Let’s face it, when discussing treatment with patients, every time we mention a tooth number and a procedure, the dollars signs explode in the patients’ head like a fireworks show. A patient will often say, “How much is this going to cost?” long before we have finished presenting the options. It is as if the patient has stopped listening and just wants to get to the bottom line, money. A typical examination requires the charting of existing restorations, periodontal probing, noting clinical conditions along with the oral cancer exam etc. all being announced for all to hear within earshot. Then come the recommended treatment options and the exchange of questions between the assistant and the doctor as the treatment plans are defined and prioritized out loud as the patient listens mutely. Terminology and language that may just as well be from an “alien planet” bouncing off the walls as the patient slowly sinks into the chair. “All that is for me? I just wanted a cleaning.”
Having a clear understanding of what brought the patient into your office is the key to building a relationship based on trust. That initial trust may start to disintegrate as the patient takes on a defensive demeanor after you have finished their examination. In embarrassment the patient has prepared several excuses as to why their mouth is in the condition that you have just described. Telling the patient that you have not lost sight of their initial concern is assuring.
After presenting treatment and payment options to patients for many years, I believe that the less the patient hears during the course of an examination the better. A dental assistant can accomplish charting existing restorations and missing teeth without saying a word. The assistant records the findings in the chart (paper or computer). While doing this they can be telling the patient about the newest and greatest services and products the office offers. Such as “Have you heard about the CadCam technique?” They can also discuss the latest research on implants, composites, toothbrushes etc. The assistant should also ask the patient for approximate dates of initial placement of existing crowns, bridgework, implants, dentures, etc. and notes that on the chart. The technology to perio probe without calling numbers to an assistant is available but many offices do not have it. A patient can become quite anxious after hearing the numbers 4,5,6 etc. Being discreet and “low key” in announcing these numbers is vital. I recommend not announcing trigger words such as bleeding, pus, mobility etc. Moving a patient into a state of anxiety is not the best way to have them primed to accept treatment but it will motivate the “flight or fight” response to get them out of the office as quickly as possible.
Taking intra-oral photos and x-rays (digital or otherwise) is necessary. I do not advocate putting them up on the screen where the patient is left to stare at them without explanation while waiting for the doctor to arrive. While the patient is waiting to see the doctor, educational CDs or Videos can be playing. A Case Book showing before and after photos of your latest success with testimonials is another good marketing source to have patients look at if there is wait time. Setting a positive stage for treatment acceptance is vital and showing respect for the feelings of our patients is paramount.
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