When do you say enough is enough – and fire a dental patient?

We’ve all looked at the schedule some days and sighed when we come across a familiar name – that one particular patient who makes everyone’s job difficult. We move past it and make the best of a difficult situation by being as patient and accommodating as we possibly can.

Thank goodness that for most offices, challenging patients are few and far between. However, I want to talk about another type of patient who is even more rare – the patient your practice should fire. In the long run, firing patients who consistently exceed the expected standards of behavior in the dental office will benefit the practice.

The chronic no-call, no-show patients
Fire these patients. If you have been scheduling patients who fail to arrive, or cancel their appointments within 24 hours, do not schedule them anymore. If they don’t call or no-show more than twice, there is no reason they should be your patients any longer.

These patients are taking up time on the schedule that could have been reserved for other people responsible enough to keep their appointments. Time equals production and a thriving practice. Do not let patients dictate your schedule.

Patients who cannot arrive on time
I’m not talking about people who are five or 10 minutes late to every appointment. While these patients are a bit annoying, it’s important to realize that some people have time management issues and we should be accommodating. I’m talking about another, special type of patient. Every once in a while we encounter mega entitled human beings who think it is just fine to walk into the office more than 30 minutes late and still expect to be seen immediately.

These patients need to be fired as soon as possible. The second time they’re late, the doctor needs to explain to them they cannot be late again or they will not be seen or rescheduled. If another tardy occurs, follow through with the doctor’s instructions. These types of patients, in my book, are worse than the no-call, no-show patients. They leave a large void in the schedule, while demanding to be seen during another patient’s scheduled time. They cause unneeded stress on the staff, and leech onto time reserved for another person. It’s not fair to divide the assistant’s time between a patient who arrived during his or her scheduled time, and a demanding and irresponsible patient. The patients who arrive during their scheduled times should be rewarded with the full attention of the staff.

Patients you can’t please
You know the patients I’m referring to. Everything is wrong and they believe they deserve a discount. Filling a bit too high? Discount. Their teeth are somehow not clean enough after a thorough hygiene appointment? Discount. The crown won’t be back from the lab quickly enough? Discount. The X-ray sensor hurts? Discount. Discount. Discount. These patients are consistently unhappy, filled with complaints, and believe they deserve a huge chunk of their out-of-pocket balance removed. Regardless of how miserable they appear to be at the end of their appointment, these patients always seem to come back. And they always manage another discount as well.

Somewhere along the line, these patients have learned that if they complain hard enough, they’ll receive a reward. The reward is a big discount from their final balance. This isn’t fair to anyone. The doctor, the staff, and the assistants are all being undervalued when this happens. Reasonable patients who are not complaining are being sent the message that their pleasant demeanor is worth less than loud and complaining patients. That isn’t exactly the type of message I would want my pleasant patients to receive.

Fire the Discount King (or Queen). Prove to your other patients that they are more valuable because they are happy with your work.

The emotional vampires
Let me share a true story about an emotional vampire. The procedure this “vampire” was scheduled for was simple enough, and it usually took only 30 to 45 minutes. We scheduled the patient for one hour, which was plenty of time to make her feel welcome and get the procedure done. The second she arrived I knew we were in for a long afternoon. The patient was hysterical, cycling between maniacal laughter and uncontrollable sobs. This hysterical behavior happened in the reception area, and I could tell our other patients were becoming upset by her behavior. One patient even decided to reschedule her appointment.

When I brought the emotional vampire into the back office, the antics escalated quickly. She refused to sit in the chair unless she was given three water bottles – yes, three. She also went into the bathroom and sobbed loudly for nearly 10 minutes, scaring other patients. When I finally managed to convince the emotional vampire to sit in the chair, her partner, who had decided to tag along into the back office, decided to squeeze into the chair as well. Her partner also gave a detailed description of every instrument I brought into the operatory, causing the emotional vampire to scream dramatically after every description.

We offered nitrous oxide to calm her. We offered oral medication. We even suggested that she try sedation her next visit. She refused all of these suggestions. A simple 30-minute procedure turned into a two and a half hour ordeal that left us all emotionally and physically drained. Everyone in the office, including other patients, was negatively affected by this person’s behavior.

Why should we, as dental professionals, put up with this type of behavior? If we are being as accommodating as possible – offering water, relaxing music, nitrous oxide, medication and kindness – there is no reason we should allow someone to drain us of all emotional energy. Fire these types of patients. Everyone in the office is negatively affected, and they are not worth your effort because they will not appreciate your efforts.

Patients who are kind and reasonable should be valued. Unfortunately the kindest patients are often shuffled to the back of the line because unreasonable patients are devouring most of our time and energy. I think this should stop. It can be a challenge to decide when a patient should be fired. Some people in the office may even disagree with the idea of getting rid of patients especially if they have been with the practice for an extended period of time. In the long run, it will be beneficial to remove those patients so the focus can be placed on the patients we want to value and cherish.

ALSO BY ASHLEY PERO:
Obamacare and the dental industry: Part I
Anti-fluoride: A frightening trend
How clean is your dental office? 5 tips to keep your patients healthy and happy

Ashley Pero is a dental assistant who lives in Portland, OR. She has most recently been working for Dental Care Today. She enjoys reading, writing, and learning about new things in dentistry.