The specter of... diagnosis paralysis

Aug. 1, 1998
Diagnosis paralysis is a dental disease. Rooted deep in the dentist`s psyche, the practitioner`s basic fear of rejection by the patient is allowed to set the tone and tempo of the practice. Small case acceptance is the norm. The expectation level lowers to the point that the doctor and staff are not looking for possibilities or opportunities. The practice settles to the lowest common denominator or comfort, its confrontational tolerance never challenged.

Is your phobia taking the practice to the lowest common denominator?

William Blatchford, DDS

Diagnosis paralysis is a dental disease. Rooted deep in the dentist`s psyche, the practitioner`s basic fear of rejection by the patient is allowed to set the tone and tempo of the practice. Small case acceptance is the norm. The expectation level lowers to the point that the doctor and staff are not looking for possibilities or opportunities. The practice settles to the lowest common denominator or comfort, its confrontational tolerance never challenged.

Diagnosis paralysis can affect even the most completely trained technician and is a source of great frustration. Obvious symptoms are daily schedules filled with single-unit preps, with many hours spent producing under $250 an hour when the overhead is closer to $275.

Great excuses have been developed to justify the lower case acceptance. The bottom line: The doctor needs to boldly define who he or she is, create some energy and excitement around that vision, and develop the sales skills that will create value for patients to say, "Yes."

Diagnosis paralysis is a real disservice to your patients. As a dentist, you are the only one who can technically deliver their dreams of a more beautiful, long-lasting smile. Who are you to prejudge patients and decide they do not deserve to hear of the latest possibilities in dentistry, and that these patients do not value excellent dentistry? It is true that not every patient will say "yes" today, but he or she will be thinking about a new smile.

To an ambitious dentist, a more frustrating circumstance cannot be imagined: to have the technical ability to produce a healthy, great-looking smile and yet lack the ability to convince patients to accept optimal treatment. Dentistry delivers a premium product that is specifically made for each individual, has great value, is used every day, enhances beauty, and lasts a long time.

Yet, even great dentists believe their work will sell itself. "Selling" is anathema to many dentists and the perception is that great dentists definitely should not have to sell because their excellent work speaks for itself.

To evaluate if you have diagnosis paralysis, make a schedule and budgetary study of the last 90 days. What is your true overhead per hour? Do not include the deductible Caribbean trip with your spouse, the leased business car, or other extraneous items. Your true overhead may be $250 per hour. Evaluate each hour spent in your practice with the monetary returns. You will discover that you are spending about 50 percent of the day giving treatment for fees less than your hourly overhead.

Recognizing and curing diagnosis paralysis is the answer. The opportunity is to change the mix of treatment so that the return per hour is increased. Why do we continue to be in the Crown of the Year Club and seldom diagnose more long-term treatment plans, including cosmetics? Has your practice developed an unspoken motto, "Never diagnose more than insurance will cover"?

What is the fear in diagnosis? What paralyzes the conversation? What is the fear in talking with patients about treatment? For most dentists, our confrontational tolerance is directly related to our level of self-esteem or self-worth. Discover how your own "deserve level" can be increased. Positive affirmations are ways of building self-esteem and increasing the deserve level. I especially like the statement, "I am in the elective health-care field." Do you see yourself this way? If not, what is the fear? What would it take to see yourself in a better light?

All the technical and academic training in the world will not sell itself. Excellence must be present to sell, but it sit there quietly as the marketplace moves beyond your moment. Your patients do not know how great you are. They cannot effectively evaluate your excellence. Dentists must step into the real business world and learn to master skills in dental sales with integrity. We are not competing with other dentists, but rather with other forms of discretionary spending.

The major paradigm shift necessary to get rid of diagnosis paralysis is this: "Dentistry is no longer a necessity." Most practices no longer see patients who need our services. We now are serving patients who choose to have dental care over other discretionary items. When patients ask, "But doctor, do I need this work?" you can confidently answer, "Absolutely not. You do not need any dental work. But, if you were my wife or a member of my family, this is the kind of work I would do for them. You said that you would like your teeth to be whiter and brighter, last forever, and you want to avoid dental emergencies. The work I have suggested will nicely accomplish your goals. Is this the smile you would like to have?"

Diagnosis paralysis is a mental condition. A change in attitude is required. To determine if you are suffering from diagnosis paralysis, analyze your schedule and budget for the last 90 days. Because diagnosis paralysis correlates to your own self-esteem and deserve level, take the necessary steps to improve your self-esteem. At the same time, learn and master skills in case presentation so that patients will tell you they want, rather than you telling them what they need.