Taking 'no' for an answer

I was coaching Heather and her staff on how to talk about money with patients.

Paul Homoly, DDS

"Knock, knock."
"Who's there?"
"Snow."
"Snow who?"
"Snow use to push patients into treatment if they're not ready."

I was coaching Heather and her staff on how to talk about money with patients.

"I hate talking about money," said Heather. "My staff does a pretty good job with it, so I stay out of it."

Her receptionist, Elaine, put a different spin on it. "Our doctor is terrific with patients, but when it comes to money, she delegates to us. Most of the time, we don't know exactly what she's said, and we often get into hassles about money with patients."

Heather and many dentists and staff I've coached have a speech impediment. It's called "Money Mumbles." Its symptoms include brain damage, anxiety, and the slurred speech that accompanies talking about money.

"I just don't like talking about money - especially big fees," explained Heather.

"What if you knew with 100 percent certainty that when you quoted big fees, patients would say yes? If you knew patients would say yes, would talking about money distress you?" I asked.

"Of course not!" Heather replied.

"Then your stress doesn't come from talking about money. It comes from not knowing what to say when patients say no," I said.

Not knowing what to say when patients say "no" leads to an awkward silence and creates stress for everyone. A big part of being comfortable about quoting big fees is learning what to say if the patient says "no."

Here's an example of what to say when a patient says "no." Your patient, Mr. Crawford, says he wants his back teeth replaced and his front teeth to look better. You've treatment-planned him for complete dentistry that can be done in sextants over time, and his total treatment fee is $12,000. You tell him the fee, give him an idea of how long the treatment will take, and ask if this is appropriate for him.

"Mr. Crawford, your total treatment fee is $12,000, and it will take us about one year to complete the work. Is this comfortable for your budget?" Mr. Crawford says no and asks what else you can do.

"Mr. Crawford, what if we spread your treatment out over time, doing half this year and half next year? Would that be better for you?"

Mr. Crawford says no again, so you extend the duration of his treatment again.

"Mr. Crawford, what if we spread your treatment out over time, doing about $3,500 this year and the rest when you're ready? Would that work better for you?"

When Mr. Crawford says "no " again, it's a good indication that he isn't ready for full-mouth care. Return to his chief complaint (front teeth), and plant the seed for future care by using the "Taking 'No' for an Answer" dialog.

"Mr. Crawford, it sounds like this might not be a good time for us to do all of this dentistry. Let me make this recommendation. Let's make the dark front tooth that you're worried about look a lot better for now. The fee for that tooth is $500. When you're ready to get the rest of your teeth fixed, we'll be here."

When it becomes obvious that a patient is not ready for full-mouth care or doesn't have the budget for it, say: "Maybe this isn't a good time to get all your teeth fixed. Let's fix that one area you're concerned about, and when you're ready to get your other teeth fixed, we'll be here." This response leaves the door open and doesn't embarrass the patient.

Accepting "no" for an answer is tough to do. We've been trained to go for "yes." Many seminars teach that no is not an option. I disagree! Often, "no" means "not now." Pushing our patients makes us sound like salespeople, and salespeople don't sell complete dentistry. Make it OK for patients to do dentistry on their schedule. Don't make patients wrong for not being ready. When you plant the seed, they'll come back to you when they're ready. Taking "no" for an answer is part of selling complete dentistry ... and it cures the "MoneyMumbles!"


Dr. Homoly coaches dental teams to implement reconstructive dentistry through his continuing-education workshops, private consulting, and seminars. This column is an excerpt from his new book, Isn't It Wonderful When Patients Say Yes? - Case Acceptance for Complete Dentistry. Dr. Homoly can be reached at (704) 342-4900 or via e-mail at phomoly@mindspring.com. Visit his Web site at www.paulhomoly.com.

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