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From the Hypnodontist: Reduce no-shows, presuppose attendance

Oct. 15, 2014
The influential language technique of presupposition can reduce the no-shows that leave your chair empty and hurt your bottom line. 
Paper or plastic? We've all been asked this question at the grocery store. What if the only thing you're buying is a loaf of bread and a bag isn't necessary? You can reject the premise of the question and say you don't need a bag. But notice what the question does – it presupposes that you need a bag. Past Hypnodontist columns have included examples of presuppositions to boost the efficacy of anesthesia, increase case acceptance, and improve patient adherence.(1,2,3) This article will explain in greater detail how to use this influential language technique to reduce the no-shows that leave your chair empty and hurt your bottom line. As the paper or plastic question illustrates, presuppositions are an ordinary part of how we speak, and more importantly, how we think. The bag question also shows how a presupposition may be implicit rather than explicit. Presuppositions may be either internal or external. Internal presuppositions are thoughts that may or may not be provably true, but serve as assumptions upon which we draw conclusions. We are typically unaware of these assumptions, and this means we don't always know the basis of every belief we have. When a belief doesn't serve us well, such as "dentists are scary," or "I can't deal with needles," there is likely an unrecognized internal presupposition at work. Hypnotherapy can help. External presuppositions are more relevant for the purpose of this article. In this context, external refers to a premise or context offered by your words so the listener has to respond within that framework. Asking about paper or plastic is an external presupposition.

However, the bag question lies outside the language of ethical influence because it remains possible to reject its premise and simply decline a bag. A review of the recent Hypnodontist articles finds several examples of external presuppositions that will go unnoticed by the patient, making these presuppositions much harder to reject. Let's revisit just one.(2)

“I understand it is important for you to be comfortable. So when you get that crown, would you rather have nitrous oxide or hypno-anesthesia?” "When you get that crown" is an explicit external presupposition. It is likely to slide by without rejection for several reasons.

First, it is placed after a statement that paces and before a question that leads.(3) Second, the question being asked breezes right past the real question of whether the patient is willing to get the crown because getting the crown is already presupposed.

Third, if said with a slight drop in voice tone and a nod of the head, "get that crown" will register as instructions to the subconscious without raising resistance from the conscious mind. As previously noted, this is called an embedded command and will be explained in greater detail in an upcoming column.(3)

Now that you understand how to create and use presuppositions, let's apply this to reducing no-shows. Of course you can get a head start when a patient is in the office and scheduling a subsequent visit, though the more pivotal context is likely to occur when calling to confirm a day or two ahead of the appointment. We'll call these scenarios No. 1 and No. 2, respectively.Scenario No. 1: When finishing an appointment and scheduling the next one: "Mary, I’ve got you all set for (date/time) for your (procedure). When you come in for your appointment, will there be anything preventing you from being right on time?"Scenario No. 2: When calling to confirm tomorrow’s appointment: "Hi Joe, this is Dr. (your name) from (your office) calling because we have a tight schedule tomorrow and we just want to make sure you’ll be on time for your appointment. Would there be any reason why you wouldn’t be able to be on time?" These sentences ask about being on time and presuppose the patient will be there. By providing an easy way out ("Would there be any reason…") the patient has an opportunity to let you address any obstacles or set a different appointment time with plenty of notice. In addition, as discussed in the Hypnodontist article about gaining greater adherence, it is a well-established principle of social influence to get a verbal commitment because people want to stay consistent and therefore will be more likely to show up and be on time.(3)

Dave Berman, C.Ht. trains dental professionals to use the language of ethical influence, practicing hypnodontics and hypnotherapy in the San Diego area. For more information, visit Hypnodontist.com or call 858-876-7930.

1) http://www.dentistryiq.com/articles/2014/07/because-words-matter.html
2) http://www.dentistryiq.com/articles/2014/07/hypnodontist-increasing-case-acceptance.html
3) http://www.dentistryiq.com/articles/2014/09/pace-and-lead-for-greater-case-adherence.html