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How to Handle the Money Issue


When patients tell you they can’t afford treatment, you can respond as either the Stern Dentist or the Concerned Best Friend. In this article, I show you what the Best Friend approach sounds like and how you can use this style to help patients convince themselves.

If a patient says she can’t afford the treatment, there could be three things she means:

  1. I want this treatment but I don’t have access to any resources that will make this possible
  2. I don’t trust you and I need a polite way of getting you off my back
  3. I don’t value the solution you’re offering (or my problem isn’t worth this solution)

I’ve observed that when dentists hear the money objection they either: back off and shuttle the patient to the front desk, reduce their fees or the treatment plan, or get more forceful in describing why the treatment is crucial.

Unfortunately, none of these actions will provide long-term success. The issue, for the patient, isn’t so much about making financial arrangements, the issue is about establishing value for the treatment. If the patient doesn’t value the treatment, you can offer Care Credit till the cows come home but the patient will still say no.  In one of my most infamous moments as a patient, I told my dentist: “Even if this treatment plan was free, I wouldn’t do it.” I’ll share that story another time.

In my last article, Responding to Objections, I described how you can use story telling as a motivational tool. In this article, we look at how to change your style from Stern Dentist diagnosing a patient to the Best Friend helping approach.

A great best friend listens to your feelings, allows you to vent and helps explore your options without judgment. This is who you want to become with your patients.

What the Best Friend approach sounds like:

  • I can only imagine how it must feel for you to hear this amount.
  • Let’s set aside the money issue for a moment, is this treatment something you want to do?
  • I’m wondering what a good solution would look like to you?
  • If you were convinced you could get that, how would that change your life?
  • What if we could brainstorm ideas on how you can get that?

When you have these conversations with patients you are not focusing on a payment plan. Your focus is on understanding your patients’ emotional barriers to getting this treatment. And while it may feel a bit like you’re a therapist, your purpose in the conversation is to move the patient away from the problems in doing the treatment to the possibilities as result of the treatment.

This is actually a profound shift. Earlier in my career as a dental consultant, I taught dentists to ask patients, “What questions or concerns do you have about this treatment?”  Now I believe this is the wrong question to ask. Why? Asking someone to name their concerns forces a patient to come up with something. And because you’ve asked them to identify a concern, you now have to respond to that concern and convince the patient that their concern shouldn’t interfere with dentistry. This whole conversation puts you on the defensive.

Better questions are:

  • What are you looking forward to when this treatment is completed?
  • How will this treatment improve your life?
  • What do you like most about what we’re planning?

These questions focus the patient’s attention on the benefits of the treatment. And as I’ve written before, once patients buy into the benefits, the money issue becomes much less potent.

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“As an Office Manager, I’ve seen a great difference in my practice since starting with Sharyn. Three years ago our staff was in turmoil with a lot of infighting and gossip and some jealousy directed towards me.

I had given up because everything I did was judged. Now I have learned to have more one-to-one communication and by being more vulnerable with individuals I found my leadership voice. As a team, we’re all focused on the same goals.

Last year, in August we produced $88,000. This year we’re on track to produce $111,000 this month. I know it’s because we learned how to follow through with patients and communicate our expectations while building our systems.

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