Gatekeeper Closing the Door on Dollars?
Is your “gatekeeper” driving up your overhead? This person means well and has your best interests at heart - or so s/he thinks - but consider how gatekeepers commonly view their responsibilities and how these “well intentioned” actions affect your practice. First and foremost, your gatekeeper not only lives by the rules, s/he feels compelled to enforce them. It is difficult to comprehend that others may not value these “rules” as they do, so gatekeepers give little if any consideration to the reality that for every action there is an equal reaction... and not necessarily a positive one. Are any of the “rules” below costing your practice?
Appointment Rule: Patients must be in the office at their appointed times. If they don’t show, the financial policy says that they will be charged a fee.
Enforcement: The gatekeeper promptly sends the invoice with the fee explaining that the patient did not cancel the appointment in a timely fashion, therefore the office must charge them a fee.
Reaction: The penalized patients don’t return. They also share details of their negative experience at your office with hundreds of their friends via one comment posted to Facebook or Twitter. Fewer patients mean lower revenues and higher overhead. If you are lucky, an offended patient or two will call and complain. However, the gatekeeper doesn’t want the doctor bothered by the complainers, so the doctor may or may not get the message.
Solution: Never charge a fee to patients that do not show in your practice. Rather, institute a recall system that ensures appointments are confirmed in advance, and patients who are not in the practice at the appointed time are notified according to a carefully crafted script.
Protocol Rule: When new patients call the office they are to be scheduled for a comprehensive visit with the doctor first.
Enforcement: The gatekeeper instructs prospective customers who want to schedule an appointment with the hygienist that the practice does not handle new patients that way.
Reaction: The practice is losing new patients. Some patients relent and follow the rule. Others agree only to cancel the appointment or simply not show. Most simply call a different practice.
Solution: The patient wants what the patient wants. As a service provider, practice success is contingent upon attracting and keeping happy patients. Simple requests and patient preferences should always be honored.
Payment Rule: Payment is expected at the time of service.
Enforcement: The gatekeeper makes it abundantly clear that the practice takes cash, check, or charge.
Reaction: Patients feel that the practice’s priority is money, not patients. Moreover, inflexible payment procedures make it very difficult for patients to accept larger treatment recommendations.
Solution: Practices need clear financial guidelines, but they also need options, such as treatment financing plans like CareCredit. Options encourage patients to not only keep appointments for preventive care, but also to pursue necessary and desired treatment.
“We” Rule: “We can’t do that here.” No, we don’t take that insurance. No, we don’t offer evening appointments. No, the office isn’t open on Saturdays. No, we don’t schedule appointments before 8 a.m. No, we are not open between noon and 1 p.m. No, we don’t honor other practices’ coupons or special offers. No, we can’t schedule all three of your children on the same day. No, I couldn’t possibly get you in this week. No we don’t have any openings in hygiene for six months. No, we don’t text appointment reminders. No, we don’t have our patient forms posted on our website. No, we don’t have a website. And on and on and on.
Reaction: Patients feel it is simply too difficult to work with your practice. If you are telling patients you “can’t,” we “don’t” or I “won’t” you are sending the wrong message. It’s not about your rules, your preferences, or your way of doing things.
Solution: “Can’t,” “Don’t” and “Won’t” are three four-letter words that should be struck from your vocabulary. Always emphasize what you can do. “We take a variety of insurance plans. In addition, we offer convenient payment options.” Pay attention to what the gatekeepers are telling current and prospective patients in your practice. And finally, never forget that the most successful practices are following the only rule that matters - treat patients as you would want to be treated.
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