THE PATIENT JOURNEY (or in brass tack speak: Service that sells!)

I had heard the expression “The patient journey” for many years in different quarters and I had a sort of idea of what it meant. I had a woolly, hazy idea that it meant how the experience was or would be or should be for the patient. I conceptualised that it would be “nice” (horrible bland word) if the patient had a “pleasant” (horrible bland word) journey through our practices so that they could go out and shout from the rooftops about how great we are. This of course would then ensure that there was a rush of similarly enthused patients beating a path to our doors. I say it was hazy because I could only see some major elements as being important such as smiling receptionists, inviting waiting room and generally “nice” stuff. It began to play on my mind that my vision was woefully inadequate and that I had to sit down and think about it more deeply if I was going to get a handle on it. For the past ten years or so I have always had big white boards in my office where I can write down ideas as they come to me and it is a wonderful exercise to sit down in the quiet and throw down a word and then try to build around it. I actually used to do this when doing exams all those years ago and it is staggering what comes to you if you start with just one word. In this exercise I stuck down the word “patient” at the top of the board and sat back. It just did not feel right at all. I thought for a while about what was wrong with the image of the patient at the top of the page and then it struck me that I could not have loads of arrows dropping down because the patient was not at the top of the concept but actually bang in the middle. When I changed the word to the middle the rest of my thoughts could flow out in all directions.

This changed my perspective on Dentistry irreversibly forever from that moment when it dawned on me that everything we do must focus on the patient and how they view the entire journey through dentistry. This has far deeper implications than we first thought and it forces us to go right back to the very beginning to way before the patient ever even considers coming to us. How can that be you say? I used to start with when the receptionist looked up and smiled but no! If you really understand you need to put yourself in the patient’s world and ask yourself the following question, “If you moved to another area, how would you go about finding a Dentist? Where would you look? Who would you ask? Where do your existing patients come from? Why do they choose you? Why do they choose to stay with you? Do they choose to stay with you? Are they happy with you, your team, your fabric, your service, your gentleness, your aftercare? Do they tell friends how good you are?”

Do you measure any of these things? Do you ask your patients these questions? Do you ever invite them to tell you the answers to any of these questions? Do you invite them to tell their friends and family and work colleagues about you? Do you make it easy for them to find you or to bring away a little bit of nice literature about you to show their friends?

As a result of my musings I ended up spending two weeks writing 17 pages of what I thought should happen for my patient journey starting at the stage of before they even considered me. Within the 17 pages I made reference to a further 37 procedures forms and templates which in turn leads on to about 300 further procedures. What this means is that the reality of patient journey is that the whole practice needs joined up thinking to get the service right. I cannot possibly show you my 17 page version of patient journey here but I have put it up on the website here

You can see it in its entirety and hopefully it will help you think about your own patient journey. If you do, it will ensure you understand your business warts and all from the patient’s view. You then have a real opportunity to influence that journey to get that loyalty we all crave.

Dr John Barry is the Operations Director of The Dental Plan

This was to be the first article I had written for Scottish Dentist for quite some time and the very first as Operations Director of the seemingly new kid on the block “The Dental Plan”. I titled the article “The journey” because it has been quite a journey from my beginnings in 1987 as a general practitioner in rural Scotland to my role now of day to day running of the “The Dental Plan”. Scottish Dentist did not have quite enough space for it so we put a smaller less political article in instead. I felt however that as I had taken the trouble to write it, it might be of interest so here goes!

Bored is never a word I apply to myself and since this is the first article of hopefully many I intend to write for my adopted native Scottish colleagues, I have decided that a major slice of clarity will do no harm and will help to stop speculation, rumour and inference from propagating! Why bother discuss my journey, some may ask? Two weeks ago I was doing a series of presentations in Ireland to a very large group of dentists who are in a similar position to that in which we Scottish Dentists found ourselves in back in the days of 1992 post the fee cut post the 1990 contract. The young bloods will not remember that but I assure you all that our actions then paved the way for the situation that prevails today which allows a decent amount of private work to be done for decent remuneration. One prominent Irish dental opinion former told me that one of my competitors was letting it be known that I have been involved in several “Dental Insurance” companies as if this in some way was a slight or disadvantage or a negative! I had to let him know firstly that “The Dental Plan” like most maintenance plan providers is not an insurance company and then tell him a little about my history and how I got here on my journey. It was quite up lifting actually as it gave me a chance to put the past into clear transparent perspective! I am writing this on the train from Edinburgh to London in advance of a day tomorrow with a magnificent practice in central London so using the 4 hour journey to write this article I begin thus: Idealistic young dentist arrives in Wick; Caithness July 1987 aged 24 to begin work in a mad crazily busy NHS filling station. My first day saw me see over 40 patients. I say see as I did not do very much of any good for them I don’t think. I thought about giving up at that stage but persevered. I worked hard to do my best and had a fluke opportunity to buy in within 1 year of qualifying which I did because I saw massive potential there. I had just married and had a small child very quickly (now in 3rd year medicine, where have the years gone?). Years passed and we set up a brand new squat in Thurso in 1990 which grew into a massive 5 man practice. By 1992 when the fee cut came I was close to burning out and after a rally cry to Inverness by fellow practitioners I became involved as a founder director of Highland Dental Plan, which was the best solution that we could think of rather than go it alone. I spent countless days and nights driving 220 miles round trip working with the other 5 founder directors and we got it going as a self funding non profit making entity which it is to this day and I am proud of our achievements. It was however non profit making and once up and running I along with some others wanted to expand it as I certainly could see the potential to create a national model that would work for our colleagues and their practices. I came up personality wise against some of my fellow members who did not wish to see the development in such a business like way and although we did get Independent off the ground as a commercial enterprise (I am still one of the original founders and still am a shareholder), it was never going to work for me as an opinion former as it was always going to be a small dental committee run business. I am a business man and have no wish to be a politician!

I left the day to day management of Independent and HDP and focussed on Vocational training for my own development and with the huge help and encouragement of Bobby Broadfoot who was head of the VT Program in Glasgow at the time became a veteran VT trainer for almost 7 years. This period opened my eyes to the challenges experienced by young dentists and their trainers and I saw many colleagues struggling with the system. A chance invitation to meet again with Dr Marilyn Orcharton of Denplan founder fame in 2001 led me to investing in Isoplan International and then subsequently becoming part time CEO, a post which I held until 2007. When I joined Isoplan initially it was simply as an investor. It became clear very quickly that the board wanted some additional input and I got sucked in to doing more and more work until my part time CEO role was pretty hands on. During that time we had some great success growing the business which was all about the Quality Management System and I re-introduced the membership plan concept in 2004 which was almost nothing when I joined. I trialled all sorts of pilots in my own practices and when they worked we rolled them out to our colleagues and friend’s practices. Isoplan was firmly established as a major player nationally when I became ill in 2006 with my serious squamous cell throat tonsillar cancer episode. I had to have the radical life saving surgery by John Devine and his amazing team at the Southern in Glasgow and when it was over it became really apparent to me that despite my belief that I was the boss and prime mover in Isoplan, in reality I was simply an employee and minority shareholder and that I could not in fact run the business the way I wanted to! I was not in charge and was left in no doubt about that by the representatives of the Royal Bank of Scotland who effectively control the company, so I resigned and took over a year off from the Dental scene sorting out my property and practice interests. After all I wasn’t sure if I would live or not. The old prognosis for that type of Carcinoma is not overly hot. (Look it up yourselves guys, you are dentists after all!). In November 2008 Dr Kenny Barr, a dear friend and colleague said “come on John we need to do something here as there are numerous colleagues out there in need of your experience, skill and guidance to help them grow their business”. We sat and debated it for days on end. As Kenny pointed out I had well over twenty years of experience of this market and this profession and there were many colleagues struggling with running their businesses so we decided that we would set up something totally different. Hence our strap line of “Dentists for Dentists”.

We are not just a maintenance plan provider now but a really strong group of Dentists working together for the common good of fellow Dentists. We have brought in other experienced colleagues and are making a huge difference in the lives of our members. Dr Jamie Newlands is Creative Director and has been voted young Scottish Dentist of the year on the back of his fellow Berkeley Dentist Mike Gow getting the accolade the year before! Dr Andy Toy is at the forefront of Dental education and we are immensely grateful and proud to have these guys working with us for the betterment of our fellow dentists. I started off in HDP being one among around sixty shareholders of a non profit making company. When we set up Independent I was one among around 25 shareholders. In Isoplan I was a 20% shareholder approximately or 1 in 5. Now I own ¾ of “The Dental Plan”. I suppose the journey therefore is simply about being promoted up the ladder for my efforts and investment! As Zig Ziglar says “If you can help others achieve what they want, you will achieve what you want”.

I very much look forward to a lot more interaction with my Scottish colleagues on “The Journey”. There is still a huge opportunity for Scottish practices as well as English, Welsh and Irish ones (No Joke!) to create the purest of relationships with their patients, i.e. one of mutual trust. The grant money will not continue forever I can assure you so plan for your future with “The Dental Plan”.