When to fire a dentist

Sometimes it’s just not worth it.

If a client is driving you and your staff crazy, there comes a point when you just have to end the professional relationship. Whether it’s the number of remakes or the late payments that have you pulling your hair out, you have to know when and how to let go.

The dentist who just won’t listen

When a dentist won’t take your advice or isn’t willing to work with you at all, it’s time to part ways, said Greg Thayer, CDT, who owns Thayer Dental Laboratory. This lack of communication will lead to remakes and frustration. In fact, Thayer said all lab owners should look over their customer list and consider ridding themselves of doctors with high remake numbers.

New dentists are often the biggest offenders. They often have a know-it-all attitude that can make them too difficult to work with, Thayer said, and he’d rather have another lab break them in than deal with all the remakes that are sure to come. While his team members are service oriented and will do what they can to help doctors improve their skills, it’s not time well spent if the doctor isn’t willing to make the adjustments.

But it’s not only new doctors who cause problems. Thayer recently worked with a more established doctor who fit this profile. In a month or two, he had sent Thayer’s lab $35,000 worth of work. But the impressions this doctor sent were substandard, which meant his technicians couldn’t meet the doctor’s or the patient’s expectations. And that, of course, led to remakes.

“My technicians were frustrated with what they were getting from the doctor’s office and the doctor’s staff was frustrated with working with what we gave them back,” Thayer said. “We were doing a lot of work twice. I called the doctor and told him the relationship was not working out and I recommended he contact another lab. It was a situation where it just wasn’t beneficial to either of us.”

While Thayer hated to lose the revenue, he knew ending the relationship was best for his business. The situation was affecting his technicians, who applauded when he told them this dentist was no longer a client.

Training new clients

While it doesn’t take long to realize you’re working with a dentist who’s going to require a lot of remakes, Warren Rogers, President and CEO of Knight Dental Group, said he’s found a way to get these problem dentists to take themselves out early.

Each new client knows exactly what Knight’s expectations are in terms of quality. If the first case they get from a new client is marginal in terms of impression or the prep, they’ll have a talk with the dentist and then send the case back.

“Occasionally clients will stand their ground and say they understand what we’re saying but we have to make it work because they’re not bringing the patient back in,” Rogers said. “Our response typically is ‘in the best interest of the patient we don’t think we can proceed with the case.’ Then we send it back. We often don’t hear from that client again. I tell our group if we do the case and it ends up a remake, then shame on us. It will just get worse after that. I’d rather nip it in the bud.”

Re-training current clients

When current clients begin to have ongoing quality issues, Rogers said their service representative reaches out to them to try to correct it. Each client has an assigned representative who is there to offer encouragement and make sure everyone is on the same page regarding expectations.

They also offer on-site lunch and learns and two-day seminars in their educational center that clients are encouraged to participate in if necessary. Impression taking, prep design and communication are among the topics covered. Offering these type of educational opportunities for clients can help improve their skill level, which in turn makes your job easier and may be the difference between firing and keeping a dentist on your client list.

If a doctor goes through both programs and still isn’t delivering quality work, the Knight’s director of professional relations will go to the practice and talk with the doctor about the specific issue he’s having, Rogers said. If that doesn’t work, it’s time to say goodbye.

Rogers said they try to not let it get to that point, but if the remakes are in the double digits or high single digits, that means the relationship is no longer profitable.

“You can train and teach and educate but it becomes a matter of compliance after that and communication with them when you get their cases,” Rogers said. “There’s a certain amount of follow up as well. On occasion we do lose clients who don’t feel they need education on impression taking. They feel their impressions are adequate. We have a natural transition with them; they just find another lab.”

The client who doesn’t want to pay

While constant remakes is one of the main reasons to fire a dentist, slow payment is another-especially if the same client who’s slow to pay is demanding of your time.

“Sometimes these needy clients don’t do a lot of work with you but expect a higher level of service. For the most part, you can’t afford to do that,” Thayer said. “They in turn become very demanding and rob you of time that you could dedicate to a larger more self-sufficient customer. If you have a customer who sends you one case every two or three months as opposed to a customer who sends you five or six cases a week, who should you dedicate more time to?”

When a customer is taking his good ole time paying you, you probably won’t have to worry about firing him, Rogers said. Once a client has owed you money for 90 days or more, there’s a good change that client will leave your lab on his own. These customers often are embarrassed. Rather than trying to work out payment with you, they take their business to another lab and end up in even more debt.

How to do it

Once you decide it’s time to let a client go, you need to have a discussion with that client whether it’s in person or on the phone. If you know the client will turn confrontational, you may even want to consider writing a letter instead. But no matter how you handle it, you need to keep the communication professional, Thayer said.

When you’re firing a dentist, your attitude should be, “I’m doing this to help you”, Thayer said. Don’t make accusations and don’t get into arguments. Don’t try to make the dentist feel bad about it, because that will only hurt you in the end. You might even want to take the blame for the relationship ending. Things may change in the next five years, and you don’t want to completely close the door to maybe taking that client back some day.

“We have to understand that dentistry is a small world,” Thayer said. “In my area, most dentists know each other. If I don’t divorce that doctor properly, the doctor will go to the next big meeting and tell all his friends about the situation. If I do it professionally, there’s no reason to talk bad about my lab.”

How to avoid it

While most of you probably have had to fire a dentist in your career, it’s not something you really want to do. One way to avoid what can be an awkward situation is to create a client profile and look for clients who fit into it, Rogers said. For Rogers, it’s important for his clients to have some sort of advanced training and to have really invested in themselves to become better dentists. Those types of clients are easier to work with because they truly take pride in their work and want the best for their patients.

Clients who appreciate the dental technician and understand the expectations are the type of clients you want to work with. If they welcome the opportunity to communicate with you and take advantage of learning opportunities-like Knight Dental Group’s lunch and learns and seminars-they’ll likely be easier to work with and will be just as disappointed when there are remakes.

But, unfortunately, no matter what you do, you’ll likely come across a client you just can’t work with. Whether it’s a personality issue or a money issue, don’t hold onto that client just because the economy is bad and you’re afraid to let any work go. The longer you hold on to a bad working relationship, the more difficult it will be to maintain it. This makes your technicians unhappy, which means they’re not giving you their best work.

Bottom line: Don’t just tolerate your clients. If it’s not working out, let them know sooner rather than later.

“You have to look at what that doctor is doing to your business,” Thayer said. “We are a for-profit company. If customers are affecting your bottom line, they’ve got to go. Our margins aren’t that great that we can afford to have one or two doctors that cost us money. When that happens it’s time to shake their hand and say goodbye.”