December 1, 2002
by Cathy Jameson, Ph.D.
You are care providers. You are commissioned to provide dental services that address the physical needs of your patients. But today we understand more about the need for the total care of people. Total care means addressing not only the physical needs of a person but also the emotional or psychological needs of that person.
As healthcare providers, you address the issue of emotional and psychological health through smile enhancement and physical health through restorative treatment.
Some people are uncomfortable asking questions about smile enhancement because of their embarrassment about their smile. You, as dental educators and as total care providers, can offer a tremendous relief to these people by (1) asking questions that open lines of communication about the person’s attitude toward their smile and by (2) informing them of the options available today for smile enhancement.
The presentation of treatment recommendations is your opportunity as dental educators to inform patients about the benefits of specific dental treatments. Each person on the team has specific responsibilities. The carrying out of these responsibilities with precision and attention is critical for success.
Your case presentation presents you with the challenge of educating and motivating a person. It also presents you with the challenge of identifying and overcoming objections and barriers. The purpose of the consultation is to make it possible for a patient to go ahead with the dental treatment. There are six steps involved in a successful case presentation. Those six steps are:
* Build the relationship
* Establish the need
* Educate and motivate
* Ask for a commitment
* Make a financial arrangement
* Schedule the appointment
Build the Relationship
The first step in case presentation is to build the relationship. Businesses tell us that a relationship of confidence and trust must first be established before a person will purchase your product or service. Most of your new clients–in fact, approximately 70% of those new clients–will come to you as a personal referral. When a person comes to you in this manner, a certain level of trust and confidence already exists. However, it doesn’t matter who referred a person to the practice, if you don’t make a conscientious effort to provide extraordinary customer service to each and every patient–every time they come to the practice–they will leave you and go somewhere else. Each person on the team has a “moment of truth” in which a relationship can be made or broken. Each person on the team must understand that and accept the responsibility that goes along with it.
In dentistry, usually, the first person to make contact with a potential client/patient is the person answering the telephone. The telephone is often considered the most important practice-building tool in the dental practice. A person calling your office may make their decision about scheduling that appointment by the treatment they receive on the telephone. The person answering the telephone needs to be enthusiastic, warm, knowledgeable, and must concentrate when answering that telephone.
The initial telephone contact is your first opportunity to encourage a person to become involved with your practice, and it is your first opportunity to “listen” to a person. Listening gives you a chance to determine what a person’s particular wants and needs may be.
Each person who speaks on the telephone must know that at that moment, they are the personality of the practice. That person will have about 30 seconds to “sell” the potential patient on the idea of coming to the office. This initial contact is critical!! This initial greeting can give the caller a sense of your own enthusiasm about your level of care and about your pride in your work.
If a person asks questions about the dentistry you offer in your practice, be able to answer those questions–briefly and in layman’s language. Write “30 second” scripts about the main options you offer. Also write brief scripts you can use to deal with potential objections or barriers. The people who make the best presentations and who have the most success in encouraging people to “go ahead” are those who plan ahead and can overcome “known” barriers and objections. Marketing experts say that poor telephone skills are one of the main reasons a person does not schedule an appointment with you or cancels an appointment once it is made.
Do not underestimate the power of the initial telephone call. The telephone may be the most important marketing tool you have in your office.
I recommend the sending of a ‘Welcome Packet’ to that new patient prior to their appointment. Carefully and caringly, prepare a set of data that encourages a patient to come to the office and to do so with a positive mindset. In other words, make sure this set of data is not a nagging, instructive set of information, but rather a “sales” piece. Your goal is to continue to develop a relationship with this person–a bond.
The relationship is further developed by the reception received upon entering the office. The person who is greeting the patients should stop what they are doing, stand up and make a conscious effort to greet the patient by name. An introduction is desirable. Use the same etiquette that you use in your home in the dental office.
In most instances, the next person a patient meets is the clinical assistant. I encourage the clinical assistant to address the person in this way:
“Ms. Jones, I’m Donna Smith. I’m Dr. Jameson’s clinical assistant, and I’ll be working with you today. You may come with me.”
Then the clinical assistant escorts the person to the consultation or clinical area and (1) reviews the health history, (2) makes sure that it is complete, (3) asks pertinent questions, (4) opens the door for communication and discussion about perceived needs, (5) makes sure that the referral source is noted and (6) listens.
Upon the entrance of the doctor, the clinical assistant would introduce the doctor. If for some reason the clinical assistant is not in the room, then the doctor introduces him or herself. The doctor can note on the patient information sheet some points of common ground upon which to begin establishing a rapport with the person.
On your patient information sheet, have questions that the person can answer about their attitude toward their dental health or the appearance of their smile. (If your patient information sheet does not have appropriate questions about cosmetic dentistry, redo the form, or create a specific questionnaire.) Make sure that you respond to the patient’s comments. These questions can open doors for you and for the patient. But they are useless if you don’t respond to their answers.
Now, begin the initial interview. This initial interview and the following comprehensive oral evaluation are essential for establishing a level of trust with a person. Confidence and trust must exist for extensive, “personal”, restorative or cosmetic treatment to be accepted. The oral cavity is an intimate zone of the body. The person receiving the treatment needs and deserves a sense of security.
During your initial interview, ask questions about their responses to the questionnaire. Ask open-ended questions that give a person an opportunity to share their true feelings. You must ask these questions sincerely–and then you must sincerely listen! Know that during this initial appointment or the new patient experience, your goal is to establish not only the clinical needs, but also the “felt” needs. Even though we have talked about establishing “felt” needs forever in dentistry, this continues to need attention and work.
Listening to Establish the Need
Listening is, truly, an art form!! Of the four things we do with language–reading, writing, speaking, and listening–listening is perhaps the most needed and is, also, the least studied and least mastered. Listening to a person when you ask them how they feel about their mouth, their teeth, and their smile is the key to discovering their innermost thoughts and feelings. According to John Christensen of Crisad, Inc., since the mid- 90’s, people have said that one of the most important things to them regarding their dentist is his/her willingness to listen.
David Satcher, M.D., Ph.D., the Surgeon General of the United States, in his 1998 commencement address at the University of Oklahoma College of Medicine, congratulated the new graduates for having received some of the best clinical training available. And then, he commissioned the new doctors to concentrate on one of the most important aspects of patient care–communication, in particular, listening.
Establishing the Need
Critical to careful and caring listening is that you do not impose your own values on the person responding to your questions. As difficult as it may be at times, you must listen and accept a person’s feelings–even if they differ from your own.
Stop and think about the significance of this. Do you have patients who would go ahead with treatment if they felt that you listened to them? If you educated them about the available options? If they had confidence in your technical abilities? If you epitomized a sincere caring for their own unique feelings and attitudes? Asking pertinent questions and listening CAN open doors for possibilities for both a client/patient and for you.
Many people have negative feelings about their teeth or their smile. If this is the case, they may be uncomfortable expressing these negative feelings. You do them a tremendous service by opening the door–by asking sincerely caring questions–and then getting out of the way and letting the person express themselves without judgment or value imposition. Ask questions and listen! Listen with honest attention. Then, together with the person, discuss possible solutions to their problem.
* Learn how to ask questions and then listen to patient’s desires.
* Be accepting of the differences expressed by each individual.
* Determine a person’s “perceived need”.
* Be ready to meet needs.
Once you have determined a person’s “felt” need, the clinical evaluation takes place and all necessary data is gathered. At this point, if a significant amount of dentistry is needed or desired, invite the patient back for a consultation. Let the patient know that you need time to evaluate the data and to develop a treatment plan. Then, schedule the patient back for a consultation appointment.
Educate and Motivate
Once you have established the need for the necessary and desired dentistry, the next step is to EDUCATE and MOTIVATE the patient. You are an educator of dentistry. People don’t come to the dental office with very much dental knowledge. In fact, the #1 reason people don’t come to the dentist or do not say “yes” to the recommended treatment is “no perceived need or a lack of dental education”.
Education–or motivation–is ongoing but is most critical at the time of the consultation. Approximately 83% of a person’s education or learning takes place visually. Understanding that this is the main mode of learning for most people, it makes sense to access excellent visual aids to show a person the end results and the benefits of the treatment that you are recommending. Keep the technical aspects simple.
Do not go into incredible detail on the dental technique itself. Technical jargon can be confusing, and a confused person cannot make a decision. Let the person know what the end results and the benefits are going to be. That is really what matters to them. Adult attention span in the consultation environment is about 17 minutes. If you go much longer than this, you lose the person. Make it short, sweet, and to the point. Show them:
What’s going on in their mouths now?
What you recommend they do to restore the mouth to health again or to change the smile.
Benefits of the treatment.
Risks involved (if any) if they choose not to proceed.
Involve the person in the decision making process. The more a person is involved, the better they will understand your recommendations. Access excellent visual aids, such as beautiful ‘before and after’ photographs, intra-oral camera photographs, or patient education programs. This will allow a person to visualize what you are explaining. Develop your own photo album or intra-oral camera library. This will let people see the features of what you are recommending, the benefits of the treatment, and the evidence that you can create the proposed results.
Suggested ways to use an intra-oral camera system effectively are as follows:
Include a “tour of the mouth” with the intra-oral camera in each new patient experience. Store the images, if possible, so you can review them while you are designing your treatment plan.
Retrieve the images during consultation, and use them to show the patient what is going on in his/her mouth at the present time. Then show them some similar situations, and let them see the results of treatment you have provided.
Ask questions during your new patient experience and during your consultation to encourage involvement in the treatment decision. If, the patient is actively involved with the decision making process, they will be more likely to agree with treatment.
Use the photographs of your desired end result as a way to communicate with your ceramic specialist. You would have a visual prescription rather than a written prescription.
Asking for the Commitment
The fourth step in the case presentation is ASKING FOR THE COMMITMENT. You must ask for a commitment, or you will have a lot of people walking out the door, and you won’t know if they are going ahead with treatment or not. Another reason that you need to ask for a commitment is to determine barriers or objections. Then, and only then, will you have a chance to overcome these barriers.
An example of an “asking for a commitment” question might be as follows:
Dr.: “Ms. Jones, do you have any questions about the treatment I am recommending for you?”
Ms. Jones: “No, I’m pretty clear on what we need to do.”
Dr: “Then do you see any reason why we shouldn’t go ahead and schedule an appointment to begin?”
Ms. Jones: “Well, no I guess not.”
Dr.: “Okay, then I am going to have Judy, my business administrator, discuss the investment you will be making, and she will schedule your first appointment. I will look forward to working with you to get that beautiful new smile.”
Once all questions have been answered, and the person indicates that they would like to go ahead with treatment, then the business administrator makes financial arrangements and schedules the appointment. There is no exception to this rule: Financial arrangements are made before the scheduling of the appointment.
Again, here are the Six Steps of case presentation:
* Build the relationship
* Establish the need.
* Educate and Motivate
* Ask for a commitment
* Make financial arrangements
* Schedule an appointment
If you follow this effective six-step process of case presentation, you will find that your acceptance rate will increase. Build the relationship to help the person feel involved in the case presentation. You involve a person in case presentation by asking questions and finding out what he/she wants or needs and by responding. Use visual aids so they can see the end results and the benefits of the treatment. And, again, ask for the commitment.
The day of telling a person what they need and having them immediately accept has come to an end. The informed patient of today wants to participate in treatment planning and decision-making. Each person on the team plays a significant part in making an effective presentation. DPM
Cathy Jameson is president of Jameson Management, Inc., an international dental lecture and consulting firm. She holds a Ph.D. in organizational psychology.