Questions? Call Us (800) 252.0955

Case Acceptance Part 2

We’re back with round two of case acceptance.  I hope you have all been monitoring your progress.  If you have not or missed the first installment of case acceptance give us a call.  Like a puzzle, every piece is important.  Leave one piece out, and you will never have the entire picture.

As a point of reference and a quick review take a moment and read these six bullet points.

  • You can’t get better at giving people what they don’t want.
  • If you are not growing, you are not meeting your patient’s needs.
  • Your systems are precisely designed to give you the results you are getting.
  • You must happily give patients what they want, and tell them what they need.
  • We sell “solutions to problems” and “good feelings”.  Nothing else!
  • True case acceptance is when the patient says yes, shows up, pays for treatment, and refers everyone they know.


If you are not currently monitoring your case acceptance success, start today.

Daily Presentations Monitor

Date Patient Name Procedures Presented Fee Presented Procedures Accepted Fee Accepted

In other words if you are not having a 90%+ case acceptance you have violated one or all of the above cornerstones to 100% case acceptance. The monkey score is 67% if you will just tell them what’s wrong.  In other words, you could have the worst location, terrible staff, poor clinical skills, and never bath and still get over 65% of your unlucky victims to say yes.  The number one reason patients don’t have their needed dental work done is that no one told them they had a problem.  (More on this latter)

In this, the second part of case acceptance, I would like to cover the goals of case acceptance and why patients say “yes”.

1. Tie the patient to the office.  Every approach works with someone, but our goal is over 90%.  The bond that ties the patient to the office begins far in advance of you actually seeing them.  It’s all about systems.  That first phone call and how they are handled.  Your goal should be for every patient to say that you, your staff, and office is caring, compassionate, convenient, and competent.  What you need to remember is that each of these areas means something different to each patient.  It is not good enough to just have a script or a set of guidelines for all of your patients.  You must hire staff members who are by nature caring, compassionate, and who truly enjoy dealing with people.  You can teach anyone to suck spit or schedule.  Only in this way can you be sure of giving each patient what they need in order to have them refer every one they know.  There are two types of practices.  The Donor Practice — through poor systems and a lack of caring and compassionate staff and Doctor, alienate most of the patients they meet.  The other is the Recipient Practice.  They are the practice down the street that quietly builds a dental empire by treating patients right (giving them what they want, and telling them what they need in a caring, compassionate way).  Both have almost a 100% case acceptance.  Doctor Donor (DD) runs them off so that Doctor Recipient (DR) can complete the case DD diagnosed.  Patients vote with their feet.  If you keep seeing the back of their heads, you are doing something wrong.

2. Never lose a patient.  On first glance, this may seem the same as number one.  Kind of like an office policy manual listing  rules.  There is office rule number 1, with all the other rules saying “if in doubt, go back to rule number one”.  This really is different.  This refers to the personality and systems of the practice that seem to say, “its my way or the highway”.   I know you would never do anything to give the patient this perception.  Remember: Only the patient gets a vote.  There are really two types of personalities when we talk about Doctors.  We have the “Assertive” (which we will abbreviate as ASS).  This is the dentist turned time-share salesman.  They have the tendency to overwhelm the patients and are perceived as pushy and overbearing.  You can tell if this is the case because a lot of your patients want a second opinion, or your CA/NS ratio is higher than 8%.  These patients always want to think about it following an encounter with the ASS doctor.  He becomes the dental stalker.  Constantly following the staff around wanting to know why this or that patient has not scheduled for treatment.  The other side and equally bad is the non-assertive doctor.  They are so non-confrontational that they have difficulty even telling patients that they have anything wrong.  They so want to be liked that they shy away from confronting patients with their needs.  You can tell if you’re in this camp, because patients will feel confused and unclear about the doctor’s findings and treatment recommendations. The bottom line is that we need to be confrontationally balanced in how we present our findings.  You must learn to read the personality type, the patient’s budget, and mirror that in you presentation.

3. Have a no contest approach.  This is not an “I win, you loose” encounter with the patient.  No “my way or the highway”.  You must tell them what they need and happily give them what they want.  Perception is everything and only the patient decides if they feel the trust and bond it takes to allow you to proceed.  I will give you my scripts for this in our next installment.  More than anything else this deals with your state of mind.  You have not lost if the patient decides to only do the extraction or filling initially.   We are looking at the lifetime value of this patient.  Each will proceed at their own pace and budget.  You have to get used to the reality that the patient is in the driver’s seat.  They have the final say.

4. Never be perceived as “Selling”.  Imagine the average practice:  20-30 new patients per month, $20-30K in production, 94% collection rate, 1.5 days per week of hygiene and an overhead of over 70%.  When one of their new patients shows up on the book its “do or die” time — it’s basic survival mode to sell and close on needed treatment.  They need every patient to say “yes”.  When that is the case, we revert to the “justify our fees” scenario with long explanations using technical jargon or we try to “crush sell” the patient using old fashion sales closing techniques.  Remember: If you don’t sell this patient you do not meet overhead.  As a goal, every general practice should strive for 60-70 new patients per month.  Some will be kids (who need very little), some adults (who need little), and some will need more extensive treatment.  In the 30 years I have been practicing, it seems I have to sift for sand (patients) to get the work I need to meet a BHAG (Big Hairy Audacious Goals).  We average 250 new patients a month for a three-doctor office.  About 43% are kids, which will leave about 60 adults for each doctor.  When I do a case presentation I don’t really have to worry if they accept the treatment plan.  I have 7 more new patients that day.  The psychology of this is that patients don’t feel forced into making a hasty decision or feel like I am trying to sell them a used car.  They know I will do what they want first.  I will try to fit it into their budget.  We will work with them to get their mouth healthy and do it at the pace they are comfortable with.

5. Remember that it is always worse than they thought.  If you find anything on examination it will be worse than they thought.  Our systems are designed to constantly revisit the fact that we understand it is worse than they thought.  We will help them with a solution to their problems that they can afford in a time sensitive schedule.  The ADA says:  “Patients cannot afford even a $500 out of pocked expense”.  If this is true, all of your patients will have trouble coming up with even the cost of a crown.  Most of our patients come in for a cleaning having no symptoms — nothing they would consider a problem.  No matter what you find, they were not expecting a single problem.  A caring staff with the right scripts and preemptive measures can go a long way to pushing up your case acceptance.

Take the first two articles along with your Case Acceptance Monitor and start down the road to increasing your acceptance to 100%.  One of the first steps would be to use these articles in a discussion during a staff meeting.  Give them the article prior to the meeting so that each member will have the opportunity to read and understand it.  Fill out the monitor so you can share where you are.  Finally begin the process of setting goals (see form below) in each area of the practice.  Each goal will deal with only case acceptance.  Each staff member needs to understand how he or she interacts with the process.  From phone call, to payment, and eventual referrals from a successful case presentation, there must be an intentional effort made by each staff member to position your office for 100% case acceptance.