Case acceptance tips

March 1, 2004
Two dentists share the secrets behind their smiles

Two dentists share the secrets behind their smiles

By Kevin Winters, DDS

During the past year I have been able to cover many clinical situations and show how to approach them with the latest techniques and most current materials. The responses I've received from many readers have been supportive.

I've received many e-mails and talked to doctors who have read my articles. One question has been asked repeatedly: "How are you able to get these cases accepted by your patients?" After all, I work in a small, poor rural town in Oklahoma. This is not the place you'd expect to see a thriving practice based solely on adhesive, cosmetic, and restorative dentistry.

Well, instead of giving you my own viewpoints on case acceptance, I thought I would seek the answers from two up-and-coming stars in our profession. Drs. Matt Bynum of Simpsonville, S.C., and Art Mowery of Gainesville, Fla., will answer how they achieve case acceptance in their practices.

Drs. Bynum, Mowery, and I have formed the BMW Lecture Series, in which the focus is to practice success in utilizing concepts to motivate team members to accomplish great things.

Let's ask Drs. Bynum and Mowery some questions to see how they have positioned their practices to achieve extreme success.

Dr. Winters: How do you incorporate technology and equipment advances in your practices to help you sell esthetic cases?

Dr. Mowery: We use a structured system during the new-patient experience. We take digital pictures of all our new clients — smiles, occlusals, and headshots. We print copies of all images for him or her. The occlusal shots are key since they give us opportunities to show and discuss conditions of the whole mouth. We have become less dependent upon our intraoral cameras since they were intended for single-tooth presentation. Having the whole office networked makes this much easier. We also use patient-education systems such as CAESY to demonstrate recommended procedures. People respond best to what they can see, so anything visual is of value.

Dr. Bynum: I incorporate technology and equipment advances in every patient visit. From the time patients walk in the door, they are visually stimulated with what is new and technologically innovative; from the radio headsets my team and I use to communicate around the office, to the 42-inch plasma screens in every operatory and consultation room, to the digital "wireless" radiography we use clinically. Every room is equipped with computer and flat-screen monitors for patient convenience and easy checkout. Esthetic cases demand modernization in technique and material. Because of the patient's perception of technology and modernization, the selling of the cases is virtually free of discussion.

Dr. Winters: How do you incorporate new materials and techniques to help you sell esthetic cases?

Dr. Mowery: We use new materials to enhance the quality of our work and service. We let our patients know about these new technologies we have incorporated. Your patients do not know the difference between the various products, so we tell them not in a technical way, but like this: "Mrs. Jones, the impression we are going to take will be much easier than what you have experienced in the past. This new material tastes good and hardens in a third of the time. Like everything in our office, the technology we use is the latest to make you as comfortable as possible." The point is to let your patients know the extra steps you have taken to enhance the process. It increases confidence, thus improving case acceptance.

Dr. Bynum: I incorporate new materials and techniques mainly in the description or discussion of esthetic dentistry. Take, for instance, the comparison of bonding vs. porcelain, or tissue recontouring with the laser. Most people are not interested in materials or technique, and seldom do I get questions regarding these topics. I always assure patients that the materials we use and will be using are state-of-the-art, and that the techniques are progressive and proven. The only real barrier I can think of when discussing esthetic dentistry is the comparison of what patients call bonding vs. porcelain. In this situation I use the material to my advantage. With bonding there is a need to have the material revitalized and often repaired. With modern porcelains, that need is eliminated. There is no staining, dulling, or wear like there is with bonding.

Dr. Winters: What do you consider to be the most influential aspect of gaining case acceptance?

Dr. Mowery: While image is important, I think the team (staff) has the most influence over case acceptance. Team members spend most of the time with patients and are trusted more than doctors. It is powerful when team members have complete confidence in their doctor. Everyone needs to know their patients and their needs. We practice the "seven-minute rule," spending the first seven minutes talking with patients about something other than dentistry. Find a common thread. People like people like them, people trust people like them, and people buy from people they trust.

Dr. Bynum: I think it's the entire package. Starting with the appearance of the office outside to the appearance inside. It is the way your team handles the initial phone call and handles the patient in the practice. It is the image you create and the work you perform. The technology is an awe-inspiring decision-maker for case acceptance, but overall I think it is the package that makes a patient want treatment, as opposed to needing it.

Dr. Winters: Why do you think so many of our colleagues are stuck in the "drill, fill, and bill" mentality when there is so much continuing education available?

Dr. Mowery: Most just don't know any better. The dominant paradigm is one of insurance dependence, which is the antithesis of comprehensive high quality. When insurance companies dictate fees and treatment options, the doctor is frustrated and suffers since he or she must increase the number of patients. Then patients suffer since they don't get the benefit of the latest technologies and quality because the practice can't afford it. Unfortunately, most don't take advantage of continuing-education courses that assist doctors in high-quality, fee-for-service dentistry.

Dr. Bynum: I think dentists do not want to invest in their educations any further. Their attitude is that they graduated from dental school and might go to a few continuing-education courses every year, but all in all they don't want to spend the money. I look at continuing education as what it truly is — continuing education. I wish the profession would open the constraints dentists place on each other so the profession can move forward without prejudice. The other point I would make is that most dentists do not like change. Change is good. Change is inevitable. Learning about something else that may help your patients, your family, or you enjoy dentistry and be a better dentist is worth any bit of money there is.

Dr. Winters: Why do so many practices struggle to do even one cosmetic case while others do them daily?

Dr. Mowery: I think this is simple and comes down to two factors. One is doctor and staff training. Do the doctor and team have confidence they can live up to their clients' expectations? If the doctor and team have advanced training, let the patients know. It is hard to enthusiastically recommend something you don't know how to do well. Two, we ask. Every patient who enters our office is given recommendations to enhance his or her smile. I see numerous patients who are happy with their current dentists, but they enter our office seeking cosmetic solutions. When I ask why their dentists are not doing the work for them, the response is, "My dentist doesn't do cosmetics." The reality is that their dentists don't ask or talk to patients about anything to enhance their smiles.

Dr. Bynum: This is a loaded question. There are so many factors that play into this that we do not have enough time to get into it right now. Again, I think it is the overall feel a patient gets when he or she initiates contact with your office. That is where it starts. From there, any one thing can go wrong and often does. Overanalyzing the patients and what they want vs. what they need continues to be a constant in every conversation I have with other dentists. For me, it's simple — give the people what they want. Sometimes you need to be skilled at verbal communication and ambiance in order to allow people to free their minds and accept what they want.

Dr. Winters: You have invested a lot of money to learn more about dentistry since your graduation. Why did you decide to do this, and what has been the value to you?

Dr. Mowery: I recognized early that I didn't like the influence of insurance in dentistry. I then sought out courses in cosmetics so I could minimize my dependence on insurance companies. There is a direct correlation between the amount of continuing education and a successful dental practice. I have attended courses at institutes around the country, but most of my training has been at the Las Vegas Institute for Advanced Dental Studies. The benefits have been immeasurable. Dentistry truly is my passion. I love what I do. There is so much more to dentistry than just fixing cavities. We really do have the opportunity to change lives. When you are passionate about what you do, you can't help but enjoy it and be successful.

Dr. Bynum: I acknowledged early on that dental school was just a beginning. It taught me the basics to go out and perform dentistry. I wanted to be the best at what I do. I needed more skill, and I needed more information. I needed it clinically but, most importantly, I needed skills in business. That is not taught in school. I wanted to increase my awareness and knowledge of everything I could. The value to me is that I have an incredible practice that is both profitable and fun. I offer treatment centered on patient comfort and desire and that has the capability to change lives. I chose to learn at the Las Vegas Institute for Advanced Dental Studies. This level of education has been so fulfilling for me and for my patients that there can be no mere monetary value placed on it.

Dr. Winters: What is the best advice for a dentist who might feel things are going fairly well, but he or she is killing himself or herself to get this far?

Dr. Mowery: Learn from those who are doing it. There is no need to reinvent the wheel. Sit down and figure out what isn't working and change it. One thing I recognize is that the most successful practices are always changing. They are constantly updating their materials and techniques. They invest in the continuing educations of themselves and their teams.

Dr. Bynum: First, I would have them evaluate what they are in search of. From there, trace the steps that lead to the goal and objective, and do not waiver from the path. If you are killing yourself and are "doing well," wouldn't it be so much better to enjoy yourself and "do great?" Find your passion and make happen what you want to happen. Latch on to those who have what you want, and learn from them. There are so many ways to practice dentistry today that it has to be overwhelming to dentists and patients. Find out what you want and go for it.

Dr. Winters: What would be one simple change that any dentist could employ that would make a noticeable, quick improvement in the bottom line of his or her practice?

Dr. Mowery: One quick thing to make the whole office happier? Dismiss your five biggest pain-in-the-butt patients. What we do is stressful enough without the added burden of unappreciative people. To improve your bottom line quickly, raise your fees. Fees reflect the quality of what you think your services are worth. You can't make everyone happy, so don't beat yourself up trying.

Dr. Bynum: Come out to Las Vegas and learn what is available at LVI. This is the single most influential thing I have done in my career, and I stand by that to this day. Invest in yourself, and the skill and knowledge you acquire will be followed with reward.

Author's Note: I thank Drs. Bynum and Mowery for their insights. It is readily seen why they have practices most of us can only dream of. I am fortunate to have teamed with them in forming a seminar on case acceptance and practice separation, Achieving Extreme Success. Call LVI at (888) LVI-FADS for course information.

Dr. Kevin Winters graduated from the University of Missouri-Kansas City in 1989. After completing a GPR at the University of Louisville-Humana Hospital, he opened a general practice in Claremore, Okla. After developing a successful general practice and being awarded the Young Dentist of the Year award in 1995, Dr. Winters transitioned his general practice to one that concentrates on esthetics and reconstruction. Dr. Winters is one of the original clinical instructors at the Las Vegas Institute. He also lectures and conducts seminars across the nation. Dr. Winters may be reached at (918) 341-4403 or by e-mail at [email protected].