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Thu 18 Sep 2008 04:00 AM

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Case closing

Many dentists struggle when it comes to closing a treatment plan. James McCarthy speaks to specialist consultant Dr James McAnally to discover the art of patient persuasion.

Many dentists struggle when it comes to closing a treatment plan. James McCarthy speaks to specialist consultant Dr James McAnally to discover the art of patient persuasion.

It can be a frustrating reality for dentists that after hours of effort trying to convince a patient of the benefits of a treatment plan, they are stonewalled with a flat "no".

As the patient leaves the clinic, the dentist is left wondering what killed the deal. While the reasons could be varied, the chances are the twin arts of sales and marketing - two roles that many dentists are not always comfortable taking on - are where it went awry. So how does the sales-shy dentist turn more of the "no thanks" into "yes please"?

As soon as you start using industry jargon, the patient’s eyes just glaze over.

Attitude adjustment

"The magic word here is ‘convince,'" says Dr James McAnally, CEO of Big Case Marketing, a consultancy company with a focus on improving treatment plan acceptance.

"Boosting case acceptance is about developing a system where it is not about convincing patients, but about them wanting to continue with treatment of their own accord."

There are a dozen common reasons why a patient will walk away from treatment. Some are down to finance, or the patient's misgivings. But others are due to the approach taken by the dentist.

When a dentist doesn't present a case properly, issues such as difficulty gaining the patient's trust, overwhelming the patient during the treatment discussion and not knowing how to follow up on the initial meeting are the main offenders.

The key things on the patient's side include not valuing their oral health and, most importantly, the shock of the treatment cost.

"If you look at any major industry that is successful you will find a sales system that determines how they approach the customer, from the point they pick up the phone, right up to the point that the customer writes the cheque and buys the product," McAnally explains.

"In dentistry we are kind of left out in the cold without any sales systems. That in itself is a huge reason behind the problem of getting patients to respond."

The first thing the dentist needs to do is get into the mindset of the patient. Establishing the patient's motivation for the visit is key.

"Often we sit there and we look at the patient from our perspective. We see it clinically and think a problem discovered during the examination must be what's motivating them," he notes. "Most of the time, it is not the case at all. So making sure we are on the same page as the patient is critical."

McAnally suggests that there are two motivational factors for every patient: the motivation of gaining something, or fear of losing something. "In our case that means their teeth or losing more of the life that revolves around their teeth.

"If we keep that in mind, anything that presents a patient with a way to keep them from losing something - they will get it."

Power points

Making the case for the treatment on offer can always prove to be tricky for dentists with a lack of marketing nous. Gaining the patient's trust and showing them the value of the treatment can depend on the simplest of things.

"The larger the dollar amount, the larger the amount of treatment, the reality is the more professional the doctor must appear," McAnally states. "It sounds so superficial but it is true. I routinely get my clients to wear a suit when they are doing their presentation, and it usually gets them better results."

The dentist might be able to dress like a million dollars, but McAnally notes that above everything else, there is one essential thing that every dentist needs to own: a good smile.

"The dentist has to have great teeth because that's what he's selling. Let's be realistic, if your teeth aren't nice and you're proposing US$10,000 worth of work to make the patient's teeth look good, why trust you?

"More often than not, if the dentist has great teeth, his case acceptance goes up. It is not rocket science, it is just common sense."

As the word ‘presentation' suggests, you are delivering information to the client. Therefore, the patient has to understand the message as well.

Years of study in an environment where many of the people around them are of above average intelligence can cause dentists to forget that the average patient will have no idea what a systemic antimicrobial prophylaxis is. Simply put, just say "a thorough cleaning" instead.

"As soon as you start talking in dental terminology and industry jargon, the patient's eyes just glaze over," McAnally says. "The patient is not equipped to understand any of that.

"If you talk about teeth that can be saved, that can't be saved, how you can make their teeth look nice - people understand these terms."If necessary, use technology to help. McAnally notes that, while smile simulation software and other treatment presentation packages are not going to snare you business on their own, if used properly as part of a simple case presentation, they can boost success rates considerably.

When offering treatment plans, it can be very easy to overwhelm a patient. Ideally, the dentist should give the patient options that primarily solve the problems, but also that they are comfortable presenting.

"You don't want to give the patient too many options. Once they have too many choices, people can get overloaded and then just don't make a decision at all," McAnally warns.

"It is very easy to overwhelm them, so offer them three options that are really good. That way no-one gets lost in the process."

The patient doesn’t want pain...not just physically, but the pain of making a big financial decision.

The presentation should have covered all the bases for both the dentist and the patient. Only after all the discussion about what is wrong, what the choices are and which one they feel most comfortable with, is it time to approach the subject of fees.

Money matters

This can be the most uncomfortable part of the process for both the patient and the dentist. As a result, timing is essential as this is one of main areas where case acceptance falls flat.

"There are some dentists who will see a patient and, within half an hour, will give them a fee of $10,000 for the treatment plan on offer," McAnally laments. "In addition, they have ignored a lot of things to set up the right structure for the patient to understand the value of a $10,000 treatment.

"If you look at the sales system in any other industry, no-one comes back and hits a customer with a price like that so quickly."

Many patients find dental visits stressful and after being talked through a comprehensive treatment plan, need time to reevaluate their choices.

McAnally believes that the process for delivering the fee bombshell needs to start at the beginning of the dental visit. There are various points along the way where a dentist can give the patient an idea of the scale of the cost.

After the diagnostic stage of the process, dentists should have a fairly good grasp of the size of the bill and McAnally suggests they should start prepping the patient then, using rough figures to ease the path.

As part of the case acceptance process, dentists need to ensure that whoever is going to be paying the bill - whethert that is the patient, their partner or their parent - is there during the presentation.

"If they are not, I guarantee you the patient will say ‘I have to go home and talk it over with X, Y or Z,'" he warns. "Invariably this will happen and, no matter how simple you make it, there is no way that they will be able to go home and explain exactly what was talked about during the consultation."

It is also good to have the financial discussion away from the dental chair. Keeping the conversation relaxed and casual is critical at this stage of the negotiations and the less dental equipment the better.

"There is a psychology behind how we deliver fees," McAnally explains. "[The patient] doesn't want to have pain, and that is not just physical pain, but also the pain of making a big financial decision. We need to help them with that.

"The goal should be that by the time you talk about the fee, you should have prepared them and established that they have the financial means to undertake the work that you are providing.

"It doesn't have to be a hard-nosed, hard-edged sales technique. It should be something that is easy for us and makes sense to us as dentists but that still works to get the patient to accept the treatment."

MED TIPS: Acceptance boosters• Make sure that whoever will be financially responsible for treatment is there during the care presentation.

• Time carefully when you will discuss treatment risks. It is like going to buy a new BMW only to be told there is a chance that it might explode.

• Use technology. Imaging and presentation software can make a huge difference to case presentation.

• It is counter-productive to baffle the patient with science. Keep the conversation as jargon-free as possible.

• Give the patient materials to take home so they can read about the treatments and problems that have been discussed. Invariably they are going to have questions.

• Never say: "Ok, call us back when you're ready." Something else will always come up and the patient gets derailed in their thought process. Make the next appointment immediately after the consultation.

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