‘Pre-suading’ your patients: How a simple questionnaire can up your treatment acceptance rates

“Ethical ‘pre-suasion’ and persuasion are important tools for dentists who want to help their patients live healthier lives,” says Christopher Phelps, DMD, CMCT. Can you make treatment acceptance more likely before your patients even sit in the operatory? The answer is yes, and here’s how.

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Christopher Phelps, DMD, CMCT

Imagine you have two patients. They have the same complaint, the same diagnosis, the same treatment plan, and the same financial situation. You present the cases in the same way, and you have the same opportunities for persuasion in both situations.

There’s just one key difference. One patient has had a great day. He got up early, had a great breakfast, hit all the lights just right, and got his favorite parking spot at your office. The other patient overslept, was out of creamer for his coffee, got stuck in traffic, and had to park around the block because your lot was full.

Which patient do you think is more likely to agree to treatment today? It’s pretty obvious, isn’t it? The patient who’s had a great day is in a better mind-set and mood to proceed with treatment, while the other patient is likely to view any treatment plan at all as just another thing going wrong on an already-rotten day. Why would one say yes to treatment and the other say no? The difference has nothing to do with you. Each patient’s mood and focus for the day was set before even walking into your office.

Pre-suasion starts before the patient ever visits the office

Think about your ideal patients. They’re proactive people who really care about the appearance, function, health, and longevity of their teeth. They want to avoid pain, discomfort, and having to spend more money down the road. They are willing to do whatever it takes to preserve their smile today. When presented with options, they’re willing to consider them. They like you and trust your judgment, and they enthusiastically refer friends and family to your practice. Now, pick a random person off the street. Are they your ideal patient right now?

Chances are they’re not. But that doesn’t mean they’ll never be. When you set the stage with “pre-suasion,” you make it easier for people to become that ideal patient. Pre-suasive strategies set up win-win scenarios for you and your patients to succeed,help themto follow treatment recommendations, and allow them to participate in their own care. In my office, that process begins with a questionnaire that is carefully formulated to help patients commit to a mind-set about what they value. It also captures what their biggest hurdles to having any dental work may be and define what their expectations and goals for treatment really are.

Asking questions that change attitudes

How you ask a question can change how patients see you, the case you’re presenting, and even how they see themselves. For instance, in Pre-Suasion, Robert Cialdini, PhD, cites a study in which people were more likely to fill out a survey if they were approached with the question, “Do you consider yourself a helpful person?” For the control group, only 29% of people asked to fill out a survey complied. When researchers added the pre-suasive question, 77.3% of the people they approached agreed to complete the survey. The question preconditioned the subjects to see themselves as helpful. That self-perception made them more likely to help the researcher because they were in “helpful” mode.1

My practice uses the same pre-suasion approach on our new patient questionnaire. The first question is about the patient’s goals for treatment. This focuses patients on their health, appearance, pain levels, and tooth function, so they’ll come into the appointment looking for solutions. Then, we follow up with our second yes-or-no question: “Do you consider yourself to be a proactive person, someone who likes to avoid complications? Do you prefer to take care of an issue today instead of letting it worsen over time, which might cost more time, money, and visits down the road, and cause you more pain?”


An example of a customized treatment and presentation questionnaire based on what I use in my practice


Customized treatment and presentation questionnaire

Do you consider yourself to be a proactive person, someone who likes to avoid complications? Do you prefer to take care of an issue today instead of letting it worsen over time, which might cost more time, money, and visits down the road, and cause you more pain?
[ ] Yes [ ] No


Do you consider yourself to be a reactive person, someone who would rather deal with issues after they develop, which might cost more time, money, and visits down the road, and cause you more pain?
[ ] Yes [ ] No



And we immediately contrast it with a third yes-or-no question: “Do you consider yourself to be a reactive person, someone who would rather deal with issues after they develop, which might cost more time, money, and visits down the road, and cause you more pain?”

When most patients are faced with these choices, they choose to declare themselves proactive. Even people who are reactive in their daily lives would rather be seen by a stranger as proactive, just as most people approached by researchers would rather be seen as helpful.

This simple choice, being proactive or reactive, translates into a big increase in case acceptance, especially if we remind patients of their answers before we present cases: “Mr. Jones, you said you’re a proactive person, is that correct?” Having just written on the questionnaire that he was, Mr. Jones doesn’t want to be perceived as inconsistent or what some may call a “liar,” so he’ll agree that, yes, he is proactive. We would say next, “Well, in light of that, these are our immediate recommendations so that you can fix these issues and avoid future expense, pain, and loss of function.”

Our treatment recommendations aren’t any different than they’d be if Mr. Jones was reactive, but now he’s in a mind-set in which he’s willing to listen to the case presentation and accept treatment now to avoid future complications. Then, because of the persuasive principle of consistency, he will want to act in accord with his verbal commitment. He’s predisposed to accept treatment, to schedule follow-ups, and to take an active role in his care. By using pre-suasive opportunities, we’ve overcome some of the patient’s objections to much-needed treatment and saved him from further damage.

Safety in numbers

A good previsit questionnaire can also help you present treatment in terms that are most likely to persuade your patient. For instance, our questionnaire asks several questions that gauge a patient’s fear of the dentist. These questions are important for two reasons. First of all, if we know a patient is fearful, we can take steps to make them more comfortable. This activates the persuasive principle of liking. When patients like you, they tend to accept your treatment recommendations and cooperate with home care.

If a patient expresses fear of the dentist, that also gives us important information about the words to use to explain a treatment. In his book, Cialdini cites research on fear and advertising. People who are afraid are more likely to seek safety in numbers. This makes them more likely to be persuaded by social proof arguments, arguments that cite the number of other people who have had a procedure and been happy with the results.2 Orthodontists tend to use social proof to good effect by prominently featuring walls full of before-and-after snapshots in their offices. If you add a book of testimonials and before-and-after pictures to your case presentations for fearful patients, you can help overcome their fear-based objections to necessary treatments.

Using pre-suasion and persuasion helps patients

Ethical pre-suasion and persuasion are important tools for dentists who want to help their patients live healthier lives. Your treatment recommendations are based in current research and best practices. You know they’ll give your patients the best possible shot at a future with beautiful, functional teeth. If you don’t do everything you can to get those patients the treatment they need, then you are failing them. Take the time to master the techniques of pre-suasion and persuasion and put them to use in your daily work. You’ll have healthier, happier patients and a thriving practice.

References

1. Schawbel D. Robert Cialdini: How to Master the Art of Pre-Suasion. Forbes website. https://www.forbes.com/sites/danschawbel/2016/09/06/robert-cialdini-how-to-master-the-art-of-pre-suasion/#565765887445. Published September 6, 2016. Accessed January 23, 2018.

2. Griskevicius V, Goldstein NJ, Mortensen CR, Sundie JM, Cialdini RB, Kenrick DT. Fear and loving in Las Vegas: Evolution, emotion, and persuasion. J Mark Res. 2009;46(3):384-395. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2735890/. Accessed January 24, 2018.


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Christopher Phelps, DMD, CMCT, is an entrepreneur and general dentist. His passion for business and marketing helped him increase the revenue of his practices by 10 times in six years. He is also a certified trainer in Dr. Cialdini’s method of influence.

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