Why Patients Don’t Come Back? White Paper 2015 #patient #business #leadership


Is your practice experiencing a lot of no shows? Are your patients requesting their records be transferred to another physician or dentist? Are your patient’s not coming back? Are your patients cancelling their appointments or rescheduling them then not showing up? If you, said yes then there may be something your practice is missing.

Medicine and Dentistry is a people service industry.  As in any service-based business, it is almost impossible to avoid the occasional disgruntled client who will not return. Sometimes we can even view losing a specific client to be a blessing in disguise. However, we all have the universal desire to build our practice upon loyal clients who refer their friends and family. Physicians and dentists (like most business owners) have blind-spots when it comes to the weaknesses of their businesses, and find it hard to accept that the service their practice provides is not as good as it should be. Physicians and dentist specially working at private sector truthfully upset their patients in a countless of situations that may not be obvious to them as business owners but they would not put up with themselves if they were in the patient’s shoes. Many times patients are not given the attention they deserve because they are viewed as an interruption to our work. They are sometimes ignored, overlooked, or pushed rudely aside as we rush to get back to performing our daily tasks. Whether patients are walking past us in the hall, in front of us, or on the phone, they deserve our respect and undivided our attention. Not only is this for their sake but also to build loyalty which is key for retaining patients. Reasons why a patient may consider leaving or not showing back into the physician or dentist practice are different but I will try to minimize to highlight the most important reasons.

To begin with Running Late .Time is valuable for both doctors and patients. Patients don’t like it if they rush to get to their appointment on time, only to sit at reception area or in the treatment room waiting for their dentist or physician to be ready to treat them. Don’t undertake that waiting for patients is acceptable as part of the deal when they reach the physician or dentist practice. Long wait times happen to be the number one complaint of patients regardless of whether they are visiting the emergency room, a physician office, or the dentist. No matter what a medical office manager does to prepare for patient appointments or visits, wait times can be difficult to reduce to the acceptable “15 minute” time frame. In a perfect world where things nothing go wrong, this can still be an impossible task to accomplish. While we strive to respect our patient’s time, time is one of those elements that can’t be controlled. There are a few ways that can minimize wait times to less than 30 minutes. Such as creating a balance between seeing enough patients that meets the financial needs of the practice but still offers a high level of quality patient care.

Don’t Criticised your Staff in front of Patients .It’s embarrassing for a patient (as well as for the team member) when a physician’s or dentist’s employee is being criticised. Equally, it is a real confidence-builder to hear an employee praised by their boss in front of a patient. There is an old rule of “criticise in private, praise in public” when it comes to providing feedback for staff.

As a practice owner you shall override any Poor Skilled Staff. Many physicians and dentists feel it is not worthwhile spending money on training and developing their staff. They often make comments like “what if you train them and they leave?” Frankly the converse is true…what if you don’t train them and they stay! Having untrained staff decreases the service level provided to patients and add to the stress levels of the patients, other staff members, and especially the physician and dentist.

A number of physicians and dentists feel uncomfortable discussing fees with patients. Physicians and dentists need to remember the adage “inform before you perform’. This is one of the biggest gripes on online review communities, and from the patients’ point of view, entirely valid. There are many times a dentist or physician can’t be precise with their estimation of costs, but at the very least, all patients should be given, a range of fees that their treatment may come to. Patients don’t want their health provider ‘selling’ them anything. Let alone a solution to a problem that hasn’t even been explained to them. And yet many dentists do this regularly when they are charting. Often treatments are charted by the dentist or the physician when calling out to the staff assistant or the nurse, before the dentist or the physician has explained the issue to the patient. Patients typically complain about medical bills being too high much like drivers complain about the gas prices. Unfortunately, there is not much that can be done about either of them. The fact is that medical care costs money. It costs the patients, the doctors, the insurance companies, the hospitals, and so on. Unless a law is passed that provides free universal healthcare to all citizens, medical bills will continue to be a part of our reality. Although, there is no way to satisfy all patients that feel this way, the medical office can reach a large number of patients regarding medical bills through effective billing communication. Simplify patient bills to improve patient understanding of billing and collection materials.

“Not enough time spent with my doctor” seems to be the fastest rising reason that patients don’t come back. Patients are reporting in higher numbers than ever before especially for new doctors. Several studies have confirmed that new doctors are spending an average of 8 minutes per patient. I can understand the patient’s frustration if their physician or dentist is spending only 8 minutes with them especially since the wait time is usually much longer than that. We understand that some of the care patients receive are indirectly related to the patient’s care. So much time goes into documentation, reading labs and x-rays, and entering orders that patients aren’t aware of. All of these are crucial in making sure patient’s get the treatment they need. So how can this issue be resolved? It is important to note that there is nothing better for the long-term dentist-patient or physician-patient relationship, than the patient feeling that the dentist or physician always has time for them. That they are not ‘rushed through’ and given the feeling that the dentist or physician is under time pressure. The majority of patients only visit the doctor once a year, if that. So when they come for a visit, they consider this as their opportunity to bring up every concern they’ve had about their health all year long in one short visit. To the doctor who has a full schedule of patients, he or she may feel the urge to rush through the visit to keep other patients from waiting too long. To the patient who has the opportunity to voice his or her concerns, he or she may feel that they are being rushed or the doctor is uncaring. There are a few ways to avoid “the doctor is ignoring my concerns” scenario. Some physicians and dentists choose to reschedule the patient for another visit to discuss other issues they may be having. The best way is to find out what issues the patient has during the scheduling of the appointment. The scheduler should be prepared to ask key questions that can help determine whether the patient needs a 15 minute appointment or if the patient needs a longer time slot. This way, the slot is available for all the patient’s needs to be met in one visit.

Sometimes patients don’t have a full understanding of what they should expect from their treatment plans or medications. Patients may not know the right questions to ask and often assume what types of results they should expect. Providing patients with a written treatment plan can encourage them to continue whatever method of treatment the physician has ordered. It is important not to talk in technical terms to the patient. Patients would like to understand what is happening in their treatment process, and dentists or physician typically use technical nonsense when explaining treatment and options. The nonsense does little to shed light on what’s happening for the patient and will often confuse them and build mistrust. Patients will be far more likely to understand their situation and trust your solutions if you use simple English!

Like it or not the public will make judgements of every business based purely on appearance. Your patients view the practice as an extension of you and your clinical abilities.
What judgements will they make of a practice that has a dated aesthetics, equipment, technology or furniture in the waiting room? What association will they make of a practice that isn’t clean or well-maintained?

When we look at online reviews of dentists and physicians another of the most common complaints people have has to do with the fees of the practice. In the absence of a relationship between the patient and the practice, then the only thing that can be measured by the patient is the price. If however there is a relationship and trust has been built between the parties, then patients will drive past many cheaper practices to go to the medical or dental practice they trust. It is imperative that physicians and dentists develop skills and take time to quickly form relationships and develop trust with their patients.

The most valuable people to the medical office is not the physicians, the nurses, or the staff -it is our patients. Without patients, the medical office serves no purpose. Sometimes, the staff of the medical office are so busy performing their job they forget that the patient is the job. Our Most Valuable Patient’s should receive VIP treatment. From the time of a patient’s first visit, the patient should be treated as if they are a celebrity. Greet your patients by first name , Show enthusiasm, smile and be genuine , thank them for coming in for a visit or let them know how glad you are to see them and Escort them to their destination instead of giving directions If they have to wait, offer them a cold beverage. Finally call them a few days later to see how they are doing

Our patients may like us, may think our service is good, and our practice is fine in nearly every regard, but still leave us as they can’t get time during our opening hours to come and see us. Everybody leads busy lives these days, and lack of flexibility and availability can cause patients to look elsewhere, especially in an emergency situation. Unfortunately, dentists and physicians only hear from the patients who keep coming back.Most patients who leave, do so quietly, and without warning. And dentists usually don’t know why.

In conclusion physicians and dentist in private sector or who are practices owners shall work to create 5 Star Service for their patients. It just requires a little more effort in understanding your patients’ desires. To achieve a better patient service experience physicians and dentists need to understand the patients want to feel special. By giving patients a little more personal attention can go a long way in making them feel special. Also, physicians and dentist should also remember to always “be present” with the patient. Patients want to feel as though they are the most important person in the world while you are with them. Another element to enhance patients experience is patients want to know that their physician or dentist honourably care about them. By giving the patient a warm welcome when they enter the office. No matter how busy your medical office staff is, someone should greet them as soon as they enter the medical office. Even if the physician or the dentist can’t verbally greet the patient, getting eye contact with them lets them know you are aware of their presence and will get to them as soon as possible. Patients want their physician or dentist to tackle any issues that arise immediately. If a problem arises with patient, rectify the situation as soon as possible. A patient will remember that you went out of your way to make them happy but if you don’t handle it right away they will remember that too. Customer service is not about getting it perfect, it’s about catering to the desires of the patient. It all comes back to the premise behind the golden rule; treat and provide for your patients in a way that would meet and exceed your own expectations, and watch your practice grow and thrive.

About the Author:

Dr.Hisham M Safadi (Hisham Safadi ) BDS & MSc Leadership and Management in Health Care Practice form the University of Salford where his Master dissertation was in the effect of Emotional Intelligence on improving Dentistry care in Middle East. He was born and raised in the Emirates of Ras Al Khaimah, United Arab Emirates. Dr.Safadi had start his professional career as a dentist then turn to the field of managing medical facilities and investment management. His main interest is business start-up, leadership and mentoring. Currently he is leading several projects in Manchester that is related to enhance patient experience and improving leadership style through education.

Twitter: @hishamsafadi

Read more from the Author:


Hicks, J. (2014). 5 Reasons Patients Don’t Come Back. [online] About.com Money. Available at: http://medicaloffice.about.com/od/patientsatisfaction/tp/5-Reasons-Patients-Dont-Come-Back.htm [Accessed 26 May 2015].

Palmer, P. (2012). Where have our patients gone? The top 10 reasons why patients don’t come back – Prime Practice, the dental management specialists.. [online] Primepractice.com.au. Available at: https://primepractice.com.au/articles/where-have-our-patients-gone-the-top-10-reasons-why-patients-don-t-come-back-167 [Accessed 26 May 2015].

Transitions, O. (2013). When Patients Don’t Come Back. [online] Transitionsonline.com. Available at: http://transitionsonline.com/resources/when-patients-dont-come-back/ [Accessed 26 May 2015].

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