Heather-Dawn: 

My special guest is Dr. Mark Hyman.

Share with us a little bit about yourself, Mark. Who are you? What are you doing these days? What do you bring to the world of dentistry?

Mark:  

I'm from Greensboro, North Carolina and I love dentistry. I love, love, love this profession. I started working in dentistry when I was 19 as a dental assistant. Next month, I turn 64 years old, which I know you're shocked by because I have pretty good hair.

Dentistry has been amazing to me. I met unbelievable men and women for my career.

I had 32 years of private practice and I adored my team. My main receptionist was with me for almost 25 years, my lead dental assistant for almost 20 years, three of my hygienists for 15 years, and another one for 14 years. It was like a family. And these women gave me such love and loyalty. It was just stunning.

Secondarily, I had the privilege of teaching at state, national, and international dental meetings. I’ve had the privilege of speaking in Jamaica, the Bahamas, Canada, England, and Israel. So that's been a real joy.

I sold my dental private practice in 2016. I worked for 15 more months with the young man, a former student of mine, who bought my practice. And now I'm an adjunct full professor and special assistant to the office of the dean at the UNC Adam School of Dentistry in Chapel Hill, North Carolina, where I get to teach practice management, leadership, team building, communications, diagnosis, and treatment planning, and I'm also on the admissions committee. It's a wonderful, wonderful time.

I miss private practice, but I love being at the dental school and teaching these magnificent students.

I love the name of this podcast, The Irreplaceable Dental Assistant, because I would have been dead meat without my dental assistants. Again, they gave me such love and loyalty and passion, and commitment. And they made such a profound difference in my patients' experience. I am the head cheerleader for dental assistants and the impact that they have on private practice. 

Heather-Dawn:

Well, thank you for sharing that. But you know, the fact that your team was so loyal to you speaks volumes about the type of leader you were and you continue to be. I'm just so happy to be able to delve in and pick your brain for a little bit and ask you a couple of questions.

I’d love to focus today on the new patient experience. Where does it begin? At what point does that new patient experience begin?

Mark:

Without giving it a lot of thought, you'd say it's when they walk in the door. But that's so far from the truth.

The fact is the new patient experience starts with your community reputation, how you present yourself publicly, the care that you give your reputation clinically and behaviorally, and the charity that you give to your community.

The source of the new patient referral is huge in the States. I say to my audience, it’s a huge distinction between a patient coming to you because you have to see them because they're a part of some PPO HMO Preferred Provider Organization or an insurance panel versus somebody saying to you, “Doctor, my friend or Dr. So-and-So, sent me to you and said you're the best.”

There's a dramatic difference between how they found out about you.

Then there’s the new patient experience. The patient makes the first phone call. How are they treated? Did somebody answer at the office? Is the office phone answered, “Dental office, hold," or “Good morning, thank you for calling the dental office of Dr. Heather-Dawn Lawson-Myers. This is Susie, how may I help you today?” Are they answering the phone with a smile, with passion, with enthusiasm?

Patients research before they even see you. Do you have an office website? Is it current, inviting, and cutting-edge?

Before the new patients come in for the first experience, we've already sent them to our website to learn more about us and to see some of our videos. We've also given them a new patient worksheet where we ask key questions to try to get an idea of who they are and what their expectations are of us.

If the first thing they say is, “You're my fourth second opinion”, that makes you go, wow, this could be a challenge, versus the first question being, “Do you take my insurance?” If they ask that question, many in dentistry say, “Oh my god, they don't value comprehensive care. They don't value optimal care dentistry because all they did was ask about insurance.”

The fact is, you don't really know what they value. If somebody asked me, “Do you take my insurance?” My answer to that would be, “May I ask you a question? Is the insurance reimbursement critical to you choosing me as your health care practitioner? Is the limit of the dental insurance going to compromise the quality of care you will let me offer you? Is it going to change your goals - for keeping your teeth, for your health, your smile?”

I put the questions back on them.

When new patients come in, it is imperative that this is an intentionally sculpted, scripted visit.

If you have a new patient coming in at the same time you're trying to seat 10 veneers and it's not going well, you don't have your best game face on.

We would limit the number of new patient visits we would have to specific times of day when they knew that I was going to be on time and fired up. We had a very prescribed system. When a new patient would arrive, if I could, I would walk out into the reception room and shake their hand. If it was you, I’d come to you and say, “You must be Dr. Heather-Dawn Lawson-Myers. I understand that Dr. Eric Ovitch sent you to me. Welcome home. We're going to take good care of you. I look forward to working with you.”

Why not knock the socks off of every new patient? Think about what the business team is going to say to them when they walk in. Do they stand? Do they greet them? Do they shake their hand? Do they offer a cup of coffee? Versus saying, “Do you have insurance? Where's your card? Sit down and shut up and fill out this health history.”

Then, the new patient would come back into our consultation room with my treatment coordinator, myself, and the patient. We would sit down at a round table, where we were not separated by a big square mahogany desk, so I could sit knee to knee with them.

We go through a list of 10 questions that I tried to ask every new patient. It would start with, “Did you have any trouble finding the office with Google Maps?” Then I would say, “Who can we thank for referring you?” And if you said Dr. Eric Ovitch, I would say Dr. Eric has sent us the nicest people. I am so glad that you're here. We're going to have a great time.

Then I would ask five magic words: What may I call you? You tell me, what name do you prefer to go by? Then I ask them to please call me Mark, Dr. Mark, Dr. H, or whatever is comfortable for you as the provider.

Next, we ask, why are you here and how can I help you? Let them talk. Stop talking and let them tell you why they’re here today.

They might say, “I hate my smile.” The temptation is to answer that with, well, I bet you hate your smile because you have a diastema between teeth eight and nine. And you have Class II Division II laterals and your teeth are VITA shade 17 and your mama dressed you funny. Don't do that.

Be open-ended.

You hate your smile? Tell me more. What do you hate about your smile? Is it color? Is it size? Is it shape? Tell me more.

"I hate my teeth because I've got gaps in them and they're yellow." How does that make you feel? "I don't smile for pictures." Well, ma'am, do you have pictures coming up? Is there a family event coming up? Would you like to be done by a certain holiday? You tell me where you are in your life. What's the timeframe?

It's stunning to me how many of our colleagues don't even ask this next question. May I ask why you left your last dentist? And it's stunning to me because many of our colleagues don't even ask and the patient often says because he or she was pushing crowns. Many of our colleagues hate that question. I love it. Because then I'll just say, may I ask you a question? Do you think you need a crown? Often the patient's gonna say, "I don't know." And then I'll say, "Ma'am, if I see changes going on in your mouth, do I have your permission to tell you about it?" When they say yes, it's a great time to be a dentist because they just said if you can show me, I'm gonna go forward with treatment.

Then I'll ask you, "If I may ma'am, why now? Why today versus next week, next month, or next year?" Imagine someone comes in on a Wednesday and says, my daughter's getting married Saturday. They don't want to get a flossing lesson. They want their teeth whitened. They want you to zoom their teeth real quick before the wedding. They don't want a lecture, "I'm sorry, you have to come back for three visits while we do initial periodontal therapy, scaling and root planing, and nutrition counseling, and then we'll talk about whitening." You're not listening to where they are in their life at that time.

Further, I'd say, "Ma'am, if I may, what are your goals for your healthy teeth and smile? Say, I'm not being smart with you, but is it important that you keep your teeth in your life?"

I may say, "Who's the decision-maker in your family? My wife, Anita, she's a nurse and she runs the family. I just want to make sure you're presenting treatment to the decision-maker in the family."

Some of my patients say, well, I have to ask my wife's mother's cousin's milkman's rabbi's neighbor's priest. Why waste your time presenting treatment when someone says that's not my decision?

I would say, "Do you have a budget?" Some would say, "I want a gorgeous white smile. I got 500 bucks." It's like, well, here's a Sonicare and a tube of Day White, because that's all you can pay. I had someone say to me, "Dr. Mark, money's a big deal. I only have $20,000 or $30,000 to spend on this." I'm like, we can do that. How soon would you like to be finished?

That new patient experience, I think, is critical. Patients walk in, the office is clean, everyone's in the same uniform, there's nice music playing, the magazines are straight, the office smells nice, and it doesn't smell like a typical dental smell. That is just a really cool experience.

The team knows what's next, and who takes what radiographs in what room. So the office looks nice, the systems are clear, and the team is well trained, well dressed, well mannered, with consistent verbal skills. We take good care of the patients on time. You make it clear what their investment is going to be financially. And then they have been given something that is distinctive.

When I left private practice, I had over 1200 5-star reviews. They've asked me, "How in the world did you do that?" Well, I earned them and I asked for them. My dental assistants were irreplaceable in gaining those five-star reviews because they were gentle and polite and well trained, well-dressed and passionate, and enthusiastic. And they believed in me.

When a patient said, "Wow, that sounds like a lot of money," my teammates were trained not to say, "Dang, I wouldn't pay that." Instead, they’d say, "You want to know why? Because you're at the best dental office in the United States. You're at the best office with the finest care with the nicest dentist who is not going to rest until you are thrilled with every ounce of everything that goes on."

Heather-Dawn:

Well, there are a couple of things that I wanted to highlight. You had tons and tons of gems.

The first thing that comes to mind is your willingness to go and greet the patient face to face. But in the event that you're not able to, I'm pretty sure, we have team members who see the value of really making the first experience a “wow experience” by knowing the patient's name as they come through the door. If you're expecting a man at 10 o'clock, and there's a man at your door at 10 o'clock, and the man on the schedule's name is James, chances are if he steps through the door you say, "Good morning, Mr. James," he's gonna be blown away. And that really did not take a lot of effort.

I love the fact that you

suggest that we customize

the treatment of each patient.

Mark:

When that new patient calls the receptionist for that first phone call, one of the questions we asked is, "Which name do you prefer?" So imagine somebody says, "Please call me Dr. Heather-Dawn," and you come in and I go out to reception and say, "Dawn." That's a nice name, but that's not the name you go by. If someone's taken the time to tell you what they’d like you to call them, shouldn't we have the courtesy to follow through with that? That takes planning and communication and time.

Heather-Dawn:  

Absolutely. I love the fact that you also highlighted the importance of systems being in place, and the team being very deliberate about following systems so that the day flows smoothly. Because that in itself attests to the quality of work that the dentist will provide even before the dentist steps in to do any form of treatment. Would you agree?

Mark: 

100%. When the dentist walks in and leaves, how many times does it happen to us and we discuss care with the patient? And we say, if you want to keep this tooth the rest of your life, we would secure the crown. Does that make sense? Do you want gold or white? Morning or afternoon? Okay, we'll go get it taken care of. You walk out and the patient turns to the assistant and says, "What do you think?"

Heather-Dawn:

Exactly. 

Mark:

Do you think I really need this? "Wow, that's a lot of money." Now, what I've tried to train my students at UNC Adams School of Dentistry and my audiences in my seminars is how we answer that statement: “That's a lot of money.” I've tried to train my students to say, "Compared to what?" Particularly when somebody walks in holding a cup of Starbucks. How much is a cup of Starbucks in Jamaica?

Heather-Dawn:

Whatever it is, it's far more than the average cup of coffee.

Mark:

Imagine if the crown is $1,000 in the States, and somebody says, "How much is the crown?" What I try to do is say, "How many cups of Starbucks a day?" So basically, I'd say for about one cup of coffee a day for a year, that's what your crown is going to cost. $1,000. That's a lot of money. One cup of $3 coffee times 365. 

Heather-Dawn:

Maybe doable, right?

Mark:

My blessed father said you can lift an elephant if you've cut them into small pieces. No matter what you say, fee-wise, it's too much. So why not break it into pieces? How many dollars a day? A week? A month? Would that work for your budget? Could you dedicate a cup of coffee a day for a year in order to keep this tooth? So does that make sense? Is that a possibility?

Heather-Dawn:

So what you're really doing is, you know if we can encourage our team members, first of all, to value what we're doing. And then second of all, to take that elephant and cut it into small pieces.

Once you can wrap your brain around something doable, what is being asked of you becomes possible. 

Mark:  

Love it. It's true.

One of the first things with a new dental assistant to me, with any practice doctor listening, is you do an extraordinary new patient exam on every teammate so they experience themselves.

It's not one of those hygiene checks that takes 30 seconds and you kind of look at the front eight teeth and go, "That looks pretty good, see you in six months." You sit down and do a comprehensive review of the medical-dental history. You do an oral cancer exam, you check TMJ,  some mandibular, some lingual. You do the oral cancer scan on the tongue, you look at the throat, you look at the tonsil swollen. Is there a large uvula? You go tooth to tooth with your intraoral camera and full mouth perio-probe. You take the necessary radiographs and review things carefully.

That's the new patient experience.

The team itself has to experience that to answer, "Why is that so much money?" Well, look at what you just bought. In the States, we report 30,000, 40,000, 50,000 cases of mouth cancer every year. Be amazed at how many patients say, "No one's ever checked me for cancer." Maybe the doctor did but just didn't tell him. So then you lost the chance.

Our dear friend Dr. Cathy Jamison taught us to create a sense of urgency. Kathy Jamison from Oklahoma said eight words to me 22 years ago that changed my life. She said, "Mark, how do you create a sense of urgency?"

Our blessed dental assistants are irreplaceable and they're joining the team to create a sense of urgency, the sense of elegance, professionalism, gentleness, passion, and enthusiasm. It's just invaluable.

Heather-Dawn:

You can only recognize the value the patient is receiving if you have been on the receiving end.

It's simple, easy to do and it doesn't cost a lot, but wow, does it make an impression on the team members that you're relying on to share the value of what you're providing for each patient. That is fantastic.

Mark:

For us as the leaders of the practice, if we don't honor the teammate's time, and the patient's time, and if we don't share the value of the new patient examination and experience, then the team's not going to value it either.

It's not okay if you have a new patient coming at eight o'clock, doctors, for you to show up at 10 after eight to work. It's not okay to come in eating breakfast, smoking a cigarette, drinking a cup of coffee, saying let me make a few phone calls and I'll be right with you. That is unprofessional and unacceptable for a doctor or a teammate. 

Heather-Dawn:  

Well, we have to lead our team by example. And what we're expecting them to show to our patients, we have to be willing to show it to them and to our patients as well. Leading by example, right?

Mark: 

Very much. So, we talked about verbal skills and that is so critical. I think if you or I were asked what is one of the number one main problems we have in dentistry, it's a lack of training, a lack of systems.

We buy a new piece of equipment and tell the team to just go figure it out instead of saying we're closing the office for half a day and we're going to sit down and every one of us is going to try this. Every one of us is going to sit in the chair and look at our teeth with the intraoral camera. Every one of us is going to go through some of these different things. Otherwise, we're cheating them with the full experience and I think the doctor has to invest in the team, as I know that you did in yours, as I did for mine, to make sure that they understand how important these things are.

Heather-Dawn: 

They do understand that teamwork makes the dream work. 

Mark: 

I love it. 

Heather-Dawn:

When everybody's invested, it makes a big difference, as opposed to just being told to do a list of things and you check the boxes.

You become a part of the experience once you are in that setting where everybody is learning and growing together.

Mark:

I tried to treat my teammates as priceless gems. I spoiled them. And people have said to me, you just got lucky, you got all these great teammates. I was like, you know, every single one of those women worked for another dentist, left them, came to me, and then stayed. There's an intentionality to that.

Richard Branson, who's got a brilliant business mind, Virgin Atlantic Airlines with Virgin Records. He said that clearly, the concept that the customer, client, and patient come first and are always right is completely wrong.

Your team comes first, your employees, your teammates, and your co-workers come first because they're irreplaceable.

They set the table, they deliver the mail, and they are your reflection when you're not present. So whether it's out in public, whether it's in the office, on the telephone, whether it's online answering emails, text messages, or on the office website, you just never get a second chance to make a first impression.

Doctors have to model that for the team.

And when the team does it wrong, we gently correct them. When they do it right, we celebrate. In America, particularly, so much of leadership is critical. "Heather-Dawn, let me tell you three things you screwed up today." Instead of, "Heather Dawn, you did 97 things so unbelievably, today. May I give you a hug? And you have your permission to talk about three little tweaks for tomorrow." So there's a difference, isn't there? There's the give and the take. I always tried to warn my team, and catch them doing things right instead of doing things wrong, because we repeat what is rewarded, honored, and discussed.

One of my best friends in dentistry, Dr. Keith Phillips, has an expression, your patients are always right. Right? They just don't have to be your patient. Or they are in their life at this time. It's okay. It's okay to let them grow elsewhere. It's okay to set them free. If somebody wants to come into your office and if they're rude to my dental assistants, they're fired, hands down, not even talking to them. They want to chest up to me and chop, chop, bring it on. But if they're rude to my team, they're fired because my teammates are irreplaceable.

Heather-Dawn:

Well, this has been such a wonderful discussion. I feel like it could go on and on. But I just want to go back and address a few of the salient points that you made about the patient's first experience.

The fact that it begins with an office's reputation, how they're guided to us, how that new patient discussion on the telephone is being so customized that we ask clients how they wish to be referred to, recognizing when they're coming through the door, to greet them by name, if possible, and to be warm and welcoming.

If the doctor can come out to the waiting room and acknowledge and greet, great. But if not, the team should feel the same kind of vibe to make everybody feel welcome, who chooses to allow us to serve them. 

Mark: 

Absolutely.

Heather-Dawn:

It's always a choice. And recognizing the fact that the more we are consistent with our systems, the smoother the visit will be for the client, the better the experience, the more likely that they will consider it a pleasant experience to return on another visit.

We didn't go much into detail about it but you did mention the appearance of the team looking tidy and uniform, and just ensuring that we do look professional and welcoming. At the end of the visit, if there are concerns that our clients want to have addressed based on the fact that they may be traveling or there may be an upcoming experience, we want to be able to get that information early. Especially, so that if we go back to a treatment plan that addresses all the other things, we're aware of their immediate concerns and we can address them early.

Recognizing that the team need not be fearful of discussions that are around finances but being really confident enough to break down what payments are and how comfortably people can do them. If we can relate those costs to everyday smaller costs that we choose to have, because a cup of coffee from Starbucks, it's not a must. It's a desire.

And I always say if we can turn

our patient's needs into desires,

then they will find a way.

So the new patient experience, would you say that the new patient experience could be considered something that is ongoing?

Because even though we develop relationships, we're always trying to find ways to welven so it's a new and different and wonderful experience each time they come through our doors.

Mark:

I love that window, a new patient experience includes people coming back to your office at a different time in their life. Maybe they've lost a parent, maybe they've had a child that has a challenge at school, maybe they've had trouble at work and circumstances have changed, maybe their medical history has changed and they're embarrassed to discuss it with you. You just never know. The new patient experience extends to the first time you give them a shot, the first time they get their teeth cleaned, the first time they have an impression, or a digital scan if you're a CAD CAM office. 

The process of wowing your patient really never ends.

We talk about it in dentistry and often we make a big deal about the new patients and then our existing patients kind of learn as an afterthought. Where the fact is, in the States, it's estimated that almost every practice has at least many hundreds of thousands, if not a million dollars, of diagnosed and undone dentistry in the books. If someone has been in your practice for several years, just getting their teeth cleaned, you might say to them, "You know, we've been doing a lot of due education courses, the team and I, and it's been many years since you and I really sat down and thoroughly checked your bite and your gums and your jaw joint and your airway and did a careful review of medical dental history. Would you like the privilege of another new patient experience?"

Heather-Dawn:

Wow, I love that.

Mark:

Because people are at different places in their life.

Heather-Dawn: 

Absolutely. 

Mark:  

Maybe they came to you and they had a couple of kids about to go to college. Now six years have gone by, the kids are out. Six years ago, they said, "I couldn't possibly afford this." And now they may say, "You know what? The kids are gone. Now it's my time. It's my turn." So if you don't ask, you don't know.

You don't ask that permission statement. "Do I have your permission to discuss this? Do I have your permission to tell you what I see? Would you like to know what's new in modern dentistry?" And to me, no is not a no, it's not yet. If they resist, I may say, "We can make a note of this and we'd pick this back up in six months. Would that might be a better time for you and your family?"

Heather-Dawn:

Absolutely. 

Mark:  

My daughter got married last September. My son is getting married this October. If someone came to me and said, "Well, don't you want to do $40,000 of dental work," I may be positioned to hang with that. Or, I may say I can't even see straight. I don't know how I'm gonna take care of these weddings. I don't care about me, my children come first.

The temptation may be to say, well, you don't value optimal care dentistry, you don't care about your teeth when the fact is, I can't even think about it because I'm gonna take care of my family first. Give patients the courtesy and the respect that they may not be ready yet, and so you invite them with no guilt and no fuss that when you're ready, I'm here for you.

Heather-Dawn:

There you go. The new patient experience is always being recreated. 

Mark:

I love it. 

Heather-Dawn: 

Mark, I always end my podcast with a quote. My quote today is from Benjamin Franklin. It's short and simple. It says, "Well done is better than well said."

I want to tell you that you gave us so many gems today. I think our listeners will have to play this podcast a couple of times. Because each time something different will be focused on and they will learn lots.

Thank you so much for joining us today. I appreciate that, friend. You are a wealth of information.

Mark:

You are my hero and I appreciate you. And I send love to my Jamaican family. I miss you all and I can't wait to come back home to Jamaica sometime soon. God bless.

Heather-Dawn: 

Alright, my Jamerican friend.

Mark:

Thank you.

Heather-Dawn:

We certainly did get quite a bit of information today. Dr. Hyman just kept dropping gem after gem after gem.

We recognize that it's the reputation of the office

that creates the first impression for a new patient. 

It starts even before the first phone call. Answering the first phone call, how you sound, and how engaged you are, the level of enthusiasm is an added value to that new patient experience. And then, when the patient comes through the door, having gathered information on that initial call, there's so much we could do to customize that initial visit. Knowing how to address the person when they come through the door, recognizing that, looking smart, and having your systems in place so that the treatment visit flows smoothly make some big difference. Not being intimidated about speaking about money, the cost of things that people may come in needing can be a big plus to our new patient experience.

And recognizing that the new patient experience occurs over and over and over because we have ways of wowing people each time they come. We have ways of meeting people's needs and each season of their lives.

It is indeed a privilege to be able to continue to create a fresh new patient experience over and over again.

As Benjamin Franklin said; "Well done is better than well said." So let's make an effort to make sure that whatever we do is well done.

You never get a second chance to make a first impression.

You know, we are better together. I'll see you next time. Blessings.

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This is Episode 14 of my Irreplaceable Dental Assistant podcast.

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