The Fundamentals of Any Case Presentation
Let’s assume on this 180 Degree Dental Journey, that we take side trips and occasionally run into people and take the time to discuss some topic. As we continue to broaden our look at case presentation, I want to try and abbreviate the conversation and give you a can’t miss foundation to the fundamentals of any case presentation.
We regularly receive questions about case acceptance, indicating that there is a lot of confusion in dentistry about the subject in general. It seems to mean different things to different people. If you attend enough continuing education courses, you never seem to discover a common consensus about how you define or measure it.
In a recent email, a doctor posed 3 questions about case acceptance and how to measure it:
- If the patient says yes at the chair, or in the consultation room, does that mean they have accepted your entire treatment plan?
- Does the patient have to say yes and then pay for all of the treatment for there to be case acceptance? (If they pay as they go would that still be case acceptance?)
- What if the patient starts the treatment but for some reason stops prior to completion of the entire treatment plan?
On this slight detour in the 180 Degree Journey, we are going to answer these questions and give you everything you ever wanted to know about case acceptance. I call it my “can’t miss, shooting dead fish in a barrel with a bazooka strategy to 100% case acceptance”.
So, what is case acceptance? Remember, in any case presentation the bottom line is to “tie the patient to the office”. I consider case acceptance to have occurred when the patient says yes, shows up, pays for treatment, and refers everyone they know.
Let me take a moment and tell you what case acceptance is not. The patient can say “yes” and still not have accepted the case. The only reason they said yes was to get out of the operatory or consultation room (otherwise they would have to listen to the Doctor go on and on and on and on). They had no intention of actually showing up for the appointment. The process of case acceptance starts with the first phone call. Miss any step, mess up once, and you’re done. What if they say yes, show up and change the treatment plan? Instead of a crown and buildup you are faced with doing an extraction. What if they say yes in the treatment room but can’t afford it or you can’t fit it into their budget? They say yes but you’re not open during the hours when they want to come in? They need to come in after work or maybe on Friday or Saturday. As you can see, case acceptance is not a moment in time but a series of systems that “set the stage” and carry the patient through to a successful result. Only if the patient says yes, shows up, pays for treatment, and refers everyone they know do we have true case acceptance. Our patients vote with their feet. If you keep seeing the backs of their heads, something is wrong. The sad truth is that potential patients have all the power in this encounter to spend money and buy services and products from anyone they choose. If you are not getting your share of patients or productivity from people accepting your recommendations, you are doing something wrong. Remember, you cannot get better at giving people something they don’t want. Your systems are precisely designed to give you the results you are currently getting. Poor results mean you are not inspiring your patients with what you have to offer. The solution is doing something different, not doing the same thing and expecting a different result. The average doctor will have a below 60% case acceptance grade. At any level, this is a poor batting average that will lead to high overhead and a practice that just barely makes it.
Where do we start? Let’s look at it from the patient’s point of view. I’m going to show up at your door step in one of two scenarios: I call with a problem (toothache) or I call and want my teeth cleaned. From the perspective of the caller (potential patient) these are the only things I know to ask for. As a dentist, coach, and owner of multiple offices, I feel we need to give the patient more of what he or she wants, and less of what he or she doesn’t want. Remember, you can’t get better at giving patients what they don’t want. If a potential patient calls and you can’t say yes to what they ask for, the first step in the system of successful case acceptance has failed. As the patient, I want my teeth cleaned or I want the problem to go away. We sell “solutions to problems” and “good feelings”. You must happily give them what they want, and tell them what they need. The trick is to help them “want” what they need and fit it into their already tight budget.
How, as dental professionals, do we balance this ethical dilemma with running a consumer driven business? Let’s look at it from the doctor’s point of view. We have conflicting strategies of what the new patient “experience” should look like. It seems that every guru or consultant has a different definition of what “comprehensive dentistry” is and how we should deliver it. How can we determine what to do?
Axiom #1: You, or a team member, must tell the patient what is wrong, what caused it, what will happen if it is not addressed and what you recommend as treatment options.
Axiom #2: You must give the patient what they want in order to have the opportunity to eventually deliver what they need. Vary from these principles and your case acceptance will plummet. These last few sentences form the foundation to excellent case acceptance. Misunderstand their implications and you will ruin any opportunity at success in dentistry. Before you challenge any of the above, remember: If you are not growing you are not meeting your patient’s wants/needs.
Back to the original question from our doctor: There are really four potential outcomes from our case presentation and the patient will say or respond with “Yes” or “No” in four separate areas of contact in your office:
| With Doctor | Financial Secretary | Scheduling Coordinator | Show up for appointment |
| YES | NO | NO | NO |
| YES | YES | NO | NO |
| YES | YES | YES | NO |
| YES | YES | YES | YES |
In each case the patient says “yes” at least once. In the first three situations the patient could not afford it, put off scheduling the appointment, or made the appointment and didn’t show. Only the last scenario is true case acceptance. Remember: You can’t get better at giving patients what they don’t want.
The following form will help you start monitoring your progress in case acceptance. Before you can get better at case acceptance you need to know where you are. Keep very careful records for the next 30 days.
It would be great to begin this monitoring ASAP. You cannot manage what you do not measure.
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.
If you are not having a 90% plus case acceptance you have violated one or all of the above cornerstones to 100% case acceptance. The monkey score is a little over 60% 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 bathe and still get over 60% 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 next week.)
Michael Abernathy, DDS
972.523.4660 cell
[email protected]