As in most professions, competition in dentistry is so fierce that good patient treatment is no longer good enough. Doctors must provide their patients with service beyond what they expect in order to keep them from wandering off and more importantly, to encourage them to refer their friends and family. Because as we all know, the patient's perception of service has little to do with the quality of care each practitioner provides.

So imagine each member of your dental team dealing with your patients in terms of "Moments of Truth," a repeatable sequence of events in which each dental team member not only tries to meet the patient's needs... but attempts to exceed the patient's expectation of service! A "Moment of Truth" is any incident in which a patient comes into contact with any aspect of your practice, and has an opportunity to form an impression. This impression is formed by what the patient sees, hears, or experiences in the course of receiving service or having a procedure performed. So the cycle of "Moments of Truth" can be characterized as follows:

The cycle begins at the first point of contact between the patient and your office either by telephone or personal visit}... The cycle temporarily ends when the patient considers the service complete... The cycle begins again when the patient returns (i.e., recall appointment, emergency treatment, etc.).

Now take a moment to think about the services you offer your patients. What are the points of contact at which a patient passes judgment on your practice? How many opportunities do you have to score points? How many opportunities do you have to "sell" the optimal treatment plan? Has your new patient flow increased? What is the "mood" of your patients when they're in the operatory?

As with most experiences in life, first impressions are all important; and negative impressions are often impossible to erase. Every patient contact should stress your commitment to patient care and overall practice efficiency. In order to discover the "moments of truth" in your practice, take a simple walking tour of your practice {or perform the exercise with a camcorder as described below}. Start with the premise that it is equally important to assess your practice during office hours as well as after all patients are gone. Also, perform this procedure with the entire dental team present to gain their valuable input. As you walk through each area of patient contact, ask the following questions and have each person take notes... then have a meeting and share everyone's observations together.

Moment of Truth #1. Periodically stop to listen carefully to everyone's {including your own} telephone demeanor at different times during the work day... listen to the tone of voice and the stress level that patients are hearing. Are calls for appointments or questions concerning treatment perceived by your patients as an interruption in your schedule or the reason for you being in practice?

Moment of Truth #2. Drive into your parking lot. Is there adequate parking? Is the lot clean? Is it well lit for evening hours?

Moment of Truth #3. Look at the outside of your building. Is it freshly painted? What is the image that your sign projects? Is your sign large enough to be seen by passing cars and does it contain information beyond your name? What does the entry or look like to the building? Is there easy access for persons with disabilities?

Moment of Truth #4. Enter the reception area. How does the room make you feel? What is the image it projects? Do you seem to be warmly greeted by your surroundings or are you shut-out by a closed, sliding glass window? Sit in several different chairs and take note of the sounds that can be heard e.g., radio music, patient education tapes from the VCR, hand pieces, the model trimmer, the telephone, the computer, etc. Remember how frightening sounds can be when you don't recognize them?

Next, check for general cleanliness i.e., baseboards, ceiling tiles, walls, carpet, upholstery, lampshades, tabletops, etc. How up to date is the decorating? How is the lighting in the room? What type and how old is your reading material {magazines and books say much about the type of service you offer}? Is there enough comfortable seating? Is there an area to make children feel at home? Do you have a video game processor, small table and chairs with board games, puzzles, etc.? Are there beverages or other comforts available for your patients? What type of art is on the walls?

Next, think about the faces of your patients as they leave your office, do they look happy? Look at the faces of your staff. Does it look like they are enjoying the work that they are performing? Do you feel that you are in a "reception area," "a waiting room" or "a living room?"

Next smell the office. This may be difficult because we are very accustomed to dental aromas. Did anyone ever tell you that your office had a medicinal smell? Dental aromas trigger fear responses for many people ... this is a proven fact.

Moment of Truth #5. Sit in all of your operatories. Make the same visual, hearing and smell observations as in the reception area. Look at the equipment. How frightening would it be for you if you didn't know what it was? Lie back in the chair, stuff your mouth full of cotton rolls and lay there alone for a few minutes ... stare at ceiling ... and listen to other activities going on in the office. Now project your patient's perception of their dental experience.

Moment of Truth #6. Visit the rest rooms. How modern and clean are they? Are supplies neatly stocked? Do you have soap, hand cream, toothpaste, cups, air freshener, etc. available for your patients? The cleanliness of your rest rooms makes a statement about your practice (just as it does in a fine restaurant).

Moment of Truth #7. Stand at your front desk. What do you see? Is the working area clear or is it cluttered? Does the patient have adequate space to write a check or fill out patient information and to look at a calendar? Remember, this area also reflects the overall image of the office... representing either organization or disorganization.

Moment of Truth #8. Sit in your private office. Pretend you are a patient sitting there for a consultation or a diagnosis. Can you see the wood on your desk top? Do you have enough comfortable seating for patients or visitors? Think about prominently displaying personal objects {e.g., family picture, dental textbooks, diplomas and awards, etc.} that give your patients a sense of who you are as an individual to further cement the bond between doctor and patient.

Moment of Truth #9. Look at all your dental team members {even the part time persons}. Are you all smiling and friendly? Does the dental team's attire and general appearance portray the level of professionalism and quality of patient care you desire?

Every time you or a member of your dental team has contact with a patient, that person is projecting your image... advertising your practice's services and therefore promoting your practice to the patient public. Given that fact, we can all take a lesson from very successful establishments that understand and set the standard for customer service like Nordstom's, FAO Schwartz, Tiffany's, Ritz Carlton Hotels, etc. These companies have done an outstanding job in exceeding customer expectations by carefully listening to their customers and then viewing the entire service experience through the eyes of the customer.

Like these famous stores, if we take the opportunity to put ourselves in the patient's shoes and view the world from their perspective... we can focus our attention on all the "moments of truth" and improve patient service. Then as a dental team, we can develop strategies to exceed patient expectations and build a successful dental practice that develops loyal patients... attracts and retains quality personnel.... creates increased referrals... and maintains a competitive edge in the marketplace.

Here's a simple exercise to identify the critical "moments of truth" in your practice... from your patient's point of view! Take an hour to produce a short home video with your dental team members, using these guidelines:

1. Get a portable camcorder and blank video tape.

2. Alert your dental team that you will be preparing the tape when the office is closed to patients, but that you want them each to respond to the camera as though it is a patient. Stress that you don't want them to say or do anything differently than they normally would in the course of a patient visit. Tell them that they are not to alter their appearance or manner in any way. Likewise, don't change anything in the office i.e., don't straighten magazines or start cleaning.

3. Begin the tape by appearing on the camera yourself, and briefly set the stage for what the viewer is about to see. For example: "You are about to see a videotape filmed on (date). In it, we will be taking an objective look at a patient's total experience of our practice... from the moment when he or she first encounters us, to the moment he or she leaves. As you watch, pay particular attention to our facility, and to each dental team member's non-verbal communication and body language. There will be no sound on this tape, so we can focus our attention on the patient's non-verbal experience."

4. Proceed through your routine, following the patient's path through your office.

5. Have the camera be the patient's eyes and view each "moment of truth" :
   1. View your sign and building.

   2. Park a car... walk to the front door and open it {you may wish to have someone assist you with the door}.

   3. Walk up to the reception counter and be greeted... sit in the reception area... fill out a new patient history and insurance information... then read a magazine.

   4. Wait to be invited into an operatory... be seated in the chair for a hygiene treatment and then a visit by the doctor.

   5. Follow the precise path a typical new patient would experience while in your office, capturing every "moment of truth" in exacting detail.

   6. Finally, the camcorder 's view should focus on your front door as the patient leaves your practice and heads to the parking lot.