Aesthetic Posterior Restorations: What Do Patients Perceive as "value?"

People buy results - not procedures! Doctors and their staff must communicate the value of dentistry to their patients.

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By Ronald Jackson, DDS, FAGD, FAACD

People buy results - not procedures! Doctors and their staff must communicate the value of dentistry to their patients.

A number of dentists still believe that cost is the key issue with their patients. However, cost is not the issue - value is. It's really very simple. People don't value what they don't understand, and people don't buy what they don't value. The problem dentists face is that we don't do a very good job of communicating the value of our dentistry to our patients. Our tendency is to talk procedures instead of benefits, and to talk technology instead of showing the results that can be achieved with that technology. People buy results, not procedures. To get this across to patients, our office (both myself and my staff) had to undergo a behavioral change. Today, we find that we really don't have to do any "convincing" to have patients accept our proposed treatment plans. We achieved this by accepting the following key concepts:

The patient must buy into a problem before he/she can buy the solution.

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Staff can speak more convincingly about advanced procedures if they have had this dentistry themselves.
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This is best accomplished visually. Patients have trouble visualizing their mouths when you just describe a problem and possible solutions. An intraoral camera is the best tool I know of to visually communicate to a patient that he or she has a problem. A picture is worth a million words. For example, when our hygienist finishes an appointment with a patient, she gives the patient a tour of his or her mouth. When problems are encountered, they are put on the screen. Patients see the problems for themselves and then ask what can be done about it , usually without any prompting.

Show the patient the benefits of the solution.

You have to educate the patient. Don't tell and sell - show and inform. We take out the photo album we keep in each treatment room with before and after photos of teeth restored with direct resins and aesthetic inlays/onlays. Patients are shown solutions to cases similar to theirs. The patients can see the aesthetics by themselves. The hygienist explains the benefits: that these restorations are less invasive, leave more healthy tooth structure intact, seal the tooth, and make the tooth stronger.

I have found that, once explained to them in layman's language, patients sometimes value these components even more highly than the aesthetics. If interested, you may obtain one of these albums by calling my office. It's very effective until you can create your own.

Build value before discussing cost.

From all this, patients will know that these restorations have a higher value. It's the same way the public compares a Lexus to an Escort. They understand that there is a higher cost for value. It is the clinical staff's responsibility to put in the value while communicating with the patient in the treatment room - before the business staff quotes the fee and deals with insurance issues at the front desk.

Let the patient make the value decision.

Don't assume patients won't want or can't afford a certain treatment option before you present it to them. Show them the options and let them decide about the value. If patients state that all they want is the least expensive treatment or whatever insurance will pay for, then they've made their value decision. Now it's your turn - you have a value decision to make: To do amalgams, or not. Is this patient right for your practice, or not? You don't have to be "everybody's dentist."

I've made my value decision. When I stopped using amalgam, I told patients I no longer use it because I felt less invasive bonded dentistry is better. If a patient still wants amalgam - I refer him or her to another dentist. Instead of trying over time to convert a patient to my values - which I think is impossible - we sincerely try to find a dentist who fits the patient's values. No judgement is intended or implied. Patients really appreciate this attitude. Of course, this doesn't happen very often anymore, because my practice attracts patients who are seeking the kind of dentistry I offer.

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The natural appearance of these restorations speaks for themselves---
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Don't misinterpret what I'm saying. If you want to offer both amalgam and tooth-colored alternatives, that's your decision, and that's OK. I'm merely stating that dentists no longer have to do amalgams, or any service they many not be comforatble with, if they prefer not to.

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they look as if they belong in the teeth!!
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Eliminating amalgams from my practice has the additional benefit of creating room and time for me to focus on those patients who are coming to me for who I am, what I do, and how I do it. Eventually, that's the only kind of patient who walks in the door. What a way to practice!

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