Patients Don't Care How Good Your Dentistry Is

It is an uncomfortable sentence for a profession that spends a career chasing clinical excellence. Dr Barry Oulton says it anyway, and he has the numbers behind it.

Patients don't really care how good your dentistry is, so long as your dentistry is good enough. What they care about is how they've had the dentistry delivered, whether they feel special, listened to, understood.

When his Surrey practice went from £250,000 to £1.1 million, the dentistry itself did not change.

The conversation and the communication. The dentistry is the same. Whether I prep one tooth or four teeth, the dentistry is the dentistry.

Nobody wants white straight teeth

Barry puts this to rooms of dentists and watches every hand go up.

I say in a room of five hundred dentists, put your hand up if you have patients that want white straight teeth. Every single hand goes up. And I say, I don't think so.

What they want is what they believe white straight teeth will bring to them as a positive emotion. Love, connection, confidence, certainty. Or they want what they believe it will avoid them: embarrassment, rejection, loneliness.

Nobody buys a crown. They buy what having the crown means. Miss that and you are selling a product in a market that is buying an outcome.

The same treatment, presented two ways

This is the part that is immediately usable on Monday morning. Barry listens to how a patient describes what they want, because the phrasing tells him how they are motivated.

Present whitening to a patient who moves towards things:

I'm gonna use this brilliant whitening gel and it's gonna whiten your teeth. And what that means is you're gonna be so confident when you're on that photograph.

Present the same whitening to a patient who moves away from things:

I guarantee that you are not going to be embarrassed on that photograph. You are not going to be worried anymore that somebody's thinking, my God, he's a dentist, he's got dirty teeth.

It's the same treatment, it's the same dentistry, and yet I presented it completely differently. If you get it the wrong way round, they're not turned on to it.

Same gel. Same appointment. Same price. One lands and one does not, and the only variable is whether you matched how that person is wired.

Do not ask directly

The obvious move is to ask the patient what they want and why. Barry says that usually fails.

Asking a direct question about emotions can actually make people feel a little bit vulnerable and a little bit emotional. And that's not what we want.

So yeah, you want to know it, you just got to be subtle how you get it.

The information comes out in rapport, early, in how they answer an ordinary question. Not from an interrogation about their feelings.

Satisfied is not loyal

Midway through our conversation I described a restaurant that brought us soup we had not ordered, and said that treating patients the way they are supposed to be treated brings them back. Barry disagreed, and the correction is the sharpest thing in the episode.

If they're treated the way they're supposed to be treated, the way that it's expected, you have a patient that is satisfied because you've met their expectations. If you exceed their expectations, they're the ones that will come back.

Meeting expectations buys you satisfaction. Only exceeding them buys you word of mouth. Barry had over a hundred and ten Google reviews, every one of them five stars, and had not advertised in eighteen years.

The trap in exceeding expectations

There is a catch, and he learned it from a curry house in Petersfield. He ordered a takeaway, declined poppadoms, and got two free in the bag. Brilliant. Same thing the next week. Brilliant again. The third week, nothing.

Now I have no right to be disappointed because I didn't pay for poppadoms. But what was an exception, where it exceeded my expectations, had become an expectation.

His practice built a comfort menu over five to six years: memory foam pillows, blankets, five iPods of different genres, noise cancelling and non noise cancelling headphones, hot wax hand treatment, heated towels. Deliberately slowly.

Because every time you added something on, it then becomes the expectation.

The lesson is not to stop delighting people. It is to ration it, and to know that today's surprise is tomorrow's baseline.

Watch the full conversation on the episode page.