Questions? Call Us (800) 252.0955

Bitchy Resting Face Syndrome

A couple of years ago, I wrote an article called “Donor and Recipient Practices”. The premise was that far too often we find that even after spending thousands of dollars on marketing, practices routinely drive away patients by not doing the things it takes to inspire a potential client. The “good” practice or “recipient practices” are the ones that benefit from this action because they are embracing consumerism and doing things right so they end up with those patients driven away by the “donor” or bad practices. Like it or not, only the patient gets to vote on whether or not they like you. This might be a good time for you to go to and click on our quick link to our past articles and read or reread that article. It is important to accept the fact that we are often our greatest enemies when it comes to growth and profitability.

Next, I want you to go online to and search for “Bitchy Resting Face”, watch the video (original) and then come back. (I wasn’t kidding, you need to go and watch the video before you go on.)

It definitely made me smile but should also strike fear in the hearts and minds of you, the doctor, and every one of your staff. Your success in dentistry will be determined by those uncommitted folks you see in your office as a new patient. The bad news is that those first impressions will determine whether they stay with you or go down the street.

Enter the “law of unintended results”. Surely none of us design our practice systems in a way that would actually drive patients away, but that is exactly what happens. Over and over, we see practices that are actively doing something to prevent their practices from even being “average”. There are several things you need to check to see if your office is driving off patients.

You may have “Bitchy Resting Face Syndrome” (BRFS) if:

• You are not getting at least 50% of your new patients from direct patient referrals. A worse situation would be to not even know this percentage. This number, the percentage of direct referrals, is possibly the most important metric you should follow. If you are getting 80% of your patients from direct referrals, you are doing everything right. If you get less than 40%, you are actively engaged in sabotaging your practice. The first thing I would ask is: Are each of you projecting the right look and actions that would inspire everyone that meets you?

• Your hygiene department is producing less than 33% of the total production for the entire office. That hygiene department is an integral profit center for your practice. If it is not carrying its weight in production, you will quickly see the office’s new patients and recall percentages will suffer. Consider that every new patient will pass through the hygiene department. If your hygienist has bitchy resting face, the encounter will not be good. Far too often we fail to look at the obvious. If your recall sucks, it could mean that your new patients don’t like the hygienist. If you think about it, the hygienist should be the one person that the patients will want to bond with. Having a marginal hygienist can spell death to your practice and show up as a plateau in growth and new patient numbers.

• High cancellations and no shows (more than 10%) will indicate that your office and front desk are rife with bitchy resting face syndrome. With that first contact with your office, patients form an opinion of the culture and overall compatibility with your office. What I am saying is that BRFS can be felt even over the phone. Being understaffed or having poor systems shows up in BRFS and increased stress. If shows when you answer the phone and fail to inspire someone that calls.

• Spending more than 3-5% or greater on marketing indicates BRFS. A practice that finds itself dependent on large outflows of marketing dollars to maintain a production level is a huge indicator of BRFS. This will usually go along with a lack of, or a low level of, direct referrals. It means that while the marketing gets them in, you fail to meet or exceed their expectations. The reason this is so bad is that these uninspired people leave your office and tell everyone they know not to go there. The quintessential “Donor” practice.

• High staff turnover. What would you think if you went into a business and every time you came in there was a different face. I pretty much conclude that the owner is horrible to work for, lacking even the semblance of leadership and business acumen. It is probably a terrible place to work. It means that BRFS is contagious and even those that are infected will flee this contagion. You, doctor, could be infected. It will show up as staff turnover, increased stress, and the inability to attract patients and pay bills. If you are a male, it is called “Asshole Resting Face Syndrome” (ARFS). Sorry to say this, but enthusiasm and leadership come from the doctor, not from the staff. Your demeanor and attitude say far more than any rule or regulation you might try to enforce on your staff.

I would guess, at this point there are a few of you out there who are thinking they may have this common syndrome. I would suggest that you and your staff take your cellphone cameras and catch people not smiling and radiating confidence caring and compassion. Print the pictures and put it on a “wall of shame” to remind everyone in the office that you are always marketing, and that your attitude is the most important thing you can control and project to a client to reinforce their decision to come to your office. During those work hours, you all have to be “on”: Best behavior, best smile, best listener, best problem solver, and incredible team member. You cannot afford to have even one person in your office with Bitchy Resting Face. Let’s print a label and wear it every day: STAMP OUT BRFS!

Michael Abernathy, DDS
[email protected]
972-523-4660 cell