out of the operatory. This may have had some justification when orthodontists were required to perform most of the operatory tasks, and income was more closely related to the use of the doctor's time. There may still be some justification, because some children misbehave when their parents are present. However, an aversion to having parents in the operatory can easily become a communication block and rob us of excellent opportunities to inform them about treatment, enlist them as allies, and make them missionaries for our practices.
If we decide to encourage parents to visit the treatment room, how do we manage it? In our office, we mark each parent visit with a blue magic marker on the treatment chart. This system lets us look at the treatment chart and see instantly how long it has been since the parent's last visit chairside. It isn't usually necessary to visit with the parent at every appointment, but if the treatment card doesn't have a blue line on it for several consecutive visits, we make a special effort to get the parent into the office.
We also removed a sign that identified the treatment room as patient territory. One of my sensitive, empathetic assistants told me it seemed incongruous to encourage parents to come in when there was a sign that made them feel out of place. It would probably be even better to have a sign on the door saying "Parents Are Welcome in the Treatment Room".
The consultation is an excellent time to make it clear that parents are welcome in the operatory and that the doctor is always available to talk about treatment progress. You can reinforce this invitation in your post-consultation letter. Many parents are intimidated by the professional office, and we need to do everything possible to let them know we value their friendship and encourage their visits and questions.
Combining the traditional separation appointment with oral hygiene instruction also creates an opportunity to enlist parental support. Because patients with clean mouths tend to be the most cooperative, it is important for the parents to share the responsibility for emphasizing oral hygiene.
When parents call us about their children's progress, we take their calls immediately or, when that is impossible, return their calls promptly. We don't ignore telephone calls from friends, and we shouldn't ignore those from parents. We actively solicit patient and parent opinions through satisfaction surveys. We publish a quarterly practice newsletter, which has proven to be a friendship vehicle. A few offices have even established parent/patient advisory boards.
Parents who feel a kinship with the practice may try harder to keep appointments, and may tend to make their payments on time. Also, with the growing interest in orthodontic treatment among adults, parents who feel friendly toward the doctor and the practice may more readily become patients themselves and refer other adults for treatment.
Orthodontists can hardly spend their time better than in cultivating friendships in their practices. It builds cooperation, it builds referrals, it avoids malpractice suits, and it makes practice less stressful and more enjoyable.