Grading patients in rural communities
“Dear Chris,
We are starting to filter the patients as suggested into A B C D categories.The response from the rest of the practice staff has been very positive. They are delighted and we have found out about a few patients who make their working life a hell.
We have found two problems, however, which we would appreciate your advice on, whether by email or at the next workshop day.
1) As we work in a rural community, most patients know each other… and when one class `D` patient receives their “bye-bye” letter they tend to check with other patients to see if they are also being de-registered. When they find they are not, they arrive quite aggressive at reception, thrusting their letter into the receptionists face saying, “Why me? You are not de-registering my neighbour/sister/cousin, etc.”
2) We now have the problem that when we are discussing some class `D` patients to de-register, staff are saying, “Yes, I really want to get rid of them, but how will I cope when they come in questioning why?” Some patients have also asked for details on our “de-registration selection policy`. This has made us all realise what a good idea it is to get rid of these patients, but any help on making the process easier for our staff would be much appreciated.
3) We have tried to categorise all patients separately at reception and in the surgery. We do, however, sometimes find a lot are between C and A/B: they don’t love us, but they are never rude to staff; they always turn up on time and pay their bills when asked; they never recommend us to their friends, but equally would never advise their friends not to attend to see us. Is this common? We have developed a `U` category `unclassified` and listed these patients there. We were wondering if other dental practice clients had similar problems.
Thank you for your help.”
“Dear Dentist
Well, for once, I am not going to give you a direct reply but pass on the thoughts of another client – this time from Western Australia of all places.
Bill James-Wallace is a business coach working with Mortgage Brokers “down-under” – an unlikely source for dental business coaching but I feel his comments are a useful starting point.
“Firstly, I feel for them being in rural area. The best thing about these areas is the “community” that is developed. It also becomes a major issue when changes are made – like this one. I was an Area Manager for a large bank and had to introduce cultural change in a short period of time. We won many friends and broke sales records all the way along (which weren’t broken for years after we left!) but we also had many sleepless nights and nauseous feelings during the day. (I know what “blood, sweat and tears” really mean!)
I’m not sure my suggestions will be on the mark but here goes:
- D Class customers: sometimes it’s just a grin and bear it situation. (I don’t suggest they grin publicly). As you have probably been through with your client, how compelling is their vision and what part would D Clients play in that vision? If the answer is “no part” can they refer them to another dentist (I am assuming they can’t). Can they manage their behavior and keep them? (I am assuming that wouldn’t fit with the vision) In the end, having a vision that does not fit in with the community may be something for reconsidering. I don’t mean keep the “D’s” and let go of the vision. I mean to consider this community issue within the vision – then classify. Perhaps also consider a period of time (3 months?) where there will be conflict and plan to get through that in a proactive way. The worst thing that could happen, however, is that while the A class clients enjoy being “A”, they may philosophically disagree with classifying clients this way – then you lose at both ends – which I hope they don’t.
- For the “U” clients perhaps it can be seen as an ongoing project. I work with Mortgage Brokers and we have been segmenting our client bases as well. One thing I impress upon them is that the classifications are in “wet” cement. That is, the classification can stand up on its own but if necessary, with information gained later, you can move the marker. If I were them I’d put the “U’s” in a category and manage them as such, then review them in 3 – 6 months and see if they still belong to that category. “
Bill James-Wallace
Director, PA Services
PO Box 87
Morley WA 6943
Web: www.pabiz.com.au
Email: admin@pabiz.com.au







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