Your current patient is in the chair. You’ve just discovered they need some major work.
You know it’s in their best interests to accept the treatment. But it’s expensive.
You’ve got to present the case to them in the best way possible.
In a way that they understand. So they can weigh up the risks, and the costs, and come to the right decision.
But it’s hard because what people really hear is the bottom line.
They want to look after their teeth, but they often balk at the cost of treatment.
It doesn’t matter whether you’re operating a high-end cosmetic practice, a specialist practice or a “garden variety” general practice. To stay in business, you need patients to accept treatment.
But how do you do that?
There is a key psychological shortcut that all of us use in the decision-making process. If you employ it correctly, it will drastically increase case acceptance rates.
Regardless of the treatment offered.
I first stumbled across this technique by accident and didn’t know why it worked so well.
I’d provide different treatment options in different orders and got very different levels of case acceptance. I was puzzled but figured out that if I presented “the Fully Monty” treatment plan, patients were shocked.
When I then presented a toned down treatment plan, they seemed to relax into it and accept treatment more readily. This happened time and again and I didn’t know why.
Then I came across Dr Robert Cialdini who provided the psychological explanation for my success. It’s the principle of contrast.
Basically, human perception amplifies the difference between two options when presented one after the other.
According to Cialdini, “if the second item is fairly different from the first, we will tend to see it as more different than it actually is”.
So if you present two treatment plans, the patient automatically highlights the difference between the two plans. We’re all hardwired in this way.
I’m not saying this is the only way to present cases to patients. It is simply another skill to have in your toolkit, to provide you with options.
For this example, let’s assume you have a middle-aged patient who grew up in the pre-fluoride era and has very heavily restored posterior teeth.
When I do an examination I don’t like to “tell” what needs to be done. I prefer to let the patient discover what needs to be done at the same time I do.
I use two primary tools; the concept of mutual diagnosis and an intra-oral camera.
This way the patient can see for himself that he has big, ugly amalgam restorations and there is only limited tooth structure remaining.
I sit the patient up and show them the photos. I ask them to tell me what they see.
I want them to say what they see because they “own” these words.
(This invokes another of Cialdini’s principles called Commitment and Consistency…more on that another time).
My DA will record this….this step is very important.
I then run through what other things are visible on the photos. Things such as wear facets, cracks, non-carious cervical lesions and so on.
I want the patient to understand that these posterior teeth are indeed heavily restored.
Using the combination of the camera and mutual discovery technique, the patient soon understands that it’s feasible that all molar and premolar teeth could need to be crowned.
I then tell them that (in this example at least) they could quite feasibly have 16 crowns and at $1,500 each that’s $24,000.
Typically the patient will recoil and say something like, “I know I need to fix my teeth Doc, but I just can’t afford that”.
At that point I’ll say to the patient, “Mr Smith, in an ideal world we’d crown those 16 teeth. But in this instance, we can probably get away with just crowning the molar teeth and monitoring the premolar teeth.” Now we’ve suggested 8 crowns at $1,500 making $12,000.
The patient is usually not ecstatic at the thought of paying $12,000 but is far more accepting of that figure than the first.
To move things along a little further, I might ask our practice manager to go through some of our payment plans including a 5% discount for paying all of the treatment up front.
Suddenly with a $600 discount the treatment is now down to $11,400 and you’d be surprised how many patients will proceed with this
Yes, crowning everything in this scenario would be a Rolls Royce treatment plan.
But by crowning the molars they still have a Mercedes Benz plan that will do the job well. Without the contrast principle, the patient may not have got the Mercedes Benz treatment they really needed.
They may have ended up with the Datsun 180B which would not have served them at all.
This is just one example of the contrast principle. In this scenario, it’s not important whether or not you agree that the patient needed any given amount crowns.
It’s just the principle I’m trying to highlight. You can this technique in many different ways.
You can use it to down sell from a crown to an inlay, from 8 veneers to 6, from porcelain veneers to composite veneers.
If you can grasp the principle and apply your own standard of care to it, you can use it for promoting whatever treatment you feel is in the best interest of the patient.
This approach to case acceptance may seem a little counter-intuitive, but it works.
My clients have had phenomenal success with it.
By employing these methods, their case acceptance has gone through the roof and so has their production.
Patients received great dentistry that they were happy to have.
And their practice blossomed as these patients told family and friends about how well they’d been cared for.
It’s a win-win situation for both you and your patients.
Happy patients who receive the best care, and a booming practice.
You’d like those results, wouldn’t you?