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WHY PATIENTS SAY “NO” TO TREATMENT

This will seem pretty simple but at the same time these well known facts seem to get pushed to the side as dentists throw money at shiny objects and chase misplaced strategies purported to be the next best thing to hit Dentistry by the newest guru on the cover of Dentistry Today. Whether we talk about case acceptance or any other topic, I continue to hear doctors tell me that they need more data or hard facts before they can decide on what to do. It seems that you could park an elephant in front of some doctors and they still could not get themselves to pronounce that this is an actual elephant. So, if it is not facts or data, what keeps our patients and us from making decisions?

  1. Fear: Fear can come in many forms. Certainly, a lot of patients fear the dentist because of pain. This can easily be remedied with Nitrous Oxide, oral sedation and IV sedation along with premeds, profound anesthesia, etc. Yet, most dentists don’t avail themselves of these absolute solutions. There is another form of fear. The fear of making the wrong decision. The fear of buyer’s remorse. Data alone will not diminish this phantom feeling that prevents patients from following through with their treatment.
  2. Cost: Statistically, the average adult patient cannot afford even one $500 out-of-pocket expense. At the fees we demand, they will have to delve in to savings or borrow money. And they sure as heck will want us to be in-network with their insurance company. Affording the dentistry that most patients need is a balancing act between their budget and the expenses that they actually want to spend money on. Cable TV is ten slots higher in value than most patients place on their teeth. Case acceptance is a team effort that requires more than just listing what is wrong. When people have this perspective, they often don’t see the value or the real need in your treatment recommendations.
  3. Time: Time, like cost, is two sided. Most people have other commitments and find it difficult to fit their treatment into a dentist’s narrow work schedule. This is why consumer hours are so important. We have to be convenient in our timing and financial arrangements. The difficulty is that convenience is different for every patient. These grey margins are where we need to become experts. Communication and anticipating what the patients understand, want, and can afford is huge in this regard. We all get the questions: “Can this wait?” Or “Do I really need a crown instead of a filling?”

 
While there is one more item (#4) to add to our list, let me pause to demonstrate human nature. In every office, every day, with a large percentage of our patients, there is a dilemma: They haven’t accepted the fact that there is a problem. In a way, we have presented them with a situation where “they” have this problem because “they” never accepted the responsibility of the care of their teeth. Decay, perio, missing teeth, or cosmetics can all be fixed and have definitive causes that, for the most part, can be prevented and certainly corrected if they don’t wait too long.

  1. Trust: Most of us consider ourselves trustworthy, but every patient has a phantom check list that they hold us up against to rate our performance and trustworthiness. Too often the dentist comes across wanting the dentistry more than the patient does. This is a massive mistake and, once the line is crossed, difficult to fix. The first three items (#1, #2, #3) all involved data and more data, but case acceptance is and always will be an emotional decision. What patients are looking for is a competent, compassionate, caring office, staff and doctor that can give them “certainty”. It is not information that they really want; it is the need to have more certainty about you and your treatment suggestions. Certainty that this is the right choice to make. Once you get to this point of certainty, you will have success with every patient. You will only fall short if you can’t identify what that certainty is.

 
As a dentist and mentor for thousands of doctors and offices, I have seen this play out every day for over 40 years. A chess match with both contestants maneuvering for position on the board. Case acceptance is like a dance. The really successful practices have perfected this. In addition to case acceptance, I find doctors acting much like their patients do when it comes to accepting a diagnosis and acting on “data”. The question I have for you, as we close, is why do doctors say “no” to consulting or coaching? It still comes down to fear, cost, time, trust and the mysterious “other”. Go back through the article and substitute your name for the term “patient”. Consider that you are contemplating making a commitment to take your practice to a new level by hiring a coach. The discussion on why we fail to act still reads the same and defines why doctors turn their backs on a sure thing: A proven, consistent way to assure their future success. The only difference I find is that I can define the “other” portion. I admit that I too have had this feeling, this mysterious “other”. It rises up when I worry about admitting that I have not been able to do it myself. I think of it as sort of an admission of failure, and that’s never easy. Even though I know that I need help, should change my approach, and may even know someone that could help, I don’t reach out. I find that I am often time procrastinating because I need more “certainty”. If you consider Summit Practice Solutions or Michael Abernathy, DDS, you can go back to last week, last year, five years back or three decades ago and listen to recordings of seminars, read articles, track reviews, or talk to hundreds if not thousands of doctors. What more certainty could you possibly need? If you have been stumbling around avoiding commitment because of certainty, call me and let’s talk. There is always a way to have the practice you always wanted. This is how you Summit.

Michael Abernathy, DDS
[email protected]
972.523.4660 cell