Feedback – lateral thinking

Jacqui Goss explains how to gather reliable patient feedback

We all want to know what our patients think, so let’s apply some lateral thinking to finding out what makes them tick. 

I read the Dental Complaints Service Annual Review 2011-2012 recently. The Dental Complaints Service is a team of trained advisors in the U.K. who help private dental patients and dental professionals settle complaints about private dental care. This is a free service, funded by the General Dental Council, the organization that regulates dental professionals in the U.K. The headline news from the report is that complaints increased by 17% compared with the previous year. What I focused on in respect of this article is that root canal treatment was equal fourth (with implants) in the top five treatment types for complaints. 

Of all complaints received, the Dental Complaints Service (DCS) resolved two thirds in less than a week. The DCS has recovered in excess of one million pounds (which is equivalent to $1.64 million U.S.) for patients since it began operating 6 years ago. 

Do these two facts suggest that not only is the DCS doing a good job, but that many complaints are readily resolved with dentists not holding back when it comes to giving financial compensation? 

For you as an endodontist, the inference from this report is that you should receive relatively few complaints (9% or less of your total patients) compared with other general and specialist dental practices. The complaints should be resolved quickly, and they may involve a refund or free treatment. 

What patients dislike 

The other information of great interest in this review is the most frequent concerns raised by patients. 

They are: 

•Not being made aware of the prognosis of treatment or alternative treatment options 

•Information or clinical terminology not explained fully 

•A refusal to continue care or ignoring attempts to resolve the matter when concerns were raised. 

To my mind, the first two reinforce the need for all dental practices to employ (either in-house or subcontracted) a patient coordinator. 

This is someone who (unlike a dentist) has the time to explain fully to a patient what a treatment plan involves – how long it will take, what lifestyle considerations/ restrictions may be involved, any on-going aftercare required for the patient, the expected results and, importantly, how they can pay for it. 

A patient coordinator needs some clinical knowledge – focusing on root canal treatments in the case of a specialist endodontic practice – but not full clinical training. 

Indeed, patient coordination works best when patients feel they are discussing the treatment plan with someone who is knowledgeable of dentistry that is not way above their own understanding. You may be surprised to learn that your evident expertise may actually make patients reluctant to ask questions for fear of feeling foolish. 

A good patient coordinator will automatically translate dentistry jargon into everyday language and explain the meaning of clinical terminology. Clinically trained dentists, particularly specialist dentists, can find this harder to do when talking with patients, as their everyday “working” language is necessarily jargon rich. 

Google alerts 

According to a link I found via Google, 60,000 new websites and 140 million tweets are created daily (this information was current last December; the numbers are probably much greater now). I’m illustrating (as if I need to) that there’s a lot of information out there. A tiny, tiny proportion of it could be useful to you. 

Now, I’m assuming that you already have mechanisms for being alerted to clinical news. I suggest you also look into Google Alerts (www.google.com/alerts). With this free service you receive emails when there are relevant Google results based on your queries – a sort of daily automatic “Google.” 

Requesting, for example, “dental research news” can be quite useful. This drew my attention to an article in Rochdale Online (which I would never have seen otherwise) about research that had shown dentists are more trusted than doctors. 

A quotation from psychologist, Emma Kenny, caught my eye. She said: “Trust underpins much of our motivation in life; when we feel that someone is on our side and has our best interests at heart, it makes sense that we will act in accordance with their suggestions.” 

The British Dental Trade Association (BDTA) published results from a similar survey called Perceptions of Dentistry and Motivation Research in April 2012, and one of its findings was: “Customers typically rely on their dentist and trust their advice and the majority say they would ask their dentist if they wanted to find out more about non-essential dentistry.” 

You can access the full results via the BDTA website (www.bdta.org.uk/perceptions-of-dentistry). 

Here we have the results of two surveys that no endodontist could afford to carry out – even within their local area – but that yield gems of information, including that trust is important to patients. 

How do you build trust? 

This sounds to me as though neuro-linguistic programming (NLP) might provide some answers. I’m not an NLP expert, but I have colleagues who are, and I’ve gained a working knowledge of it as a result. 

In order to gain trust, NLP states that you must establish rapport. This is done in a number of ways, which there is only space to describe briefly here. 

There’s body language and facial expressions – I guess we’re all familiar with the “shifty eyes” and hence untrustworthy person. There’s how you speak and the words you use. NLP advises matching a person’s tone and pace (and so on) of speaking and using the exact same words to avoid misunderstanding. For example, a patient might say: “Did you say you’ll fill my roots with a sort of rubber substance? Won’t this make my teeth feel funny?” 

Your reply could be: “Yes, it is a rubber-like material, which we call gutta percha. On top of that I’ll put a normal filling so, no, your teeth won’t feel funny.” 

Keeping the patient happy 

•Patient complaints increased by 17% last year 

•Think about what patients need to feel secure with the service they are receiving 

•Try not to bombard patients with dental jargon 

•Employ a patient coordinator to help explain procedures 

•Attempt to build rapport with your patients. 

You should also try to match experiences. I guess this is why politicians so often talk about their upbringing, schooling, family life, working life and so on – to attempt to “connect” with the widest section of the population. You might say: “I had an operation to replace damaged knee cartilage a few years ago – a rugby injury. I was the same as you – wanting to know exactly what was involved, so go ahead and ask as many questions as you like.” 

The same processes of building trust with patients also applies to your patient coordinator, of course. For reasons explained earlier in this article, a patient coordinator may find creating this relationship easier than you.