Excellent customer service in the age of compromise

Providing excellent customer service is likely the most important ingredient for having a successful orthodontic practice. If the patients are happy with the attention and care they receive in your office, then the staff are satisfied and fulfilled, and you are gratified to know that you have achieved your goal and purpose from all the hard work and dedication you have invested. You may measure this success in different ways, whether it is in terms of the value you perceive your practice brings to your community, the monetary rewards to you, your staff and your family, or just knowing that you have played an important role in shaping the lives and future of your patients.

By these parameters, most orthodontic practices are successful. In comparison to other health-related services, orthodontic treatment provides the outcome that most patients want: improved esthetics. They know from the start that they want a better looking smile and we know how to deliver that. We know the basic ingredients for making the teeth occlude properly, for making them line up so they are not spaced or overlapping, and for placing the smile symmetrically and esthetically within the patient's face. At the end of treatment, for almost all of our patients, these goals are achieved and the patient, staff, and doctor can smile together, knowing that they have fulfilled their expectations.

The most successful orthodontic practices do all this and more. They provide the excellent outcomes that patients want AND they do it with an extra caring attitude and attention to the patients' needs. The phone gets answered professionally and promptly. The patients are seen on time and appointments are short. The office has the latest technological advances and gadgets at their disposal, and for the patients to experience. The doctor informs the patients and parents of treatment progression and reassures them when needed. The staff members remember personal details about patients and engage them with their attention. The office is involved with the community. Maybe there are contests or organized events that show that the practice values the patients' loyalty. The patients know that the doctor and staff care about them personally.

BUT, great customer service does not begin necessarily with providing everything that the patient wants. Modern health care begins with informed consent and the patients MUST understand and participate in the decision-making that takes place when the treatment plan is formulated. Many patients would like care to be provided at the lowest cost, with the least inconvenience, without extractions and certainly without surgery involved, and in the shortest time possible. How many times has a patient or parent walked into your office asking if you can “just treat the upper teeth”? And how many case reports have you read where, somewhere along the way, it says “the options were presented to the patient but they refused extractions” or “they declined surgery”? Why publish a case report in which a compromised outcome was anticipated from the start?

When I began teaching 30 years ago, the schools were instructing dentists and orthodontists to provide ideal, uncompromised perfection. It is true that we at least believed that our patients were more compliant then. They seemed to brush their teeth better, wore their headgear more often, used their elastics more reliably, but they also stayed in treatment longer to achieve perfect outcomes. Noticing that this sometimes resulted in iatrogenic harm, there was a need to teach students to recognize when it was time to quit on some patients. We taught them how to compromise the perfect outcome to avoid harm then, eventually, to accept occlusal imperfection if the patient didn't seem to be doing what we told them to do. After years of trying to slow and reverse what appeared to be an innate drive by dentists to always achieve perfection, it should be no surprise that the message was eventually received successfully. All of a sudden, it is becoming more and more common to see acceptance of, and maybe even pride in achieving compromise.

With so much added competition challenging the ability of orthodontic practices to attain what is considered to be success recently, it may be time now to remember that there is more to realizing success than capturing every patient that presents to the office. Yes, it is true that there is another office in town that will treat only the upper teeth, or a place down the road that the patient can go to avoid extractions. Is that really, however, the best service that can be provided for everyone? I don't mean to say that patients should not participate in the planning process. I mean that the patient should help establish what the goals of treatment will be, but not necessarily the steps that will be taken to get there. If the goal of treatment is to just align the teeth because that is what the patient tells us to do, then where do you think the specialty of orthodontics will end up?