Th Patient A

Family members ... the cosmetic dentistry case-killers

Jan. 1, 2005
Through the years, I have presented thousands of dollars of dentistry to help improve the health and beauty of my patients’ mouths.

By Kevin Winters, DDS

Through the years, I have presented thousands of dollars of dentistry to help improve the health and beauty of my patients’ mouths. Fortunately, the majority of it has been accepted, many people have been able to smile more confidently, and I have been able to make a very good living.

But there has always been a group of people who have tried to rain on my parade. These people usually have never met me. They have never been in my office or met my team. They have never seen pictures of cases I have done. Apparently, many times, they feel they actually know more about dentistry than I do.

These people decide what should be done based almost entirely on money. They make dentistry a commodity. After all, a veneer is a veneer and a crown is just a crown. Many times they do not even want to hear about potential dental changes. All they hear is that it’s going to cost them money.

What they fail to realize is the effect that improving dental health or improving a smile can have. Just because they may feel good about their own smiles, or they don’t even care about their own smiles, this group of people fail to see the importance of others who may not feel this way.

So, who are these people who continue to be a thorn in my side? Husbands! We have all been haunted by the husbands who will not take the time to come to the office to hear about the treatment their wives may desire. Doesn’t it drive you crazy when you’ve prepared a great treatment plan and your team has completed a wonderful case presentation only to hear the dreaded words, “I’ll have to talk about this with my husband.” Husbands drive me crazy!

Let’s take a look at this dynamic a little closer. I’m going to tell you about four ladies who came into my practice this month.

Patient A is a lady who came to the office wanting to improve her smile. She had had her existing porcelain-to-metal crowns for more than 30 years. She is a very attractive lady who cares for her appearance. She dresses nicely and has her hair done, manicures, etc. After all of the years of being unhappy with her smile, she finely decided this was something she really wanted to do for herself. She had spent her life providing for her family and husband, putting herself and her desires on the shelf.

Patient A
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Finally, it was her turn. She came into the office and, after talking about her desires, we did a complete exam, took models and photos, and asked that she come back for a consultation. As we always do, we encouraged her to bring her spouse with her.

This is a very important point. When the financial decision-maker is not the patient, it becomes very difficult to engage him or her into the emotion of the decision. Typically, spouses go home and try to communicate what the dental office has told them. It usually comes out much different than when it was presented. However, without fail, the one thing that gets presented very clearly is the fee.

This creates our biggest problem - there is no emotional connection to the service. It comes down to only money instead of the impact of how the wife will feel about herself.

One thing that can improve our odds of success in treatment acceptance is getting the decision-maker to attend the consultation. When the husband gets involved in the consultation, sees the up-close pictures of the teeth and smile, visualizes what the improvements can be by seeing pictures of similar cases, your acceptance rate will increase dramatically.

We encouraged Patient A to bring her husband to the consultation appointment. When the time came, he did not accompany her. Apparently he “did not have time” - or was it he didn’t want to take the time? What I have found is that husbands often choose not to participate. They either feel it is not important or they have already made up their minds and do not want to hear anymore because it might cost them some money.

In Patient A’s case, my team member went through the presentation in perfect fashion. She walked the patient through a PowerPoint presentation of exactly what we saw in her mouth. She saw pictures of similar cases and saw testimonials of others who had already gone through what she was contemplating. This was done with great energy and enthusiasm.

Needless to say, Patient A was sold and ready to go. She scheduled her next appointment to pay and go over final details of her smile design.

A couple of days later, she called back to cancel the appointment. She was canceling the one thing that she wanted more than anything at this point in her life. My treatment coordinator began to ask questions to find out what the objections were. Well, as you might expect, the problem was her husband. He felt her teeth looked fine. He thought she had a great smile.

That is great for their relationship, but he totally missed the point. As she told us she was not going to be able to improve her smile, she was crying. “As badly as I want to do this, I can’t. My husband just doesn’t think I need it.” My treatment coordinator immediately encouraged her to have him come to the office so we could talk to him and show him the wonderful improvements that could be made and how happy his wife would be. Knowing her husband, she told us he would not come. There goes another case down the drain, thanks to a husband.

Our next patient, Patient B, was very similar to Patient A. Old, cracked porcelain-to-metal crowns had become very unsightly. Recession and the dark roots added to the look of the old crowns. Overall, she just had a very unattractive smile.

Patient B
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Once again, money was not a real problem. This lady was otherwise very attractive, wore nice clothes, and took good care of herself. She also felt very self-conscious about her smile and was ready to do something about it.

We again encouraged patient B to bring her spouse to the consultation appointment. Once again, he did not come. Once again, the patient left enthused, excited, and ready to improve her smile. But, once again we did not do the case because the husband did not think it was necessary. It wasn’t that they couldn’t afford it; he just didn’t think she needed to have it done. Even though she desperately wanted to, the husband - whom we have never seen and who has never been to our office - makes the bad decision. Husbands ... arrrgghhh!

Contrast these ladies with the next two. Patient C finally decided enough was enough. She had hid her smile her whole life. She is a very happy, fun, and outgoing person who learned how to smile without showing the large gap between her teeth.

Patient C
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After her consultation, she too left enthused and encouraged about her new smile. Here was the big difference - when Patient C went home, she didn’t have to ask anyone. She didn’t have the “case crusher” to ruin everything. She simply made a decision, then did it.

Patient D also did not have a husband to ruin things. She almost ran into another monster though. For many of our elderly patients who have lost a spouse, there has been a replacement who is almost as deadly to case acceptance - the children.

Do they see their inheritance being spent when Mom tells them she’s going to spend a significant amount on her teeth? Do you think they might try to influence Mom to not do treatment if it might cost them $10,000, $20,000, or $40,000 when she passes on? I have run into this situation. It’s sad to think this influence would actually happen, but it does.

Patient D
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Fortunately for Patient D, she did not let this influence change her mind. She basically told her children “too bad” when they gave her this advice and went ahead with treatment anyway. I gave her the smile she had always wanted for the 78 years of her life.

I think it is pretty cool that Patient D will get to spend the rest of her life with the smile she has always wanted. The pleasure and joy she will have will certainly be worth it for her.

So, here is the best money-making advice I can give to all of you - make sure all of your female patients do not have husbands. If you do this, you will see your case acceptance rate skyrocket. Husbands are the bane to all cosmetic dentists. In fact, if you can find a location that is full of widowed, well-to-do ladies, this could be your perfect practice location.

Good luck.

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].