Practicing the "customer is always right" philosophy is sometimes difficult to maintain, especially when you do not believe that the customer is right. However, it really is irrelevant who is right or wrong. Your responsibility is to keep the patient or parent happy, satisfied, and confident with your services. One poor experience with a patient or parent can severely damage your relationship with your referring office, and can potentially cost you the referral of future patients. When you handle each person's complaint, always remember to address them as if they are your most important patient.

Strive for 100 percent patient satisfaction, hope to achieve at least 95 percent, and expect to encounter problems occasionally. When a problem surfaces, remember not to ignore it, rather, handle it effectively. Focus on solutions. When you manage customer service problems, you are, in a sense, managing damage control. You must neutralize the problem and ensure that the patient or parent leaves the practice satisfied. Your recovery efforts will stifle any damage inflicted on your relationship with the referral source.

Step 1: Communicate with the patient/parent.

When you are confronted with patient/parent problem, handle it immediately. Problems should be analyzed using the following seven-step system:

1. Identify the nature of the problem.

2. Determine why the patient feels that a problem exists.

3. Give options for a resolution of the problem.

4. Select the best possible solution.

5. Make sure that the solution is acceptable to the patient.

6. Execute the chosen solution.

7. Follow up to be certain that the patient continues to feel satisfied.

This resolution system is appropriate for virtually every customer service problem the treatment coordinator may encounter. Remember, a problem is not always commensurate with the damage it can cause. Sometimes, an unhappy patient will reveal their displeasure to their general dentist. A referring relationship may be destroyed in the process.

Step 2: Determine who should handle the problem.

Select the appropriate person to work through a problem with the frustrated patient/parent. If the problem is clinical in nature, it should be handled by the orthodontist. If it is a financial or insurance problem, it should be addressed by the office manager. However, any problem that will ultimately affect the practice's image and its referral base should be managed by the treatment coordinator.

You may not relish this interaction, but you cannot afford a dissatisfied patient. There is rarely an instance worth the loss of a referring office. Always operate under the assumption that one problem has the capacity to create multiple problems with the referring office.

Step 3: Communicate with the referring office.

Alert the general dentist about complaints before the patient does. If the patient complains first, the general dentist may suspect that the orthodontist is responsible for the problem, and will be, at the very least, disconcerted. Based on the patient's recounting of the incident, the general dentist will assume that his or her patient received inadequate care or service. The dentist will also resent being brought into a difficult situation and be expected to resolve it.

If you contact and update the referring office about the problem, the general dentist will assume that you have resolved the issue and will anticipate a phone call from the patient. When the patient/parent does call the general dentist — and he or she will, you can be sure — the general dentist can freely participate in the resolution process, effectively diffusing the situation.

Remind your referring doctors of the customer service strategies that you do for their patients in the "Office Updates" of your mailings. Review with your referring doctors the correspondence that they can expect from you and ask them how you could do it differently. Tell them about the special continuing education programs you offer.

Doctor surveys are a great way to get feedback from your referring doctors. If you want to learn how to improve the services that you provide both to patients and to referring doctors, then surveying your referring doctors is an ideal strategy. Not only is the information that you receive worthwhile, but a survey is an excellent marketing strategy in that it shows your referring doctors that their opinions matter and that you recognize that it is your job to meet their needs.

Step 4: Always follow up.

Follow up with both the patient and with the referring doctor to ensure that the problem is solved. When you receive signed responses to your doctor survey, follow up immediately. (Give people the option of signing their survey.) If they sign their names on the survey, send them a handwritten thank you card. You may also want to schedule a lunch or dinner to discuss their survey responses. As with any strategy, the goal is to find as many ways to have positive contacts with your referring doctors. Let them know what new policies you are implementing as a result of their comments and suggestions. If necessary, follow up with an additional survey to gather more information.

1. Communicate with the patient/parent. Do whatever you can to discover and resolve the problem.

2. Determine who should handle the problem.

3. Communicate with the referring office. Let your referring doctors know that you are doing everything possible to ensure the happiness of their patients.

4. Follow up with both patient and referring doctor to ensure that the problem has been solved. After you send the doctor surveys, send a letter explaining the changes that you will be implementing as a result of the survey responses.

For the survey, create a mailing list of your referring doctors from the last year. You may also want to include some non-referring GPs on your list.

Develop a survey that addresses the main contacts that you have with your referral base in a format that is quick and easy for them to complete.

Consider coding the surveys by using a different color paper for surveys to each type of referring office. For example, non-referrers could receive a blue survey and top referrers could receive a green survey.

Send an initial letter introducing the purpose of the survey. One week later, send the survey with a self-addressed stamped envelope. Then send a thank you letter thanking everyone for their participation. You may want to send handwritten thank you notes to the doctors who sign their surveys.

Following the four steps will help to create good relationships with your patients and referring doctors.

Roger P. Levin, D.D.S., M.B.A. Dr. Levin is on the faculty of several dental schools and serves as a consultant to the American Dental Association Council on Dental Practice. He is an accredited member of the American Academy of Cosmetic Dentistry and a diplomate of the International Congress of Implantology and has completed the L.D. Pankey Institute's continuum series.