When patients book appointments at Blackhills Clinic, a specialist dental referral clinic outside Perth in central Scotland, they are given, among other things, a map that shows the location of speed cameras in the vicinity of the practice. It might seem an obscure detail, but this is one of a number of deliberate patient-centric steps the clinic takes to make sure the patient’s experience is a positive one. By alerting first-time visitors to speed cameras, dentists at Blackhills believe anxiety levels before and during complex clinical procedures may be reduced.
Other such measures include making sure there is always fresh coffee available in the waiting room, having a full and varied range of up-to-date magazines and giving the patient a choice of music during surgery. These seemingly small details might seem immaterial when set against the technical, clinical procedures of modern dentistry, but they can make the world of difference to the patient’s experience.
“We try to make sure that the whole patient journey, from the minute they first hear from us after referral to the end of their treatment, works well for them. The list of things we do is actually quite long and covers a whole range of factors. Sometimes dentists get so carried away with all the gadgets and gizmos of dentistry that they forget the soft skills,” says Paul Stone, specialist oral surgeon and clinical director at Blackhills.
Dentists under pressure prioritise procedures
Soft skills are not just about physical comforts such as music and magazines but, perhaps more importantly, taking the time to talk to the patient and build a relationship, making sure different options and procedures are thoroughly understood.
“For patients who may be anxious, giving time and attention in a sympathetic and honest way helps to put them at ease,” says Marilou Ciantar, specialist periodontist and oral surgeon at Blackhills.
This kind of patient-centric approach to dentistry might seem obvious, but under the constant pressure to stay on top of dental science, comply with regulations and keep waiting times under control, dentists may be driven to cut corners and focus their attention on the procedures rather than the patients.
In NHS practices, in particular, there is pressure to squeeze more appointments into each day, reducing the time available to build long-term relationships and make the patient experience more comfortable and enjoyable. Dr Stone and other specialists believe the most precious commodity that comes with private practice is simple: time.
“Given the time constraints in NHS practices, where dentists are being encouraged to get as many patients through the door as possible, the concept of a patient-centric approach has been allowed to slide because it is the only way to get the work done,” says Jonathan Lack, a specialist periodontist in London’s Harley Street.
Sometimes dentists get so carried away with all the gadgets and gizmos of dentistry that they forget the soft skills
Patient-centric soft skills cannot be taught
In his clinic, Dr Lack has also taken care to ensure the patient journey is a positive one, allowing a full hour for initial consultations to give sufficient time to build a rapport. Other comforts include subdued lighting in the waiting room to create a calming atmosphere and an iPad on the arm of the chair so, during lengthy procedures, patients can choose their own entertainment.
But above all, he has a cast-iron rule that no patient should ever be allowed to experience pain. “We see patients every day who avoid the dentist like the plague, and yet dentistry can be so pleasant and pain-free. With the anaesthetics we have today, nobody should ever feel pain during treatment,” he says.
The patient-centric approach might be second nature to some practitioners, but despite its potential to dispel the fear associated with dentistry and engender long-term patient loyalty, it is not always intrinsic, even in private practice. Experts say the important soft skills that put patients at ease in the dentist’s chair cannot always be taught, and may be more likely to come with maturity and experience rather than training.
“In dental training, students get very caught up with the hardware and techniques, and learning how to physically carry out procedures, and there isn’t time in the curriculum to devote to the soft skills. Newly qualified dentists can sometimes be lacking in this area, but they develop and become more empathetic with time,” says Dr Stone.
A century of patient care
Treasured files at the Freiberger Dental Practice in central London include a large collection of cards and letters from grateful patients. They express thanks not just for the quality of treatment, but also the high level of care and attention bestowed by the practice’s dentists. One patient even declares his surprise at looking forward to his next appointment.
“The culture of caring for the patient pervades everyone and everything at our practice. We are interested in our patients as people and we treat them as we would our friends or family,” says Philip Freiberger, who has worked in the family practice since 1982.
Freiberger Dental Practice was founded in Shaftesbury Avenue in 1920 by Israel Freiberger, a Polish immigrant. After his death in 1946, the practice passed to his newly qualified son Vivian and subsequently to two of Vivian’s sons, Malcolm and Philip, moving to new premises in Portland Place in 1966.
Not only has the practice benefited from the unique continuity of family dentists over nearly a century, but their shared commitment to patient-centric care has allowed the practice to flourish and retain patient loyalty for many years.
“I have heard from one or two people who were patients of my grandfather in the 1920s, when local anaesthesia was far less sophisticated and procedures could be more traumatic, that he developed a personal connection with them, which went far beyond pure dentistry and made them feel at ease in his chair. That connection endures today,” says Dr Freiberger.
Philip’s daughter Avigail joined in 2011, marking the fourth generation of Freibergers in the practice. “Coming from a family of dentists, I knew the work would be interesting and challenging, but another key draw is it allows us to build relationships with patients that can last for many years,” she says.