Monday, January 27, 2014

Generation Gap

Do you accommodate patients differently because of their age? In my practice, we have a relatively narrow age range, with the majority of patients in the 25 to 40 range. This accounts for the fact that our office just celebrated a two-year anniversary. Every now and then, I do get an older patient. I notice some big differences in their wants and needs, as well as the type of interaction they seem to crave from their dental practitioner. There are definitely positives and negatives on both sides.

My main struggle with patients that are my age or younger is the fact that they do not make their oral health a priority. They are too busy dealing with their careers, starting families, and just living their lives. Coming to the dentist to redo those old crowns or even for regular six month checkups is not at the top of the priority list. I find that this is not a financial or even a lack of insurance issue. I have good friends who have great dental insurance from their jobs but have not been to the dentist in years. Every year, it goes untouched because coming in for a cleaning and a checkup is just not in their immediate realm of interest. No matter how much oral hygiene instruction I give, flossing is a constant challenge to many young adults that have gotten through years of graduate school and are successfully earning a living in a major city. They have jobs in law, finance and even healthcare (doctors and nurses, I am talking about you!). At some point, I just have to be happy with the fact that I try to review all their needs and give them good guidelines during their exams; the rest is out of my hands.

As patients get older, they are ready to become more invested in their oral health. They may have neglected their teeth as young adults, but now that they are more established with their careers and have older children that do not need as much attention, they are more ready to focus on themselves. Many typically have a mouth full of dentistry that needs to be replaced and they are excited to learn about what their options are.

I am almost 31 years old. Over the last decade (most of my adulthood), I have grown accustomed to communicating with those around me via email and social media. That’s just how things evolved with my generation. I see this mentality in many of my patients that are in my age range. For the older generations, it’s a bit of a different story. For the majority of their lives, they have dealt with technology-free human interactions and see value in this when visiting their health care provider. When I am doing a new patient exam or even a hygiene recall, I would say I easily average an extra 10-15 minutes more on older patients, simply because of their desire to talk about things other than dentistry. They have grown accustomed to this type of interaction, which I have seen is very common with older dentists. Schmoozing your patients is something they seem to be quite good at, though it can be debated whether this is essential to being a good practitioner.

When I was in school, one of the facts that many instructors shared was that most patients will never know if you are a good dentist or not in terms of your technical skills. What they will remember and appreciate is how they are treated; that is the number one thing you can offer in terms of customer service and growing your practice. I still have issues with this statement because it implies that, in the long run, your clinical skills are less important that your people skills. But I can definitely see how it could have been the case in past generations. Patients established a human connection with their dentist, and if they were treated well and felt good, they kept going back, no matter how “good” the actual work was. These days, younger patients have more choices and more importantly, more access to content. They can go on your office Facebook page, blog or website and peruse before and after photos. They can filter through patient reviews on websites like Yelp or post their smile photos and get responses from doctors on That first impression of you is established way before the patient meets you and you have a chance to impress them with a friendly greeting and some witty banter. A 28-year-old patient will be impressed by a nice website and some clever posts on Facebook. Some fancy high-quality before and after pictures would not hurt either. A 58-year-old year old patient, however, may be more impressed by the way he is treated on the phone when he actually calls the office, as well as the amount of individual attention he receives from the doctor when he comes for his appointment.

What do you guys think? Am I totally stereotyping age groups, or have you found similar things to be true from your experiences?

Have a great rest of the week. I hope the weather is treating you better than it currently is in the NYC region, where the East River is literally starting to freeze over.

Lilya Horowitz, DDS

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