Business Lessons from Seattle

The Seattle area has produced many impressive businesses, including, for example, Microsoft, Nordstrom, Starbucks—and, of course, the Seattle Study Club. Another of Seattle’s finest businesses is, founded by Jeff Bezos. He created the market for online book selling, and now is the world’s largest retailer. Mr Bezos is the world’s richest man. One day in April 2018, Mr Bezos’s net worth increased by $12 billion due to a spike in his company’s stock price. All in a day’s work, as they say.

Dr Peter Diamandis, who spoke at the 2018 Seattle Study Club Symposium, provides valuable insight into in his book Bold: How to Go Big, Create Wealth, and Impact the World. Dr Diamandis says that everyone asks Mr Bezos, “What will change in business in the future?” The answer from the founder of is that we are asking the wrong question. He says a better question is, “What will not change in business in the future?”

Mr Bezos gives three answers, which are intrinsically interesting but need to be translated and applied to the dental profession. (Mr Bezos’s comments are listed first; my application of his concepts to dental practices is listed in parentheses.)

1. Speed (Efficiency)

Mr Bezos says that no one ever complains that the product they ordered from arrived too fast. Customers want everything right away. Amazon Prime was recently in the news because the company raised the price of that two-day, unlimited shipping service by $20 per year. There has been little pushback; the company has 100 million Prime members.

While already recognized as setting the standard for speedy delivery, continues to look for ways to slash delivery times. Books can be downloaded to the Kindle (an invention) or another electronic device in seconds, and the company is testing a drone delivery service that can get a package to a customer in as little as 30 minutes.

In dentistry, the goal is certainly not to rush the patient out the door, but there is a need for efficiency, which speeds up transactions and helps make practices more profitable.

Here are questions to consider to improve efficiency:

  • How can we make better use of automated confirmation systems? These systems are widely used in dental offices, but they are not always used to the fullest. Gone are the days when patients demanded a call from a real person to confirm an appointment. Physicians, hairdressers, veterinarians, and a long list of other businesses have discovered the efficiency of automated systems that call, email, or text reminders. The public has come not only to accept these electronic services but to depend on them. The next step is using a system that allows patients to make their own appointments online. The practice controls the specific times and types of appointments that are made available online. Dentists are not early adoptors of this technology, but it is coming soon to a practice near you. Most patients do not miss the personal touch, but they do appreciate the convenience. The mantra should be, “Anything that can be automated, should be automated.” This technology will not replace human workers but instead free up their time to do tasks that computers cannot do, such as bond with patients and make them feel comfortable in the office.
  • How can the checkout process be streamlined? When patients are ready to leave the office, they do not want a delay at the front desk when taking care of payment or making their next appointment. (The next appointment can often be scheduled when the patient is still in the back.) Keep in mind that when patients leave the treatment room, they have mentally checked out of the office. They are thinking about where they are going next. To patients, delays in checking out are exasperating. One minute on the clock seems like so much longer to them. All offices should examine their systems to determine how to eliminate bottlenecks and get patients in and out as efficiently as possible.

2. Price (Value) is known for low prices, but a deeper look at this issue reveals that the company often wins on value, and it is the value message that is the take-away lesson for dentistry. Consider that recent surveys have shown that, for certain commonly purchased items, is significantly more expensive than Walmart. Yet routinely outsells Walmart on this basket of items. The reason is that customers perceive a higher value when buying from They buy with a click of the mouse; they do not have to spend valued time driving to and from Walmart and standing in the checkout line. Think about that. illustrates that price and value are not the same. Every day people come into dental practices and accept treatment, not because they could not find a lower-priced dental practice somewhere but because they perceive value. Often when patients do not accept treatment, the problem can be traced back to a failure to adequately educate patients about the benefits of the proposed treatment and how it will improve the quality of their lives.

Topics to discuss at your next team meeting on the value proposition include:

  • What opportunities are you missing/not using fully to communicate value? There are so many ways to get the message out to patients: a robust website; testimonials from other patients (video comments from patients are particularly effective); lists of benefits of key procedures used as handouts for patients; improved verbal skills; patient education videos on the website; and a practice culture that promotes a patient-centered philosophy and empathy from the point of first contact until the patient completes treatment and refers others to the practice.
  • Where do you think the value proposition message/dialogue breaks down? There may be team members who are sometimes at a loss for words when patients ask questions or express concern about a fee. There are also instances when patients leave the office saying that they plan to go forward with treatment, but due to inadequate follow-up some patients procrastinate and ultimately allow recommended treatment to drop to a low position on their priority list. In addition, patients can be handed off from a team member who is comfortable promoting value to someone who is less skilled in this area. Dealing with these issues is an ongoing challenge that requires frequent team meetings and reinforcement.
Amazon Headquarters Skyscraper and Biosphere, Seattle, Washington

3. Relentless emphasis on customer service (and team training)

It is fair to say that most dental practices do a good-to-excellent job of customer service. Courtesy is very common in dental offices. Most team members are polite, friendly, and conscientious. With the baseline being high, it is often possible to take an office that is very good at customer service and move the team to the level of truly exceptional. The idea is to get patients to notice, to remark that “everyone here is so friendly,” “the staff here is great,” “I got so much attention and I felt really cared for,” or “the practice is really organized and everyone knows what they are doing.” All of these statements indicate that patients recognize and appreciate the level of competence, caring, and compassion that the team demonstrates.

However, to achieve or maintain the highest level of customer service, continual training is needed. Team training is the ultimate secret of practice success. A well-trained team has the resources necessary not only to provide great customer service but to be efficient and communicate value for the dollar.

Training topics to cover at your next team meeting include:

  • Ask everyone for examples of great customer service that they experienced outside the dental office. Sometimes there are discussions of poor customer service that are supposed to provide examples of what not to do; but I find that it is more effective to start positive and stay positive. What did someone do that was notable and impressive? How can that experience be used in the dental office?
  • Go over “What do you say when . . .” scenarios. I was doing verbal skills training via the phone for a practice recently when a team member told me that her greatest fear is “not knowing what to say.” Notice her comment was not that she might say “the wrong thing” but that she would not have anything at all to say in a certain situation. By going over scenarios I was able to give her practical and concise suggestions. She now has the responses at the ready. The goal is not to always have the perfect answer but to learn to respond tactfully and appropriately, listen well, and engage the patient in a conversation that will at once defuse what could be a tense situation and also provide the patient with important information. Patients appreciate this type of kind and helpful approach.
  • Schedule a team retreat once a year. There are practices that try to hold retreats once every two or more years, but an annual meeting is essential to work out issues and keep everyone focused. The retreat does not have to be in a faraway place or at a resort (although these types of venues are good for morale), but they do need to take place somewhere other than the dental office.
  • One essential goal of team training is team building. The two should be inseparable. While there are countless team-building exercises, I stay away from those that may embarrass people or exercises that are games with no real purpose. My favorite activity for team building is to use the MBTI (Myers-Briggs Type Indicator). There are other instruments, but MBTI has been validated over many decades and is still widely used and respected today. Although the MBTI and certain variants are now widely accessible on the internet, the instrument should only be used for training purposes by a skilled administrator not only to get the most out of it but to prevent unfortunate misunderstandings about what MBTI results indicate and do not indicate. When I facilitate sessions, the MBTI gives me an essential tool for team building that people can use on a continual basis at work and in their personal lives. There are many “aha” moments as team members come to recognize each other’s strengths and appreciate their differences.

As usual, when he opines on business issues, Mr Bezos is spot on. He teaches all of us a lesson when he points out what will not change in the coming years. It is comforting to know that even as we deal with a changing healthcare environment, the continued success of dental practices, especially those that are part of the Seattle Study Club family, will be based on a consistent emphasis on efficiency, value for the dollar, and customer service achieved through continual team training.