Overcoming patient objections

It’s normal for patients to have objections to dental treatment during case presentation. Some patients truly cannot afford dental services, but there are many others who just don’t value oral health above their other expenses, or just don’t know how treatment could be adapted to meet their needs. In this article, Chris Salierno, DDS, chief editor of Dental Economics, recommends a response that helps you organize your thoughts and present information to the patient logically.

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I have completely bombed patient consultations. In my first few years in practice, I was very good at talking at my patients. After some small talk, I would launch into a list of their oral health issues. If they raised any objections to my proposed treatment, I would get a little frustrated and then restate how important their oral health was. Like I said, I was good at talking at my patients—I wasn’t talking to them. Having a productive conversation with a patient involves skills such as building trust and discussing dental problems in patient-friendly terms. It also means genuinely listening to an objection and then crafting a thoughtful response.

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First, let’s consider the common objections. I place them into three categories: financial (e.g., “I don’t have the money”), temporal (e.g., “I don’t have the time”), and psychological (e.g., “I’m afraid”). If a patient is concerned that he or she can’t afford care, then I shouldn’t start blabbering about how gentle I am. Clearly one has nothing to do with the other, and the patient will justifiably feel as if I’m not listening.

Now let’s build a thoughtful response based on the patient’s objection. It’s easy to start rambling about disease progression and the importance of good oral health, but that’s just lecturing to your patients. I think a better approach is to engage them in a dialogue about their objections. I like to use a simple framework that helps organize my thoughts and presents them in a logical sequence:

  • Acknowledge: Recognize the concern that the patient just raised.

  • State objective: Be crystal clear about what you want the patient to do.

  • Present argument: Turn the patient’s concern into a reason to accomplish the objective.

  • Conclusion: Restate your objective with rallying enthusiasm.

Let’s put this structured response into action with a few examples.

Case one:

A patient has a few areas of decay, and the treatment plan calls for composite restorations. The patient is objecting to having to pay $200 as co-insurance.

  • Acknowledge: “It sounds like you’re concerned about finances. I certainly understand.”

  • State objective: “Let’s find a way to make this care affordable for you so we can get it done as soon as possible.”

  • Present argument: “Unfortunately, as this tooth decay progresses, the problems only become more expensive to solve.”

  • Conclusion: “So here are a few options we can provide that will help you stay within your budget.”

Some patients are in genuine financial distress and cannot afford our services. We must always respect that. However, there are many others who can afford care, but who don’t value oral health above their other expenses. Let’s focus on the second case. Sure, we could have just responded by listing financing options to your patient. But I think it’s important to first remind the patient that delaying care can only lead to more expensive dentistry. Not only is that the truth, it also helps the patient think about his or her concern in the bigger picture. Once the patient realizes that delaying treatment can only make financial concerns worse, he or she will be more receptive to financial solutions like CareCredit.

Case two:

A busy patient is notorious for putting off treatment due to his hectic schedule. You diagnose the need to replace a crown during a routine hygiene appointment, but you know he won’t make time to come back for it.

  • Acknowledge: “I know you’re a very busy guy and it’s been a challenge in the past to make time for your care.”

  • State objective: “We need to replace this old crown for you before the decay progresses.”

  • Present argument: “I’ve got great news for you. We’ve just invested in same-day crown technology. A procedure that used to take two visits now takes only one.”

  • Conclusion: “I treat a lot of busy professionals like yourself, and this same-day technology has really helped them out. Let’s make this work for your schedule.”

In this case, I wouldn’t wait for the patient to raise the objection; he already has a history of delaying care. Patients don’t always verbalize their objections, and so our ability to read body language and recall past experiences with their care will serve us well. And let’s not forget that one of the reasons we invest in same-day technology like Planmeca FIT is for the patient wow factor. We should be finding opportunities to wow our patients, especially when our technology helps address their concerns with traditional dentistry.

Case three:

A patient is interested in a full-arch reconstruction, but she appears to be anxious about the process. After inquiring about her concerns, you learn she is saddened at the prospect of extracting more teeth (hopeless though they are). She is also afraid that the final restoration may not look natural or function comfortably.

  • Acknowledge: “This is a big transition for you and it’s perfectly normal to feel nervous about it.”

  • State objective: “I think we’re making the right decision to replace your teeth as we’ve described.”

  • Present argument: “I have a patient that went through a similar transition a few years ago. She’s given me permission to be contacted by folks like you who could use some reassurance.”

  • Conclusion: “Would you like me to put the two of you in touch so she can share her experience?”

Psychological objections can be tough to overcome, whether the patient is fearful of painful procedures or being unhappy with results. In this case, the patient just seems overwhelmed with anxiety. I’ve found that satisfied patients are far more convincing than I ever could be.

We are members of a health-care profession, but we are also in a service industry. Part of our role as service providers is to help concerned patients realize that their care is affordable, efficient, and comfortable. By having a structured, thoughtful response to objections to treatment, we can hopefully overcome their perceived barriers.

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