Faithfuls, Traitors and the Undecided - a guest post by Lisa Bainham

Who's really sitting at your practice's round table?

If you've spent any winter evening shouting at the telly while a group of strangers in a Scottish castle accuse each other of treachery, this one's for you.

I've been in dental practice management for the best part of 30 years and I've worked with hundreds of teams in that time. Somewhere along the way it struck me that every practice has its own round table. Around it you'll find three kinds of patient: the Faithfuls, the Undecided and, every now and then, a Traitor.

Now for the uncomfortable bit. Most of the patients at your table didn't turn up by accident. We invited them, through our marketing, our phone manner, our policies and, more than anything, the way the team behaves day to day.

So, it's worth asking. Who are we trying to attract?

The Faithfuls

These are the patients we all want more of. They book their recall before they've even got their coat on, they thank the nurse, and they send you their sister, their neighbour and half of their gym. When something goes wrong they come and talk to you rather than heading straight for Google.

What we forget is that Faithfuls aren't loyal to a building. They're loyal to how we make them feel. In my experience you rarely lose one through a big mistake. You lose them slowly, by taking them for granted. They're left sitting in the waiting room with nobody explaining the delay. They leave without their next appointment booked and nobody chases it. Or they find out about a fee increase at the desk, after ten years of coming to you.

Keeping them isn't complicated, but it does need everyone doing it every time. Make a note of how they like to be addressed. Make the post-treatment call. Say thank you when they refer someone. Treat them as people rather than appointment slots, because even the most loyal Faithful will drift off if they're ignored for long enough.

The Undecided

This is the biggest group at the table and, honestly, the one most practices neglect.

New patient enquiries, nervous patients, people ringing round for prices, and the patient who's had a treatment plan sitting in a drawer for six months.

The Undecided notice everything. How long the phone rings. Whether whoever answers sounds pleased to hear from them. Whether the price they're quoted matches the website. Whether anyone actually takes the time to explain things.

Whenever I sit down with a team to look at their new patient enquiry figures, I see much the same thing. The calls are coming in but the bookings aren't following, and two people taking the same type of call can get wildly different results.

Implant enquiries are a good example. A patient rings round for prices, the team panics, quotes a number and the patient books down the road because it was cheaper. A confident team handles it differently.

They help the patient compare like with like by suggesting a few questions to ask wherever they call:

•      What's included in the price?

•      Which type and brand of implant will be used?

•      Is a CT scan included?

•      Is the lab based in the UK?

•      Might bone grafting be needed, and would that cost extra?

That isn't selling. It's helping, and patients can tell the difference straight away. Add clear pricing, no pressure and following up when you said you would, and an Undecided patient becomes a Faithful. Get it wrong once and they've gone.

The Traitors

We've all met them. The repeated late cancellations, the failed appointments with no apology, the haggling over fees, the patient who's all smiles with the dentist and short with reception, and the one-star review that gets mentioned the moment they don't get their own way.

I'll be honest, though. Most of these patients aren't bad people. They've just learned that our rules bend, and often we're the ones who taught them. We do it when our marketing leads on discounts and pulls in people who only want discounts. We do it when online bookings go through without a prepayment, but phone bookings don't. We do it when we waive a failed appointment fee because the conversation felt awkward, or when we let someone speak to the team in a way we'd never put up with at home.

The words we use matter as well. I always encourage teams to talk about a prepayment rather than a deposit. A deposit sounds like money you might lose, whereas a prepayment is simply paying for your appointment in advance. It's the same policy, but a very different conversation.

None of this is about punishing patients. Clear policies, applied the same way by everyone and explained kindly, protect your time, your team and the Faithfuls who do turn up.

Sometimes the Traitor is us

In the programme, the Traitors survive for one reason. The Faithfuls don't work together. They bicker, they suspect each other and they vote on gut feeling rather than evidence.

Sound familiar? If one receptionist waives the fee and another enforces it, patients quickly learn who to ask for. If the dentist agrees to everything in surgery and reception then has to say no at the desk, reception ends up as the bad guy.

Patients don't take advantage of strong teams. They take advantage of the gaps between people.

Part of the reason those gaps appear is that we all work differently. In my training I use four simple working styles: Quick, Warm, Steady and Careful. None of them is better than the others. Quick gets things done, Warm makes patients feel at home, Steady keeps the diary on track and Careful spots the mistake before it turns into a complaint. When a team understands each other, that mix is brilliant. When it doesn't, you get the sniping and side comments that patients pick up on the second they walk through the door.

It helps, too, if the whole team handles a complaint the same way. I teach three Rs.

Recognition comes first, acknowledging how the patient feels before anything else. Then reassurance, letting them know you're going to help. Then resolution, agreeing what happens next and who's doing it. A team that's aligned doesn't just deal with Traitors better. It gives them far fewer gaps to slip through in the first place.

Try this at your next team meeting

You don't need a castle or a cloak, just twenty minutes and a team willing to be honest.

1.     Start with your Faithfuls. Name three things you do that make loyal patients feel valued, and one thing you've quietly stopped doing.

2.     Then the Undecided. Listen back to a recent new patient call, or role-play one, and talk about what would have made that patient say yes.

3.     Then the Traitors. List every policy you apply inconsistently and agree who's going to close each gap.

4.     Finally, take a round table vote on one change the whole team will make this month. Everyone, every time.

The final reveal

You don't beat the Traitors by being suspicious of everyone. You beat them by being a team that's united, consistent and kind.

Patients learn how to treat a practice from what the team lets them get away with. Boundaries and warmth aren't opposites. Put together, they're exactly what Faithfuls are built on.

So have a look around your round table. If you're not happy with who's sitting at it, the answer probably isn't better patients. It's a team that's pulling in the same direction. And unlike the programme, you don't have to wait until the final episode to find out who's on your side.