It’s not your fees ... it’s their beliefs!

Too often, we become distracted when patients mention the high cost of dentistry, when what we should be doing is listening for the beliefs and emotions underlying their comments.

Too often, we become distracted when patients mention the high cost of dentistry, when what we should be doing is listening for the beliefs and emotions underlying their comments. During a recent coaching visit, I witnessed this all-too-common mistake. An attractive, smartly dressed, 63-year-old woman came in for what my client referred to as a “review of findings.” We call this a “consultation.” Although the doctor will diagnose and recommend, it’s the patient who will ultimately decide what he or she is willing to do.

Kay sat down in the well-appointed consultation room with the HRC (Health Relationship Coordinator), a staff member responsible for extra special care for all new patients in the practice. After a warm greeting and being offered something to drink, she was asked how she felt about the visit. Kay said, “I’m feeling anxious - I just don’t know if I should spend $20,000 on my mouth. After all, I’m 63 years old.” The HRC responded by saying, “Oh, let’s not discuss the money until I’ve had a chance to orient you to your records. Then, you and Dr. Smith can discuss your investment, and I’m sure we can help you with the finances.”

This was not a terrible response, but she totally missed the beliefs and emotions underlying the patient’s comments! Remember, every major purchase is an emotional decision, backed up by enough logic to rationalize it to others (husbands, coworkers, etc.). Also, as we discussed last month, to truly educate someone, we must affect beliefs. Beliefs lead to behavior and behavior leads to results. Changing beliefs will change results.

In my role as a coach, I’m supposed to observe and make notes for discussion later, but this was headed in the wrong direction. So, I asked if I could visit with Kay. I began by asking about the money involved, since no one had yet mentioned the fee. Kay said, “Well, I came in for eight veneers to correct my smile, but when Dr. Smith examined me, he began to show me how my old fillings were breaking down and how my lower partial (replacing Nos. 19, 20, and 28 through 31) was defective. I simply did the math. Aren’t veneers and crowns about $1,000 each?”

I acknowledged that was about right, but told Kay I would like to come back to that discussion after some other important questions. I then asked her, “Kay, do you want to have the rest of your teeth for the rest of your life?” She said that she did. “Well, in some ways, my next question is unanswerable, but how long do you think you will live?” She wasn’t sure, but said she was in very good health and took care of herself. We then discussed her parents. “Are your parents still alive?” She said her father had passed away at 62, but her mother was still going strong at 87. At 60, her mom had to have dentures. “So, who are you more like?” I asked. She replied, “My mother, but healthier than she was at my age, so I suspect I’ll make it at least into my nineties and with most of my teeth!”

Remember, your patients are educably handicapped until you have asked them about their probable versus preferred future. If Kay thought she would not live to a ripe old age, why should she invest in her mouth? What had I begun to do with Kay? I had begun to examine and change her beliefs. But, she had provided me with even more powerful insights!

She mentioned her mother was in assisted living. I asked how her mother liked it. She said, “Not too bad.” Then I asked about her mother’s dentures in that environment. She leaned back and frowned. “You know Dr. Frazer, once when mother was ill, they took her dentures away, and when I saw her, I was really upset.” “So, Kay,” I replied, “it sounds like you would never want to be that dentally vulnerable.” “Absolutely not!” she said. “Let’s talk about implants to replace my partial,” she replied.

Some of you may be saying it can’t be that easy! That wasn’t easy; I had to be listening intensely to discover Kay’s beliefs. Even more importantly, I had to discern the emotions that supported those beliefs. Then, I had to find a way to sensitively examine those beliefs, first with the intent to understand, and then making an appropriate reply in the context of her beliefs and emotions. So, how do you get better at this? By learning to listen for your patients’ beliefs and emotions.

Learn. If you have to speak, ask questions! When you are talking, all you learn is what you already know. When you listen, you learn what the patient believes. That day, Kay elected to have a $38,000 complete reconstruction. Although it would take two years for her to complete it and stay within her budget, she was totally committed.

Dr. Bob Frazer, FACD, FICD, is founder of R.L. Frazer & Assoc., whose custom programs help dentists achieve top 5 percent status in financial achievement and life balance (fulfillment with significance). Thirty-one years of quality practice and superb communication skills have propelled him to a 29-year speaking career. For information on his “Building Emotional Intelligence Workshop,” 10/20-22 in Austin, or the new audio series, “How To Build the Exceptional Life and Practice,” contact him at (512) 346-0455, or e-mail him at

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