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Wed 20 Feb 2008 04:00 AM

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Money talks

Adding fancy financial footwork to your treatment plans should see patients sign on the line.

Adding a little fancy financial footwork to your treatment plans should see patients sign on the dotted line, writes Julie Ferry.

Afamiliar saying to all of us is that ‘money makes the world go round' and within a profession like dentistry, this saying has never been more apt.

Breaking treatment into steps is a very useful tool, especially when you are looking at the area of patient finances.

While patient care and satisfaction is at the heart of any consultation between dentist and patient, there is also a point where the subject of financing treatment has to be addressed. Indeed, financial considerations can have a major impact on treatment plans and therefore it is essential for the practitioner and customer to be on the same page.

After all, time can be wasted and expectations unfulfilled if a certain course of treatment is simply unaffordable.

Essentially there is a tricky balance to be found when discussing financing options with a patient. First and foremost, the dentist has to try and gauge the patient's priorities - are they more swayed by finding the best possible treatment, irrespective of the cost, or do they have certain financial limitations, which precludes some procedures from being brought into the mix?

Very often, it is difficult to tell, so the easiest way to proceed is to put all of the options onto the table, pointing out the advantages and disadvantages of each and then letting the patient decide for themselves what suits their needs.

Soft option

Faced with a multi-cultural patient base, it can be difficult for regional dentists to know how best to approach the issue of finance. Helpfully, tips for finding the right balance seem to be the same the world over.

"The most important thing when looking at the area of finance is to present the patient with all of the options," argues Irfan Ahmad, who runs The Ridgeway Dental Surgery in Harrow in the UK.

For example if someone has a chipped tooth that they want to have repaired you can either fix it with a simple composite filling, which can be a few hundred pounds or a veneer, which can end up being a few thousand pounds. However, it would be wrong to make the decision for the patient - give them the choice.

"If they can't afford the most expensive option, they may have the cheaper option for now and then come back to you and have the more expensive treatment done at a later date. To focus solely on the most expensive option and present it as the only choice available is a mistake. It may mean that you will lose that patient all together."

Kathrine Trelles of Vila Fortuny Laser Centre in Dubai agrees and says that putting together treatment plans that are affordable and successful is all about taking the process in stages.

"Breaking treatment into steps is a very useful tool, especially when you are looking at the area of patient finances," she says. "Sometimes, if money is an issue, then I take the patient through the options and then focus on the first step, which is getting the mouth healthy again.

Once we have done this and the patient has easily afforded this work we can then look at step two and the treatment can progress from there."

A matter of priorities

Often it can be difficult for a dentist to judge how much a patient is willing to spend on dental treatment. However, the advice in this situation would be not to even try. As Dr Ahmad has found out during his career, it can be a very difficult task to read people in this way and isn't always successful.

"People vary enormously, so it doesn't pay to try and second guess how much they are prepared to spend and to adjust your treatment plan accordingly," he explains.

I have found that even if people have a lot of money, sometimes they don't want to part with it for dental treatment. In fact I've found that people with the most money are the most difficult to sell treatment to. It really depends more on what their priorities are and I think dental treatment is a priority.

Most people can afford excellent dental care but it is whether they choose to afford it that is the question. They may not think twice about spending money on a designer handbag, so clearly they have got that disposable income, it is just whether they choose to spend it on their teeth or not."

‘Trust' is a major buzzword when talking to patients about complex treatment plans, believes Trelles. At her clinic, which fuses plastic surgery with dentistry, she finds that patients only feel comfortable accepting treatment and the costs incurred if she has built up a good relationship with them.

"Usually when I see patients it is when they have reached a crossroads in their life.

They want to do something about their appearance and are ready to spend money to get good results. However, they are only willing to do this if they trust you completely and know that you will take good care of them. You are selling them a service, so it is very important that you give them a lot of background information on that service and your reasons for choosing it.

Then it is just a matter of them trusting you to complete the work to a high standard. After that, they see an improvement and a good result and are happy to pay appropriately for the high quality they have received.

It pays to talk

Explaining the treatment to the patient is key to overcoming the hurdle of finance, agrees Dr Michael Frankl of the Lotus Clinic based in North London.

"It is very important to spend time with the patient in a clinical setting talking about treatment options," he says. " That's why in our practice, our practice manager talks to patients about finances and I only deal with clinical questions in the surgery.

It means that I don't discuss money at all with the patient; they deal with the administrative staff for that. It works because patients don't have the opportunity to ask for discounts in the surgery setting, which can get a little awkward and it is better for dentists to stick to clinical matters and the administrative staff to deal with their area of expertise.

I find it is more cost effective for me to spend time on the areas that I have trained in and patients get a clear view of all of the finance options from those who know most about them.

So what are the most effective and convenient financing options available to dentists and patients?

"There are so many options for patients it is about being creative and tailoring finance to the patient's needs," says Trelles. "We rarely have any issues with money, as most of our patients see it as a long term investment and know the benefits they will get from having high quality treatment.

However, we offer the option for patients to either pay in one lump sum or to spread the cost over a longer period of time. Sometimes patients will get a full consultation and even though they can't afford the treatment at the time they will bear it in mind for a later date and save up to have it done. In that instance we would make sure the mouth was healthy and then give them the preferred treatment plan that they can aspire to."

Dr Ahmad also believes in a flexible approach to treatment and financing. He offers longstanding patients the option to pay over a greater period of time than newcomers to the practice because he has built up a solid relationship with them.

"For people who have been coming to us for a long time we often give them the option of paying per month as the treatment goes along. For new patients we usually insist on them paying a deposit, which can vary from 10-50%, and then the balance when they are happy with the final result, which is usually at the try-in stage. This works well as long term patients appreciate the flexibility we provide."

Bank on it

At the Lotus Clinic, Dr Frankl finds the option of interest-free loans for patients, which are handled quickly and easily by his reception staff, very popular.

"For large treatment plans we offer patients interest-free credit and it has been very successful. We use a reputable finance company, which our receptionist phones up while the patient is at the practice and discovers whether they have a good credit history. If they have the finance company will approve the loan over the phone in around 10 minutes.

They will then pay us the full amount for the treatment and the patient pays them back in instalments, so it makes it much easier to spread the cost.

This system has been very helpful when persuading patients to go ahead with treatment because if you present a large sum for the patient to pay, they will immediately think they can't afford it. However, if you break it down into a more manageable sum they seem to prefer it and are much more likely to go ahead with the treatment. Everyone is happy.

MED TIPS: A done deal• Find out what your patient's priorities are and discuss where dental treatment ranks on the list.

• Present all of the options and don't be tempted to limit their choice. Patients will take on board everything you've said and may just be waiting until they can afford the more comprehensive treatment plan.

• Build up a good relationship with your patients. They are more likely to be willing to spend money on the right course of treatment if they trust that you will be able to deliver high quality results.

• Make sure you explain the benefits of the treatment fully. The more patients understand the perks of procedures, the more likely they are to commit.

• Try and keep financial and clinical matters separate. As the dentist you should focus on treating patients. Have the patient see a trusted administrative colleagueto discuss finances.

• Make sure you have lots of finance options for patients to take advantage of. These could include monthly instalments or the option of taking up an interest-free loan from an outside company.

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