Reinventing case presentation

June 1, 2011
In the recent economic downturn, more patients postponed or rejected treatment. Dentists are looking for ways to increase case acceptance.

Roger P. Levin, DDS

For more on this topic, go to and search using the following key words: case presentation, new patient experience, financial options, Dr. Roger P. Levin.

In the recent economic downturn, more patients postponed or rejected treatment. Dentists are looking for ways to increase case acceptance. To accomplish this goal, practices must evaluate and modify their case presentation process. The target is to close 90% of all cases.

Dentists typically experience good case acceptance for smaller, single-tooth procedures. Success has little to do with an ability to “promote” treatment. Unfortunately, as soon as the case size begins to increase, everything changes. They experience a very steep drop in case acceptance — a key reason so many dental practices plateau and remain far below their real potential.

The time has come to step back and think about case presentation in a whole new way. Almost every practice can increase production by as much as 30% to 50% in a relatively short period of time, but only with excellent business systems — including case presentation.

The new patient phone call

The new patient phone call is all about scheduling patients and getting them into the practice as quickly as possible. You have to create confidence for patients on the phone, demonstrate great value for the practice, transfer trust to the doctor and staff, and ensure patients see value in the practice. This is the first step in creating a powerful relationship and a high level of desire by patients to be part of this high value-oriented practice.

The new patient phone call includes scripting such actions as thanking the patient for calling the office, complimenting the individual who referred the patient (if applicable), and thanking the patient again at the end.

It includes factors that build confidence, such as commenting on the endorsement of the referral source, and the transfer of trust that includes a 40-second, customer-written script talking about the doctors, staff, and practice. All of this is meant to achieve the ultimate goal of creating value in the mind of the patient.

The new patient orientation

Very few practices think of the new patient’s first visit as “orientation.” They typically either give patients a pile of forms to fill out or give them a cursory greeting and assume that value-building will take place in a clinical area. This is a mistake.

The new patient orientation should include:

• A welcoming greeting

• Relationship-building

• An overview of the office

• Value-building

• Insurance overview

Step-by-step scripting lets patients know how delighted the front-desk staff person is that they have joined the practice. On a subconscious level, it promotes the idea that they will become lifetime patients. Scripting includes an overview of the practice and all of its positive features, and then a positive discussion about the doctor and staff that reinforces the idea that the patient will have an outstanding experience.

The new patient experience

Here, the patient meets the dental assistant and then the doctor. The assistant builds a relationship with the patient, using techniques such as The Golden Ten™, which means learning 10 things about each new patient prior to commencing any clinical examination. Next, learn at least one new thing every time a patient comes to the practice to further deepen the relationship.

The new patient experience reflects the entire process from the patient’s entering the practice to move to the clinical area. First, a dental assistant is properly introduced to the patient. This individual continues the relationship-building process using key questions and scripting, and further educates the patient about the practice. This includes an explanation of the first-visit examination. Then, the patient meets the doctor, who will spend a few minutes furthering the relationship once again using powerful scripting.

Remember that scripting is no longer about communication, but rather about influence. In the postrecession era, patients want more value for their money and better reasons for why they should take a particular action regarding treatment, paying bills, etc. Levin Group recommends that practices develop highly influential scripts to motivate patients and focus on the benefits of every action for the patient.

The new patient case presentation

In case presentation, we must understand the patients’ perspective. As the recent economy shows, patients are more reluctant than ever to reach into their pockets. This requires some different approaches to case presentation.

For example, we recommend that approximately 60% of all case presentations need a second consultation if more than $1,200 in fees is involved, and 15% of those cases may need a third consultation.

A dentist recently asked me at a seminar why it would ever be necessary to have a third consultation for case presentation. I answered with a question: “If I were willing to pay you $7,000, would you meet with me three brief times to discuss it?” After he thought about my question, he answered, “Yes. I see your point.”

This was a simple way of pointing out that we normally deal with patients who are having single-tooth treatment, and these individuals do not need second and third consultations. However, if a practice is going to expand the range of treatment and fees over a broad base of new patients, then it is imperative to give them an opportunity to become comfortable with the recommended treatment.

The new patient financial options

To make case acceptance easier, Levin Group teaches practices to offer the Four Financial Options™ to patients. These options should be presented to every patient, regardless of economic background, age, status, or longevity in the practice. Having these options available can make the difference between marginal case acceptance and outstanding case acceptance:

• Cash up front merits 5% off — This eliminates concern over collections or administration of the financial account. Further, patients who have paid have an incentive to be pleased with the dentistry because they have already paid for it.

• Credit cards — Today, people prefer to charge most of their purchases. Credit cards are the norm and dental practices interested in high case acceptance rates should be most happy to accept them.

• Half up front, half before the end of treatment — This means no case should ever be started without half the payment in advance. Short of this commitment, collection problems are common in slower economic periods.

• Patient financing — Outside patient financing should be offered to all patients. By offering every patient a wide variety of financial options — including outside financing — more clients are able to access the care they need and want. Outside financing also removes the burden of collections from the practice. Furthermore, programs such as CareCredit® offer many tools for your practice, including a customized Practice Performance Review to help practices reach their goals. The Practice Performance Review uses real data from your practice to help you track new patients from CareCredit’s network, doctor locator search results, and more.

The new patient follow-up process

The follow-up process is for patients who either reject treatment or accept phased treatment. If a patient rejects treatment, most practices do nothing else. In fact, many of these patients are lost to the practice because they also never receive hygiene appointments while the practice is waiting for them to call and make up their minds about having treatment.

In reinventing case acceptance, the practice must follow up. This can occur by front desk people setting up the next conversation using scripting such as:

“Mrs. Jones, as a service to you, where can I conveniently call you tomorrow morning?”

Levin Group recommends that patients who reject treatment get a follow-up call the next morning and once a week for three weeks unless they actually state that they are not interested in treatment.

Phased treatment (treatment will be provided over time in different segments) should also be presented. For example, a $6,000 case presentation could be provided at $2,000 every six months. The simple question any dentist should ask is, “Would I rather have 25% of the case now or nothing at all?”

With phased treatment, there must be follow-up from the practice. We recommend that the hygienist become responsible for identifying the time for the next phase, communicating that information to the patient and the doctor (in the morning meeting) and for using scripts to have the patient scheduled. This has been an extremely successful process, enabling more patients to afford treatment than they might otherwise, and creating a wonderful opportunity for production increases.

Increase case acceptance now!

Case acceptance rates can be increased right now. However, dentists must reexamine how they conduct their case presentations and adjust accordingly. To increase elective case acceptance, patients need to be motivated for treatment, trust the practice, and be pleased with their experience. Reinventing case presentation makes all of this possible.

Visit for Levin Group’s Resource Center to see a wide range of educational materials, including “The Tip of the Day” newsletters, and white papers. You can also connect with Levin Group on Facebook and Twitter (@Levin_Group) for tips, news, and the sharing of ideas.

Roger P. Levin, DDS, is chairman 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 can be reached at (888) 973-0000, or

More DE Articles
Past DE Issues

Sponsored Recommendations

Clinical Study: OraCare Reduced Probing Depths 4450% Better than Brushing Alone

Good oral hygiene is essential to preserving gum health. In this study the improvements seen were statistically superior at reducing pocket depth than brushing alone (control ...

Clincial Study: OraCare Proven to Improve Gingival Health by 604% in just a 6 Week Period

A new clinical study reveals how OraCare showed improvement in the whole mouth as bleeding, plaque reduction, interproximal sites, and probing depths were all evaluated. All areas...

Chlorine Dioxide Efficacy Against Pathogens and How it Compares to Chlorhexidine

Explore our library of studies to learn about the historical application of chlorine dioxide, efficacy against pathogens, how it compares to chlorhexidine and more.

Enhancing Your Practice Growth with Chairside Milling

When practice growth and predictability matter...Get more output with less input discover chairside milling.