CASE 3: DR.

BECKETT’S DENTAL OFFICE

1. WHICH OF THE EIGHT ELEMENTS OF THE SERVICES MARKETING MIX ARE

ADDRESSED IN THIS CASE? GIVE EXAMPLES OF EACH “P” YOU IDENTIFY.

 Price and other costs: Patients may incur both financial and non-financial costs. Most
financial costs are covered by insurance, but patients must pay any additional expenses.
There are extensive non-financial costs associated with the service.

 Product elements: Beckett’s core product is “to provide superior dentistry” in “a quality,
caring environment.” Both facilitating and enhancing supplementary services add value to
the core and distinguish Beckett’s practice from those of competing dentists.

 People: Beckett understands that her employees are a critical part of service delivery. She
states that “90 percent of patients’ perceptions of quality come from their interactions with
the front desk and other employees—not from the staff’s technical skills.” Beckett treats her
staff as both friends and valuable company assets. She expects a lot from them but also
motivates them with training, profit sharing, and rewards like bonuses and vacations when
the practice meets its financial goals. While patients are most affected by the employees, they
also come into contact with other patients in the waiting room. Because many of Dr.
Beckett’s examining rooms are adjacent to one another, patients can also overhear other
people’s conversations and reactions to procedures.

 Physical evidence: Beckett carefully manages the physical evidence of service. The patient’s
first experience is a clean, nicely landscaped parking lot. The new office is visually attractive,
and the Scandinavian design reflects Beckett’s desire to balance function with aesthetics. The
entire back office staff (including the dentist) wears matching uniforms in cheerful shades of
pink, purple, and blue that match the office décor, while the front office employees wear
professional business attire. The technical equipment looks very modern and is spotlessly
clean. State-of-the-art computerized machinery is used for some procedures. Dr. Beckett’s
dental degrees are prominently displayed in her office, along with certificates from various
programs that she and her staff have attended to update their technical skills. The office logo
and business cards are done in a style that matches the high-quality image Beckett wants to
portray.

 Place and time: Because sanitary conditions and specialized equipment are needed for most
dental procedures, patients must come to Beckett’s office for treatment. Service delivery
normally occurs between 7 a.m. and 5 p.m., but employees will occasionally work late to
finish a procedure or accommodate a special request from a patient. Beckett also sees
patients after hours and on weekends to provide emergency care.

 Process: Dental care is a people-processing service, so patients must be physically present to

receive care. Beckett has spent invested both time and money in improving both front office
and back office service delivery.

 Productivity and quality: Beckett has positioned her practice on the basis of high-quality
service provision. But she is also aware that productivity is critical. These elements are
reflected in the internal mission statement displayed in the back office, which reads: “It is
 our goal to provide superior dentistry in an efficient, profitable manner within the confines
of a caring, quality environment.” Beckett moved to a new office because her old one was
too cramped to allow her staff to work efficiently. She also redesigned all of the office systems
(billing, ordering, lab work and patient treatment). One of her main goals was to standardize
some of the routine procedures so that error was reduced and all patients would receive the
same level of care. Specific times have been assigned for each procedure, and the staff work
very hard to see that these are met. Front office staff attempt to fill cancellations to make sure
office capacity is maximized. Staff members will substitute for one another when necessary
or help with tasks that are not specifically in their job descriptions to make things run more
smoothly.

 Promotion and education: Beckett’s office does no advertising or promotions. All of her new
business comes from positive word of mouth by current patients. She believes that referrals
are a real advantage because new patients don’t come in “cold.” Because friends or family
have already told them about her service, she doesn’t have to sell herself. However, Beckett
does put a lot of energy into educating patients to be partners in their own dental health care.
This philosophy is reflected in the patient mission statement displayed in the waiting area:
“We are a caring, professional dental team serving motivated, quality-oriented patients
interested in keeping healthy smiles for a lifetime. Our goal is to offer a progressive and
educational environment. Your concerns are our focus.” Beckett’s staff educates patients in
a variety of ways, including verbal discussions, videotapes, and pamphlets.

2. WHY DO PEOPLE DISLIKE GOING TO THE DENTIST? DO YOU FEEL THAT

BECKETT HAS ADDRESSED THE PROBLEM EFFECTIVELY?

Many people don’t like going to the dentist because of the non-financial costs in time, effort,
and discomfort that are typically associated with the service process. Dental patients can sometimes
get the financial cost of treatment covered by insurance but experience all four kinds of non-financial
costs to varying degrees:

 Time costs: These include both time waiting for service and the actual service delivery.
Beckett’s office tries to minimize waiting time by having patients make appointments (a
method of reservations) and scheduling an appropriate number of patients each day. Patients
whose wait is longer than twenty minutes are given the option to reschedule. The front office
employees often call patients if they know there will be a delay. Beckett’s office has tried to
minimize in-process waits by standardizing most of the routine procedures. Specific times
are allotted to each of these procedures, and the staff works hard to see that these are met.

 Physical costs: Visits to the dentist often involve discomfort—ranging from the mildly
unpleasant sensation of having one’s teeth cleaned to the severe pain accompanying a more
intrusive procedure. Some patients go to the dentist for help in reducing pain. But many
others feel fine when they enter the dentist’s office, only to be miserable upon leaving as a
result of the treatment they receive! Beckett’s staff tries to be gentle in treating patients, and
Novocain and gas are used when necessary to reduce painful sensations during procedures.
The employees also warn patients when a procedure is likely to be uncomfortable or painful.
Patients who will experience discomfort after they leave Beckett’s office are provided with
soothing mouthwashes and prescriptions for pain-relieving drugs.
  Psychological costs: Fear is the main psychological cost—both before and during a visit to the
dentist. Most of this fear is related to the expectation that unpleasant physical costs will be
experienced during dental care. There is also a cost of feeling embarrassed to leave the
dentist’s office with a temporarily swollen mouth and altered speech. Beckett’s employees
try to reduce psychological costs by educating patients (through discussion or with brochures
and videos) about the specific procedures they will be undergoing.

 Sensory costs: There are many sensory costs associated with a visit to the dentist. Patients
encounter unfamiliar sights (e.g., the frightening-looking dental equipment), sounds (e.g.,
whining drills, teeth being ground), smells (e.g., the “burnt” smell from drilling, the medicinal
smells of the dental materials), and tastes (e.g., blood, the dental materials). While Beckett’s
employees can’t reduce most of these costs directly, they attempt to offset them by decorating
the office in soothing colors and providing distractions like music (played in the office and
also available through headphones if the patient has a special request). Patients whose
procedures are lengthy are given pillows and blankets so that they won’t get cold from sitting
still for a long time.

3. HOW DO BECKETT AND HER STAFF EDUCATE PATIENTS ABOUT THE

SERVICE THEY ARE RECEIVING? WHAT ELSE COULD THEY DO?

All new patients have an initial exam with Dr. Beckett so she can do needs assessment and
educate them about her service. Before any non-routine procedure, Beckett discusses with each
patient the reasons for her treatment recommendations and the possible options. The office staffs
also provide information about specific dental procedures through conversations with patients, and
videos and brochures are available.

Beckett does not yet have a Web site, but this might be a very useful tool for educating and
building relationships with her patients (especially since they are primarily white-collar workers who
match the demographics of Internet users).

4. WHAT SUPPLEMENTARY SERVICES ARE OFFERED? HOW DO THEY

ENHANCE SERVICE DELIVERY?

Beckett’s service delivery involves both facilitating and enhancing supplementary services.
The facilitating services are required in service production, while the enhancing services add value
to the core product.

Facilitating supplementary services:

 Information: Beckett’s staffs tell patients about dental procedures and costs before treatment
occurs. During treatment, patients are advised about what is happening and how long the
procedure will take to complete.
 Order-taking: Whenever possible, patients make an appointment (a reservation) for dental
care. For a routine cleaning and exam, patients may have to wait three to four months if they
don’t have their appointments automatically scheduled every six months. Less routine
treatments (like crowns or gum repair) are scheduled sooner. Emergency procedures (which
disrupt the normal order-taking process) are handled immediately—even if they occur after
regular office hours or on weekends.

 Billing: Beckett’s employees contact patients’ insurance companies to collect payment.

Office policy requires patients to pay any fees not covered by insurance at the time of
treatment, but additional statements are mailed if necessary.

 Payment: While insurance covers most costs, patients sometimes have to pay additional fees.
They can do this via cash, check, or credit card.

Enhancing supplementary services:

 Consultation: Beckett and her staff consult with patients both before and after treatment.
They hope that by educating patients about proper maintenance (like flossing, brushing, and
regular checkups), future corrective procedures can be avoided. They also discuss non-
routine treatments with patients and provide counselling about how to maximize their
treatment outcomes.

 Hospitality: Beckett’s office is designed to maximize guests’ comfort. The waiting room and
reception area is attractively furnished. Live plants and flowers are abundant, and the walls
are covered with art. Classical music plays softly. Patients can enjoy a cup of coffee or tea
and browse through current magazines while they wait. The chairs in the examining rooms
are covered in leather and are very comfortable. Each room has a large window that allows
patients to watch birds eating at the feeders. Mobiles hang from the ceiling to distract patients
from the unfamiliar sounds and sensations they are experiencing. Headphones are available
with a wide selection of music. Some of the most successful hospitality services came from
staff suggestions about how to improve patient care. These include follow-up calls to patients
after major procedures; a “goodie box” for patients that contains a toothbrush, toothpaste,
mouthwash, and floss; buckwheat pillows and blankets for patient comfort during long
procedures; and a photo album in the waiting area with pictures of staff and their families.

 Safekeeping: Parking is available in a clean, nicely landscaped lot right in front of the office.
There are coat racks in each examining room where patients can hang coats and purses.
Children can play with toys or watch videos in a conference room under the supervision of
front office staff while their parents receive treatment.

 Exceptions: Beckett’s employees treat emergencies when they occur—even if this means
Beckett has to come in after hours or on weekends. Service failures of any kind are corrected
immediately (e.g., replacing a broken temporary tooth or refitting a crown). If payment is a
problem for patients, the front office staff will attempt to work out a reasonable billing
schedule.
 5. CONTRAST TO YOUR OWN DENTAL CARE EXPERIENCE WITH THOSE
OFFERED BY DR. BECKETT’S PRACTICE. WHAT DIFFERENCES DO YOU SEE?
BASED ON YOUR REVIEW OF THIS CASE, WHAT ADVICE WOULD YOU GIVE
(A) TO YOUR CURRENT OR FORMER DENTIST AND (B) TO DR. BECKETT?

In comparison to my own experiences I only notice a few differences. First of all, the office of
my dentist isn’t as modern as the Dr. Beckett’s office. There are only simple chairs, some
magazines and there is also a TV to show patients different dental procedures. Also you don’t get
tea, coffee or things like that, and there are no special gifts like at Dr. Beckett’s office. It is also
easier to get an appointment, you don’t have to wait like 3-4 months, you get it there faster; but
that’s maybe because there aren’t so many patients. Another difference to Dr. Beckett’s office is
that my dentist has put up some monitors above the dentist’s chair where he shows some holiday
pictures of himself. So you will concentrate more in this monitor than on the treatment.

My advice to my dentist is to take more care of their patients. He should also include a service
like getting coffee or things like that, so that you feel really comfortable there. It would be also
great if the whole office would be more modern and not that old standard.

I don’t nearly have any advice for Dr. Beckett because she’s doing her job very good and
provided a really excellent service. But maybe she could also add some monitors above the
dentist’s chair on which she can show some holiday pictures or pictures from the trips the entire
office took.