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Part of taking care of your staff is teaching them how to wow your patients. Teach your staff how to amaze your patients every time.
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AUDIO - Shep Hyken - HSP #119
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VIDEO - Shep Hyken - HSP #119
Shep Hyken says, "You can't manage what you don't measure." Learn to measure and improve the strong and weak links in what Shep calls your Patient Journey Map.
Shep Hyken is a customer experience expert and the Chief Amazement Officer of Shepard Presentations. He is a New York Times and Wall Street Journal bestselling author and has been inducted into the National Speakers Association Hall of Fame for lifetime achievement in the speaking profession. Shep works with companies and organizations who want to build loyal relationships with their customers and employees. His articles have been read in hundreds of publications, and he is the author of Moments of Magic®, The Loyal Customer, The Cult of the Customer, The Amazement Revolution and Amaze Every Customer Every Time. He is also the creator of The Customer Focus™ program, which helps clients develop a customer service culture and loyalty mindset.
Howard: It is a huge honor today to be bringing on another bald beauty. We might have had same mother. I think after this show, I'm going to call my mother and ask her if she gave a kid up for adoption and never told me about it. Thank you so much much. You're an extremely famous person. New York Times bestselling author. The Amazement Revolution. You're a customer service expert, and I wanted to bring you down to the little world of dentistry. There's 150 thousand dentists in the United States. The billed out 103 billion dollars last year. We got to school for 8 years, and all we learn is math, and physics, and chemistry, and biology, and morphology, and dissect humans and all this stuff. We walk out of school, and we don't have an hours worth of education on how to do payroll or what should overhead be, how do we market, how do we meet new patients. We're basically scientists, engineers, mathematicians, so what would ... Thank you so much for coming on my show.
Shep: Thanks, and my brother form another mother. No, it's an honor and I appreciate it. I don't know how famous I am, but you know what, in my little world of creating customer, or in our case, patient amazement, that's what I Specialize in and people know me for that and that's where I am.
Howard: So what do you ... What would you say to dentists who, they go into work, they're driving to work, they're worried about this root canal, or they have this surgery, or they hope they get out this impacted wisdom tooth, and they just think clinical, clinical, clinical. You're the other side of the coin. You're the customer. When you walk into dental office, or if you walk into 10 restaurants, or 10 dental offices, or 10 chiropractic offices, what do you think the patient wants to see? What amazes the patient? What makes them want to leave and say, tell their best friend Shirley, hey you should go my dentist?
Shep: There's a number of things I think are important, and I think they're important to anybody in any business. Which, by the way, you're comment about you go to dentistry, or you go to medical school specializing in dentistry for eight years and you've come out not taking one business class on how to run your practice, and maybe there are some. I know that there's very little if any programs and classes you can take on creating that amazing patient experience. I think that's part of what grows your practice.
So some standards. What I would call non-negotiables. That is respect the patient. That's means respect their time, respect who they are. That's one of the big pet peeve. You go to a doctor's office, and you may have the 8:00 appointment to see that particular doctor and you realize there's four other people there for the 8:00 appointment, you know. Whether it be a doctor, a dentist, any type of service. It could be an attorney you're going to see for an 8:00 appointment. If the attorney walks in 20 minutes late, all of a sudden you've proved tremendous disrespect. So I'm going to say first and foremost, respect your patient. Respect them immensely.
Howard: That's the hardest thing about what you just said is, the internet does not know boundaries. These people list these podcasts on every single country on earth. It's funny, when you talk to old Soviet Union country dentists, whether it's Poland, Ukraine, Russia, they are actually when a patient asks them a question because they're like, I'm a doctor, how dare you ask me a questions about what I'm doing. I think it's very regional around the world. A lot of dentists just don't ... Especially old Soviet Union country dentists, they don't even think ... You're not even respecting your doctor by asking them a question.
Shep: Well, I don't know how it is over in the Soviet Union, but I know how it is in most countries. I know they're bringing customer service into the Soviet Union. People like myself are being asked to speak there and try to bring some of this western way of thinking into their way of thinking, and really it's important to do so.
I think when we're asking, we're not always asking to question what the doctor is doing, we're trying to get an idea of what you're getting ready to do to me. I want to know. I think herein North America predominately, we are in a place where we expect to be told these tings. We have a different culture than some other places. Here's the thing. Respect goes to a couple of different levels. In respect that I'm on time, and respect my time. You know what, inform me. If you want me to be compliant, if there's something I'm supposed to do, after you pull my tooth and you tell me to go get a prescription to make sure that I dint get some type infection. If you want me to comply, explain to me why I need to do what is it I need to do, because it's gonna make the case to why I better go to that pharmacy and pick up that medicine. I better do it. You say, I better come back in three weeks and make that appointment.
So education is another piece of it. I believe that's part of the service experience. To make that patient feel as comfortable as possible about doing business with you because I don't think the patient gets up in the morning and gets excited about going to the dentist. I can't wait to go get that root canal. This is the thing I've been waiting for my entire life. I don't know if that's what they're thinking. Now I know what the dentists is thinking, yes another root canal. No, but you know what I'm saying. The idea is that we want to create an experience where we go, wow I enjoy going.
I think it's really cool when I walk into a dentists office and the waiting room is empty because I am the patient there on time. I realize emergencies are gonna happen and people are empathetic to that, as long as you talk to them ans explain what's going on. I love going into the dentists chair and sitting down and they put headphones on me just like the ones that you have, and I'm listening to amazing music. The music of my choice, because there's different channels that are there. I love looking straight up and there monitor and I can watch a movie and listen to the movie on my headset. Those are little things. I love it.
We talked briefly about David [Moffat 00:06:28] and his new book. When I was preparing for this interview, I went out and talked to other dentists. I went to my dentist. I went to David, who's over in Australia, who's written a book about creating the ultimate patent experience. I said "What does it take?" He says "You gotta think about it in terms of what other businesses do. Not just what dentists do." You have a nice car, I assume? You're fairly successful guy, yes?
Shep: Can I ask what kind it is? Is that fair to ask?
Howard: Sure a Lexus 450.
Shep: I was hoping you'd tell me it was a Lexus. Honestly, I had no idea. When you go to the Lexus dealership for service, what's your experience?
Howard: Same guy for 10 years.
Howard: He know my name. He's a mighty smart gnome. I call him on his iPhone, he calls me on my iPhone. He's in a uniform, name tag when my car's getting worked on. It looks like you can eat off the floor, but I say for me personally, growing up with five sister and playing Barbie dolls till I was 12, I don't know what lifters are. I don't know what rotors are. So I need the trust. I trust the Lexus dealerships gonna do the right thing. I don't think they're gonna try to sell me something I don't need, or I don think they're gonna fix it wrong. What's amazing about my Lexus is, I bought it in 2004. It's got 109 thousand miles on it. Every time I go in there they're like, do you want to just trade this in for a new one? I always think to myself, the car's never blinked in 10 years. Why would I want to trade it for another one? I think I'll get 200 thousand miles out of it. I love that car.
Shep: Yeah. I try to get the 10 year extended warranty and I sell it after about nine and half years with six months left for the guy that buys it to have a little bit of cushion. When you go in there, what's the waiting room experience like when you're waiting for your car?
Howard: I pull into the garage and they're standing out there in slacks and white shirts, name tags, and I roll down my window and they just walk right to my window. They usually guess my name or know my name or my guy is standing out there. He sees me and I just get you and I walk into the desk and they give me keys to a loaner care, and then, it's just easy.
Shep: So they make it easy. That's important,. The other thing is they use your name. One of the things that David shared with me, which is just the little things that separate it, when you know, you've got somebody in the waiting room and you slide that window open and the front desk manager sticks their head out of the window, and rather than says, "Farrett", or just yells a name out. Here's a little touch. They don't stick their head out. They actually walk around. They walk right up to you. They say "Mr. Hyken, come on in, instead of screaming it from the window. That's a little tiny touch. Rather than call it the waiting room. Maybe it's called the lounge. If you go to the Lexus dealer and you have to wait, cause maybe if your car's just getting a quick oil change it's gonna take 45 minutes, you might not need that loaner car. Have you been to their waiting room? Have you seen what it looks like?
Howard: Oh yeah, it's nice. It's got a big screen TV for free. All the snacks and vending machines don't cost money.
Shep: Yeah exactly. I've talked to different dentists and they do different things. Imagine this, if you're dealing with an elderly group of patients, rather than have them drive in, why don't you send a car service to pick them up. By the way, well who's gonna pay for that? The patient's gonna pay for it. Make it part of the package of doing business with you. You know what? They will pay more for a great service and great value. If they love you, that's what they'll do. If you don't offer these services and you don't offer that value, you're gonna be a commodity. If all you do is clean teeth and do root canals and fill cavities, that's all you are is a commodity. Basically, at that point it's carpentry.
Don't take this the wrong way. I have a buddy of mine, he's an orthopedic surgeon. We're playing golf one day and he says, "I gotta hurry up and finish, I got a surgery over at noon I gotta do." I mean it's like 11:00 and I go "We got a couple more holes.". "Oh, we got plenty of time." "Don't you like, need to get prepped?" He says "Shep I do these all the time. I probably do 15 a week and I've been doing it for 30 years." He said it himself, "it's like carpentry. But, it's how I handle the patient when they're finished that makes patients want to come back if they other problems and refer their friends to me." I go "Okay." You get it.
So really what I'm saying is that most dentists, they're very comfortable with what they're supposed to do. It's like carpentry. They do it everyday, very comfortable. It's just another procedure, but that patient is not just another patient. They're that patient. It's that person, and you treat them like an individual, not a number or you know, if it's on a file you know, patient number 674 is in today.
Howard: Who do you think does a better job, dentists, physicians, vets, chiropractors? It seem like when I go to physicians and hospitals, it seems like I'm treated more like a lab rat than when I go to a dentists or a vet or a chiropractor. It seems to me, maybe I'm biased, that dentists overall seem to be more customer centered than the health care system.
Shep: I'm gonna tell you why I think that. Number one, I believe that in the health care system, health care systems are buying up doctors offices and now they're telling doctors they need to meet a quota of patients. Usually, that quota means they're overworked, they don't have the time, and I just think they rush people through the process. A dentist, on the other hand, I think they're still in a private practice, most dentists.
Now some are part of a larger group, but most dentists aren't bought by a health system and put this type of activity in to place. So I think that's first and foremost, I also believe hat a lot of dentists are entrepreneurial. It is their own practice and they are building it. They do build relationships. I think if I were to go ... I know this. I feel a lot more comfortable going to my dentists than I would if I had to go to a clinic where there might be six dentists and I just go in, I don't know who I'm gonna get that particular day. Especially if it has anything more than a cleaning.
Howard: I agree. So how do you ... I this dentists is driving to work. So most of these dentists, their multi-tasker, I know, it's a podcast, most of them are listening to audio, they're on a treadmill, they're on a commute to work. Again, their thinking about that orthostatic surgery they gotta do that they've done 15 times a week for 30 years, like you just said. How does the doctor get his staff, his team, to more focus on an amazing customer experience?
Shep: All right. So here's where it gets tough. That's questions that goes to culture, and I'm gonna say that typically, a doctor, dentists, chiropractor, physician, you mention all the different ... They aren't going to school to be business people, be marketing experts, be branding expert, and you'll see that some of the most successful dentists have something they have a wire in their brain that allows them to think this way, but I think that's a smaller percentage. So it really id cultural, and here's where culture for a customer focused, or in this case, patient focused operations begin. They being at the top. However, if I'm a dentist and I recognize you know what, I just want focus on being the best dentist that I can be. I'll be a nice person. I'll be nice to my patient, but I want to focus on dentistry. What do I do? I need to hire basically a chief operations officer. COO. Call them whatever you want . Call them the office manager, but that person has to become the leader and manage everything but my specific unique ability, which is to do that dental work. What that means, is that that person's gonna define what that culture is about. If it's creating that amazing patient experience, they need to define what it is.
I always say, starting at the top, define it. I'm going to go through a little six step process if I can.
Shep: Very simple. Very simple, okay> Simple does not always mean easy. So if the dentist is wired for this side of it, great. If not, get somebody who runs your office and runs the practice who is, and that person, whether it be you or that other person, are gonna define what the culture is. Now, I want you to think about creating a simple one sentence phrase that everybody can grasp onto, remember easily. I'll give you some examples. The Ritz-Carlton is may favorite. They created something called their guest credo. I call these a mantra. A simple one sentence phrase that can be easily repeated. Their mantra, or credo, is nine words long. We're ladies and gentlemen serving ladies and gentlemen. Think about that. We're ladies and gentlemen serving ladies and gentlemen. If I go to work for the Ritz-Carlton, I know exactly what that means, and if I'm a guest of the Ritz, I know what it means as well. Now not all these mantras have to work for both the internal people you work with as well as the guest, but you've gotta start inside.
Outback Steakhouse. I don't know if you've ever been to an Outback before. Good little chain of steakhouses. Nothing special. Lower end compared to a Morton's or a Ruth's Chris, but still very, very good, family type of casual dining. On the way out, above the door on the way out from the kitchen it says "Great food, no rules." Now that used to be their tagline, but it stayed their internal mantra. Four words. They're gonna walk out. They're gonna deliver great food, and there's not rules that say we can't do anything. As long s it's not illegal, immoral, and if we can do lets do it. Of the customer says, I want my ribs without sauce, we can give them ribs without sauce. Not a big deal.
So anyway, I share this. So what is the dentists mantra if you will? Is it, we want to create an amazing patient experience? That's a great one. It's simple. My mantra here at my office is always be amazing. Three words. We want to be amazing for our clients. We want to teach our clients to be amazing to their clients, which is kind of w3hat we're doing right now.
So number one: define it. Number two: communicate it. I call that kind of, dissemination process. We communicate it. We make sure that our people understand it. It isn't a flavor of the day, it's communicate it. It's on our wall on a sign. It's on pads of paper. Collateral material that might have, I know I have a moments of magic pad around here somewhere. We talk about creating moments of magic. It's on our paperwork that we have. Just this constant reminders we're communicating it.
Number three: We train to it. That's the most important. You must train to this vision, because you can't say, hey everybody, lets go out and just be nice to the patient. You can hire the nicest people in the world, but they gotta be trained hoe to do it in a dentist office. Them once you train them, and training isn't something you did by the way, it's something you do ongoing, the you have to demonstrate it. The leader to demonstrate it. By the way, that means that if you hired somebody to manage your practice for you, and they're this great leader, you still have to demonstrate it because you're actually the owner of the practice. You're the dentist. You're really at the top. You can't say, hey everybody, do what she says, don't worry about what I do. I'm not one of you. No. That doesn't work. Their has to be congruencey.
Walt Disney used to walk through the theme park and he knew that all of the employees, which they call cast members, were looking at him saying, okay what's Walt going to do. Where's he gonna go, and the they watched him stoop down, pick up a piece of paper and throw it away. They said wow, Mr. Disney just picked up trash off the ground. He know, he called this stooping to excellence. He knew that if he walked by that piece of paper, he gave permission to all the other employees or cast members to walk by that paper. So he demonstrates it. Then, if it goes out of alignment, if there is a person that's out of alignment, that culture needs to be defended. That means you use it as a learning opportunity and if it persists and it becomes a issue, maybe you've got the wrong person working for you.
The finally, you celebrate it when it works, you know. Lets find out if were doing a good job. Lets ask our patients, and if we see people are happy and we have, and we actually measure and analyze ... I believe that you can't really manage what you don't measure. So if you have some type of analytic to determine whether or not your patient had a great experience. It can be in the form of a survey as a walk out, it can be a telephone call they get as far as they survey, but you find out if you're doing a great job, celebrate. Let everybody know that they're doing a great job. I just did a 45 minute speech in about 4 minutes.
Howard: Well you know, I'll even give that example on the government issue. When you and I were little, when we were in high school, the number one cause of a car death wreck, crash, was drunk driving. My boys lost an uncle. I know several people in my childhood that were just ran over by a drunk driver. In fact, when I was in high school a friend got killed by a drink diver, didn't even get a ticket. They massively cracked down on it. Now, it's not even in the top five anymore. Distraction by cellphone is number one. The country never stopped and said hey, we did good. We want to tell everybody, this was the number one cause of death forever, and now gosh. The country never stopped and said, we achieved a goal. Congratulations, let's all go get drunk and drive home.
So you're right. I think that all of us can celebrate, but I want to ask you this. Every dental consultant tells me the same thing. That when you walk into a dental office, every consultant says they can smell and sense a successful practice just instantaneously. I mean, you cam just walk in there. The energy, the karma, the fun, and sure enough it's a doctor probably doing a million a year, taking home 400 thousand. Then you walk into all the people struggling, and you just instantly walk in there and it just feels like a library. Someone hands you a deal to sign in. You feel tension, you feel stress. How does a doctor change that culture? How do you change from a library of ear, to having fun?
Shep: Well, I think first thing is look at businesses and what are they doing to achieve that and what can you bring in from that other business, in your business? We talked about the Lexus car dealer ship and you talk bout their waiting room. Well that waiting room isn't a waiting room, it's a lounge. You sit there and you have a snack and you watch a big screen TV. I just ... What came to me, when I, I've been very fortunate, I had one office. I stayed in that office building for 22 years before I moved to this office.
Do you know, one of the first things as I walk around an office building that I'm considering moving in to, and I did this 20 something years ago, and I did it again just recently a couple years ago when I moved into the office that I'm in now. What I did is I looked around an then, this was the one that did it for me, I walk into the bathroom and I check out the bathrooms. How clean are they? How new do they look? How dies the lighting look? I can tell if they're taking pride in the bathrooms, they're probably taking pride in other places in the building. I walk into a dental office, all I've got to do is look at the waiting room. Are there magazines there from four moths ago? Or is it today's newspaper? Today's Wall Street Journal? Today's, you know, this month's, or this week's, People magazine or whatever it is. I'm looking at the seats. Are they folding chairs at one extreme? Are they leather chairs? Maybe you can ever recline in that leather chair. I mean, you can sense right away. So I think that's one area, just look at.
A friend of mine, Mel [Clyman 00:22:50] who's an amazing guy who talks about hiring. He says, there's always a question, one question that you should ask. We were working together, believe it or not, for a salon industry, you know, cutting hair. Imagine that. Me going to a place to talk about cutting hair. I said "Mel. What's the perfect question to ask that applicant who's coming to work at this salon?" Just like you might be considering another dentist. If you walked into the office you can sense it by just looking at the waiting room and maybe how you're greeted. What's the one thing you would ask? Mel said "I would ask what type of shears they have." You know, let me see your shears. How much did you pay for these shears, because shears are all different prices. You can buys shears that are 50 dollars, or you can buy 500 dollar shears, and if somebody says well, I'm just out of cosmetology school and I can only afford these 60 dollar shears, chances are they're probably not taking as much pride in their work as a person that's buying a three or 400, or even a 500 dollar pair of shears.
Now, how does that apply to the dental world? Well, when you walk in, you sense it right away. You should look for things, like look at that waiting room, Look at how recent the magazines are. If somebody greets you, how do they greet you? How quickly do they greet you? These are all telltale signs about how you're gonna be treated as soon as you decide that this is the dentists you want to do business with.
Howard: You know, I always ask patients when they come in, oh, did you just move to Phoenix, or like, if you say, like you, oh, I just moved here from St. Louis. I'd say fantastic and did you have a good happy dental home there> How long have you been going to your last dentist? A lot of times they'll say no, I've lived here for five years or 10 years, or 20 and I'll say oh, well have you been to the dentist the last 10, 20 years? They'll say yeah, and Ill say well, why didn't you go back? It's amazing how much of what you're saying is true. In fact, they'll say, well you know, it was a dirty office. I didn't want him sticking instruments in my mouth when he had dust all over the baseboards, and this and that. So many times I hear the front desk lady was mean, or she didn't care for you at all or she was ...
Then the other thing with dentists, I get messages to call back dentists, a dozen a day. What's funny is when I call back dozen dentists a day, at least half of those calls go to voice mail. If someone does answer the phone, it's just can you please hold? Boom, and I'm just like, wow. Then I'm sitting there for two, three, four minutes, and a lot of times I'll just hang up and I think you know, this poor dentists. I called him back. He's never gonna know. I only had four minutes.
Shep: Right. If I wanted my question answered in 10 minutes, I would've waited 10 minutes to get the question. It's like that simple.
Howard: Yeah, but I totally agree that the, what was it, the mafia, that said that the fish rots from he head down? I believe the dentist sets-
Shep: That's a good line.
Howard: Yeah, that was from the Godfather. I think that it's true. I think that when you go into a dental office and it's like a library and everybody's quiet and everybody's afraid. The hygienist won't explain what's wrong with your tooth because she things the dentist will get mad at her because she's diagnosing and treatment planning and she's not a doctor so she's just supposed to be quiet and not say anything. They're worried about HIPAA. It's just all fear and scare and quiet and there's just no happiness. I just don't think people refer their friends and loved ones there.
Then you walk into that other office and it's just like, you just totally feel the energy and the karma the minute you walk in there. Just fun, it's exciting, everybody loves it. The staff have been there along time. I mean, to me it's just so easy but it it's not implemented.
Shep: To your point, I think you still have to deal with the HIPAA and you don't want to have a misdiagnosis. You still have to deal with all of that, but there's a right way to deal with it. There's a positive spin on all of this. I mean, laws are laws. You can't get around them, but there is definitely a way to handle it that just makes it easier, more palatable. I tell you, it's so obvious when you walk into an office and the culture is so different. I know my dentist. I've never met a dentist like this guy. The guy gets there at four in the morning. Here's why. He said "[Shep 00:27:20], there's a lot of people that work at factories, that they're just getting off work at 3:30 or four in the morning they want to go home to bed. They don't want to get up. They sleep during the say. So you know what I tell them? I'll be here when you get off work." That's the way he thinks.
As a result, he's built up this huge practice. Sure, he starts at four in the morning, and he goes home, by the way, around three in the afternoon. He works hard. Three, four in the afternoon he leaves. He's servicing and taking care of people at a totally different level than I think most. He's a hard working guy, but wen you walk in that office, he's got his main assistant is actually I believe a sister-in-law or somebody, and then he's got another person that's working there. He's got another dentist that's working there. He's a very traditional dentist. He like to even do, he has a hygienist, but he personally like to clean the teeth of most people.
Here's an interesting thing. I said to him one day. You clean my teeth. It seems like I get in here and I get out of here. I know my friends go to see a hygienist and they sit in that chair to 45 minutes to an hour before the dentists comes over and checks things out and they're getting cleaned. How come you do it in such a short? Are you doing as good a job as they are? He said "Well Shep, lets look at your records for the last, get this. 24 years. I've been going to him for 24 years. He says "No cavity, no cavity, no cavity." He went through. You haven't had one cavity since you've been to me. Prior to coming here you had cavities. I've had to refill some of the existing cavities because cavities [inaudible 00:28:51] but I've been taking care of your teeth. Now I've told you for four years now, you're gonna need a crown on this tooth. I don't know when it's gonna happen and I hope it doesn't happen for a long time, but I can show you why. He has, he's shown me. I just love the way he doesn't business with me.
Howard: What do you mean when you talk about creating the patient journey may, and mapping out every possible interaction of the patient experience?
Shep: The journey map is exactly that. What is the interaction? So lets got back to a book that I read, and actually it even goes eve further back because I read an article back in the early 1980's by this guy named [Yon Carlson 00:29:27] from Scandinavian Airlines. He ran this airline that was failing, losing millions of dollars, and he turned it around, because here's what he taught everybody that worked there. He said we're gonna manage what we call the moment of truth. That was any time a customer came into contact with any aspect of the business, they formed an impression. So I'll repeat that cause it's important. Any time one of, and I'll paraphrase. Any time one of our patients comes into contact with any aspect of our practice, however remote, they're going to form an impression. We must manage that moment of truth. He said they can be good and they can be bad. So I call the good ones moments of magic, and I call the bad ones moments of misery, and the ones in the middle are average, or satisfactory, and there's no place for bring mediocre or satisfactory.
All of these touch points, or the interactions that a patient has with someone in our practice. It could be somebody that answers the phone, it could be someone at the desk, it could be when they're greeted and walking in and put in the chair and being prepped for the dentist. All of these are interactions. As they walk out, how are they paying? Are they setting up their next appointment? All of these interactions, you map them out. You create a journey map.
Now there probably different journey maps that you'll create. You'll create one for the person that's coming in the very first time. They've gotta fill out the paperwork, do everything else. You'll create another one for somebody that's just coming in for a cleaning. Another one that might be different for a root canal or some other process or procedure that you're going through. You map these out. Every single interaction. The key is, you want to look for the weak links in this chain. So in the airline example that [Yon Carlson 00:31:06] used when he was working with his airline personnel, he said "People make a reservation, they check their bags at the curb, they check in at the ticket counter. Maybe they see one of your employees walking by as they're walking to their gate, and it's not even somebody from their flight, but that employee's obligation is to engage with either a wave, eye contact, hi how are you, just as you walk by, because you're even managing the smallest interactions. You get to the gate and you're greeted by the gate agent, the flight attendant takes care of you. You're greeted at your destination and you get your bag.
So those are the main moments of truth. What happens behind the scenes, I call those touch points on the front, you know at the top, the links or the chain that the customer is actually, or the patient's interacting with. The what happened behind the scenes are impact points. Things that impact that patient experience. Back to the airline example, and St. Louis where I live and I'm going to visit you in Phoenix. Two and a half, three hours later I show up at the airport and my bag's going around that carousel. Well it didn't magically vanish in St. Louis an end up at the carousel in Phoenix, no. They went down a chute. Somebody picked it up, put it on this cart , they scanned it, they move it over here, they made sure it got on the right plane. All kinds of things had to happen. All kinds of people were involved. So impact points happen behind the scenes.
What do you do to make sure behind the scenes, that that front-line touch point is gonna be managed well. That journey map is the starting point of getting that done.
Howard: Yeah, another one was Southwest Airlines where they say they hire on attitude and train for skill.
Howard: So walk through HR for this dentist. A lot of times they say they had five people interview for the front desk person and four of the had no experience and one had like 20 years experience. They always seem to go with the one who's had the job five, 10, 20 years experience and has the training, but a lot of times they've got five, 10 years of horrible attitude. A lot of bad habits.
Howard: They're great technocrats and they pass up on people that just dynamic, amazing, karma, energy, and personality, hire on attitude, train for skill. So what would you say to the dentist? Would you vale attitude or skill? Then what would you do from an HR point of view if you just have Shirley up at the front desk and Shirley's just not a people person. She does the insurance great, she does the scheduling great, she does all of her job right, but at the end of the day she probably doesn't like people..
Shep: I think you need to decide whether the other person gets to stay with you or not, and it's unfortunate because if you're hiring and you're trying to create that culture, that person will erode and destroy it quickly. So hire for attitude, train for skill. That's an old adage, just doesn't really mean anything. When you're talking about insurance forms and getting appointments for people and managing the front desk, I think you can train people pretty easily to do those tings. Sure, there's some skill that's involved there, and it may take a little bit of time to train them, but that is a very trainable piece that you don't even need to be certified or have a technical licensing. A hygienist is a whole other level. You need somebody. There you have have to hire for both high attitude and skill, because the skill is a skill that's required. You need to be, go to school for this type of thing, but I'll come to that person in a moment.
Let's talk about that person at the front desk who's filing out forms and taking care of the business side of things, the business manager. American Express is a great example of this. In American Express, the call center people, the customer support people that you might call if you have a problem. It's really amazing how they hire them. Jim Bush, I believe he t still is their senior vice president worldwide, of customer service. Jim said, "we don't really care if they've had call center experience. There's something that we'd rather them have. We'd rather them have worked in a hotel or a restaurant, and they understand what the hospitality experience is because we can train people to log on and look at different views of different windows on a computer, but we can't train them to that hospitality mentality." Actually, you can train them to that if they have the right background to do so, but we'd rather take somebody with that hospitality mentality and put them into that position.
So that's a good string point for that job. You don't look at the experience they've had in a dental office. It's a plus, as long as they've worked in a restaurant, a hotel, or even a retail store.
Howard: You know its amazing. I've lectured a lot over the last 20 years, and so many people have the American Express card and don't realize that it has the 1-800 number on the back, what you're talking about. When you have a plane flight get cancelled or a hotel cancelled, or something like that, it is amazing. You call the American Express number and they have every flight in the world in their computer system. They can just sit down and tell you, okay you're flight has been cancelled. Here are the only five options on earth that you can do. I've been in Brazil, Rio de Janeiro, the hotel doesn't even know I exist. I have the confirmation number. You cal American Express right there and they just fix it instantly. It's just amazing customer service.
Shep: They're an amazing company, and actually, they refer to customer as members and they want to create member experience for them, which is pretty cool. I can give you a lot of different American Express stories. Once gain, you see what happening here is we are taking lessons that we're learning fro mother industries, other businesses, the Ritz-Carlton, American Express, Lexus, and we're applying them to the dental industry. So we're taking the best of the best and saying what can we learn form these people? There's another great lesson.
So lets talk about the hygienist. I'm going to talk about a medical system that I work with down in Phoenix, Arizona in fact. They were really focused on the patient experience. Now this is a hospital, medical system. They could not hire the right nurses. They could hire nurse. Licensed, totally smart people, like that person you had working at the front desk, but they couldn't hire for the right personality. They said we would rather shut down one of our floors, because we can't get the right number of people, than put the wrong people in there and erode our grand promise to our patients. I think that's a pretty good stand to take and I think it's a noble one and I think they did the right thing.
Howard: Well you know I think academia is the problem for a lot of health care because if you go to college and you're well-rounded and you join a frat and you have a girlfriend and you pick up basketball and work out or whatever, and you go-
Shep: You talking about me?
Howard: Yeah. You go through college and you make some A's and B's and C's you don have prayer in hell of getting into med school, law school, or dental school. Then you take geeks like me. There were 88 guys on my floor, and there was four of us that every day after dinner, walked straight to the library and studied until midnight every night and at midnight we heard the same thing. Ding, the library will be closing in 10 minutes, and then we'd walk back form the library to Swanson Hall and as we're getting in the elevator, there'd be all these other people. They'd be having beers, they might be making out, they had a girlfriend. They're just some of the greatest people in the world. They didn't have a chance. Not one of them. Not one of them got into medical school, dental school, law school.
So it's the deans. The same school in nursing school and hygiene school. They only accept 4.0's. You try to go to hygiene school in Arizona and you made one B or one C. You might as well just go to another country. You don't have a chance. So the academia rewards these introverted geeks, that aren't well-rounded, totally over-focused, don't have a life. I didn't have a date for three years of undergrad or the first three years of dental school. It was just one mode. It was just study, study. These are all the people the are doctors and dentists and lawyers and hygienists and nurses. I know one school, only one dental school is trying to change that, and that's here in Mesa, Arizona. [AT Skill 00:39:32] [Jack Gillemburg 00:39:33] is 70 years old. He's the dean, and he gets it and he's trying to say, I don't care you made a 4.0. I don't care. Do you have a personality Are you a nice person? Do people like you? It's tough because the selections are tough with hygienists and dentists. All that same 4.0, over achiever, not well-rounded, overly focused mode.
Shep: So how do you solve that? I think the way to do it, here we are trying to solve the world's problems. Is, I would say, there has to be some level of great competency, because part of that indicated how responsible the person is. Although, I admit, I was a C student, but I knew going out of college I probably wasn't going to work for anybody. I was gonna do my own thing. So I was I in the half that made the top half possible, as they say. That's the funny thing. At the University of Missouri, you now what D is. You get a D. D stands for diploma.
Howard: I went to University of Missouri.
Shep: I know you did. So that's the other joke. What do you call the dentists that got the lowest grade in medical school?
Shep: Yeah, exactly. A dentist. Here's my point. I love what you're saying, so what's the solution? If I'm that dean of the school that's bringing in hygienists and says, you know, I don't really care if you've got a 4.0. I do care that you didn't care that you didn't get any C's and D's. So you gotta show me some level of education. That's number one. Number two. I'll take a chance on you. I'm gonna give you the first semester. At the end of the first semester you're gonna self-select yourself out of her because you can't handle it. You're gonna lose because your grade are in there. Or you're gonna progress and move on because you can handle it. So maybe that's the way of doing, because I think if you can get out of medical school, or hygienist school, or whatever school you're going to. I think if you can get out of that and you pass, you pass. Okay? End of story.
Howard: It's amazing. Some of the biggest heroes like the founder of Southwest Airlines, [Herb Keller 00:41:48]. He's a wild, drinking, what is it-
Shep: Crazy man.
Howard: A wild [inaudible 00:41:53] on ice, chain smoker. Thomas Watson Jr. of IBM quote "Drank his way out of college." Then ended up taking IBM and being a billionaire because they were people people.
Shep: You know, some people don even get out of college, and what they've don. Look at the Bill gates and the Steve Jobs, who ... I know Bill Gates, dint he-
Howard: Bill Gates dropped out of Harvard. Mark Zuckerberg dropped out of Harvard-
Shep: They dropped out of Harvard.
Howard: I know.
Shep: They got into Harvard. That alone is amazing, okay? My grandpa passed away when I was 14 years old. An amazing guy. Built a really great company and he never graduated high school. Never graduated high school. I have a friend of mine who's father created an incredibly successful business that went public. Never graduated high school.
Howard: Yeah. Larry Ellison or Oracle. He's the third richest dude. He didn't graduate from college. A whole ton of them didn't graduate from college.
Shep: Keep in mind that guys like that don't say, well that doesn't mean I shouldn't go to school. No, I think school is great. I think for most people, school is the right way to go, because once again, it's not so much the knowledge you amass as much as the experience you gain and how to assimilate that knowledge, get that knowledge, meet deadlines, make sure you handle your schedule properly. That's all part of it. I talk to my kids. My son, he's a musician, and you know what? He's probably going to be a musician and hopefully very successful. He's an entrepreneurial musician. He didn't graduate from college. I can't wait for one day for him to be super-duper successful and say to kids, even though I didn't, doesn't mean you shouldn't.
Howard: Well what I see with dentists and physicians and lawyers, because I've flown to so much to so many seminars. I'm always getting bumped up to first class and I'm always ... I set by lawyers and congressmen. They're all lawyers, and layers are in the same boat as dentists and physicians. They didn't have one day or hour of business training, accounting. You can see. I remember I was flying, sitting next to one of the most famous senators in the United States history, and I just asked him "can you explain to me the difference between a statement of income, a statement cash flow, and a balance sheet?" He said "What?" I said "Can you just tell me the difference between those three things?" He said "well why are you asking me that?" I said "I'm just curious your level of training in law school." He was very offended and he was just known for all the budgetary things. I shouldn't say his name. It was one of the Gramm Rudman. One of those two. He couldn't tell me any of that stuff.
What I see with dentists, physician, and lawyers, is they're all book smart. If you're a dentists, a physician, or a lawyer, you're book smart. There's no way about it, you just are. You're just book smart. You can read a chapter anything. Math, physics, chemistry, English, remember it pass a test. You're book smart. It's the one's that are book smart and street smart that just crush it.
Shep: There are a percentage of those that are out there. Not everyone is. Look how successful you are. You eve said, there is a group pf dentists, and I've met a bunch of them because I've gone to some of the programs, that are crushing it. They're making seven figure incomes. They're working 40 hours, I'm sorry, not 40 hours, 40 weeks a year. They're taking 12 weeks of vacation. They're taking a couple of days off, a couple of afternoons off. They're not killing themselves. The reason is because they work smarter, not necessarily harder and they figured out. By the way, you're gonna be out of balance. You can't come out of medical and start making seven figures a year. Right?
Shep: You gotta work it. You gotta understand it and you've gotta build into it. You do have to have a vision of what that ideal practice is going to be because if you don't, and you say, so I believe that success doesn't happen by accident, it happens on plan. If I can just draw an analogy ti even my business. I spent 10 years hitting my goal of what I thought was a reasonable amount of money to make in my business. I hit it actually, eight years. Here's the point. I worked my rear end off and then when I hit that second set of 10 year goals, I started to change form monetary goals to lifestyle goals. I always had the vision of what this business was going to be about.
Howard: You know, I'll give you some examples of who's crushing it. The United States has 5,000 ophthalmologists. 400 of them do 95 percent of all the laser surgeries.
Shep: 400 people out of 5,000.
Howard: Do 95 percent of all the laser surgeries.
Shep: Wow. Less than 10 percent do 95 percent of the work.
Shep: Yeah. What's the reason? What's you opinion on that?
Howard: You see the same thing in dentistry. Say it's the impact case where someone comes in, they're missing a bunch of teeth they need like five or 10 dental implants and 50,000 dollar deal. It's the same thing. It's like, 10 percent or less do 90 percent of all the cases. 10 percent or less do 90 percent of cases. They're just going for it. They're street smart. They have a business manager. They have someone do their marketing. They're focusing on the dentistry. They learn how to do implants or cosmetic cases, or in the ophthalmologist deal, leaser surgery whatever. They're street smart. They build a big operation and I will say it again. I think 90 percent.
We see in ophthalmology. 400 out of 5,000 ophthalmologists do 95 percent of all the laser surgeries. In dentistry it's the same thing 10 percent of the dentists are doing 90 percent of all the big case dentistry and the other nine out of ten, they just do one tooth a time. They do a filling here, a crown here, and putt along forever.
Shep: So that's the point. I think you're gonna find that's the case with most businesses. That's the case of most. Whether it be ten percent, 20 percent. You're always gonna see there is a ... Look at the law firms. There's only a small group of law firms that are crushing it big compared to all the other lawyers that are out there. Or maybe a lot of those lawyers, they may be in firm that's crushing it, however they're just one of many lawyers doing a lot of the grunt work. They're not partner. They're not going out and hanging their own shingle and having a successful practice on their own.
By the way, I keep using the word practice, practice, practice because that's what we have. We have a practice. We don't show up to actually do an implant or whatever it is that we do, some type of procedure. We don't get paid that day. I think that it ... I don't want the hour that we have to slip away without saying, we really need to be cognizant of what the future looks like, because if something happens to us and we can't put our hands in somebody's mouth anymore, what are we gonna do? So we've gotta think of ways to turn this into more of a business. Make sure that we're getting the most out of it.
By the way, I have no problem with capitalistic dentistry as long as they're an extremely patient focused capitalist. So they're not just trying to put an impact in my mouth because they know they're gonna make money. They're doing it because I need it and they convinced me that I want it.
Howard: I think health care is so interesting in that they think they're so different from other businesses yet if you're like me, where you lecture to dentists in 50 countries, like Brazil, and India, and China, and Africa, there's no such thing as dental insurance. You go to countries that have had socialized medicine for a long time like England. When I got out of school, it used to be all 14,000 dentists participated. Now 5,000 have cancelled, dropped out of the system and said forget it and they're free enterprise.
So a lot of Americans think that dental insurance always has been, always will be. It wasn't here when George Washington started. It wasn't here when Abe Lincoln started. For every country that's adopting dental insurance, another one is getting rid of it or has never had it. Like Obamacare, it could be good, bad, but 50 years form now it could be completely different or gone or what have you. I just think it's business is business and it all comes down to managing people.
I think big religion is trying to manage people. I think the government is trying to manage people. Business trying to manage people. As a father, I'm trying to manage my four boys. The whole game, seven billion people, trapped on a flying dirt ball that goes around the sun once a year, and you're just trying to manage all those relationships. I just think that dentists can manege all of these relationships the best with the staff, with their patients. The ones who just manage the people side do the best.
Shep: The cool thing is, you put the staff before the patient, and I think that's an important piece of it all. Even if your customer or patient focused. They way to get there first is to become employee focused, because you cannot expect your employees to deliver a level of service that you want your patient to experience, unless they're getting some sense of that internally. What's happening on the inside of your business or practice is gonna be felt on that outside by the patient.
Howard: Yeah. I think that saying that the customer's always right, I don't think that could be more wrong. I have-
Shep: They're not always right.
Howard: I have fired a patient at least every other year for 28 years, and one of them was my very best friend. He was just like, I don't know if he felt too comfortable in there, or whatever the hell. It was the third time he raised his voice and he was using profanity and my front office ladies, their hands were shaking, I just said "Get out of here and don't ever come back." Just leave.
Shep: By the way, certain customer, or patients may not always be right. However, they are always a patient, and even if you're gonna fire the patient, you ask them to leave. You let them be wrong with dignity. Let them go out with respect because you always want to leave that door open because maybe a year form now, two years from now, they come back. They apologize profusely. I'm a very forgiving person. You do something to me that's not all that bad and you apologize for it, it's waster under the bridge. It's done. Even if you've done something to me that may seem terrible. You know, time does heal the wounds. That's why, I've never been divorced, but I know plenty of divorced people what they're friends with their spouses. When they were married, they would fight with each other. I'm surprised they didn't get arrested for murder. Five years later, they're good friends because they ... That means forgiveness kicked in.
So ideally, always leave the door open. I've said to people, hey I know we're getting ready to do business together and I just want you to know, this is my philosophy. Whatever good you do for me, I'm gonna try to better for you. That's the way I work. Now by the way, what I don't say to them is whenever you try to take advantage of me, I'm gonna do one better than that. I joke about that, but the truth of the matter I believe is, you can always do something nicer for the person that's doing something nice for you. You can't ever go wring with that. I call it the law of reciprocity. My version is somebody does something nice for me, I feel obligated. I do something nice for them, I don't keep score. I just think that it'll eventually come back to me. Whether it be from that person or somewhere else.
You just do the right thing by the patient, for the patient, and guess what. The patient comes back, the patient talks about you to their friends, to their family. By the way, if they're not happy, we haven't touched on this subject. This might be for another day. If they're not happy, what are they gonna do? They're gonna tell other people. They're also gonna broadcast it. They've got Facebook, they've Twitter, they've got all kinds of social channels. It used to be they would tell five, six people. Maybe they sit around the dinner table. Today, they trow it on Facebook, they may tell 25, 50, 500.
Howard: So true. They're always telling us dentists that we should think outside the box you have so many amazing business stories. What are some close industries to dentistry, that maybe dentists should be looking at? What are some examples of amazing customer service that you think dentists may lean from at other industry?
Shep: I tell you, just go to your doctor. A regular physician and see how they're handling things and see, do I like the way I'm being treated here? Or do I love it? Look at what your competitors, if you will, are doing. I don't want to you to copy them per say, but if you say, hey they're setting a bar, what can I do to change it? What can I do to raise it? If you're looking at other industries, I mentioned the hospitality industry. What are some of the things that you have to do with other industries? For example, you have a waiting room at the auto dealership. How can we incorporate that high-end waiting room at Lexus into our waiting room? Let's not call it a waiting room, let's call it a lounge. I know there's some really cool things that we can incorporate technology wise with music and video and get people's minds off the procedure that you're working on, which might calm them down. Might make the feel more comfortable. Might distract them. Just take a look at what other businesses are doing.
I would say look at the hospitality industry because if you really want to create a practice that's patient focused. Okay? Beyond the actual dentistry that you deliver, look at the people that do it best. The people in the hospitality industry have that hospitality mentality.
Howard: I think that as I get older and older and older, it's easier for me to get along with people and it's far easier to forgive people when you're 52 versus when you're 22 because you just relax that everyone's just basically a crazy talking monkey and you don't get mad at dogs or cats. So why would you get mad at talking monkeys? People are crazy. The craziest thing about people is that they absolutely can believe whatever comes out of your mouth. They can rationalize anything. Dentists will look you straight in the eye, and I'll say, he would you say that you're dentists focused or customer focused? Would you say that you're all about you, or are you all about your patient? They'll say, oh, I'm totally patient focused. I'm totally customer focused. I go okay, what are your hours? Eight to five Monday through Thursday. Really? No early morning, no lunch, no evening, no weekends? No. No. You ask him ten customer service questions and it's all about them. The same person will look you right in the eye and say they're customer focused. So how do you ... If you're a guy like me, and you're trying to convince your buddy, dude I know you say you're customer focused, but you're not. How do you try to get them to see gravity?
Shep: Well one of the things, we have little exercise that we do. We call it the the moments of magic exercise. I just asked them, give me an example of when you created that positive patient experience. That moment of magic for one of your patients. I did a great job on a root canal. I did a great job on their implants. I did a great job on a crown. That's the product. What have you done to create a positive experience? Tell me about that experience. Okay? That's where the rubber hits the road. Can they do it?
So we love to put our, this is something easy for any dentists or any office manager, business manger to do. Have everybody in the office take an index card and every week just write down one example of when they created a great experience for the patient. If they don't even deal with the patient, maybe they're dealing completely internally, can't imagine that but if they are, what did you do for that internal customer? That person you work with. Just one example. What happens it if you say this is due Friday at noon, at about five minutes to noon you're gonna see everybody getting out their card, the paper m their pencil and writing it down on their card.
What'll eventually happen is they're gonna be thinking, what did I do this week? Them next week or the week after, on Tuesday afternoon, they're gonna go, oh this is a great example for me to put down. They start writing it down when it happens. This only takes one or two minutes to do. You hand it to the manager and the manager goes through and you say, wow. We're getting some really good examples, and you pat them on the back. You tell them you're doing a great job. You take the best of the best and you say, we're going to create a manual of best practices to use here at our dental office. You start to create the best practices based on the feedback from your fellow employees. They can't argue with their own data. They can't argue with the experiences that they're turning in. It's theirs.
Howard: That was a great, amazing story. I want to ask you, I only got you for a minute and half. We both went o University of Missouri. I was in [Cansid 00:58:39] the dental school and you were in St. Louis, but I wanted to ask you one thing. I'm 52. Do you care if I ask you how old you are?
Shep: Sure. I'm two years older than you.
Howard: You're two years older?
Shep: At least for a little while longer.
Howard: You look great.
Shep: I'm going to be 65 in about 10 years.
Howard: (laughs) I love that. I wonder if this is true to you. So when I was in high school and I started losing all my hair in college, my hair was falling out. Complete strangers would treat you like you had a disability. Like people come up to you and say "Oh dude you're losing your hair, I'm so sorry. What are you gonna do? Are you gonna get a wig?" I thought, well I thought this is kind if cool. I'm not losing my hair I'm losing my blow dryer, and shampoo, and conditioner, and this is just really nice and simple and easy. I see you've lost your tie. All these things like that. I think the whole attitude changed. We just had th4e NBA finals last night of the Golden State just beat the Cleveland Cavaliers. It was when Charles Barkley was in the Phoenix Suns, and Michael Jordan was with Chicago Bulls, and they went to that series, and two gorgeous bald men. Charles Barkley with a million dollar smile. Michael Jordan, million dollar smile. Two men that couldn't be more handsome and energetic and karma. It seemed like it was that seven game series, where bald went from a disability, like oh I'm so sorry we're where a wig and get transplants, to bald is cool.
Howard: Is that how you saw it in your life? We're both 50. We're both bald guys. Was it like that? Was it like a bad thing when you were 25 but now it's a cool thing?
Shep: In high school, I was voted most likely to recede. It started then. Eventually, I had the ring. You had the ring? I also had this little island. I remember when I came back and the person that cut my hair whacked off the island and the person said, you could be doing this. You could come in here every month and pay me more, but I'm going to sell you this clipper for 30 bucks, put it on a number 2 and just do this and make sure that island stays off, and you're in good shape. I never went back. I took all my money and I invested it in Microsoft. At that point ... But here's the thing. One day I lost a bet and I just shaved off the side of my head because of that bet. I came home, my wife didn't even notice for two and half hours. My kids didn't notice till the next day. So I think they look at you and not your hair.
The other thing is, this is a good thing. I'm sitting in an airplane. Flight attendants are rubbing my head and walking by and going, "Make a wish."
Howard: On that story though, do you think that Charles Barkley, Michael Jordan was a significant part of that? Or did you not see that to be any influence?
Shep: I didn't see it, but you know what? I think Michael Jordan, very handsome man. Charles Barkley, he's pretty big right now.
Howard: Well maybe it was because ... Maybe I felt that because I was in Phoenix where Charles Barkley is from. Maybe ...
Shep: They gave you confidence.
Howard: Maybe it was a bigger impact in Phoenix because that's where he was. I just want to say to all of you, there 250 dental societies out there. I know every time you want to have a meeting, you always want to bring in someone how to teach them how to do a root canal, or a crown, or a bone wrap. You know doc, you're just one employee. You got two assistants, two receptionists, hygienists, and they need to hear non-critical stuff. They need to hear from Shep Hyken. It you're a meeting planner out there, this is the stuff they need to hear. You need to focus more on getting your business, having an amazing patient customer experience, not trying to do the ultimate root canal, build up, and crown.
Shep, thank you so much for spending an hour with me, and I hope you go on to educate more and more dentists on how to have amazing patient experiences.
Shep: You're a great host man. Let's do this again. I love it. This was a lot of fun. Thank you.
Howard: All right. Have a great day.
Shep: You to sir. Thank you.