Interestingly enough, the strength of your practice systems will ultimately determine the “range” of patients that you can “inspire”. The only limits to your practice growth are those you have consciously or unconsciously imposed on yourself. (Reminder: The bold statements sprinkled throughout each article are Michaelisms.)
I would wager that most of us love little tricks or tips that almost always guarantee a 100% predictable reaction by our patients. Today, I want to zoom in on a little tip that will increase your patient saying yes quotient. As a whole, dentists struggle to get patients to say yes to their treatment plans. The foundational reason is that many of the things we offer do not translate into observable symptoms to a patient: Perio isn’t always noticeable to a layman, cavities have not yet caused pain, cancer rarely has painful symptoms until it’s too late. We have an audience that doesn’t want to be in our offices, they are always surprised when something they put off now needs a crown or more extensive treatment than they expected, and they rarely have the finances to do what they need to do.
Ah, “need” what they need to do is important. Patients will often put off what they “need” because they don’t “want” what we have offered. So, the trick is always approaching case presentation from the onset by understanding that patients can always afford what they want and will always put off what they need. Our job is to try and make sure we turn their needs into wants. This is the truth of great case acceptance. One of the biggest mistakes I see doctors making is assuming that patients want what you have to sell. No matter how much continuing education you take, it will be wasted if you are thinking that your patients will necessarily want these things. It could be anything: sleep apnea, veneers, TMJ occlusal adjustments, clear aligners, etc. Just because you now have this technique in your hip pocket, doesn’t mean patients really want it. Too often, doctors gravitate to these areas because they are burned out on fundamental general dentistry, or they just can’t seem to make a living in dentistry. Their reaction is a new weekend course, or a new shiny piece of equipment that hope will turn their life and practice around. This almost never is the case.
What I would like to do is look at case presentation for a moment, but in reverse. We will take a peek at how to turn the needs into wants when we have a patient that is balking at following through with improving their dental health. I call these “Phantom Pressures”. They come into play when you have done everything right, yet patients still don’t seem to want to own their dental problems. On your side, you need to make sure that you are engaged and intuitive enough to see when a patient is not convinced of their problems. We want to nip this in the bud, and by using these nine simple actions, turn our patients into dedicated fans who will follow through on their treatment plans and refer everyone they know to you.
- Second Opinions: There is nothing more disarming than telling patients they should get a second opinion. Growing up in a small town and returning there to practice created a few interesting challenges for me. I would have patients show up on Fridays and Saturdays who were patients in another, older doctor’s office in town. I would diagnose the problem and explain the why and how much, only to see an expression of incredulity. You have all “been there, done that”. Young doctor seeming overly aggressive in their diagnosis when old Dr. Goodrocks would never find anything of concern. As soon as this would happen, I would print the x-rays and a photo of the tooth and give it to them, and not charge them. I would just say, “you probably remember old Dr. Goodrocks saying he was “keeping an eye” on your tooth”, and they would nod energetically. I would then say, “why don’t you take these x-rays and photos and get a second opinion or see Dr. Goodrocks when he comes back in two weeks from his vacation, and there is no charge today. Just let me know if you would like our help.” I have only had a handful of patients ever decide not to have me do the work after this offer and explanation.
- Reciprocity: Doing something for someone without asking for something in return always elicits the patient wanting to do something for you. We used to have an old diner in our small town where the waitresses would bring you your check and leave a couple of peppermints, which is the perfect example of reciprocity. We tend to want to give back and, in this case, it takes the form of a tip. Olive Garden does this with a mint chocolate candy.
In dentistry it might be giving them a small gift such as a balloon for the kids or a simple key chain; just something small like we do with toothbrushes and floss after a cleaning. The lesson here: Give them the gift first instead of last and magically, your case acceptance will go up. I know it sound hokey, but it works every time.
- Authority: There was a time when dentists dressed like doctors (dress pants, shirt, tie, lab coat, etc.) and patients only referred to them as doctor. In 1999-2021, we moved towards scrubs, masks, and gloves. Today many are more relaxed. I would suggest that we use our title and dress the part. I am as guilty as anyone in encouraging my patients to call me by my first name, but the “authority” that clothing and title can bring is key to case acceptance and culture in your practice. Our patients have built in expectations of what a doctor should look like and act. We should be sensitive to this and exceed their expectations. Hair, facial hair, tattoos, and type of clothing should all reflect excellence in appearance and deed. Don’t discount how this can affect your career.
Along with the arena at work, also consider how you look and act away from the office. As leaders in our office, we should also seek leadership in our schools and cities. Use your built-in respect for our position to encourage others to look to you for wise council in your various areas of influence. Projecting your culture does not end when you leave the office.
- Same day service: Like ourselves, our patients are pressed for time and respect your considerations when we can offer same day service and emergency care as quickly as they can get to our office. With this said, 90% of dentists do same day dentistry all wrong. The key lies in several caveats. You only fit someone in when it will not cause you to run late. You only extend an appointment knowing that it will not challenge your excellence in care or your “on time every time” mantra and commitment to every patient. Don’t do same day dentistry if you do not have the capacity of facility or the time. The team, rather than the dentist should make this decision. They secure the financial commitments, questions about treatment, x-rays, scheduling considerations as well as your current ability to do the same day dentistry in an excellent manner. This should push you to read The Super General Dental Practice book (free at www.supergeneralpractice.com) and the chapter on The Purpose Driven, Doctor Led, Staff Owned Practice. Delegating same day service to your team is a high-level practice strategy.
- Pre-op Phone call. I started this over a decade ago. I called every new patient the day before their appointment. I didn’t tell anyone. They had already been called to confirm the appointment. The reason I did this was to get a step up on my partners. We averaged 17 new patients every day in two offices 2.5 miles apart. I merely called and said: “Hi. This is Dr. Abernathy, and I see that you are coming in to get your teeth cleaned tomorrow at 9. I am just calling to see if there are any questions I could answer for you so we can make your appointment go better for you”? In this day of text and email, this simple call I made set me apart from any other dentist the patient had ever seen. Even though I worked only one day in the newer office and 3 days a week in the older office, 37% of the new patients I called requested to have any work done by me. Keep in mind that this was in spite of the fact that every one of those patients saw another doctor. The ones I saw on my schedule all made an appointment with me for their treatment. Read this again, and assume that this call also eliminates almost every cancellation and no-show for new patient appointments. You can’t afford not to take the time to ensure your patients show up to see that remarkable doctor that took the time to actually call them the day before their appointments. Who does that? I do. It works every time.
- Take a shade on every new patient. My hygienist pulls out her Vita Classic shade guide on every new patient. Without a word she asks them to smile as she selects the patient’s shade. Without a word from the hygienist, the patient always asks what she is doing. The hygienist always responds with the same answer: “Oh, our office does a lot of cosmetic work and the shade is just a starting point for making sure we have a starting color before any whitening procedures, crowns, or white fillings are done”. Remember, without a word from the hygienist, the patient is requesting information on some of our most profitable services. They are hooked. All you have to do is answer their questions. Boom, another happy patient that always shows up, pays for their treatment, and tells every person they know about their remarkable dental office.
- Camera and imaging: We were the first practice in Texas to have the first commercial intraoral camera system: The Sony-Cam. It was on a cart that weighed more than I did. Huge tube and transistor monitor, camera, and a huge color printer. No one had a color printer in their offices for anything back then. There was a problem with it. I couldn’t get my hygienists to use it. They didn’t have enough time, it was too big to move, and too complicated to use. No problem. I just told them I would pay them one dollar for each photo they took on the patient. Like magic, the time space continuum changed, they had the time to get it done. I remember one of my more intelligent hygienists ask: “What if I take two photos? Which I responded; I will pay you $2.00. Not to be caught flat footed, she again asked: “What if I took 10 photos?” Which I responded it would be $10. I was soon paying FedEx to get me more film ASAP. After the first couple of weeks, we doubled our scheduled production, and I quit paying them for the photos and shifted them to a commission pay which is another long story.
People are visual learners. Use your external and internal digital cameras and reap the benefits of a resounding YES to your treatment plans. If we ever have someone who balks at a crown for a cracked tooth, the photo is printed and sent home with them for their spouse to see. It’s almost as if printing, rather than digitally sending it, has some mystical power to whisper to the patient at night and keep popping up in their purse or on their desk like the little elf for kids at Christmas time. It is a flesh and bone reminder that their tooth is a ticking time bomb that will only get worse with time. Again, it works every time.
- Staff Recommendations: A team that lives the culture of the Super General Dental Practice embraces the idea of “Staff Ownership”. They think and act like the practice is theirs. We share the profits with them. We take their counsel when making decisions. They have final say on the doctors I hire and the team we assemble. I owe my success to them in every practice I have owned.
Oddly enough, patients trust your team more than they trust you. Recommendations from them regarding what they feel you will suggest are readily accepted by a patient because they believe that your team has no reason to try and sell them something. They will also feel like they can ask a team member anything without feeling stupid. If done correctly, you can have a complete treatment plan sold before you enter the room. This is another long story that we will need to get to on “staging” the ideal case presentation appointment.
Your team members can build you up in the eyes of every patient before you ever walk into the room. Their attitude and personalities are contagious because our culture is built by their commitment to every patient that sees us. They are committed to serving our patients while delivering services that they are proud of. If you can’t even imagine this, it is time to tip the mirror up and take a long hard look at where you are and where you would like to be. Now is the time to commit to a new culture and brighter financial future.
- Urgency and the hand-off: Every staff member is trained to work hand in hand with the patient to help them want what they need. This takes quality time by a team member that accepts the responsibility of moving the patient along to saying yes to treatment. Everyone is focused on the goal: Serving our patients in a way that helps them say yes, fit their investment into their budget, and have them become a raging fan of our office. Part and parcel to this is the ability of your team and yourself to tie urgency to needed procedures when necessary. Each person in our offices was hired for their high-level people skills and self-motivation. They own the process and truly know that what they do can change people’s lives.
Don’t just read these Michaelisms, embrace their intention. They are designed to transform your practice while eliminating the stress from your life. Just do it. Just do it, now.
Michael Abernathy DDS
[email protected]
972.523.4660 cell