Dentistry for Sale What Makes a Patient Buy Into a Treatment Plan?

Dentistry Today


Nothing produces a quickened pulse like making a proposal. Whether you’re proposing marriage, a business arrangement, a home purchase, candidacy for political office, or a plan for dental treatment, you’re putting yourself out there, at risk. To be or not to be? The flip side of acceptance is rejection. Despite the nature or extent of the proposal, we humans have a hard time when our advances are thwarted. It makes us feel clumsy and embarrassed. In the case of treatment plan proposals, however, more than your ego is at stake. The rate of treatment plan acceptance—in some measure—foretells the outlook for your practice. To be or not to be? We cannot leave this to chance.

Before focusing on the specifics of what makes a patient buy into a treatment plan, let’s take a critical look at the 3 primary reasons why they don’t. From there, we’ll go right to my “Ten Tenets of Treatment Acceptance.”

Here comes the judge. And jury too. Every time a treatment plan is proposed, both you and the plan are subjected to being mulled over, reflected on, and deliberated not only by your patient, but by the patient’s family and friends. Consequently, although the decision regarding your treatment plan will ultimately be made by the patient, it is often influenced by one or more of the divergent opinions expressed by this “concerned” jury of the patient’s peers. Here’s how some of this concern might be offered:

Patient’s good friend: “You’re going to spend how much for veneers? Sounds like an awful lot. You should try my dentist. He’s really reasonable.”
Patient’s spouse: “Why would you put yourself through all that pain and suffering? Just have the darned teeth pulled and get a partial like mine. It’ll save you a whole lot of discomfort and save me a whole lot of bucks.” 
Patient’s boss: “How much time do you think you’ll need to have all that dental work done? Maybe you should plan on using some of your vacation time.”
Considering the attitudes and viewpoints of judge and jury, is it any wonder that treatment acceptance is often not up to par? For starters, the premise needs to be changed. Instead of your patient going home and telling her hubby why you want to do these procedures, you’ll need to work it out so she tells her hubby why she wants the work done. She might also tell herself as well as the entire jury that she who wants a rose must respect the thorn.

For eons, it seems, much of the public has been under the impression that dentists (and physicians, of course) are in it for the money! When a patient or family member is convinced that you specialize in dental procedures guaranteed to give you a nice income, it puts an excessively heavy burden on treatment plan presentation. After all, which patients would accept your treatment recommendations if they suspect that you’re out to pick their pockets? Beware of any treatment plan or presentation that reeks of self-interest. Business transactions—like religion—must be founded on faith.

Heeding this old stock market advice, patients are in no rush—after being given only the sketchiest overview of treatment—to begin scheduling the procedures you’ve recommended. At best, they want some time to “think about it” but often end up refusing the treatment or simply not scheduling it. Dental education, apparently, is not just for dentists. Patients must be schooled too. Education, they say, is a race against catastrophe.

When dentistry is on the auction block, no amount of “auction-speak” will bring in the high bidder. It is the patient’s need and desire that are actually at issue, not the dentistry itself. In other words, you’ll have to figure out what will make the patient want to win the offered product/service and pay the hammer price. Fortunately, there’s a formula I’ve developed that should bring your treatment acceptance to greater than 85%. Here, then, is my formula, my “Ten Tenets of Treatment Acceptance.”

Tenet No. 1—Give Them What They Want
Treatment acceptance begins not with the first office visit, but with the first phone call to the office. When Ms. Jones, a prospective patient, calls and asks for a cleaning, she should be scheduled for that procedure, preferably within a week of her call. In some offices, however, she’d be given a lecture about why the doctor needs to do an exam and take x-rays before scheduling her for a prophy. The result of such a reprimand is that from day one, Ms. Jones is bound to feel some conflict. It’s apparent that either she’ll need to surrender or the practice will have to do without her as a patient. Instead, from the start, listen to what patients want and whenever possible, give it to them. This tenet is the most important of all 10 and should be in operation throughout all the rest.

Tenet No. 2—Information, Please
In addition to all the paperwork that a new patient is asked to complete, it is highly effective for a treatment coordinator to conduct the new patient interview. This personal, face-to-face dialogue can go far in making the patient feel like patient relations is an integral part of your practice.

Tenet No. 3—Giving the Right Impression
There’s an ancient Chinese proverb that states a man without a smiling face should not open a shop. What we can learn from these words of wisdom is that the new patient interview should be conducted by a treatment coordinator who has a nice-to-look-at smile and a sunny personality. This, of course, goes along with a McKenzie proverb that suggests if you’re selling smiles, your team should wear the beautiful smiles you’ve given them and not be shy about singing your praises.

Tenet No. 4—Getting the Right Impression
During the new patient interview, in an attempt to determine what the patient wants, the treatment coordinator should ask open-ended questions to uncover what haunts, obsesses, or pains the patient. Such questions might include the following: How important is your image to you? Do you feel that your image has helped you or held you back in your career? What about in your personal life? Does anything bother you about your smile? Do you have any special occasions coming up? If I had a magic wand and gave it to you, would you change your smile for that special occasion? Do you ever have problems with chewing or with pain in your mouth? Have you ever had a bad experience in a dental office? On a scale of 1 to 10, where would you place the value of keeping your teeth and oral health in optimum condition?

They say that nothing is real until it has been expressed in language. There is often so much psychic energy built up in these teeth/smile-specific areas that once the patient has expressed the desire for a prettier smile or admitted dental discomfort, acceptance of your treatment plan will be a slam dunk.

Tenet No. 5—Emotional Survey
Immediately after the interview, the treatment coordinator should take the time to review the notes, enter them into the patient’s chart, and at an appropriate time, go over the patient’s overall survey with the doctor(s) prior to the actual drafting of the treatment plan.

Tenet No. 6—Seeing is Believing
During the initial exam, the doctor should use an intraoral camera to show the patient what he finds that appears to need treatment. Knowing the patient’s perspective from tenet No. 5 will help in determining how far to go with explanation. In an informal way, the doctor can point out the disparity between what patients have and what they want or need. For example, a female patient with large MOD silver fillings in the first and second bicuspids may never have noticed the blackness that appears on the sides of and between the teeth when she smiles. Based on her input about wanting to have a beautiful smile, the recommendation of porcelain crowns will likely be approved by the patient now that she sees the way her smile actually looks to others.

Tenet No. 7—Preparing the Treatment Plan
Although the treatment plan used internally needs to include what procedures will be performed at each appointment—along with chair time and doctor time needed at each one—the plan that will be presented to the patient only needs to include the following: the number of visits; what the proposed work will look like. (Imaging software can be very helpful in this regard.); whether procedure(s) will be painful, and if so, how the pain will be managed; cost of treatment; expected payment schedule; and applicable financing options.

Tenet No. 8—Stick With Dentistry and Leave the Selling to Somebody Else
While the dentist plays an integral role in case acceptance, details of presentation can be most effectively delegated to a treatment coordinator who has the training and skills to (1) build rapport with patients, (2) explain dental procedures, (3) comfortably discuss fees and financial arrangements, and (4) follow up on outstanding treatment.

Tenet No. 9—Encourage Patient Acceptance
Within the art of salesmanship, asking for concerns is fundamental to making the sale. Once patients are able to express their concerns, they’re ready to be won over. Answer their questions, quell their concerns, overcome their objections, and then ask them to schedule a visit to begin treatment.

Tenet No. 10—What the Patient Wants, the Patient Gets
I repeat here that if you’ve really listened to what patients want and present their treatment plan to them as the route to meet their objectives, treatment acceptance will be a fait accomplis and patient satisfaction will be within easy reach. It will be a clear win for all concerned.

Ms. McKenzie is a nationally known lecturer, author, and consultant to the Council on Dental Practice of the ADA. She is president of McKenzie Management, which provides in-office analysis of business, clinical, and hygiene departments and offers a full line of educational management books, audiotapes, and videos. She is founder of The Center for Dental Career Development in La Jolla, Calif, which provides advanced dental business education to dental professionals such as office managers, scheduling and financial coordinators, treatment and patient coordinators, and dentists. To receive Sally McKenzie’s Weekly e-Motivator newsletter, which provides targeted management tips, call (877) 777-6151 or visit or