Why do some dental patients say, “When can we start?” while other patients mutter, “Um, let me think about this.” In this article we’ll explore how to transform your traditional treatment presentations into treatment dialogues so patients are motivated and committed to doing the treatment they need.
The Problem with Treatment Presentations
Let’s begin by retiring the term, “treatment presentation.” This phrase implies that you are delivering a speech to a passive audience of one who is literally imprisoned in their chair. This image is the opposite of what should be happening when you make treatment recommendations. You don’t want a passive patient who feels stuck. You want an active learner who feels empowered to make decisions that fulfill her own goals. So, the question becomes, how do you do that?
Principles of the Treatment Dialogue
- Because people do not argue with their own data, goals or feelings, you need to ask questions that will enable the patient to uncover and express her perceptions of her oral health issues.
- Most patients are not interested in the process of the recommended treatment; they are motivated by the benefits or the results of the treatment. Treatment dialogues need to focus on benefits that will appeal to the patient.
- Patients are more motivated by the benefits they identify themselves. Your job is to ask specific questions so the patient describes these benefits and how they will help her improve her life.
- No one likes to feel pressured to do anything; in fact, the greater the pressure the more we resist. Therefore, the treatment dialogue always emphasizes the patient’s autonomy to make her own decisions.
Treatment Dialogue Framework
Following is an overview of the five stages of a treatment dialogue. The stages can be expanded or contracted depending on your time and the patient’s readiness. The overall purpose is to do less lecturing and more conversing.
- Observation: Here is what I see and here is what it means…
- Recommendation: Because you said, because you want…
- Benefits: This is how/why this will be so good for you in particular …
- Fee estimate: The fee for this is generally…
- Feedback: What are your thoughts/feelings/questions? What do you see as the next step? How soon would you like to start?
Description of the Stages
Begin the treatment dialogue by making observations of what you see and what it means for the patient. To engage the patient, ask questions that uncover the patient’s awareness of her problem and her dental IQ. The goal is to enlist the patient in her co-diagnosis.
- I’m noticing that you have ….
- What have you observed/felt?
- What do you know about X?
In the next stage, connect your recommendations to a motivator or concern expressed by the patient. A motivator/concern should be linked to the patient’s personal goals, overall health, lifestyle, special events, etc. In this stage you are justifying your recommendations by linking it to something personal to the patient.
- Because you mentioned that you want/don’t want, I am recommending…
- Since you have x, I am recommending…
- This solution will be perfect for you because….
In this stage, you will also describe the potential consequences of not doing the treatment. Because patients react badly to fear or pressure tactics, you can broach informed consent with a skill I call “reading their minds.” Anticipate the most likely objection and answer it as if you were psychic.
- I know it may be tempting to think you could wait for insurance to cover this, but here is what could happen…
The bulk of conversation should be about the benefits the patient will enjoy as a result of the treatment. When patients buy into the benefits, they will overcome their own objections. The most impactful benefits are those the patient identifies.
- I’m seeing a great value for you in taking care of this now, but how do you feel about this?
- What do you see as the most important benefit? What would change in your daily life once you complete this treatment?
I recognize that many dentists would rather be boiled alive than discuss fees, but you cannot consider a patient “closed” until they hear and agree to the fees. The dentist’s role is to provide a fee estimate and then talk with the patient if she has an emotional reaction to this number. For most patients, this is not actually a conversation about money; it is a conversation about value. If the patient objects to the fee, it is often because she doesn’t yet perceive the value of the treatment in context with the investment.
The last stage confirms that the patient is committed to taking some action. But remember, the patient has autonomy, so these questions are designed to guide a patient not to force a patient.
- Given everything we’ve talked about, what do you see as the next best step?
- When would you like to start?
Final Thoughts and FAQ
I’m going to read your mind a bit and hazard that you have concerns about how you could implement this dialogue. You may have questions such as:
- I have five minutes to do an exam. How will I find the time to do this?
- Don’t patients want me to tell them what to do?
- I don’t know my fees and I don’t want to make financial arrangements
- I have high case acceptance already – why should I do any of this?
I will answer these concerns in upcoming blogs. You can also read my article, Lose the Lectures, in the Feb 2022 issue of Dental Economics. I love training teams on this topic, so let me know if you would like to schedule a team training.