Getting a “YES” in Case Acceptance While Eliminating the Things We Do Wrong
Just like bad drivers, we tend to develop habits that tend to decrease the results in our driving. This 180 Degree Dental Journey is all about mastering the basics. Let’s take a look at few of the things I see offices do wrong.
They never clean teeth on the first appointment: This is a sure-fire way to ensure patients not referring, not following through on treatment, and getting poor reviews online, as well as poor case acceptance. Remember that most patients without any felt dental issues, always request an appointment to get their teeth cleaned. Great start to this new relationship. Of course, we are not talking about someone needing periodontal treatment. Remember to give them more of what they want and less of what they do not want if you desire to grow.
Having the dentist see the patient first and do the exam and diagnosis: This could be number one in the reasons people don’t say yes. You need your hygienist or assistant to find out what the problem is, what they want, what their dental IQ is, and what their budget is. This is an excellent example of “staff ownership” and your opportunity to partner with your team while improving the overall results in case acceptance.
Too formal of a presentation: We’ve said it before, and we’ll say it again: The office with the highest case acceptance is the one with no “formal” case presentation. We sell “good feelings” and “solutions to problems”. It will be an “emotional” decision, not a “logical” one. Your patients want something that looks good, feels good and lasts a long time. Give them this and they will never leave. I keep seeing practices confusing what “core” is in a dental practice. Figure it out and stick with it. Everything else is just fluff. Let your clients define core and give it to them. It’s always been cost, convenience, control, comfort and compassion. These five “C” words define your culture.
Too many treatment options: It is called the Paradox of Choice. Patient Paralysis always occurs when given too many choices. Their expectations go up with more choices which is not good. Eliminating choices decreases anxiety for patients.
Thinking that patients want what you have to sell: In the order of importance, this is the number 2 most common reason patients never say yes or come back. You have become a “hammer and nail” clinician. You see every patient needing whatever you learned (or spent too much money on) at the last course you went to. Everything looks like an implant, sleep apnea, TMJ dysfunction, occlusal adjustment, ortho, Botox, etc. You get the idea. Listen to the patient and then decide.
Too many appointments to get it done: The patients want a “low stress” way to meet you and find out what’s wrong. Make it easy for them to say yes. What does the patient want? Get competent in what you want to do. Competence breeds confidence. Time is, and will always be, a foundational reason patients either say yes or pass on your diagnosis. They, and consequently you, need to fit the treatment time into the patient’s schedule. Don’t draw it out. Do as much dentistry as time and clinical judgement will allow.
Too much presented: Many doctors tend to overwhelm the patient if you do not present dentistry in a certain way. This is especially common in overly assertive doctors. Staging every step of case presentation is the key to success. Waiting until the doctor comes in before the patient finds out it was “worse than they thought” will kill case acceptance every time. Go back and re-read each step. It is the staff’s responsibility to help the patient own the problem, realize it is worse than they thought, and find out what they want in order to let the patient decide how quickly they proceed. Your team is the missing link in 100% case acceptance. They are key in helping the patient want what they need.
Failing to use staff to close and explain treatment and determine patient’s budget: Your staff must qualify, educate, and create trust. The staff is the most important element in case acceptance. They supply the caring, convenient, sensitive element in the relationship.
Too many technical terms: Stop justifying your fees by talking “doctor talk”.
You and your team need to communicate, not pontificate.
You don’t use a balanced approach: Staff must realize that if your patients come to the front confused your doctor is too “non-assertive”. If your patients come to the front wanting a second opinion or just crying, your doctor is “too assertive”. You can’t confuse your patients. Give them what they want and tell them what they need. You assertive doctors need to remember this: the moment you want the treatment more than the patient wants the treatment; you have crossed the line. Don’t look needy or desperate. “Selling” in the traditional sense, makes you look both needy and desperate.
Not being on time every time: It’s like putting a billboard outside saying you don’t care. There is a double standard here, and there shouldn’t be. You expect your patients to be on time but you never are. It shows a lack of respect and caring. Being on time creates trust. It also enhances patient referrals. No one wants to refer a friend knowing that the friend will have to wait.
You don’t know how to bundle treatment and dollar amount: You could be charging the least amount in town per procedure and still be considered the most expensive doctor. How you present treatment says far more than the actual cost. Give them what they want and tell them what they need. Preempt any diagnosis with the permission statement. It lets the patient feel in control. It lets them feel like they can decide when and how fast you go. Any other way makes it seem it’s your way or the highway. People vote with their feet. If you keep seeing the backs of people’s heads, you are doing it wrong.
We all have bad days: There is always an exception to the rule. Sometimes things just don’t work out the way we planned. Let me give you a few bonus ideas that seem to create phantom pressure to help patients say yes.
Second opinions: If you feel or your staff feels you are about to overwhelm a new patient, consider offering a second opinion. There have been times when, despite my best efforts and those of the staff, we felt the patient just didn’t trust us or were not buying into what we were telling them. They just didn’t own the problem. In such a case, I have said: “Mrs. Jones, you don’t know me from Adam. I want you to be sure you are making the right decision on what to do and how quickly you proceed.” I turn to the staff person helping me and ask her to make a copy of the FMX and give it to the patient so that they might get a second opinion. This is often enough to insure they don’t go anywhere else. It says we care and have nothing to hide.
Reciprocity: Robert Cialdini in his classic book on persuasion says that giving someone something prior to asking the person for an action increases the positive response 300%. We all give our patients toothbrushes, fluoride, bleaching gel, etc. A great way to help your patients open up to your suggestions is to give them a gift coming into the appointment instead of after. Many of our clients have used this strategy for high end patients to trigger reciprocity.
Authority: We started wearing scrubs 35 years ago in response to the publicity about sterilization in dental offices. Prior to this we all wore ties, dress shirt and lab coat. It is time to go back and recapture the authority afforded us by the way we dress. Robert Cialdini demonstrates that this will increase our ability to sell dentistry. He also said we should let our patients call us “doctor”. I’m really bad about insisting that my patients call me Mike. It is a mistake. It lowers our ability to make recommendations that the patient accepts.
Same day service: With the holes I see in many of your schedules, just offering same day service will make a huge difference. Just ask: “Mrs. Jones, would you like to get this done today?” (NOTE: For the financial impact of this strategy in your practice, see the accompanying chart — One More Per Day).
Pre-op phone calls. These are like magic. The doctor must make the call. He or she calls the day before and just introduces him or herself and asks if there is any question he/she can answer or anything he/she can do to make their visit more pleasant. As many of you know, I had three partners in my original practice. I stumbled onto this system in order to get more new patients to ask for the old guy. It worked every time. It was almost as if the patient had already met me. They always requested that I do the check and it always seemed to help them say yes to proposed treatment. You will also find that every patient will comment that they have never had a doctor do this before. (Of course, you still need to make a post-op call, too).
Urgency and the hand-off: Following any check or consultation you must tie urgency to the treatment. I have just confirmed to a hygiene patient that they need a crown on an upper molar. (You’ll notice I said confirmed, not diagnosed. The hygienist or dental assistant has already discussed the crown, taken an intra-oral photo and x-ray, talked to the patient about crowns, and given them literature about the procedure. They were also given the time to ask questions and have a one-on-one discussion with this staff person about when, where, how and why. In this way when I enter to talk to the patient, everything is done). I then turn to Vickie and say “Vickie you make sure you get Mrs. Jones in ASAP. You tell Kathy (the front desk scheduler) to get her in today or tomorrow even if she has to move some one”. I turn to Mrs. Jones and say goodbye. Vickie takes Mrs. Jones to the front desk and hands her off to Kathy by saying: “Mrs. Jones needs a crown on tooth number three. Dr. Abernathy said: Whatever you do get her in here today or tomorrow even if you have to move someone”. (Note: No one was ever moved because we already knew that there was an opening tomorrow.) Each person ties urgency and hands off the patient to the next person. All of this is done by talking over the patient so she now has 3-4 staff that she will have to disappoint by not going thru with treatment and coming in ASAP.
Shade every tooth: Every tooth should be shaded at the first appointment. Just take the guide and hold it up to the patient’s mouth without any comment. The patient will ask what you are doing and it opens the door to a cosmetic discussion.
Camera and imaging: Every patient should have the opportunity to have an intra-oral camera image made. We have cameras in every operatory. The only thing that has changed in the last few years is that we have used Macro lenses on digital cameras to take before and after images. These extra-oral photos really seem to work better than a tooth-by-tooth intra-oral imaging. The intra-oral photos have been more or less relegated to insurance documentation.
www.scentair.com. This company shows that buying will increase with the correct scent in your offices. Eugenol and oil of clove should never be in your offices. At worst our offices should have no smell. The use of electric hand pieces also removes a barrier by removing the “drill” sound from your offices.
Staff recommendations: It is your staff’s job to build up your image in the minds of the patients. Everything they say and do reflect the image and branding of your office. Get your staff to use every opportunity to make you a super star in front of your patients.
Don’t forget to share this with every staff member. Then have a staff meeting on what you could improve. Continue to monitor your progress. Let us know how well you are doing.
Michael Abernathy, DDS
PS. I added this table below one more time. It is a reminder that one more or one less can make or break your profitability. The increase in profit by doing just more of each of these procedures each day equals more than the average practice would have in total profit for a year.
ONE MORE PER DAY
|Procedure||Fees||# Days||ADDED $$|
ONE LESS PER DAY
|Procedure||Fees||# Days||LOST $$|