Dr. Bear's Dental Ofce A dental surgeon seeks to differentiate her practice on the quality of customer service. She constructs a new ofce and redesigns the practice to deliver high quality service to her patients and to improve productivity through applications of ergonomics. But she still faced the challenge of convincing patients that her superior service justifies higher fees than those covered by insurance. Moving to Orchard Paragon \"I just feel that the quality differences are visible to our patients,\" as reected Dr. Bear as she moved around her ofce and practice in a new location in Orchard Paragon which housed many medical practices. She has recently moved to Orchard from an ofce that cramped to allow her staff to work efficiently. Though productivity gains were necessary, she did not want to compromise the quality of service her patients received. Back in the nineties, she was well trained in the technical side of dentistry in National University of Singapore and King College in London for her post-graduate studies but nothing about the business side. She received no formal training in the running of a business or understanding of customer needs. The profession discouraged marketing or advertising of any kind. Dr. Bear did not have to face this problem when she started the practice 20 years ago as prot margin had been good back then. However, the dental care industry had changed dramatically. Costs had increased because of labour law, malpractice insurance, and the constant need to invest in the state of art technology that the industry is facing. So much so that her overhead was now between 60% to 70% of revenues. Ministry of Health The Ministry of Health (MOH) also aimed at reducing healthcare costs for insurance companies, employers, and patients by setting guideline for clinics to adhere to. The upper limit on the amount that doctors and dentists could charge for various procedures are provided in the guideline. This price limitation meant that the MOH doctors and dentists would not be able to offer certain services that could provide better-quality care but too expensive. Dr. Bear had decided not to become an MOH provider, because the reimbursement was only 70% to 80% of what she normally charged for treatment. To adhere to the MOH rates, she felt that she could not provide high-quality dental care to patients. These charges recommended by the Ministry would make the dental clinic becomes a low-cost provider for dental care and treatment. With the help of a consultant, she decided to differentiate the practice based on quality. Together with the consultant, she developed the mission statement displayed at the entrance to her clinic. The mission statement read, \"It is our goal to provide superior dentistry, in protable manner within the connes of a caring and quality environment.\" Redesigning the service delivery system The move to Orchard Paragon gave Dr. Bear a unique opportunity to rethink the service delivery and customer needs that her patients is experiencing. She wanted the work environment to provide a pleasant place for her staff to work and a good experience from the patient perspective when they seek treatment. The bigger space in this new place gave Dr. Bear the opportunity to redesign her service delivery to meet patient expectations. Facilities and Equipment Dr. Bear decided to use lighting and space to create a contemporary clinic that would differentiate her service 'om other services. She decided to have live plants and owers as her brother was a horticulturist and offered her free landscape services. Classical music played softly in the background. Patients could enjoy a cup of coffee or tea and watch Netix shows while waiting for treatment. Educational videos and readings were available to demonstrate different dental procedures such as root canal treatment and implants which are popular with patients. The dental chair was enhanced with the latest technology. The room was also soundproof so that patients who are waiting outside would not be stressed by the sound coming out from the treatment room. Headphones were available with a wide selection of music to keep the patient entertained while having dental treatment. All the equipment in the treatment rooms was very modern and spotlessly clean. In view of the pandemic, all equipment was fully sterilised to give patients a sense of security. Each room has a chairside computer monitor, where both patients and staff could view digital X-rays while discussing treatment options. Procedures and Patients One of the main goals was to standardize some of the routine procedures to reduce the occurrence of errors and ensure all patients received the same level of care. Specic times were allocated for each procedure, and the staff worked very hard to see that this time requirement were met. Standard operating procedures specify that a patient should be kept waiting no longer than 15 minutes without being given the option to reschedule and hunt ofce staff usually called patients in advance if they knew there would be a delay. Dr. Bear would emphasise on customer satisfaction and make it a point to conduct a 2-minutes online survey with every patient after they visited her clinic. The present level of customer satisfaction level is only 85% in 2020 and Dr Bear would like to see this improve to 95% level of customer satisfaction within the year 2021. She strongly believes customer satisfaction will help to improve her business in the long run. Staff development The entire ofce sta wore uniforms in cheerful shades of pink, purple and blue that matched the ofce decor. Dr. Bear dental degrees were prominently displayed, along with certicates from various programs that she and her staff had attended to update their technical skills. letter of appreciations from patients, old folk homes were also displayed to show her sense of corporate social responsibility. The practice set a high expectation for staff technical competency and patient interactions. Dr. Bear provided her employees with many opportunities to update their skills and workshops organised by Life-Long Learning Institute (an agency set up and heavily funded by the Singapore government). She also rewarded their hard work by giving quarterly bonuses if business was good. Employees could see the difference in revenues if the schedule were slow or patients were dissatised. This provided an extra incentive to improve service delivery. Before the pandemic, the entire ofce also went on trips together once a year (paid by Dr. Bear), spouses were welcome to participate. Past destinations included Bali, Phuket and Hanoi. In view of the social distancing and quarantine period imposed, Dr. Bear decided to reward the staff with staycation in popular 5 stars' hotels for 2021. Service Personnel There were six employees in the dental practice, including Dr. Bear (who was the only dental surgeon). The ve staff members were separated by job function into \"front-oice\" and \"back- ofce\" workers. Front-ofce duties covered by two employees included receptionist and secretarial tasks and accounting and nance work. The back-ofce was divided into technical support staff and chairside assistants. The two chair-side assistants helped Dr. Bear with treatment procedures. They were trained in nursing school but do not possess any degree. The technical support assists her in preparing the dentures and others for patients who have special needs. Though she is highly professional in her own eld, Dr. Bear valued her iendship with sta' members and understood that they were a vital part of the service delivery. Dr. Bear discussed her goals with the staff members and involved them in the decisionmaking process. She would brief the staff early in the morning to discuss the day's schedule and patients. During this meeting, staff made suggestions about how to improve patient care. Some of the staff suggestions included \"reminder\" cards to patients to come for followup treatment. \"Gift\" bag containing toothbrush, toothpaste, mouthwash and oss were given to every patient on every third visit to the clinic. Referral Dr. Bear practice included 800 \"active\" patients. The prole of these patients is mainly white- collar workers with professional jobs. She did no advertising; all her new business came from positive word of mouth by current patients. Dr. Bear's practice was so busy that patients often had to wait 2-3 month for a routine cleaning and examination if they didn't have their appointments automatically scheduled for every six months. The dental surgeon believed that referrals were a real advantage, because patients have better trust and faith in her treatment and was more willing to pay for the quality service provided. Dr. Bear strongly advocate for all new patients to have assessment and educate them about her service. She believed this was the rst indications to her patients that her practice was different from others they had experienced. Other Issues \"Redesigning the service delivery was the easy part\