Küster Dental Blog

Archive for the ‘practice management’ Category

Gotta Know How to Smile

Posted on: May 14th, 2014 by James Kuester No Comments


There is a woman that works as a barista at my local Starbucks that makes me cringe whenever she is on the cash register when I come in. Occasionally, as I sit contemplating my next blog post, I’ll watch her and the other baristas as they hustle and work hard to serve up the various coffee beverages and keep the morning line moving. This particular woman probably hustles more than most of her coworkers. She is never idle. If there is a lull in traffic she is immediately looking to see what needs to be done next and jumps to it. There is no question that she takes her job seriously and puts tremendous effort into trying to do it well. However, she doesn’t seem to know how to interact with customers.

Being a barista requires one to interact with the customers. A significant part of the coffeehouse culture, and an area where Starbucks normally shines, is that they have consistently warm, friendly baristas that learn customers’ names, take time in spite of crushing lines to banter with them, and always provide service with a smile. This particular woman doesn’t seem to be able to do this. Perhaps it is her personality. Perhaps the manager has not bothered to coach her on her demeanor. Whatever the case, she is diminishing the coffee house experience with her gruff manner and lack of rapport with customers.

We see this same problem when performing Patient Experience Evaluations for clients. Front line personnel that are gruff and terse with patients have an immediate dampening effect on patient experience ratings. Patients want to be treated with respect and dignity and not like they are an annoying interruption to the person’s day. A warm smile and greeting go a long way toward helping to reduce patient anxiety.

For some people learning to smile, laugh, and engage with patients does not come naturally, especially while under pressure. This behavior requires training and coaching and consistent reinforcement until it becomes second nature. We believe everyone has the ability to learn to be warm and engaging if properly coached. As an employer one doesn’t have to hire for “type” – nor should they. But, one does need to understand the roll doing the entire job right plays in creating a positive patient experience and not just the technical proficiency portion of the job description.

You Have them at “Hello”

Posted on: May 9th, 2014 by James Kuester No Comments


Remember the old adage that you only have one chance to make a first impression? Well, we may not have as long as we’ve thought to make that impression. A recent research project has found that we humans form impressions of people from the very first “hello.” Michelle Trudeau on NPR’s “Morning Edition” reported on the research this past week. The way men and women say hello immediately causes us to form instinctive judgments on how trustworthy the speaker is, along with a host of other important attributes that were very important in keeping humans alive over the years.

Think about your dental office and how the receptionist answers the phone or says “hello” to people when they first walk in. I’ve always been shocked at how many offices I walk into to be greeted gruffly or with an irritated tone – like I’m interrupting their day. During our Patient Experience Evaluations this is one of the things we notice right away. If that first word out of the greeter’s mouth isn’t warm, friendly, and welcoming it sets a bad tone for the entire visit. The entire dental team has an uphill battle at that point to salvage the experience and send the patient away happy. Luckily, research has also shown that the way the patient is sent out the door has a very strong impact on how the entire experience is remembered.

Why set the dental team up for this much effort when proper training can avert potential disaster? Evidently, the famous line from Jerry Maquire, “You had me at hello,” isn’t all that far off.

Is Healthcare Killing the Planet?

Posted on: October 25th, 2013 by James Kuester No Comments


The Earth as seen from space

The Earth as seen from space

I spent most of today in the emergency room with my parents.  My father called shortly after I arrived at the office and said he’d just called 911 because my mother had collapsed in the kitchen.  I met him at the hospital where we spent the next six hours watching the staff perform all kinds of tests trying to determine what caused my mother’s collapse.  As I watched the staff going about their examinations I became appalled at the sheer volume of waste generated by my mother’s brief stay.

As you’ve no doubt noticed if you’re a frequent reader of my blog, I’m a big proponent of green dentistry.  I believe there is so much room for positively impacting our environment and reducing our carbon footprint by following the guidelines as set forth in the Eco Dentistry Association’s GreenDoc program and USGBC’s LEED program.  While the hospital my mother was taken to achieved LEED Gold status when it was built, I was overwhelmed by the amount of waste generated.  Virtually everything used in the examination of my mom went into a single, large trash container after it was used.  This not only included the packaging for the bandages and syringes, but the plastic bedpan, wash basin, and staple gun, as well.  Why are these things single use?  I understand the need for sanitation and infection control, but isn’t there some more environmentally responsible manner of cleaning and reusing these things rather than sending them to a landfill?  Not to mention the amount of energy it took to produce them for a single, five minutes of use.

The trip today makes me realize just why the cost of healthcare is so high.  Effective cleaning agents can’t possibly cost as much as throwing these things out every time a patient uses them.  What about someone who has a longer stay than my mother did? How much trash must they generate?  Today’s visit also makes me better appreciate the mission of the Eco Dentistry Association and motivated to see if there’s some way to carry their message to other areas of healthcare.  There is just something not right that an industry dedicated to making us healthier should be having such a detrimental impact on our planet.

A Little Extra Touch

Posted on: October 23rd, 2013 by James Kuester No Comments


The extra little touches on one's mocha

The extra little touches on one’s mocha

When I picked up my mocha the other day the barista had created a lovely design on the top.  While I see pictures of creative decorations on the tops of coffee drinks all the time, the places I go are usually so busy the baristas really don’t have the time to put this extra little touch on top.  I will admit it made me feel special. 

Isn’t this the way we want our patients to feel when they interact with us?  Special.  I know I do.  My staff and I work hard to create a client experience second to none.  We also want to give our clients a dental office design complete with little touches that make it easier for the dentists and staff that occupy them to make their patients feel extra special.  Little things, such as: a place for ladies to place their purses while in the restroom without having to set it on the floor; a beverage station to pick up cold, fresh water, tea, or coffee; a front reception that welcomes every patient as soon as they walk in the door. 

Of course, it is easier to be friendly and welcoming while interacting with patients if the doctor and staff have some comforts of their own that alleviate some of the stresses of the work day.  For example, a staff lounge to go and “get away” from patients for a short break – complete with comfortable chairs and tables.  Or, how about lockers and a private place to change into and out of one’s scrubs rather than having to do this is a restroom?  A kitchenette for preparing lunch and snacks rather than always needing to go out? 

The little extra touches really do make life more pleasant and isn’t it a shame that in our hectic world we seem to find it harder and harder to take time out to think of them?

How Well Does Your Dental Office Due at Delivering An Excellent Patient Experience?

Posted on: August 2nd, 2013 by James Kuester No Comments
Be Amazing!

Be Amazing!

My sister and I were comparing notes recently about how poor customer service in grocery stores is getting.  She lives in Wisconsin and shops at an entirely unrelated chain of stores than I do in Indiana, but so many of our experiences are the same: rude cashiers, insufficient number of cashiers to handle the volume of customers, lack of baggers that are trained how to do their job.  One has to wonder what is going on in the world of grocery stores that the same problems are occurring across the industry.

Unfortunately, the customer service complaints we hear about dental offices are quite similar.  We hear patients complain about rude receptionists – both on the phone and in person; waiting for 30 minutes or more past the appointment time to be called in for service; waiting on hold when calling to make appointments.  These are just a few examples – none of which produce a positive patient experience.

Why is it that dental offices seem so content to deliver such a poor patient experience?  Given the fact that there seems to be increasing competition and soft demand for dental services, one would think that dental offices would be striving for ways to improve their practice management in order to deliver an ever better patient experience.  Often the problem stems from both poor procedures – or the lack of them – and poor training of the staff on how to interact with patients.  A practice management coach, such as Gary Takacs can assist with getting the offices’ procedures in shape, and a coach like Starla West can train the staff on how to improve their interactions with patients.

In this age of heightened competition no one’s practice can stand to be turning patients away due to a lousy patient experience.

Do You Value Your Patients’ Time?

Posted on: July 3rd, 2013 by James Kuester No Comments
Our most precious resource,

Our most precious resource,

Earlier this week I took my father to the doctor for a follow-up appointment from his emergency retinal surgery in May.  We arrived at the office a bit early and were surprised when they called us in right away.  The eye tech performed a series of preliminary examinations and asked Dad how he was getting along.  Then she directed us to an inner waiting room and said the doctor would be with us shortly.  One hour and forty minutes later we were finally called to see the doctor.  I find this outrageous, and as a professional that makes my living billing for my time really want to send the doctor and invoice for wasting it without any apologies or explanations.

The doctor and his staff walked about the office, coming and going, with sour looks on their faces like keeping people waiting for hours was routine.  This was the first time I’d taken Dad for one of his follow-up appointments.  Mom usually does, but she wasn’t feeling well that day.  According to Dad this was a typical visit.  Seriously? No wonder they all have such sour dispositions.  If the office has no better time management and control over the schedule than was demonstrated during our visit I can understand why working there would be miserable every day.

As service professionals we owe it to our patients and clients to show them the same courtesy for their time as we expect from them for ours.  I see signs at reception desks all the time saying patients will be invoiced for missed appointments and please call ahead if running late.  I never see anything about how the office will compensate the patient if the office gets behind in its schedule.  Why not?  Don’t patients deserve to be treated better than we expect them to treat us?

Getting More Done with Less

Posted on: June 24th, 2013 by James Kuester No Comments

I was at a conference a couple of weeks ago and one of the speakers presented the following predictions:


  • 7 Billion people on Earth
  • 49% live in urban areas


  • 9 billion people on Earth
  • 70% live in urban areas

In order to feed 9 billion people agricultural production on existing land is going to have to increase 70%.  Think about that, the productivity of existing agriculture is going to have to increase by 70% in the span of 37 years in order to meet the demands of the world’s population.

In your dental office would you be able to increase the productivity by 70% in the same amount of space?   Well, yes, you probably could if you put a second shift on and hired a second doctor.  A crop tends to take up all of the space in a feed for the entire time it is in the ground and is a 24 hour operation already.

What if adding more work hours in the day was not an option and one had to create more efficient ways to work?  My guess is that we’re going to have to do this in dental office design.  As we add 2 billion more people to the Earth and crowd them into urban areas, the amount of available space is going to become more constrained.  Dental offices will need to find more productive and efficient ways to get things done within the same, or less space.  Going digital is definitely one great space saver.  We’ve already helped clients make more efficient use of the space they have by reusing space previously taken up by storing paper and putting it to use as added operatories, staff lounges, on-site labs, and such.  What new techniques will be developed over the next 30+ years that will help us get more done in less space?  As designers we can hardly wait to be a part of this exciting and creative future!

How To Keep Patients Coming Back

Posted on: June 12th, 2013 by James Kuester No Comments

I came across this FaceBook post by my good friend Starla West of Starla West International the other day relating an experience she had while shopping with a client.  This is so applicable to patient relations in dental practices that I asked her immediately if I could repost it here.  Thankfully, she agreed.

Want to know how to keep customers coming back?

SWI [Starla West International] spent just over $1500 on clothing and accessory purchases for a client two weeks ago. Of the six stores where these purchases we made, only ONE sent a Thank You Note. The note was handwritten by the sales associate who assisted us, AND he personalized it by making note of our unique conversation.

This personal touch certainly made the COACH store stand out among all the rest. I suspect our team will continue to visit that store.

On the flipside, one store asked for our email address stating, “We will email your receipt to you. And don’t worry, we won’t send any advertising emails or anything.” That turned out to be a blatant lie. Within 24-hours the first of many “advertising” emails landed in our inbox.

We unsubscribed and moved this store to the bottom of our list. It is unlikely we will return. And, if we have to (for client purposes), we will do so begrudgingly.

We are amazed at how few dental practices do not thank their patients for their patronage and engage in practices more akin to those of the “other” store mentioned above.  Just imagine what a positive impression your dental practice would make on your patients if a hand-written thank you note was sent after every appointment.  Too much to ask?  I’d wager there is a much better return on investment from this marketing activity than ads in the phone book.

Adventures in Appointment Scheduling

Posted on: May 15th, 2013 by James Kuester No Comments

I was working to make an appointment the other day to take my car in for a service appointment.  When I called the dealership their voice recording touted being able to schedule one’s appointment on-line via their website.  Being fond of web scheduling, I immediately hung up and went to the website.  The site was clean, neat, and easy to read.   I easily stepped through to selecting my date for my appointment.  Suddenly, no dates were available.  As far out as I could go on the calendar all I got was an NA for the date.

Not to be deterred I logged off and re-entered the site.  Again, everything went smoothly until it came time to select a date.  Again, only an NA would appear.

Needing to schedule an appointment I resorted to 20th century technology and dialed the service number.  This time I waded through the menu options and arrived at a message asking me to leave my name and number and they would return my call to schedule.  I did this.  All of this activity took place right after Noon.  As of 5:00 p.m. the same day, the time the message said the service department closed, I’d yet to receive a return call.  The next day I waited until 10:00 a.m. before calling.  This time I maneuvered through the menu to a live person and was able to schedule an appointment, but I was left feeling that spending money with a business should not be this difficult.

I am a frequent advocator of on-line appointment scheduling.  In my experience fewer and fewer people like having to dial the phone to buy something or make an appointment.  I’m bewildered why more dentists are not moving to on-line scheduling.  The excuse I’ve heard is that the patient can’t know how much of the doctor’s time their procedure will require.  I understand this; however, even though I own a car I have no idea how much time changing the oil or replacing the timing belt requires and yet dealerships seem to be able to move to on-line scheduling for their service departments.  I continue to believe that the delay in moving on-line is merely procrastination and not founded on any viable argument. Any business, or dental office, that wants to offer a truly client oriented experience needs to be adopting the technology that their clients use every day.  Failure to do so will cause their business to be left in the dust.

Bring Your A Game

Posted on: May 13th, 2013 by James Kuester No Comments

Yesterday I took my mom out for Mother’s Day.  To start our day we went to brunch at the little local breakfast place that I frequent virtually every Sunday when I’m in Indianapolis.  I know almost the entire staff and often feel more like family than a customer while I’m there.  They have amazingly good food and great customer service.  It doesn’t hurt that I’m also very fond of their clean, contemporary décor.  My mom had never been there so I was really looking forward to sharing one of my favorite places with her.

As yesterday was Mother’s Day, I expected the restaurant to be busy.  Well, it is always busy on Sunday mornings, but busier than normal.  What I didn’t expect was for none of the regular staff to be working.  Chris, the manager, is a really nice guy, but there have incidents in the past that made me question his decision-making skills.  While I can appreciate wanting to reward some of one’s best people with a holiday off with their mom’s, I question the wisdom of having the entire, regular Sunday crew absent.  After all, Mother’s Day is a really big deal in the restaurant biz, and often times the only opportunity a restaurant has to make a good impression.

Now, I’m not saying the replacements did a poor job.  They didn’t.  Actually, if I hadn’t known better I would have said they did a good job.  Unfortunately, I know how spectacular of job the regular crew can do and the replacements haven’t had years of working together to generate that seamless flow that propels one’s performance to World-Class status.  Not their fault, but I was disappointed in the experience Mom received yesterday.  She didn’t get this establishment’s A Game.

In a dental office what is the equivalent of a really high-profile, Mother’s Day holiday event?  Off hand, I can’t think of anything.  The closest is when a new patient comes into your practice for the first time.  Undoubtedly, you and your team want to make a good impression so this new patient will tell all his family and friends about his amazing new dentist and will not find an excuse to cancel his next appointment.  To me a dental office team needs to bring their A Game each and every day.  This is hard.  It is a difficult thing to always be “up” and firing smoothly on all cylinders, but that doesn’t reduce its importance.  So, what do you do, as the team leader to help the staff always put their best game face on?  One thing is to provide a work environment in the form of the dental office design that is conducive to a positive work experience.  Make sure the front office is efficiently laid-out and ergonomically designed to reduce work-place fatigue, frustrations, and bottle-necks.  Make sure there is a clean and comfortable place for staff to escape from the rigors of the day occasionally and vent frustrations away from where patients can see or hear.  There will always be challenging patients and giving staff a place to regroup build camaraderie is critical.  Lastly, make sure the operatories themselves are efficiently and ergonomically designed.  Again, this will reduce fatigue, frustrations, and the likelihood of work-place injuries.

One’s dental office design cannot ensure that one’s dental team always brings their A Game to their job each and every day, leadership and coaching play a big role in that, too. However, having a great place to work certainly helps.  If you question this, just think about the demand for newer and better stadiums and arenas at all levels across the country.