Who Wants to Be a Millionaire?

Paul Homoly, DDS, CSP

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“Money won’t create success; the freedom to make it will.”— Nelson Mandela

Who Wants to Be a Millionaire is an internationally successful television show. All you have to do is answer 15 questions in a row, and…ta-da, you are a millionaire! The catch is that you have to answer weird questions like, “How many gallons of water are in Lake Superior?” Give the right answers to questions you’ve never heard before, and you become an instant millionaire.

Who wants to be a millionaire in dentistry? I’d bet you do. And how are you going to do that? It’s easy. All you have to do is answer the 5 questions, not 15, that your patients ask you every day. The good news is none of these are like the Lake Superior question. In fact, you already know the questions before they ask them. They are as follows: (1) How much does my dentistry cost?, (2) How long will it take?, (3) How much will my insurance pay?, (4) How much will it hurt?, and (5) Do I really need all this work done?

Answer these questions right every day, and you will be on your way to being a millionaire in dentistry.

KNOWING THE RIGHT ANSWERS
The trick to giving the right answers to the above questions is discovering the patient’s concern that inspired the question. For example, what’s the concern behind “How much does my dentistry cost?” Is it the dollar amount, or is it a bigger issue of affordability and budget? What’s behind “How long will it take?” Is it the number of appointments, or is it a concern related to time lost at work or an upcoming important event for which the patient wants nice teeth? What’s the concern behind “How much will my insurance pay?” Is it because the patient wants to know his or her annual limitations of coverage, or is it an issue of affordability and budget or a desire to get out of their insurance what has been paid into it? What’s behind “How much will it hurt?” Is this an objective query into physical discomfort, or is the bigger issue about safety, mental comfort, or stress? What’s behind “Do I really need all this dentistry?” Are patients looking for more physical evidence for your recommendations, or is this an issue of trust and ethics?

The secret to giving the right answer is discovering the real concern.

DISCOVERING THE REAL CONCERN
To discover what’s going on in the lives of your patients, especially the ones who are considering rehabilitative dental care, structure your new patient experience so you have the time and place to do it. A conversation with your patients about the current (or foreseeable) events and circumstances of their lives is a mandatory step in discovering their real concerns. These life events and circumstances are fit issues, issues that your dentistry must fit into.

The leading fit issue for most patients involves family: kids, schools, homes, vacations, aging parents, etc. Other fit issues include budgets, work schedules, special current events, travels, stressors, health factors, significant emotional issues, and issues that dominate the patients’ energy, attention, and money.

It’s within the domain of your patients’ fit issues where most of their real concerns reside and where you’ll find the right answers to their questions.

CASE STUDY
Here’s an example. Your new patient, Kevin, is scheduled for the first appointment in the morning or afternoon, which ensures he won’t be kept waiting. He is brought into a private, nonclinical area (a small office or consultation room), where you introduce yourself and have a conversation with him that centers on 2 things: his chief dental condition and his significant fit issues.

Discovering the chief dental concern is easy; simply ask, “How can I help you today?”

He answers, “I wear a lower partial denture that I got when I was in the US Navy. I’ve had it for years, and it is so loose now I have trouble keeping it in.”

Now, get curious about how this condition gets in the way of his life, and where and when this condition bothers him. Do this by asking, “Kevin, can you tell me about a time when this condition bothers you the most?”

Kevin answers, “It bothers me the most during business meals. When I’m eating and trying to have a professional conversation, it’s embarrassing for me to talk. It really interferes with my speech.”

Now you know his chief disability; the partial denture interferes and embarrasses him during business meals. Once you know the chief disability, you automatically know the chief benefit Kevin is looking for—he wants to be confident during business meal conversations. The chief benefit is the real reason why Kevin is in your chair.

Shift gears now in the conversation and get curious about his line of work. He already brought it up, so it’s an easy transition. Kevin tells you he sells investment software to financial service organizations. As he speaks, you ask follow-up questions about his travel schedule and his business, making mental notes of issues that involve time, travel, expense, and stress. You listen for fit issues.

Transition the conversation to his family by asking, “Have you lived in the area long?” As Kevin talks about his family, talk about yours. Give this conversation the feel of give and take. Listen for fit issues.

After a few minutes in your private talking area, here’s what you’ve discovered about Kevin:

  • He wears a mandibular partial denture (chief condition) that interferes with his speech during business conversations (chief disability).
  • The reason he’s in your dental office is that he wants to be confident during business meal conversations (chief benefit).
  • He travels once a month to London, the home office of his company. He has a demanding work and travel schedule (major time-fit issues).
  • Next month starts the busiest part of his work season, which lasts 4 months (major time-fit issues).
  • He’s married, has 2 boys who are in college, and is adding an addition onto their home for his wife’s new business as a graphic designer and Web developer (major expense-fit issues).

You end the new patient conversation and bring Kevin into an operatory, where you complete your examination. Based on his clinical condition, your initial thoughts about his treatment plan include bilateral implant-supported fixed bridges.

You return Kevin to an upright position in the dental chair (or return to the consultation area) and have the post-examination conversation.

BE A PATIENT ADVOCATE
Begin your post-examination conversation with an advocacy dialogue that clearly demonstrates the following: (1) your awareness of the benefit that Kevin is seeking and (2) your acknowledgment of Kevin’s fit issues. It sounds like this:

“Kevin, now that I’ve had a chance to look at your teeth, I know I can get you confident in speaking during business conversations. I have helped many of my patients with similar concerns. I’m sure I can do it for you too.

“What I am not sure about is whether this is the right time for you to get this done. I mention this is because it seems like you have a lot on your plate now. Your work travel schedule is tough. Your boys are still in college, and you’re remodeling your home.

“Dentistry of this nature is time-consuming, and many patients are surprised about its cost. We need to figure out the best time for you to do this. Do we do it now, or, wait until your busy season is over? Or, do we do a little bit at a time? Help me understand, how do we best fit this into your life?”

Kevin may respond by asking, “What are you recommending I have done?”

You answer, “I recommend we replace the loose removable partial denture with nonremovable teeth that you can brush right in your mouth.”
Keep answers to technical questions brief. This is not the time for an informed consent conversation. The big question Kevin will get to is this: “I can tell you how it best fits in my life if you would tell me how much this costs.”

This is the question you knew was coming. The “right” answer will always be from the context of Kevin’s fit issues and chief benefit.
Here’s one version of a “right” answer:

“Kevin, fees for patients of mine who have had similar dentistry are in the range of $10,000 to $15,000. We can get you confident with your speech within 6 months, or, as I said earlier, we can spread it out to fit your schedule and budget. Most patients pay for their care over time, so we have in-office financing available if you want it. Joy, my financial coordinator, will go over financing and dental insurance with you if you’d like. She helps most patients keep their payment to a few hundred dollars per month.

“Kevin, does this fit into your life right now?”

As the reader of this article, I want you to pause now and consider how Kevin feels relative to the previous paragraph’s advocacy dialogue and my response to his question about cost.

  • Does Kevin feel the complete absence of sales pressure?
  • Does Kevin feel he understands you and without a lot of confusing technical language?
  • Does Kevin feel you understand why he’s unhappy with his partial?
  • Does Kevin feel he’s in control of the rate and budget of his care?

Yes, to all of the above.

And in the event that this is not a good time for Kevin to start his care, will he feel like returning to your practice when he’s ready?
Yes, he will. If you can get your patients to feel like Kevin, you’re on your way to becoming a millionaire.

IS THAT YOUR FINAL ANSWER?
The big question for most pa-tients is about cost and how to fit their care into their budgets. Your final “right” answer for many patients will be patient financing.

Many good patient financing resources exist for dental practices: CareCredit (carecredit.com), Citibank (tinyurl.com/ke4qpwj), and Wells Fargo (tinyurl.com/82utcr6). In the May 17, 2010 issue of the ADA News, there is an excellent article entitled “Patient Financing Options Explored.” In it, you can read about comparisons of several patient-financing companies.

What you will not read about is some fresh thinking concerning patient financing by a company called Comprehensive Finance (comprehensivefinance.com). It has an in-teresting and unique process for patient financing options that enables the dental practice to participate in the interest rate capture from patients’ payments. Throughout time, practices can experience significant income from interest payments; enough to fund retirement plans, college educations, and also to pay off debt.

CLOSING COMMENTS
Whatever resource you utilize for patient financing, and however you handle the discussions about your financial options, the prior conversations must acknowledge the patient’s significant fit issues. Be certain to make it unmistakably obvious to your patients that you understand them and the chief benefit they are seeking.

Start blending your patients’ fit issues and chief benefits into your treatment recommendation conversations. If you do, your final answer will be the “right” one.


Dr. Homoly is a certified speaking professional and a world-class leader in dental education. As a comprehensive restorative dentist and acclaimed educator for more than 35 years, he is known for his innovative and practical approach to dentistry. Dentistry Today recognizes Dr. Homoly as a Leader in Dental Consulting. He can be reached at (800) 294-9370 or send an e-mail to paul@paulhomoly.com.

Disclosure: Dr. Homoly is sponsored by CareCredit and Comprehensive Finance for speaking presentations, but was not compensated for writing this article.