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Can an apple a day keep the lawyers away?

24 May 2018

Dental Protection’s Dr Raj D K Dhaliwal draws on Apple techniques to avoid litigation

Read this article to:
  • Discover how communication issues can lead to complaints against health service providers 
  • Learn how Apple approach customer service 
  • Understand how this technique can help you avoid litigation 

I think it’s fair to say that complaints are upsetting to receive. At Dental Protection we are always assessing complaints and looking in more detail at how they arise. Most are borne out of clinical or non-clinical factors or, in many cases, a combination of both.

The non-clinical factors tend to relate to issues with communication: the manner of the dental team, being kept waiting and the lack of information. This was reflected in the Health Care Complaints Commission annual report for 2015-2016, which highlighted communication issues as the second most common reason (17.2%) for raising a complaint against a health service provider.1

So if communication is an issue, can we look at other organisations in the service sector and learn lessons? The customer service provided by Apple is well known, and to such an extent that other organisations have tried to emulate this in improving their own customer relations.

It became public knowledge a few years ago that Apple employees are trained to follow a step-by-step approach to customer service. This approach follows the acronym A-P-P-L-E:2

A  - Approach customers with a personalised, warm welcome

P  - Probe politely to understand the customer’s needs

P  - Present a solution for the customer to take home today

L  - Listen for and resolve issues or concerns

E  - End with a fond farewell and an invitation to return.

Could this step-by-step approach be transferred to our own practices to help reduce non-clinical complaints?

A – Approach

The first contact that a patient will have when they attend the practice is with the reception team. This is your chance to make a good first impression. We should be asking the following questions:

  • How are the patients greeted?
  • Do the reception team introduce themselves with their name? Names are powerful tools and are invaluable in building up a rapport.
  • Is the patient’s first name used or a more formal greeting? Is the greeting appropriate for all patients or will this depend on the patient relationship? Studies have shown that it may be best to ask the patient how they would like to be addressed.3

The continuation of this warmth in tone should continue as the patient moves through the treatment process. Does the treating practitioner come and greet the patient or is the patient invited into the clinic by the dental assistant?

Take time when the patient enters the clinic to greet them and maintain eye contact. We’re all busy and it’s easy to use this period to catch up with notes, but taking time to show the patient they have your attention can be a valuable and powerful technique. Studies have shown that computers can have a negative impact on a consultation.4

P – Probe

This is an opportunity for us to gain a social, dental and medical history from the patient. Be polite and give the patient an opportunity to explain their needs without interruption. Do give non-verbal cues, such as nodding and open body language, to encourage the patient to talk.5

Use active listening to respectfully ask questions and listen for any relevant information. It’s important that we don’t approach each consultation with preconceived treatment plans, as all patients have different needs and wants.

Importantly, after listening to the patient, can you meet their expectations? Does this patient need a specialist referral?

P –Present

After taking the history are you able to present all the treatment options?

It’s important to remember that if you don’t discuss all the treatment options, then it could be argued that you haven’t obtained the patient’s consent. Therefore, it is important to discuss all the risks, complications, and cost and time implications for all the options discussed. Will the patient require ongoing maintenance?

It’s important to spend the time with the patient, ensuring that they understand all the options.

Studies show that those clinicians that spend extra time with their patients help to change their perception of care. Those patients that felt rushed are more likely to pursue a claim.6

L –Listen

Once all the options have been discussed, it’s important to listen to any questions and queries that the patient or their families may have. Take time to document any specific concerns that the patient may raise and the responses you have given.

In addition to listening to them, pay attention to their body language, voice tone and facial expressions – these are key indicators and can often say more than their words.

Ensure that your non-verbal communication is indicating that you are listening to the patient and remember it is an ongoing process. This can show that you’re actively listening and engaging, and give them confidence in you as a practitioner.

E – End

At the end of the consultation appointment, give the patient an opportunity to think over the treatment options. Address any questions and concerns and ensure they understand everything you have told them.

At the end of treatment, ensure that the patient is aware that if they have any concerns, they should come back to the practice. This openness helps to deal with the concerns locally, rather than a third party becoming involved.

All members of staff should know how to deal with a complaint or concern, even if it’s, “let me take you to Mrs Smith our PM who can address this” rather than “I’m sorry I can’t help you, you’re speaking to the wrong person”.

In conclusion, taking a bit of time to address the service we provide to patients can have dramatically positive effects on the way they interact with us as dental professionals and, ultimately, could reduce the likelihood of complaints.


1. Health Care Complaints Commission Annual Report 2015-2016

2. Gallo C. How the Apple store create irresistible experiences.

3. Parsons P, Hughes A & Friedman N. Please don’t call me Mister: patient preferences of how they are addressed and their knowledge of their treating medical team in an Australian hospital. BMJ Open 2016 Vol6 Issue 1

4. Frankel R, Altschuler A, George S et al. Effects of exam-room computing on clinician – patient communication: a longitudinal qualitative study. Journal of General Internal Medicine 2005;20:677-682

5. Warnecke E. The Art of Communication. The Royal Australian College of General Practitioners. RACGP vol 43 No 3 2014 p156-158

6. Mehta S. Patient satisfaction reporting and its implications for patient care. AMA Journal of Ethics. Vol 17 No.7 2015 p616-621

7. Kourkouta L & Papathanasiou I. Communication in Nursing Practice. Mater Sociomed. Vol 26, No 1 2014 p65-67

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