Why patients say ”I'll think about it“

BY Michael Kesner, DDS

How many times has this happened to you? You do a thorough examination on Mrs. Jones, taking a full set of X-rays. You work up a well thought out treatment plan that will restore her mouth to health and function. You take 30 to 45 minutes out of your busy schedule to treatment plan and educate her about the restorations you will use to fix the problems. She smiles and says, "Okay, I'll think about it."

Why did she say this? Why doesn't she immediately want the treatment? Doesn't she know how important it is? Doesn't she know what an excellent dentist you are? What could you and your team have done differently to get a positive response?

The first thing you should realize is that most patients don't make decisions about their dental treatment based on education. I know this is not what you've been taught in dental school or CE courses, but it's true. Education does not inspire most patients to want to do their dental treatment.

People will always find a way to do what they want, but not necessarily what they need. I'm sure you've had this happen 100 times. You educate your patient about some dental treatment he or she needs and you hear, "I need to talk to my husband first," or "I'll check my schedule and get back with you." These statements really mean, "I may need it, but I don't want it."

The reason education kills case acceptance is because patients decide to do dental treatment based on emotion, not education or intellect. In fact, most buying decisions are emotionally based.

When you bought your last car, was it an emotional decision or an intellectual one? For most of us this was an emotional decision. We imagined how it was going to feel driving this new car down the road. We felt good as we envisioned others seeing us in this car. We fell in love with the color and the smell of the leather.

Why do women spend $1,000 on a designer purse? Why do men buy $10,000 watches? These are not intellectual decisions based on education and need. These are buying decisions based on emotion and want.

When you try to educate and teach patients dentistry, you are accessing the thinking and analytical part of their brains. You should be accessing the emotional and feeling part of their brains. This is also the part of the brain that changes behavior.

Education does not change behavior very well. For example, health organizations have done a great job of educating the public over the last several years about the importance of diet and exercise for long-term health. Everyone knows this, yet heart disease, diabetes, and obesity continue to climb because education does not change behavior in most people.

Emotion changes behavior. If a person has a heart attack and survives, that person is much more likely to change his or her diet and start exercising. Why? The person always knew what needed to be done, but now he or she has been impacted on an emotional level.

When you teach your patients dentistry, you're trying to educate them in the hopes that they will make an intellectual decision and want what they need. Then you send them up to the front desk where they get a treatment plan printout that says it costs $12,500! Now they have sticker shock over something they need but don't want, so they say, "I'll think about it."

Why wouldn't they want to think about it? You accessed the "thinking part" of their brains when you taught them about the needed dentistry. If your treatment presentation is like "Dentistry 101," then lots of patients are leaving your office without appointments. I want my patients "feeling" about their dental treatment, not "thinking" about their treatment.

Let me be really clear. I'm not saying that you should withhold necessary information from your patients. I am also not saying there is never a place for education. What I am saying is if you want your case acceptance to go up, you must learn to present treatment to your patients in a way that appeals to their emotions instead of their intellect.

When you look into a patient's mouth and when you examine someone's radiographs, you are analytically processing a lot of information to come up with the appropriate diagnosis and treatment plan. You're thinking about occlusion, vertical dimension, perio, endo, ortho, onlays, crowns, implants, cosmetics, and more.

You then communicate these concepts to your patients in an analytical and educational way, because this is the part of your brain that you're accessing to come up with the treatment plan. We dentists are very analytical people, so this is how we feel most comfortable communicating with patients.

Most dentists have a case acceptance rate of around 20% to 30%, which means that seven or eight out of 10 patients don't follow through with treatment. If you and your team learn how to connect with patients on an emotional level, your case acceptance will go up to around 60% to 70%. This means you double your revenue with the same number of new patients!

So, how do we present treatment in a way that impacts patients on an emotional level?

First of all, case presentation is a "team sport," not just the dentist's responsibility. My team connects with patients on an emotional level, creates urgency for the needed treatment, and inspires patients to emotionally want the treatment as opposed to intellectually needing the treatment. Since people will typically find a way to pay for what they want, our job is to get patients to want the treatment they need.

How do we help patients make that jump from need to want? There are several strategies that we use in our office to get patients to this point, such as talking over the patient, hand-offs, and creating urgency. There is no way I can teach you the whole process in this article, but there is one thing you can do in your practice that will immediately make a difference in your case acceptance.

Tell your patients what is going to happen if they don't fix the problem. Anytime you tell them a particular treatment they need, follow that immediately by talking about how not fixing the problem will negatively impact their life - pain, more expense, inconvenience, more involved treatment, etc.

What dentists typically talk about is how they are going to fix the problem. They do this because fixing the problem is the part they like to do and talk about. But this is also the part that is usually boring, confusing, or scary to patients.

A really easy way for you to improve in this area is to keep what you say to patients short and sweet. Don't go into a long explanation about the problem. Just keep it to one sentence. "Mrs. Jones, your tooth on the upper right side has a big crack running through it." That's it! That's the problem.

Next, talk to Mrs. Jones about what is going to happen if she doesn't fix the cracked tooth - turn into a root canal, cause a bad toothache, cost more to fix, need an implant, tooth split in half, etc. You may also want to talk about experiences you've had where a patient did not fix the problem and it got worse. If you are the type of person who likes to talk a lot, then this is where you can do your talking.

Lastly, talk about the solution. Keep this part short too. "Your tooth needs a crown to strengthen it and keep it from breaking." That's it! That's the solution. Don't go into lots of detail about materials crowns are made of, how you do a crown prep, how a root canal is done, or the steps to doing an implant. Remember that while this part really turns you on, it is usually a turn-off to patients.

Helping your patients say "yes" to the treatment they need is important for their health, and important to your financial success. Learning how to improve your treatment acceptance is a win/win situation for everyone. When your practice is financially successful everyone wins - the patient, your team, you, and your family. On the other hand, nobody wins when your practice is not financially successful.

MIKE KESNER, DDS, is a practicing dentist and author of Multi-Million Dollar Dental Practice - How to net $1 million a year in your dental practice ... even in a recession. He is founder and CEO of Quantum Leap Success in Dentistry, a consulting company that helps dentists build the practices of their dreams in 24 months or less, guaranteed! Reach him at drkesner@qlsuccess.com.

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