Coming into a medical office can cause anxiety for some … and be a calming influence for others. The former is often referred to as “White Coat Syndrome,” where people’s blood pressure is consistently measured higher in a medical office than in a normal setting. The latter tends to occur when patients who may naturally be predisposed to worry actually calm down when they get the feeling of getting an expert opinion.

There are many types of patients, each with differing comfort levels, and if they are relaxed and believe in the therapy/treatment they are receiving, then they have a better chance of a positive effect from that treatment. It’s sometimes known as the “placebo effect.”

In a recent conversation with San Francisco’s Green Dentist, Dr. Namrata Patel, whose service I use, love, and highly recommend, I found one comment she made fascinating: Some people don’t appreciate her office’s focus on getting patients to relax, despite the obvious benefits to the patient in terms of treatment effectiveness. Dr. Patel has a LEED-certified office with a spa-like setting, where natural serenity coincides with calming extras like hot shoulder wraps, an iPod with yoga-esque music, a massage bed, and of course, healthy and natural alternatives to mercury-based amalgams and high radiation x-rays. Her service is actually less expensive for comparable work than many other dentists in San Francisco, so my customer loyalty is extremely high.

It made me wonder, though … do other patients have similar experiences? With referrals from satisfied customers being such a key source of new business for dentists and other medical practitioners, I think it’s important to find out if being green, healthy, and sustainable really has a positive impact on the revenue end of medical practices. Bill Roth demonstrated the financial savings of going green for dentists earlier on 3P, but what about the customer experience? To find out, I did a little digging.

For reviews, I looked at the online customer ratings for several green medical practices. Yelp, as a source of data, is fraught with inherent drawbacks. First off, reviews can be changed, which means that businesses that receive a bad review can contact reviewers and ask how they can make the situation better. While this is good for customer interaction, it also facilitates a motivation for people to leave 1-star reviews just to see if they can get something for free. More troublingly, rumors abound about pay-for-removal services Yelp offers to businesses that have suffered bad reviews. Are these reviews reliable?

However, as the number-one customer reviews site on the web, Yelp does provide an insight into customer mindset. I took a look at the dental scene in the Bay Area, just to get an idea of what people are saying about dentists, then compared their reviews to the Bay Area’s two most prominent green dentists, Dr. Patel, and Dr. Fred, the East Bay-based “Transcendentist.”

After reading perhaps a thousand customer reviews of local dentists I found a few trends:

  • People who needed a lot of work had either 5-star or 1-star ratings. There was almost nothing in between. The 5-star reviews likely need no explanation. The 1-star reviews tended to blame the dentist for the outcome, whether it was continuing pain, having to come in for follow-up work, or a perception of poor work. In many cases, these reviews contained enough extreme words to make me believe the person was truly angry, but fell quite short of a calm, collected argument that might actually convince me the work was subpar (more likely that the patient had spent years ignoring tooth pain and come in as a desperate last measure).
  • People tend to think their dentists cost too much. This is probably the number one complaint. The 5-star reviews usually did not mention price. Some of the poor reviews with regard to price mentioned insurance and dental loans through Capital One that were “quickly approved.”
  • Dentists with less than 20 reviews tended to have all positive reviews. Those with more than 30 tended to get at least a handful of dissatisfied customers, whose 1-star ranking would pull the average down somewhat disproportionately.
  • People who received just a basic treatment tended to be happier than those who received more.
  • Traditional dentists tended to fall into one of three categories: the ones people absolutely loved (usually the first sentence included the word “awesome”), the ones that people were indifferent about (reviews on these tended to be pretty dry and straightforward), and the ones that were deemed unprofessional. This latter category tended to receive a lot of very poorly written 1-star reviews with grammatical and spelling challenges throughout. I’m going to venture to guess this is a result of insurance obligations, price-sensitive customer, etc.

In terms of green dentistry, I found only a few things that separated the two green dentists from the rest of the reviews:

  • While the overall rating average was similar to general trends among other dentists, there was a polarization of results. There were more 5-star and 1-star ratings, and very little in between.
  • Satisfied patients consistently referred to the treatments as “peaceful,” “relaxing,” “calming” and “holistic.”
  • Dissatisfied patients consistently referred to price.

What does this mean for sustainable and holistic medical service providers?

  1. Green practitioners may be able to leverage their happier clientele as word-of-mouth evangelists more than traditional practitioners. According to an article in the Harvard Business Review, focusing on these customers can be one of the most important elements of a successful business.
  2. The niche exists in the customer base of people who have White Coat Syndrome, and that holistic practices can address this niche better than sterile, white-walled offices.
  3. The other major takeaway is that there is a perception of higher cost. Despite Dr. Fred, the Transcendentist, and Dr. Patel, SF’s green dentist, being price competitive with other dentists in the area (in fact cheaper on many services), the perception may well remain and is an obstacle green practitioners must address with patients. It is imperative for long-term success that these costs either be easily justifiable with premium services, or are brought close enough to be considered in line with the competition.
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About The Author

Scott Cooney

Scott Cooney (twitter: scottcooney) is an adjunct professor of Sustainability in the MBA program at the University of Hawai'i, green business startup coach, author of Build a Green Small Business: Profitable Ways to Become an Ecopreneur (McGraw-Hill), and developer of the sustainability board game GBO Hawai'i. Scott has started, grown and sold two mission-driven businesses, failed miserably at a third, and is currently in his fourth. Scott's current company has three divisions: a sustainability blog network that includes the world's biggest clean energy website and reached over 5 million readers in December 2013 alone; Pono Home, a turnkey and franchiseable green home consulting service that won entrance into the clean tech incubator known as Energy Excelerator; and Cost of Solar, a solar lead generation service to connect interested homeowners and solar contractors. In his spare time, Scott surfs, plays ultimate frisbee and enjoys a good, long bike ride. Find Scott on

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