By Hollie Bryant, DA II
Do you ever sit in the audience of a continuing education course and wonder how that dentist was able to get all those great cases? How do they get people to say “yes” to treatment? For many years I have had the privilege of working with some of those stage grabbing dentists, and it’s all about the process. Understand that the entire team is required to create the proper support for patients to want to purchase your services.
It starts with the phone call. How you answer the phone sets the tone for the entire process for patients. If they feel that they are being helped, getting answers to their questions, and even finding a commonality with the person on the other end, then they will want to form a relationship with you. Here is what it looks like:
1. The phone rings: The new patient calls to make an appointment. The call must be friendly and welcoming, not focused on policy and protocol.
2. Appointment gets scheduled: The appointment is in the schedule and the referral code is placed in your system. A welcome packet is mailed out. This packet should contain a welcome letter with the patient’s name on it, an appointment card, practice directions, an office brochure, and a handwritten card from the doctor telling the patient that you look forward to seeing them.
3. Appointments get verified: 48 hours prior to the appointment, a courtesy call is made verifying (not confirming) the appointment. This call should address what the appointment is for, the time of the appointment, how long the appointment will be, and if the patient should arrive early for paperwork. Trust is being built between the patient and the office even before the patient walks through the door. This makes canceling harder and keeping the appointment easier for the patient mentally.
The process continues. You have gained enough trust to get them in the door, but what are you going to do from here to earn all of their trust? They must believe in what the practice is about. That is really up to the team at this point. They must be prepared to greet patients, have positive conversation with them, and provide assurance that they have come to the right office. If the staff does not portray a positive attitude, doubt will be created in patients’ minds, and they may decide that your office is not the right place for them.
Now, your patient has arrived and we continue the process.
4. Patients are greeted by the front office staff: When patients arrive at the practice, they are acknowledged and greeted by name.
Example:
Team member: “Ms. Smith, it is so nice to finally meet you.” Stand up, make eye contact, and firmly shake the patient’s hand – all with a smile on your face. This continues to gain the patient’s trust. You want them to have every reason to stay, to believe that this is the right place for them!
Patient: Response
Team member: “Did you have any difficulty finding our practice?”
Patient: Response
Team member: “One of our team members will escort you to the clinical area and show you around the office. Is there anything else that I can assist you with? Would you like some coffee or water?”
The front office member has done their part for now. There will be variations of this process. Some offices have their patients fill out paperwork, some offices do it online, and some mail it to the patient and have them complete it at home and bring it to the appointment. (This is a decision that your office makes based on age/demographics/technology available.)
At this point, the clinical team takes control of the process and makes a connection with the patient. Many times that connection is easier when the clinical team members review the charts of the patients coming in, participate in morning huddles, take notes, and interact with the front office members.
So here is where we are:
5. Clinical team steps out to greet: The clinical team member steps into the waiting room and greets the patient. They don’t stand at the door and call out the patient’s name. They make eye contact, give a firm handshake, and escort the patient to the back. They give a tour of the practice on the way to the treatment area. They point out the rest room, share the great credentials of the doctor, show smile photos, and offer pertinent information. If you pass the doctor or any team member, it is courteous to make an introduction. Yet again, you are building trust. This method may seem crazy to some, but it has been duplicated many times over in other offices, and it produces a large amount of dentistry.
6. Photos are taken by a team member: If an office is looking to add some form of patient education in the practice, a camera would be the place to start – not an intraoral, but a high quality digital camera. A camera is the ultimate communication tool. The old saying, “A picture is worth a thousand words” is very true in the dental practice. Patients are consumers and they want to make good decisions/purchases. People make purchases from people that they trust. Showing patients what their current oral situation is will create believability. Photos are imperative for great case success. Take at least the standard five quick photos – head shot, smile shot, retracted smile, upper arch, and lower arch.
7. Photos are reviewed with the patient by a team member: These pictures should be on the screen during all appointments. They are the best education tools available. The team member points to areas of concern, such as wear, calculus, puffy gums, old, broken fillings, cracked or broken teeth, missing teeth, extra bone, discoloration, etc. This educates patients about their problems and creates a better understanding of the current condition of their mouths. It will also prime the patient for what the doctor may diagnose or recommend.
8. Print photos: Print the photos that pertain to the discussion. These photos should be printed on copy paper, in color, a full page each. Take time to write on photos with a Sharpie.
Example: 10 broken/missing teeth, 30% wear, 12 holes [things that will deepen their concern about their current condition]. The team is helping the patients to own their problems.
i. If you are speaking of the bite, the wear, or the broken fillings, you should print the arch shots and the retracted smile shot.
ii. If you are talking about a smile makeover or bleaching, you should print the smile shot and the retracted smile shots.
This process continues to create believability with the patient. They believe you because you have showed them the current condition of their dental health – they can see it for themselves.
The next step is transferring information to the dentist.
9. Transfer the patient to the doctor: Do not discuss the patient privately in the doctor’s office or the hallway. Try a new approach. A proper transfer from the team member to the doctor is very important. Here are some suggestions:
1. Personal transfer: The introduction, the referral, and a little personal information will bring the doctor into the conversation. Pause for the doctor to speak with the patient for a few minutes and get familiar with them. (This system can also be used in recare, consults, or emergency exams.)
2. The laundry list: List all concerns with the doctor. Example: “Here are the things that we did today, Dr. Greene. We were able to take some digital photos of Barbra’s teeth, we charted her gum health, took some X-rays so that you could detect any cavities, and we used the cavitron to clean her teeth. Barbra and I looked at all the holes in her teeth, talked about the health of the bone, and looked at all the missing teeth…”
Pause for the doctor to look through the X-rays and digital photos with the patient. Then continue with the “shopping list.”
3. The shopping list: “Dr. Greene, we need you to tell us Barbra’s options for replacing the upper teeth, fixing her cavities, and getting her gums healthier. [We want to address the potential objections that Barbra may have such as time, cost, fear, lack of urgency.] Barbra also has some concerns. She is very afraid of the dentist and will need some sedation information, and she has some financial concerns. We want to find the best options that will fit into her budget. Barbra wants to get her mouth as healthy as possible and not let things go anymore.”
Tell the doctor the goals that the patient has for his/her mouth. Do they care about cosmetics? Health only? Just wanted to have a cleaning? Transfer these desires to the doctor. When treatment is discussed, it is based on the patient’s desires and wants for their health needs, cosmetic wants, and the level of prevention that they are seeking. Do not diagnose their wallet. Present dentistry to the patient that is based on their desires, not yours.
Example of turning a negative conversation into a positive one:
Patient: “I don’t care what is going on in my mouth, and I do not want you to sell me something.”
Team: “Absolutely, Mr. Jones. I would not want you to feel like we are selling you dental care that you may not have an interest in, but with your permission, would you be open to my sharing any areas of cavities, infection, or disease with you?”
Patient: Response.
Team: “It is my obligation to share with you what is going on. Whether you choose to treat the issue or not is your personal choice. I am only here to provide you with professional council.”
Now you can continue without the pressure, and the patient will be more receptive to listening. The wall will be down.
10. Options: Present the patient with some options. Provide a simplified explanation of what could be done to fix the areas of concern. Consider what they are seeking for their mouths. This is what they want, based upon what you are willing to do. You do not have to give an exact treatment plan (e.g., core, crown, root canal, DOBL onlay, etc.) until the patient has decided to do treatment. Give a brief summary of findings such as: “You have seven teeth that need some kind of work such as broken teeth and cavities. There are a couple of ways to treat these seven teeth in order to get your mouth healthy again.”
Ask interactive questions such as: “Does this sound like something that you may be interested in doing to get your teeth healthy?” Let them direct you in the way that they would like to head. If they select an option, then place an X over the options that they do not choose. Patients retain only about 10% of what you say, so scratch it out for them to see, give them some pros and cons to each option, and attach photos. Team members must also listen to the options since they will be reviewing them again.
11. Affirmation: When the doctor leaves the room, the team members will give patients the confidence to move forward with treatment. Tell patients that they have chosen good options to get their mouths healthy and that the doctor does very good work. Sit knee to knee with the patient and review each option. Point to the teeth on the screen, and provide a range of fee for what is needed.
12. Decision making: If you are discussing treatment for a few teeth, patients frequently will agree to treatment on the spot. When you are discussing large cases, find a starting point. Keep them in the pipeline of care if they haven’t made a decision yet. We all decide to buy at different times. When a patient decides on an option, create a treatment plan, sign a financial arrangement, get approved for CareCredit if necessary, and sign consent forms.
13. Transfer: Now it is time to transfer the patient to the appropriate people without confusion. Create the transfer to the front office team member. Include personal information, the “laundry list,” and the “shopping list.”
Example: “Susan, you remember [personal information] Barbra, Lisa’s friend from your gym. Today we were able to [laundry list] measure Barbra’s gum health, take some photos, get her teeth examined by the doctor, and take some X-rays. We [shopping list] found some cavities, broken teeth, and missing teeth today that we are ready to address. After reviewing her options, Barbra decided that she wants Dr. Greene to fix everything at one time. I need you to set an appointment up for Barbra to come back on Friday so we can take some impressions of her teeth, sign her dental consents, explain her treatment to her, and make a detailed plan of what we are doing and how much it will cost. Barbra would also like some information about CareCredit. Will you get Barbra set up with that appointment and also make her appointment to come back to see me in three months for about one hour?”
You then look at Barbra, shake her hand, and say something like “Barbra, Susan will take good care of you and get these appointments set up for you. If you have any additional questions, please write them down and bring them on Friday so we can be sure to answer them for you.”
Transfers are important because you are transferring trust from one team member to the next. You are building believability and likeability with the patient. More importantly, you are letting the patient know that they are in the right place and making the right choice.
14. Follow-up: Follow up can be anything from a care call to a written note to the patient. This keeps them thinking about the importance of their dentistry. Sometimes this can be as simple as “Good morning, Barbra. This is Hollie from Dr. Greene’s dental practice. I was thinking about you and wanted to reach out to you this morning and wish you a happy Monday! I am so glad that you are a patient in Dr. Greene’s practice. Have a great day.” Or send a note care with the same message. It may not have anything to do with dental, but the care call or note has the office’s name on it. That helps keep your office and their dental needs in the front of their mind.
15. Tracking: How do you know if what the practice is doing is really working? You can track case acceptance, case declines, new patients, individual team member stats (to know if they are in the right position), monthly cancelations, recare acceptance, perio cases, etc. I can go on and on with this list, but the importance is tracking success and failure. It helps us to be better.
16. Celebrating: Celebrate daily, weekly, and monthly. This can be done in a morning meeting by going around the table and sharing a win from the previous day. This can be done at the weekly or monthly team meeting with each person sharing something exciting that has happened in the practice. When we see that we are making an impact on lives or within the practice, we are motivated to push ourselves forward.
Do you really want the big cases in your practice? The recipe for success is written down. Take the ingredients that you have in your practice and mix them up for your own success story.
Hollie Bryant is a graduate of Bowman Gray Dental Assisting Program and is the former chairside assistant for Dr. Ross Nash and clinical instructor and treatment coordinator at the Nash Institute. She is currently a member of the American Academy of Dental Office Managers, American Academy of Cosmetic Dentistry, North Carolina Dental Association, Academy of Comprehensive Esthetics, and the American Dental Assistants Association. She is the former editor-in-chief of Contemporary Dental Assisting magazine and currently serves on the Advisory Board for DentalCompare. She is on the editorial board of Dental Assisting Digest™ and Contemporary Product Solutions, and is a consultant for various dental manufacturers. She has authored numerous manuscripts on clinical assisting and practice-management topics. Hollie lectures for the NICHE Practice Seminars nationally on clinical and management topics, while she travels for her independent consulting firm from practice to practice working with teams to increase customer service, profit, and implement effective systems. You may reach Hollie at [email protected].
