The blueprint for a successful case presentation

April 1, 2019
Treatment acceptance is dentistry’s weak spot. But when it’s fixed, it offers the quickest route to practice improvement. Here are three simple—but essential—strategies for improving dental case presentation.

Gregory A. Winteregg, DDS

Over the past 25 years, I’ve lectured to thousands of dentists about how to improve treatment acceptance, and I can tell you categorically that as a profession, this is our weak spot. For the average dentist, it’s the area of practice that underperforms the most.

But conversely, when fixed, it’s also the area that offers the quickest route to practice improvement. Specifically, improved treatment acceptance translates into

1. higher professional satisfaction, because the doctor is doing more of the dentistry he or she enjoys doing,

2. better production, collections, and profitability, and less open time in the schedule, and

3. most importantly, patients accepting the dentistry that they need.

Healthier patients are what all of this is about in the end anyway, isn’t it?

Higher treatment acceptance is truly a win-win-win scenario for you, your practice, and your patients.

And while it’s not hard to improve on this subject, there is potentially a lot to learn—communication skills, case presentation structure, and how to address objections, just to name a few things. In an effort to make the subject less daunting, I thought it would be productive to center this article around a few simple actions that you could easily put into practice and which could start you on the right road.

Now, all these actions assume you’ve completed a comprehensive examination, created the resultant treatment plan, and are ready to present. With that in mind, let’s have a look at three things that can help ensure your treatment plan has the best chance of acceptance.

Enough time

I have a rule—don’t start a treatment plan presentation unless you (and your patient) have adequate time to complete it. That means enough time to answer your patient’s questions and concerns, address objections, and so on.

How does this normally go wrong? The doctor walks into the hygiene room for a new-patient examination. On average, the doctor has 20 minutes set aside for this. After a 15-minute comprehensive examination, the doctor finds that the patient needs four root canals, six crowns, and a few composites. Depending on fee structure, we’re looking at an $11,000 case. The doctor then spends the last five minutes of the appointment (there’s another patient who’s been seated and is waiting now) telling this new patient that he or she needs all this treatment, and then sends the patient up front to work out finances.

And, surprise, at the end of the day, when the doctor asks what happened to these patients, the front desk says they “are going to think about it.” Or they only want to do the one root canal and crown that the insurance will cover and wait on the rest.

And it’s no wonder: the doctor spent all of five minutes explaining an $11,000 case. When was the last time you decided to spend over $11,000 in five minutes? Maybe you have—but I can assure you it’s not the norm.

Whether you’re dealing with a new patient or even a patient of record, you need adequate time to present. So, what should you do if you or your patient doesn’t have adequate time?

Schedule a consultation. Historically we’ve reserved consultations for “big” cases. But they don’t have to be. You might need 20 minutes to discuss a couple of crowns with a patient to ensure he or she fully understands why they are needed and answer any questions.

A couple of hints here: don’t push the consultation off too far (e.g., three weeks from now). Get them in right away. Don’t let their enthusiasm wane. And second, the larger the case is, the more time it will normally take to discuss it with your patient. Schedule accordingly.

You can also apply this concept to patients of record. Rather than try to jam the treatment discussion during a five-minute hygiene exam, you’re better served bringing patients back for a consultation.

That little bit of extra time discussing treatment can pay off in a busier, more productive schedule and healthier patients. It’s worth carving out the time in your schedule because it results in more production long term.

Don’t use big words

Have you ever witnessed that “glossed over” look a patient gets when you use an unfamiliar dental term? You mention a “periapical radiolucency” and you see that glazed stare (it could be for less than a second). So, you ask, “Do you have any questions?” And the patient says . . . “No, not at all.” You know the patient didn’t get it, but what are you going to do, challenge him or her on it? Of course not.

I’ve heard the concept that “using big words makes you sound more ‘doctor-ly’ or professional.” I thoroughly disagree. The most important thing in a treatment presentation is that patients understand what you are trying to explain. If that’s the case, why use words that they don’t understand? Your patients are accountants, mechanics, car salespeople, etc. They are not dentists. Act accordingly. Use nontechnical terms, or if you do use technical terms, make sure you explain them.

Discuss the fee

Here’s the big one. As the doctor, the idea of discussing fees with patients may prompt any number of reactions. You might worry that patients will think you are “unprofessional” or “just after their money” (they won’t). You may have a difficult time even contemplating the idea of doing it. But let’s be real here. Why do most of us not want to discuss fees? I can tell you why I didn’t: fear. People can get emotional when you discuss money. So, we avoid discussing the fee and send them to Susie at the front desk to do it.

Years back, one of the consultants I worked with (prior to working with and becoming a partner at MGE) told me that I should never discuss fees, and that I would “mess everything up” that he had put in place if I did so. I asked him, “What should I tell a patient if they ask me how much something costs?” He told me: “You tell them you don’t know.” I found this ridiculous and couldn’t do it. If patients asked, I reluctantly told them, but often I didn’t have to because they discussed it with my financial coordinator. After I became an MGE client, I began discussing fees with patients. This, coupled with better communication skills, was instrumental in moving case acceptance to an entirely new level.

It may seem trivial, telling a patient how much their treatment will cost. But it’s not. And why does it help? Well, survey your staff. Ask them, “Who in the office is a patient most likely to listen to?” Uniformly, you’ll hear “the doctor.” When you tell a patient something, it carries more weight.

And much of the time, if patients have a concern or objection about the treatment, they won’t bring it up until it comes time to talk finances. If you’re no longer in the room at this point, you can’t address those concerns with them.

I’m not asking you to have them hand you their credit card or fill out a financial company application for them. Just find out, prior to presenting, how much the treatment is and tell them. They won’t bite. They may have questions, concerns, and so on, and you can discuss these with them. Then turn them over to your financial coordinator to wrap things up.

I hope you find this useful. Try these strategies out in your office and let me know how it goes.
Greg WinterEgg, DDS,is an internationally recognized practice management speaker and author. After transforming his small-town office into one of the top practices in the nation, Dr. Winteregg joined MGE Management Experts as a partner in 1994. Since then, he has personally consulted and lectured to tens of thousands of dentists across the United States and Canada. Visit or call (800) 640-1140 to complete Dr. Winteregg’s Effective Case Acceptance Course online.

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