Every day when we check the news, we are bombarded with examples of the trust famine that exists in our culture. Star athletes lie about their drug use and throw any truth-telling witnesses to their misbehavior under the bus. Politicians deceive their families, staff, and constituents, and then expect (sometimes correctly) to be re-elected. CEOs of large companies commit crimes and require those under their supervision to keep quiet. What is happening to us? Does anyone believe in “Truth, Justice, and the American Way” anymore?
No wonder our patients are suspicious. Before 1997, when Reader’s Digest printed its much publicized article “How Dentists Rip Us Off” by William Ecenbarger, patients typically suffered some anxiety about undergoing the procedures, but very little suspicion about the treatment dentists recommended. Since then, continuing negative media coverage and our penchant to believe everything that appears on the internet or TV have some patients second guessing even the most obvious treatment recommendations.
According to David Horsager, author of The Trust Edge**, “We are in a trust crisis, and organizations are slow to realize the bottom line implications.” So much so, he goes on to explain, that world leaders at the World Economic Forum in China in 2009 “declared that our biggest crisis is a lack of trust and confidence.” Mr. Horsager defines trust as “a confident belief in someone or something… to do what is right, to deliver what is promised, and be the same every time, whatever the circumstances.” Throughout his book, he sites
numerous examples and significant research pointing to trust as the key to a successful business and a successful life. He also declares that trust over talent is the key to one’s success.
In a recent conversation, I was able to ask David some questions about trust that were specific to dentistry. When asked what was the most important thing dentists need to know about trust, Mr. Horsager replied, “Dentists need to realize that a lack of trust is their biggest expense. They lose patients every day because of how the patient feels while he or she is being treated. Every aspect of patient care could proceed along perfectly, but if one person representing the office breaks the patient’s trust, the patient could perceive the visit as a negative one.”
We now live in an electronic world. Dentists are constantly being ranked and rated by patients in a very public way. One unhappy patient can do a great deal of damage to a dentist’s reputation.
As dentists work to be more efficient with care and to delegate more procedures to staff members, we do spend less time with patients. This may exacerbate the trust problem. According to Mr. Horsager, “With the current changes in health care, physicians and dentists are pressured to see more patients in less time. The patient wants to feel taken care of. The doctor wants to move on; the patient wants him to stay.”
So what do we do? How do we earn trust? Where is the manual?
Mr. Horsager simplifies things by breaking the requirements necessary to develop trust into eight “pillars”. The good news is that these pillars are concrete and easy to understand. The bad news is that you must have all eight to maintain trust. Lose one pillar in your relationship with your patients and the trust edge crumbles. “While it may appear to be static, trust is more like a forest — a long time growing, but easily burned down with a touch of carelessness.”
The first pillar Mr. Horsager identifies is clarity. Each of us needs a clear vision for our practice, and our patients need to have a clear understanding of their treatment plans. Clarity affects both staff expectations as employees and the standard of care set in your office.
The second pillar is compassion. This is particularly important for dentists, as many of our patients experience anxiety about their appointments to begin with. Do they know without question that we care about their needs first?
The third pillar is character. Do we choose to do what is right over what is easy? Do we have the patient’s best interest always driving the decision?
Pillar number four is competency. Keeping up with new procedures and making sure we are maintaining our skills can help us on this one.
The fifth pillar is commitment. Are we committed to our patients and our staff? When hard times befall them, what do we do? Patients and staff notice these things.
Pillar number six is connection. Do we greet our patients warmly and recognize them as individuals? We are in a unique profession that connects with our patients both on a regular basis and over many years. Working hard to maintain those connections is one of our best practice builders.
Contribution is the seventh pillar. People want to see results. Do you show your results and celebrate the completion of extensive treatment? Do you stand behind your work?
Rounding out the list of pillars is consistency. People want to know what to expect, and we should give them our best, every time. Consistency also includes making sure every patient is seen on time, or if there is a problem, he or she is notified immediately and given options. Patients should always be greeted warmly and made aware of any changes taking place in the office, including its financial policy.
The importance of these individual issues is common knowledge, but realizing that neglecting just one pillar of trust could cost us a patient, and possibly an entire family, is sobering.
Most patients trust their own dentists more than they trust dentists in general. Here is another fact that is significant in the discussion: Remember that members of the media, insurance company employees, and policymakers need dental care. If we, as a profession, start working to improve trust in our practices, our most vocal critics will have less to write about or to legislate. We will also have more successful practices and more satisfying lives.
David Horsager was right: The trust edge not only adds to the bottom line, it is also “the foundation of all genuine and lasting success”. Does your practice have it?
*Dr. Harms is a former president of the Minnesota Dental Association and a Certified Grief Counseler in Bloomington, Minnesota. Email is firstname.lastname@example.org.
**From The Trust Edge by David Horsager. All quotations with the author’s permission.