Highly experienced practice manager and dental practice management consultant, Lisa Bainham, explores how to help team members cope with the inevitable challenging conversations team members will face.
In every dental practice, being called on to field difficult conversations from time to time is inevitable. Whether it’s a patient unhappy with treatment costs, a persistent no-show angry about a cancellation fee, or a team member struggling with communication, these interactions can turn a normal day upside down for the unwary.
However, rather than viewing them as something dreaded and confrontational with some judicial reframing we can start to view them as opportunities—opportunities to build trust, show professionalism, and reinforce the values of your practice. Here’s how.
It All Starts at Reception
The patient journey often begins at reception, and so do many of the challenges. From late arrivals to cost complaints, the front of house team is frequently called upon to defend the practice against frustrated patients. The mistake some practices make is to devalue the role of reception. It is not just a seat-filling role that anyone can jump into without training. Rather it’s a job that is emotionally and professionally demanding and requires a unique set of communication skills.
Receptionists need to be well-equipped emotionally, to be able to succeed (and survive!). Putting a nurse on reception during holidays may fill a gap, but without training, you’re exposing them to emotionally charged situations without a safety net.
Equip Your Team with Communication Superpowers
There are a number of skills I refer to as ‘superpowers’ which are essential for handling these situations confidently and compassionately:
Emotional Intelligence (EQ)
EQ is a receptionist’s first line of defence. Self-awareness helps team members recognise when they’re being triggered and teaches them to step back rather than react. For example, if a patient questions a treatment plan for the third time, possibly quoting ‘Dr Google’ or even ChatGPT, staying calm and constructive is crucial. It’s not about ego—it’s about guiding the patient to a solution that works for everyone.
Self-Regulation
Team members need to appreciate that they don’t need to have all the answers immediately. Phrases such as “Let me take some time to look into this properly and come back to you” can buy valuable thinking space and reduce tension. When navigating a challenging conversation, it’s about responding rather than reacting—offering empathy without absorbing the stress.
Empathy and Rapport
Contrary to what some people may suggest, empathy is not weakness. It’s a strategy. When patients feel heard, they’re less likely to escalate issues. Saying “I completely understand how that might feel frustrating, let’s work out a solution together,” helps builds rapport and de-escalates tension. It helps take some of the heat out of the situation.
However, it’s vital not to over-identify with the patient’s frustration (e.g., “I know, it’s so expensive!”). Instead, balance empathy with professionalism.
Clarity and Consistency
Every team member needs to be on the same page when it comes to policies—whether it’s cancellation fees or appointment protocols. If a patient repeatedly misses appointments and is rude to staff, it may be time to ask why your practice is still seeing them? I believe that my team is more important than that one patient.
Consistency is also about fairness. Teams must understand that policies are not personal, and they are there for a reason. Patients who are constantly late or miss their appointments have a disruptive effect upon the practice. While imposing a missed/late appointment fee is not a pleasant task, these rules exist to ensure fairness and sustainability.
Conversations Without Confrontation
Use of language is important when handling these types of difficult conversations. Having some key phrases to hand can be extremely helpful. For instance:
“I can see you’re upset, and I want to help, but I can’t do that right this minute. Please leave your details, and I’ll make sure someone calls you later today.”
This approach acknowledges emotion, sets a boundary, and offers a practical next step. It’s professional, calm, and—most importantly—empowering.
Try to avoid reaching the stage where the patient demands to see the manager. Managers shouldn’t be ambushed in front of a waiting room full of patients. Instead, teams should be trained and trusted to handle these situations confidently, escalating them only when absolutely necessary.
Building Confidence Through Practice
Confidence is key. Often team members aren’t afraid of the difficult conversations themselves —their worry is about getting them wrong. Thorough training sessions that include practical phrases and real-life scenarios help build muscle memory. Things may start off feeling awkward but soon feel completely natural and comfortable.
These conversations are happening all the time. Possibly not every day, but often. In which case it’s important to be prepared, be present and remember that positivity matters. Confidence not only makes conversations easier; it boosts morale, supports staff retention, and makes a huge difference to patient satisfaction.
Final Thoughts: Shift the Mindset
Ultimately, mastering difficult conversations is about shifting from a reactive to a proactive mindset. Equip your team with the tools to manage—not fear—challenging interactions. Help them to develop their own conversational style, rooted in empathy, clarity, and professionalism.
It’s important to remember that empathy is not tiptoeing around difficult patients. It’s a powerful strategy for protecting relationships, reputation, and your team’s wellbeing. Chiefly, it’s about finding the best way forward—for the patient and the practice, not about getting your way.
About Lisa
Lisa Bainham is involved in all aspects of the practice, including, compliance, accounting and business development. Lisa had been recognised as an award-winning practice manager and is now a Judge.
Lisa’s knowledge and experience over her last 28 years enables her to support other practice managers in her role as Chair of The Association of Administrators and Managers, who have members throughout the UK. She is a speaker at a wide range of dental events and covers a varied range of topics including, Leadership, Team Building, Complaint handling, Customer Service, patient journey training, and her PM mentorship programme. Lisa also provides support to practices across the UK & Ireland through her consultancy, Practice Management Matters.
Lisa still works in practice, making her relatable and empathetic to the challenges many practices face, and understands the support many teams need.