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3 dentists offer expert case acceptance advice

March 1, 2021
Here are three perspectives on case acceptance from dentists who have struggled and learned a few things along the way. They want to share what's working for them with their peers.

In most dental practices, clinicians walk a tightrope between offering the best treatment for their patients while trying to persuade them that it is in their best interest to move forward with that treatment. This can feel a bit like selling, and you probably didn’t go into dentistry to be a salesperson.

But like everything else in this profession, improving case acceptance is a skill that can be developed. You just need to know a few basic principles.

During my career in this industry, I’ve had the privilege of meeting thousands of dentists. I’ve observed firsthand what separates the successful ones from those who struggle. To show you how the best dentists succeed, I’ve asked a few of my friends who are experts in implants, endodontics, and cosmetic dentistry to share their techniques.

An implant expert’s perspective

Sameh El Ebrashi, BDS, MS, FACP, is a board-certified Diplomate of the American Board of Prosthodontics and the American Board of Oral Implantology. He specializes in delivering all-on-four dental implant treatments at ClearChoice Dental Implant Center in Portland, Oregon. He’s presented thousands of treatment plans during his career, and he says success involves many factors, but one of the most crucial is to have crystal clear communication with patients. 

“One must have an understanding of why the patient is in your office in the first place, and what triggered that patient to seek treatment, perhaps moving from a state of apathy to a state of urgency,” Dr. El Ebrashi said. “Is their child’s graduation approaching? Are they at a different point in their personal life, perhaps dating again? Are they making a career change? 

“One needs to take the time to understand the patient’s emotion and motivation in seeking treatment,” he continued. “We know many treatment plans provide patients with teeth, but the plans can also leave them feeling underwhelmed and defeated at the end of treatment.”

How can that be avoided?

“Get to know your patients’ needs by asking open-ended questions. Try to put yourself in their shoes and imagine how overwhelmed they feel and how they might find the treatment options confusing. Get a feel for their family dynamic since the patient’s family may be the driving force behind their acceptance or rejection of treatment.”

Dr. El Ebrashi says that shifting from a doctor-centered treatment model to a patient-centered approach has made a tangible difference in his practice. 

“We can fall victim to our own cognitive biases when a patient shares a story that sounds like another patient’s story,” he said. “We may take a mental shortcut, thinking we know better, and offer the same solution. But every patient is unique.”

To address this, he advises weighing various factors when treatment planning, including demographics, gender, support structure, someone’s competence to consent, and their understanding of the treatment.

He shares a final piece of advice that his father, Kamal El-Ebrashi, BDS, MS, PhD, gave him many years ago: “Meet your patient’s mind before you meet your patient’s mouth.”

An endodontist’s perspective

Endodontics may be the most misunderstood of all the dental specialties. It’s common for patients to believe they should avoid root canals because they’re painful. How does Diwakar Kinra, DDS, a successful endodontist in Flint, Michigan, overcome these objections?

“With endo, we understand there are certain perceptions that we must overcome,” he said. “Pain is the biggest, but also cost to a certain extent.”

He says that he and his staff have taken a systematic approach to preparing everyone to handle potential objections. “We plan ahead, and this starts from the minute someone books their appointment to when they walk out the door. Each member of my staff has a script that they personalize. No matter what question a patient asks, everyone is prepared.” 

What about the fear of pain? “We work hard to remove the white coat syndrome. I even have a slide presentation filled with family photos running in the background so that my patients can see our team is human just like them.” 

What’s his advice to general practitioners who want to improve case acceptance? He says to invest in training and education. “GPs often treatment plan up to their comfort level. By investing in your skills, you’ll have greater confidence in the treatment plan you’re presenting. That will translate into your communications with your patients.”

Finally, don’t forget about future patients. “Once we exceed patients’ expectations, we’re not afraid to ask them to spread the word or leave us a review. This helps to gain the confidence of future patients who are doing their research on us and our competition.”

The cosmetic dentist’s input

For Brian Harris, DDS, founder of Smile Virtual, case acceptance starts before a patient ever walks in. “Dental offices receive calls all the time asking about prices. As dentists, we’re taught never to quote a price over the phone. Instead, we have patients drive to our office for a consult, and possibly for a follow-up appointment, before they ever get to see the price.” 

According to Dr. Harris, this model is inefficient for both dentist and patient. But what else are dentists supposed to do? Many believe that quoting a price over the phone will turn them into a commodity. “We’re taught that we have to demonstrate value to our patients before discussing price. The way to do that is to have patients jump through a lot of hoops.”

Dr. Harris has found a way to turn the old model upside down by using social media. “Dental websites are static,” he said. “I have a highlight reel on Instagram that I constantly update. I post photos of the type of cases I want to attract. This way, future patients can see the quality of work I’m providing before we ever speak.”

With every post, Dr. Harris includes a call to action that says, “Click on my bio to get your questions answered in three steps.” Finally, he makes it as easy as possible for patients to move forward. 

Dr. Harris suggests that dentists ask patients to upload a picture to the practice website or in an email with a short note about what they’d like done. He writes them back with treatment options and cost.

“Patients want transparency and convenience, and that’s what we give them. If they still don’t move forward, that’s fine. We’ve saved everyone a lot of time.” 

Does this mean the traditional model doesn’t work? “There will always be patients who want to jump through the traditional hoops,” said Dr. Harris. “But in my experience, there are many more who don’t have time for all of that. With all of the technology that we have today, establishing that trust up front is easier than ever.”

The final advice he offers to his fellow dentists to improve case acceptance is to think about patients first. “It’s not about telling and selling. It’s about asking and delivering.”

With a few adjustments and a little practice, dentists can master the skill of case acceptance with the best of them. I wish you the best of luck and let me know how it goes.  

DONAVAN DICHTER, MBA, is the senior director of marketing for Implant Direct, part of the dental platform at Envista Holdings. He is passionate about the dental industry and loves helping dentists find ways to grow their practices. Connect with Dichter on LinkedIn at linkedin.com/in/donavand/

About the Author

Donavan Dichter, MBA

DONAVAN DICHTER, MBA, is the senior director of marketing for Implant Direct, part of the dental platform at Envista Holdings. He is passionate about the dental industry and loves helping dentists find ways to grow their practices. Connect with Dichter on LinkedIn at linkedin.com/in/donavand/.

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