Dancing with patients

June 1, 2000
In my 25 years in dentistry, I`ve seen just about every system you can use to improve case acceptance. I`ve avoided most of them, because they are either not based on reality or are manipulative. Systems for case acceptance - CD-ROM-based presentations, slide shows, leading/manipulative questions, clinical show-and-tells - don`t always fit the situation.

Paul Homoly, DDS

"Knock, knock."

"Who`s there?"

"Howdy."

"Howdy who?"

"Howdy ya` get patients to say

`yes?` "

In my 25 years in dentistry, I`ve seen just about every system you can use to improve case acceptance. I`ve avoided most of them, because they are either not based on reality or are manipulative. Systems for case acceptance - CD-ROM-based presentations, slide shows, leading/manipulative questions, clinical show-and-tells - don`t always fit the situation.

The dentist and team often focus on the execution of the system to gain case acceptance, rather than focusing on the patient. The temptation is to think that there is one right way to promote case acceptance, then we do it that way every time. Don`t! Case acceptance is not a one-size-fits-all process.

Ever learn to ballroom dance on a cruise ship? It`s easy! The foot pattern of the dance is painted on the floor. All you do is keep in tempo and follow the pattern. It`s a system that works well at the beginner level.

But what if the band changes its tune from a waltz to a rumba while you`re still following the painted foot pattern for a waltz? You`re not going to be able to dance. The only way you can dance if you`re locked into your foot pattern is to ask the band to change its tune. That`s not going to happen!

If you have the steps of case acceptance painted on the floor and you know only one dance - "The New- Patient Waltz" - and a complete- care patient comes in whistling a different tune, you`re going to be dancing with your staff. Will that complete-care patient change his tune for you? That`s probably not going to happen.

Early in the dentist-patient relationship, learn to let patients lead by taking the steps they`re most comfortable with taking. If you`re too rigid in your approach, you`ll step on someone`s toes.

Although rigid systems are popular, they will limit your success. A rigid system is when all new patients go through the same process - i.e., every patient gets a preclinical interview; every patient gets a complete examination; every patient gets full-mouth radiographs; every patient watches the videotape on periodontal disease; etc.

The "every patient" approach helps organize the process. It works fine at the low-fee, tooth-dentistry level, but at the complete-dentistry level, the "every patient" approach fails. It fails because it doesn`t make distinctions between patients.

Is your case-acceptance system the same for a young, male patient who needs a few fillings and wants his teeth cleaned (tooth dentistry) as it is for a 60-year-old female with failing full-mouth reconstruction (complete dentistry)? If it is, then two things are happening in your practice.

First, you`re making the tooth-dentistry patients mad about too many radiographs, too many appointments, lack of insurance coverage, and not doing what they came in for. Next, you`re frustrating your complete-care patients by overanalyzing/overeducating, overselling, not listening, and not taking "yes" for an answer.

Don`t get out of step

Here are three ways you can be sure that you and your new patients are dancing to the same tune:

(1) Ask your new patients if they`re interested in simple (chief complaint) care or complete care. The toughest part about asking this question is accepting the answer.

(2) Cheerfully treat patients` chief complaints. Look at simple treatment as planting a seed that can lead to complete care in the future.

(3) Get really good at saying, "When you`re ready..." Let people know that you`re happy to proceed with their care, based on their schedule and their budget.

Successful case acceptance for complete dentistry is not a process to which patients are forced to conform. It`s a dance that flows with the music of each individual patient.

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 [email protected]. Visit his Web site at www.paulhomoly.com.

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