Have you ever had a patient that you feel yourself dreading every time you see them on the schedule? More patients mean more money in your pocket but sometimes a particular patient isn't worth your time and effort. It's ok to fire a patient. Casey and Jarrod are joined by Toby Hampp, a National Sales Rep for Four Quadrants, to discuss when and how to fire a patient.
Announcer:
Hello, everyone. Welcome to the Millionaire Dentist Podcast, brought to you by Four Quadrants Advisory. On this podcast, we break down the world of dentistry finances and business practices to help you become the millionaire dentist you deserve to be. Please be advised, we do speak with an honest tongue and may not be safe for work.
Casey Hiers:
Hello and welcome. This is Casey Hiers, back at it again at the Millionaire Dentist Podcast. Co-host, Jarrod Bridgeman, joins me in studio and we also have Mr. Toby Hampp joining us. He helps with our continuing education, presenting that and talking to practice owners all around the country. Gentlemen, thanks for joining.
Jarrod Bridgeman:
Hey, thank you.
Toby Hampp:
Thank you.
Casey Hiers:
Well, Toby, we wanted to have a conversation about, when is the right time to fire a patient? So if you're a practice owner out there, as most of our listeners are, I guess, as you can picture maybe one or two, maybe a handful of patients that you know when they're coming in and everybody just sort of grits their teeth a little bit. Hopefully, you don't have too many of those, but a lot of times you do. And so this topic's going to just touch on that point of, when is the right time to fire a patient? Why would you do that? But what's that look like? And we wanted Toby to join us today. He has a fantastic bandwidth of knowledge within dentistry. And so Toby, I'm going to ask you first, why would a practice owner even consider firing a patient? Don't all practice owners want as many patients as possible?
Jarrod Bridgeman:
Yeah, don't you want that money?
Toby Hampp:
Well, I think that's partially true, and I think this is something that practice owners often struggle with. It's twofold, my answer. So, if you think about the disruption, so dental practices by and large, they're a small ship in a big ocean. Everyone's moving in the same direction, it's a team effort. Dentists I talk to all over the country, they tell me they have a great team. They have that team mentality, and when you have a patient that can be difficult, it could be difficult for many reasons. There's a myriad of reasons why.
Toby Hampp:
It disrupts the flow of the office. That sets you back. Time, as we know, equals money, and I think that kind of is the magic answer there, is that it's a disruption of time, which is a disruption of... It's going to hit you in the wallet. So these patients can often seem like great patients on the front side. They come in, they're on time, they're in the waiting room, they're available, but it's behavior, or what have you, that leads them to become disruptive. And so the time to fire them is when you realize that they're no longer actively a part of your success.
Casey Hiers:
Well, and to be in a position as a practice owner where your patient flow is good, you're established, all the metrics we talk about, overhead, income, all of that, when that's in place, you're in a much better position. Obviously negative word of mouth, you want to be cautious of and Google reviews are important, but being in a position and knowing that it's okay sometimes to recommend that, "Hey, for your special type of dentistry needs, I think there's somebody maybe across town that's better for you." And I'm saying this tongue in cheek-
Jarrod Bridgeman:
So that's the best way to approach, is that you can't just be like, "Get out."
Casey Hiers:
Well, maybe someone from your dental class that you guys play pranks on each other and send each other bad patients. Toby, from your perspective, is that what that looks like?
Toby Hampp:
That can be it. And it often works really well. I think a lot of practice owners are aware that there are other people perhaps across town that might be better suited for that patient, right? Just because it's time to fire that patient doesn't mean that patient's a bad person. They still deserve a great quality of care. Your office just may not be the option for them going forward. I've been in dental for nearly 20 years, in the old days, you would perhaps forward a paper chart across town to that other office.
Toby Hampp:
Now that we do things digitally, it's a lot easier to share that information. And you may even call. Having been where these conversations have taken place, some doctors will even call that other office. I'd call up, "Hey, Dr. Casey, I'm sitting here with Jarrod and Jarrod is looking for a new dental home. I'd love to introduce you two. When's a good time for me to have Jarrod come to your office and fill out paperwork?"
Jarrod Bridgeman:
I like how you assume that I would be the bad patient in this scenario.
Casey Hiers:
Well, I think that's a good segue. Jarrod, you've been a business owner in your past.
Jarrod Bridgeman:
Yep.
Casey Hiers:
And you mentioned this briefly before we started today, but tell our audience about when you've had to make some tough decisions.
Jarrod Bridgeman:
I, at one point, did have to fire a client, not to give away any details, but I co-ran basically a small local video production company. And I had a client of a client that kind of gave us a connection. And this guy didn't seem to understand the rules I laid out for, "Here's how video works. Here's the things I'm looking for." And I spent four days making a sample for him and he came back and said, "I don't like the font. I don't like the colors. I don't like the logo you used." Even though he provided that. And so it was very much to the point where he's like, "I want a spokesmodel on screen or whatever." And I was like, "That's not what we do here." I was like, "I know somebody who'll work well for you in that scenario. Here's his email, here's all this." Having known that guy, still, 10 years later, I was like, "I really dodged a bullet on that one."
Casey Hiers:
Well, and it makes total sense if... And that translates if you're a practice owner and maybe a patient's trying to tell you how to do dentistry, there's a red flag.
Jarrod Bridgeman:
Yeah.
Casey Hiers:
Somebody who's rude to your staff, there's a red flag. Somebody who maybe has some real dental issues doesn't follow the advice, comes back in and complains, and makes accusations where they're the problem. They're not the one doing it. They're taking up your time. They're not being nice. A lot of those things are what happens and it sounds like that happened with you and you had the courage to do it.
Jarrod Bridgeman:
Really think about it, I don't know if you guys ever seen the show, What We Do in the Shadows, but there's a character who's a energy vampire. He feeds on other people feeling bad. And so sometimes these people just maybe [inaudible 00:06:27], they like the idea of drama and the feeling of drama. And sometimes you just don't need someone draining on you like that.
Casey Hiers:
Well, and if you want to talk about areas that practice owners shouldn't waste time on, today's topic is a patient that's just not great for many reasons, but there's a lot of things that practice owners shouldn't waste their time on. And we've talked about this in the past, but if it's 9:30 at night and you're getting your QuickBooks up to date, that's probably not a good use of your time. Just as dealing with an unruly patient consistently isn't a good use of your time.
Jarrod Bridgeman:
Yep.
Casey Hiers:
And that just, I know in a personal perspective, there's people sometimes, as you mentioned, that you need to maybe not associate with. And so a lot of practice owners personally, in your life, they need to have the courage to realize don't be around these people. But if they're in your practice and they're willing to pay you for your services, there's still a level of mutual respect that needs to be hit.
Jarrod Bridgeman:
Yep. You still got to be cordial about things. Toby, I actually wanted to ask you, having been working with and around Dennis for so long, do you have any... Without giving away details, any particular strong, scary story about knowing a patient that needed to be fired?
Toby Hampp:
So one of the things that I like about dentists, practice owners, they often have great war stories. Casey and I just met with a group of dentists recently and there were some great stories, right? And they provide some interesting ways to look at the practice of dentistry. And for me, one was an endodontist who was working on a patient. There was a point in treatment where they needed to take a break. They needed to get some other equipment or bring in other materials. So they allowed her, get up out of the chair, go to the restroom, come back to the chair. And when she came back to the chair, there was blue discoloring in her mouth that wasn't there prior to them dismissing her.
Toby Hampp:
And she was only gone for a few minutes and she revealed to them that she was hungry. So while she's taking this dental procedure, she went into the bathroom and ate a blueberry muffin and compromising potentially her dental health, who knows what other things. None of us are dentists on this podcast today, but it was very frustrating for the endodontist because at the end of the day, they're staking a lot of their reputation on the success of these procedures. And here you have a patient actively within the procedure undermining that, right?
Casey Hiers:
And then if it doesn't go well, they go back to their GP, potentially the specialist is going to compromise a referral dentist. There's a domino effect there, right? And no, that's a great story. I'm glad you shared that. Toby, anything else about firing patients that you wanted to touch on on this topic?
Toby Hampp:
I think that if you do get to the point where you fire the patient... And Jarrod's story is great. You treat them with respect on the way out of the door, you treat them with respect on the way out the door, but you have to be firm, because you don't want to allow that disruption back into your practice, right? So the idea there is that if you let a patient leave or you send them to a colleague that's much better suited, could be a personality match, or what have you for that patient, that patient's no longer your patient. You're not concerned about it. You go on with your group of patients that you have that are currently active members of your dental team in a way, right? So I've always looked at the dental practice as an extension of the community. Sometimes there are members of that community that you don't want as part of your practice.
Casey Hiers:
Well put. And ultimately, I think having the courage to make those decisions... And we've talked about this, painting a broad stroke, a lot of practice owners, they're non-confrontational by nature a lot of times. And that's not a bad thing, except when you are a business owner and a practice owner, there's a lot of things that they can be. They can take your energy, they can take your time. And at the end of the day, you've got to protect yourself and your team, right?
Jarrod Bridgeman:
Well, and as Toby said, it can affect the wallet as well. And so if you get that person out of that chair, that gives you time to get someone else in that chair, that is a good patient and can work with you.
Casey Hiers:
Multiple benefits if it's the right decision and establishing criteria, I think that's important. Establishing criteria with maybe a few trusted folks within your practice to say... And empower them, "Hey, if you come across behavior like this, here's the process internally to let's document it. Let's make sure we understand it because we don't want to be subjected to certain things." It's not just a real quick decision, there should be some processes involved.
Jarrod Bridgeman:
We kind of touched upon it a little bit, but if it was kind of a bad patient or whatever the case may be, and because of them eating a blueberry muffin or whatever the case is, their dental work ends up being subpar because of their own actions. But they're not going to blame themselves. They're going to say, "Dr. Casey really kind of screwed the pooch on this one." And that is where they come away from. So you end up looking like the bad guy, even though it was not your fault.
Casey Hiers:
The good news is there's probably less than 5% of patients within any practice [crosstalk 00:11:55], and maybe even less than 2% that fall into this. But the point of this conversation is have the courage to make those decisions. It's good for your practice, it's good for you, it's good for your team, good for your staff, but have those criteria. Understand what rises to the level of, "We might consider this." Not just a snap judgment, right? And then if there's process involved, there's some documentation involved, be courageous, and to Toby's point, be direct and be firm. "This is what we've decided. These are the reasons why, and we've got a couple of alternatives for you that we'll be happy to send your records to." And when you have that in place, that can be empowering. And ultimately, that's one of the areas we want this podcast to help practice owners is to feel a little bit more empowered, not just with knowledge, but ways you can turn that into action. And again, don't be shy. You may need to fire a patient and that's okay. Any parting shots before we go, gentlemen?
Toby Hampp:
I think what you said there has a lot of value. Don't be shy in doing that, but also it's a minor amount of your patient base that could be considered for that. So also, dentistry can be a lot of fun. So I think it's focusing on the positive aspects of your day and not worrying about that [inaudible 00:13:12] when it comes up, recognizing it, and handling it appropriately.
Casey Hiers:
Gentlemen, I appreciate it. Toby, Jarrod, be well.
Jarrod Bridgeman:
All right. Thank you.
Toby Hampp:
Thank you.
Announcer:
That's all the time we have today. Thank you to our guests for their insight and for sharing some really great information. And thank you to you, the listener, for tuning in. The Millionaire Dentist Podcast is brought to you by Four Quadrants Advisory. To see if they might be a good fit for you and your practice, go on over to fourquadrantsadvisory.com and see why year after year, they retain over 95% of their clients. Thank you again for joining us and we'll see you next time.
