Th 284897

Case closed: Case presentation skills matter!

May 1, 2008
Dr. Miller* stepped into his office and sighed. Today was going to be another HECTIC DAY...
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For more on this topic, go to and search using the following key words: dentist, treatment, plan, case presentation, motivation, patient education, trust.

Dr. Miller* stepped into his office and sighed. Today was going to be another hectic day — so hectic he wished he could have just stayed home in bed! His patients were not accepting his recommended treatment plans at the rate he wished. This confused him because he felt his case presentations were perfectly adequate. He could feel the knot forming in his stomach as he realized that disappointing case acceptance was severely limiting his ability to do the kind of dentistry he enjoyed — the kind that really changed people's lives. As a result, he had nearly given up on having any goals other than simply getting through the day. He was losing his passion for dentistry. He knew it. His team knew it. And perhaps even his patients knew it.

Too many doctors could easily fit into Dr. Miller's shoes. He has found out case presentation is one of the most challenging skills for any dentist to master. There are many reasons to explain this difficulty. First, many individuals who pick a professional field such as medicine or dentistry are not naturally inclined to address motivational and influential necessities inherent in case presentation. True to their dental school training, dentists instead tend to focus on the technical and clinical features of cases. Patients, on the other hand, are more focused on lifestyle benefits.

Dr. Miller faces other obstacles as well. Like many practices today, the pace in his office is rapid — often hectic. He is finding it hard to take enough time to talk patients through every aspect of medium-to-large cases, answer questions, and work through each issue to help patients make a decision. Dr. Miller is part of the problem here. He has become increasingly unmotivated to present more cases because of their low acceptance rates. As a result, he doesn't spend additional time and effort to improve the presentation because he doesn't believe it will matter. Dr. Miller has become caught in a vicious cycle, and he is not happy with it. He has joined the almost 25 percent of dentists who report high stress, according to the 2007 Dental Economics®/Levin Group Practice Survey.

Enhancing case presentation skills

One of the critical factors in increasing practice production is obviously case presentation. Yet, it is often taken for granted by many practices like Dr. Miller's.

Dr. Miller thought his case presentations were "perfectly adequate." Adequate is never enough. To begin to boost his case presentation skills, Dr. Miller will need to think differently. The first step is to understand that most patients are not motivated to accept treatment in a dental practice. Their motivation is to get only what is needed. Patients do not mind spending money, but they want to spend it in places that give them enjoyment or satisfaction. Rarely is that place a dental practice.

Keep in mind that patients are often unaware of what services are available in a dental practice. The following steps should be immediately implemented if Dr. Miller is to create a higher level of interest and motivation on the part of his patients:

1. Educate patients. Every patient should be educated about all of the practice's services, preferably during a hygiene visit. Levin Group recommends calling this visit the "periodontal maintenance and oral cancer exam appointment" because the hygienist has more time than the dentist does to educate patients who may need treatment. Use hygiene visits with standard scripting to educate patients about all the potential services in the practice.

2. Provide support materials. Educational materials, such as brochures, should be available to reinforce services discussed with the dental hygienist. This information is not a replacement for a good case presentation. Instead, it is, as the name suggests, "support" material.

3. Reschedule when necessary. If the doctor does not have time to fully discuss a potential case during a hygiene exam, the patient should be rescheduled at no charge for a consultation. This should be a 20-minute or 30-minute uninterrupted appointment to give the patient an opportunity to meet with the doctor to discuss the potential case. If these appointments are handled correctly, most patients will accept treatment and practice production will increase.

4. Follow up on treatment. If you have made your case presentation to a patient and that patient does not schedule treatment, a follow-up phone call should be made by the front desk staff the next morning. Many patients are extremely interested in having treatment and just need a slight additional prompt to schedule it. By having a front desk staff member call the next morning to schedule treatment, you have a much greater opportunity of the patient making the decision to have treatment.

Patient trust is everything

Dentists like Dr. Miller believe patients have high levels of trust in the doctor and the practice. That's not true. That type of confidence is purely conditional. Dentists often do not realize that trust does not apply to all services. Patients may have confidence in the dentist restoring a broken or decayed tooth, but they don't necessarily have the same kind of confidence about the need for a larger case or elective treatment. Keep in mind that patients have a specific vision of dentists. Most patients think of dentists as taking care of basic dental needs. They don't realize that dentists are capable of providing larger or more comprehensive treatment as well.

Levin Group finds that only a small percentage of practice production is elective in nature. This is a clear sign that patients still view dentistry as a need-based activity. Consequently, dentists must develop different styles of case presentation depending on the type of case being presented.

One recommendation is to have a separate consultation that is scheduled during specific times of the day. Levin Group scheduling — a mathematical approach to designing ideal schedules for clients — usually places these consultations in the midafternoon when most of the high-level treatment has been completed for the day. This would allow Dr. Miller to focus completely on the patient in a relaxing atmosphere in order to spend the necessary time to present the case, answer questions, and work through objections.

Better skills, brighter future

Dr. Miller's future success hinges on case presentation. Even if other systems are in place and operating efficiently, failure to master case-presentation skills will restrict growth of his practice. Until Dr. Miller enhances his case-presentation skills, he will have to depend on a high volume of patients to generate production, with a disproportionate number of cases focused on single-tooth treatment.

Invariably, a hectic schedule like this leads to a dentist like Dr. Miller eventually thinking that his only objective is to get through the day.

The good news is that there is a bright future waiting for Dr. Miller and all dentists in similar situations. That future begins with superior case presentation skills.

*Dr. Miller is based on a composite of Levin Group clients.

DE® readers are entitled to receive a 20 percent courtesy on Dr. Levin's Practice Success seminar for general dentists May 15-16 in Las Vegas. To receive this courtesy, call (888) 973-0000 and mention Dental Economics® or e-mail [email protected] with "Dental Economics" in the subject line.

Roger P. Levin, DDS, is founder and CEO of Levin Group, a leading dental management consulting firm that is dedicated to improving the lives of dentists through a diverse portfolio of lifetime services and solutions. Since the company's inception in 1985, Dr. Levin has worked to bring the business world to dentistry. Levin Group may be reached at (888) 973-0000, or at

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