A five-step selling system

Aug. 1, 1998
Take each step gingerly, as if checking the thickness of ice. The point, as always, is to develop strong relationships.

Take each step gingerly, as if checking the thickness of ice. The point, as always, is to develop strong relationships.

Roger P. Levin, DDS, MBA

Only when patients perceive that proposed treatment is valuable will they be motivated to accept it. Prompting each patient to accept care requires the five-step selling system developed by The Levin Group after 12 years and over 2,500 consulting clients. Dentists and staff must be able to help patients answer the following four questions about treatment:

- What is it?

- What will it do for me?

- How long will it take?

- How much will it cost?

You and your staff also must provide each patient with WOW-factor customer service, a comprehensive diagnosis, and an organized, confident case presentation. However, you may find that you perform each of these elements flawlessly and patients still do not accept treatment.

This is precisely why you must follow the five-step selling system. Patients will not accept treatment if you have not involved them emotionally and logically in the treatment-plan process. Unless patients thoroughly understand treatment and have had all of their objections effectively responded to, motivating them to accept treatment will be difficult.

Step 1. The Open Probe

The five-step selling system begins with the open probe, which is a series of questions that require more than a yes or no answer. These questions elicit answers that reveal personal information about patients, such as their interests, hobbies, anxieties, perceptions, previous dental experiences, and current knowledge base. You can know your customers only when you ask questions.

A direct correlation exists between case acceptance and questioning - that is, the more questions you ask, the more likely it is that patients will accept treatment. Questions enhance case acceptance because they not only provide you with the opportunity to gather essential patient information, but they also involve patients in the diagnosis and treatment processes.

Answering questions encourages interest, motivation, and commitment. Patients want to know exactly what is wrong with them and how it can be corrected or, if considering elective procedures, how they can improve themselves. However, giving them too much clinical data early in the selling process might precipitate a loss of confidence in you. The open probe indicates how you should proceed.

When using the open probe, give patients a lot of latitude with which to answer. For example, open-probe questions may include the following:

These broad questions will reveal a great deal of information. People enjoy talking about themselves and their dental experiences - they simply need someone to ask them. Answers to open probes provide you with a road map of patient perceptions and expectations. As you move through the five-step selling system, it is these perceptions and expectations that you must influence. Therefore, determining what they are early on is important. You can go nowhere if you have no starting point. Following this conceptual map is critical to selling dentistry.

The open probe should be conducted during the preclinical interview, but do not assign it a time limit. Patients, discussing very personal issues, such as fears and perceptions, need time to tell their stories. Rushing patients through this often-delicate process severely hinders case acceptance because time constraints limit patient involvement and commitment. Patients become comfortable by talking and learning. Take your time!

In most offices, patients are never informed of elective or comprehensive dental options. Instead, they are told only about broken or decayed teeth. That serves as the treatment plan!

Practices that present comprehensive treatment enjoy case-acceptance rates nearly 400-500 percent higher than those that do not.

Allow your patients plenty of time to talk. Patients should do 70 percent of the talking during the open probe. If you find that you are doing most of the talking, stop and listen! Failing to actively listen reduces your case-acceptance potential.

Active listening is a skill learned with practice that facilitates patients` comfort with and confidence in you. Never interrupt patients.When patients know that you are truly listening to them, they internalize your compassion and concern and presume that you are a more qualified clinician.

Instruct your entire staff to engage in active listening. Though you will never be paid directly for this service, it is one of the best investments you can make. Take notes on key points made by the patient, as this forces you to concentrate. Overcome your desire to jump into diagnosis and treatment. Failing to fully pursue the open probe is a common mistake. The benefits of this step are nullified without active listening.

Step 2. The Closed Probe

The closed probe, the second step in the five-step selling system, evolves naturally from the open probe. The closed probe involves questions that elicit yes or no answers. You must get to know and understand your patients before asking closed questions. If you initiate the closed probe too soon, your questions might generate no response at all. This practically guarantees that the patient will not entirely buy into the treatment plan.

The progression from open to closed probe should be smooth. The open probe provides you with the information you need to begin more specifically exploring your patients` points of view. Use it to evaluate your patients` real and perceived needs and establish your parameters for the rest of the diagnosis and treatment presentation. Note the interests, concerns, motivations, and confusion patients express. These are all opportunities for further exploration during the closed probe.

The specific information elicited during the closed probe lets you know the direction in which to move. While the open probe should be used in the preclinical interview and diagnostic stage, the closed probe is used only during the treatment-presentation stage. It is at this point that you must begin streamlining the conversation to move toward the close.

Use the closed probe as you move toward case acceptance, but move cautiously. Initiating a closed probe is like checking ice on a pond. Do not run impulsively into the middle of the pond. Instead, gingerly take each step to determine if the ice is thick enough to support your weight. Ask a series of related questions to make sure that you and your patient are on the same wavelength.

Closed probes may include the following questions:

Do not discuss fees during the closed probe. As you become more specific, patients will follow your lead and ask more specific questions. However, you have not built enough value at this stage to offer any information regarding fees. If a patient continues to press you on fees, you have not addressed treatment benefits and value-building issues sufficiently. Someone else is always willing to perform a service for less. The goal of the five-step selling system is to establish value sufficient enough to prompt patients to pay your fees, regardless of how much it costs.

The closed probe should build excitement, enthusiasm, and motivation. Patients should buy now with emotion.

A great deal of education regarding clinical problems already has occurred during the diagnostic phase. Additionally, all open- and closed-probe questions now have been answered. At this stage, patients should be excited to hear more about what you can offer them. You are now ready to present treatment. Remember, base your approach on the information already gathered.

The treatment-plan presentation is a separate appointment from the consultation, and is not covered in detail in this article. However, certain factors critical to treatment presentation include:

- If possible, the dentist and staff should not be interrupted during treatment presentations. Interruptions hinder case acceptance, because they make your patients feel as if they do not have your complete attention. Therefore, everyone must be aware of the times during which treatment-plan presentations are scheduled.

- Spend the time necessary to document your treatment plan properly and provide copies for your patients. Anything larger than your most basic case requires organization and extensive planning. Encourage patients to follow along with each step of the recommended plan as you present it. It is essential, that your plan be thorough, detailed, and easily understandable.

- You must remain completely focused on your patients. Clear all other thoughts from your mind. Negativity and stress are evident to patients and will inhibit severely what is supposed to be an enthusiastic presentation. Remember, you now are engaged in a selling activity, and you must regard it as such.

- Your financial coordinator must be prepared to present financial options when you think it is appropriate. Avoid a long delay between your educational/motivational treatment-plan presentation and the presentation of financial options.

Following your treatment plan presentation, you should have some indication of the patient`s intentions. This indication is called a buying signal.

Step 3. Buying Signals

A buying signal is a statement made by the patient that indicates his or her level of interest in or commitment to the proposed treatment. Because buying signals come in many forms, you must pay careful attention to detect them. Common buying signals include the following statements:

While some buying signals are stronger than others, each is an indication of patient interest. A buying signal is not a commitment - it merely alerts you to your patient`s frame of mind.

Until you hear a buying signal, you can be fairly certain that you will not close the case. Case acceptance depends on steadily building interest and enthusiasm so that patients may ultimately justify and accept treatment emotionally.

Buying signals can come at any point during the five-step selling system. While they generally do not occur at the beginning of the presentation, some patients are relatively comfortable with the prospect of treatment and are prepared earlier than others to make a commitment. The five-step selling system may need to be abbreviated or expanded, depending on the patient`s intentions.

Some patients require multiple appointments for consultation and treatment presentation, while others require only one appointment. It is possible that a $12,000 case will be accepted in one consultation appointment, while a four-unit bridge will take three!

Once you hear a buying signal, you must decide if you should establish more interest or present your fees and final treatment time-line.


Once you address fees, you may begin to receive objections. Many doctors become defensive or frustrated when they encounter objections. They do not realize that objections are a natural part of the decision-making process for most consumers, regardless of the product or service being sold. Instead, the doctors interpret these objections as attacks on their professionalism and expertise.

Many dentists also erroneously consider patient objections as a rejection of the treatment plan and subsequently abandon the treatment-plan presentation.

Again, you cannot equate voicing objections with rejecting treatment. Raising objections is simply the patient`s way of asking for further information. Poor handling of patient objections will limit your case-acceptance potential.

Objections are essential to closing treatment plans. They help patients feel comfortable with the idea of treatment and promote its value. Most people feel comfortable accepting comprehensive care only after being given the opportunity to thoroughly analyze and internalize it. Therefore, a patient voicing no objections is cause for concern.

Objections benefit you, too, for they help you understand your patients` perspectives and give you guidance as to how to proceed. Not only should you appreciate objections, you should solicit them throughout the treatment-plan presentation.

Patients often express their buying signals through objections. For example:

Respond not only to the surface objection, but also to the buying signal contained in each remark.

Step 4. Support Statements

Support statements that you or your team make reinforce the proposed treatment and its benefits. Continu-ally speak in terms of treatment benefits and focus on the primary reason that the patient should want to undergo treatment.

Additionally, once a patient has offered a buying signal, you must immediately respond with support statements. Use this opportunity to reiterate the benefits of treatment and negate any patient objections voiced earlier. Patients will not accept treatment unless they trust you. They need to hear you say, "I would recommend this treatment to any member of my family."

Support statements serve as reassurances that the right decision has been made. Support statements include:

These support statements address the patient`s quality of life and offer a concrete reason to undergo treatment.

Equally critical support statements focus on the patient`s decision-making ability. This type of support statement includes:

These statements reaffirm the patient`s decision and set the groundwork for a relationship based on trust and value. Remember, as soon as you hear the buying signal, capitalize on it with several support statements.

Step 5. The Close

Each aspect of the five-step selling system leads logically to the last step - the close. It is during the close that you must ask for the patient`s commitment.

Many dentists are apprehensive about closing the treatment-plan presentation. However, dentists who never ask for patient commitment have low case-acceptance rates. Everyone needs a coach - someone to whom they look to for motivation. You are your patients` coach. You must provide the gentle push that prompts treatment.

You will not be able to motivate patients using a hard sell. The decision to undergo treatment is ultimately the patient`s decision. However, a decision of this nature is very easy to postpone unless a commitment is requested. Doctors who implement each step in the five-step selling system and then ask for a commitment, usually get it.

Ask for the close only after you have offered support statements. Talking excessively to avoid the close is a common and dangerous mistake.

Many of The Levin Group`s clients have closed cases simply by asking patients: If money were no object, would you want to have this procedure done?

If the patient responds with a yes, you have presented the case successfully thus far, and the only objection left to overcome is money. You must then ask yourself: Did I create enough value for this patient to pay my fee?

It is during the close that the treatment fee must be presented. Be proud of your fee and reinforce the fact that the results are well worth it. Reiterate the treatment benefits, giving the patient an opportunity to respond. Be aware that the total treatment fee is seldom as much a concern as how payment will be made.

Almost inevitably, if you have followed the five-step selling system properly, the patient will respond to the treatment fee with an objection or a buying signal. Once objections have been overcome and support statements offered, you must ask for a commitment. The best strategy involves asking the patient to schedule an appointment. For example, ask the patient the following question: Mrs. Jones, would you like to start this treatment within the next two weeks?

If, in response to this question, the patient tells you that he or she needs more time to think, or in any other way dodges making a commitment, you have not closed the case. Unanswered objections remain - you may not have even uncovered all of the patient`s objections. When this occurs, ask the patient to come back for a second consultation to finalize your treatment proposal.

Do not limit your close to one consultation. Too many dentists try to present comprehensive or elective treatment the same way that they present a small restoration. One consultation may not be sufficient or provide enough time for the patient to make a commitment of this magnitude.

To get patients to accept your treatment, you must successfully motivate them and build a positive relationship that shows that you care about their health and appearance. Using the five-step selling system effectively will help you accomplish this.

The Five-Step Selling System - the only way to ensure case acceptance - consists of:

Step 1. Open Probe

Step 2. Closed Probe

Step 3. Buying Signals

Step 4. Support Statements

Step 5. The Close

- How do you feel about dentistry?

- What were your previous dental experiences like?

- How do you feel about the dentistry previously performed for you?

- How do you feel about your smile?

- What have you heard about the latest advancements in dentistry?

- What do you know about recent advancements in cosmetic dentistry?

- How much do you know about implant dentistry?

- What kind of dental care did you receive as a child?

- Would you like a prettier smile?

- Are you interested in having your mouth restored to perfect health?

- Are you aware that dentistry does not last forever?

- Were you aware of the number of problems that I found in your mouth?

- Do those fractured teeth cause you pain?

- Would you be interested in dental implants to replace your missing teeth?

- Would you like me to place porcelain facings on your front teeth to ensure a beautiful smile?

- What kinds of payment plans do you offer?

- Can we do this on a Wednesday?

- Will I be able to get back to work within a few days?

- Can you perform the cosmetic procedures first?

- How long will it take to complete the first phase of treatment?

- How long will it take to complete the entire procedure?

- How do I know this will work?

- It`s very expensive.

- My friend said it was very painful.

- How many of these procedures have you performed?

- You will look younger.

- You will be able to chew better.

- You will keep your teeth for a lifetime.

- Your teeth will be whiter and brighter.

- Your pain will be gone.

- Your decision to pursue treatment is right on target.

- I certainly agree that a whiter smile would make you look younger.

- I know that you have been experiencing discomfort, and I can understand why you would want to eliminate it.

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