‘N’ Word - "No ... Not Right Now"
Humiliation. You know the feeling, the blood drains from your cranium,
your vision blurs, as the patient sets you straight. “Dr.
Jones, I’m really impressed with what you’ve shown me
today. But, no, I’m just not ready to pursue that type of
treatment at this time.” In just two short sentences,
your hopes for a major treatment plan are deminished. Forty
percent treatment acceptance rate – hey, I can live with that.”
Dr. Jones really can’t live with that, nor does
he have to. At 40%, his treatment acceptance numbers aren’t
just low. They are abysmal. But in fairness to Dr. Jones, his presentation
skills are very good. He is well prepared, patients listen
attentively, and often indicate that they will pursue his recommendations
only to cancel or not show for subsequent appointments.
In this case, he was fortunate because the patient told him up front
that she just wasn’t ready.
what’s going wrong? Keep in mind there are three primary barriers
to overcome in securing treatment acceptance – time, fear,
and money – and they don’t necessarily fall in that
order. Money is an issue for the majority of patients, regardless
of what late-model car they pulled into the lot driving today. However,
as that new Mercedes illustrates, patients are still making major
purchases every day. They are choosing to do so because they are
emotionally involved in the decision, all of their objections
have been addressed, and they can logically justify the expenditure,
whatever it may be. The patient will not proceed with treatment
if they do not have an emotional attachment to the benefits.
Dentists frequently find themselves wasting precious time presenting
treatment plans that are either dismissed or half-heartedly pursued
by patients. While there are many factors in securing treatment
acceptance, rethinking some basic patient communication strategies
can yield significant improvements. One of the most important
communication steps a dentist can take is involving a treatment
coordinator in the presentation process.
Patients often have objections or even questions that they are not
comfortable raising with you, the doctor. In reality, patients are
far more comfortable discussing treatment plans with an auxiliary.
Next week, proven strategies for getting patients to say “YES”!
in having Sally speak to your dental society or study club?
An Ailing Business Foundation Can Cause
“Digital Chaos” Part #15
VP Professional Relations
Last week I discussed tracking your new patient sources other than
professional referrals. [see
article]. No matter what type of dentist you are (general or
specialist), co-managing patient care with other professionals can
get tricky. It can be time consuming, confusing, and sometimes downright
inefficient. However, it
have to be. This week I will focus on managing all of those
professional relationships with your computer system.
If you are a general dentist ...
all of the specialists you refer to into your referring
doctor database. Be sure to create complete contact
records, including cell phones, pagers, email addresses, web
site addresses, hours of operation, etc.
When you refer out to a specialist, be sure to enter the date
you referred the patient out, why you referred them, and the
patient’s expected date of return.
run a report to find your overdue returning patients. Delegate
the task of contacting each office with overdue patients. Enter
pertinent notes as to why the patient is overdue, in
the patient note area of your practice management system. Follow
up directly with patient as necessary.
store pertinent clinical contact notes from conversations with
the referring doctor into you practice management system. Some
practice management systems give you contact notes in the referring
doctor area. If you have those, use them. If you do not, use
the contact note area within the specific patient.
opening and establishing an email communication process
between you and the specialist(s). Your normal everyday
email address may not be the right one to use. You may want
to establish a sub account email address and use that one just
for communication with your specialists.
synchronize your personal digital assistant (PDA, Palm, etc)
with your practice management system. If you ever have an emergency
call during off hours, you can provide instant and complete
service to the patient on the phone.
you are a specialist ....
we discussed last week, a specialist wants to keep their
referring doctor database clean and clear of other new patient
sources. Enter all other new patient sources (besides
referring doctors) into your database as patient records. The
only exception would be if your practice management system offers
multiple referral fields and multiple referral tracking systems.
rely heavily on professional referrals for new business. Your
practice management system “should” be able to provide
production reports by referral source. You should be able to
select any date range you wish. Look for total number of patients
referred, total production value of patients referred, and average
production value of patients referred.
an email communication strategy with your referring doctors.
Specialists should embrace technology and leverage its power
to add value to the generalist/specialist relationship. We have
specialists as clients who have established internet service
providers, secure web site access (to share digital x-rays and
intra-oral photographs), and email accounts for all of their
best referring dentists. This makes it ridiculously simple for
the referring dentists’ team to communicate with the specialist's
office. Who do you think the general dentist thinks
of first when it’s time to refer a patient out?
synchronize your personal digital assistant (PDA, Palm, etc)
with your practice management system. Keep a complete accurate
database of all of your referring dentists. You can even synchronize
the information from patient records attached to specific referring
dentists, just in case they call while you’re not in the
use the referring dentists contact note area when summarizing
telephone conversations. This allows the specialist
to quickly review prior pertinent discussions before calling
the referring doctor or preparing to take a call from a referring
your computer system to generate monthly update reports
of procedures performed on each referring doctors’ patients.
A monthly recap report is perfect for a general dentist. You
can still send the individual reports but that monthly recap
gives them all the information they need quickly without having
to remember or go pull charts. Some specialists put the monthly
recap report in professionally done folders with business card
or Rolodex card replacements each month. You can really make
the monthly recap report useful and very effective if you use
specialists have yet to exploit the relationship management aspects
of technology. Sure, most specialists have practice management systems
and use them to run their practice but as you can see, there are
a lot of ways to use your computer system for more. I know a periodontist
who established an on-line local dental e-community with an emphasis
on implants. The referring dentists can share in discussions on
specific cases and learn from one another. Guess who gets all the
I want next week’s topic to come from our readers.
So, email me some specific questions regarding computer issues or
technology concerns and I will do my best to include them in next
you have any questions or comments, please email Mark Dilatush at
in having Mark speak to your dental society or study club?
The Cold Shoulder
Giving Dentists And Their Staff Different Perspectives On Day To
world of coaching offers solutions which are not obvious to the
causal eye because these
concern the principles of human nature, and human nature is a force
that we must learn to convert to our own purposes.
weeks ago I answered a question sent in by Dr. Desperate [see
response] who was a victim to the female forces of human nature.
I then received an email from "his brother" who found
the mere presence of these problems to be such an inconvenience
that he capitulated and limited the size of his business in order
to keep control.
Desperate and his older brother perpetuate their family tradition
of “the glass will always be half-full” perspective
not by choice but by family mandate. Here is another perspective
to consider which incorporates some universal truths about human
are discussing men and women. It is an anatomical and cognitive
science fact that the brains of men and women reason differently
within the same environment. I didn’t say ”better or
worse, good or bad”. I said differently.
Humans are at the top of the food chain in part because of our adaptability
and the overlap of male and female solutions to the challenges of
survival. This is a testimonial to the power of any male-female
For the purposes of this article, I will offer a reasonable perspective
from which individual perspectives might diverge. In order to grasp
the complex interactions of the sexes, we have to understand the
intra-dynamics of each sex.
By nature, women will socialize freely and frequently.
This is one of the ways that women feel safe in the world. They
establish groups and networks. Their association provides them with
the emotional strength to feel secure in the world.
Whereas women will collect in groups in order to feel safe, men
will isolate themselves and simply work harder in order to achieve
mastery of their technical skill and create a sense of
safety by creating their indispensability.
Whenever a new person appears within the environment, the sexes
deal with it differently. Acceptance into any group of females is
always conditional, and the criteria for acceptance into the group
is usually reasonable; Truth #1 Every group is entitled
to the criteria they value.
Acceptance by the group of men is often simply to evaluate the contribution
in the form of skills and talents that will be provided by the newcomer.
Truth #2 Skills and talents are essential to survival of
Dr. Desperate’s practice, belief that a newcomer woman has
a questionable morality has created a tension in the office. In
response to this tension, the inner circle has found a reason to
close ranks, get stronger, and solidify their sense of security
as any group might when their morality is challenged.
Desperate thinks that the issue is about the facts of her tainted
history, but it is not. The women in the office, as women everywhere,
created criteria for their group and network. Anyone of questionable
moral character is not acceptable to them. This is very universal.
Dr. Desperate, being a man and therefore thinking “rational
thoughts” says that a dental practice is not about moral character
but about doing a job correctly. Since the woman in question has
excellent technical ability, his rational perspective makes sense
to his masculine mind.
positions have merit but only one position will relieve the tension.
The rational solution is to take a stand but that stand when faced
with the cultural and evolutionary realities may look very foolish
in the long run.
In summary, the women value moral character while their employer
values technical proficiency. The problems in this office will continue
forever because they are not speaking about the same problem. Truth
#3 Morality trumps proficiency.
Want your issues answered? Ask the email@example.com.
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Not Sure Where To Start?
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the week of 7/14
I would like to drop a PPO plan. I feel I need to inform the patients
who have those plans the reasons why and how it will affect them.
How do you suggest I word the letter?
I am writing to notify you of an important change in your dental
insurance. On January 1, 2003, (Insurance Company) made a very significant
change to their policy, which, without warning, became part of the
agreement of every dentist who participates with (Insurance Company).
This was done without consulting or discussing the issues involved
with the dentists themselves.
Because this change would make it impossible to practice high quality,
exceptional dentistry for my (Insurance Company) patients according
to this new agreement, I have reached the decision that I must become
a non-participating dentist. As all of you know, my first priority
has always been to deliver the most superior, state of the art dentistry
that is available in a caring and warm environment. As a non-participating
dentist, I can still do so!
As a non-participating office, you are still free to come to our
office for your dental care or can choose to go to another office
that (Insurance Company) may "assign" you to. We will
treat (Insurance Company) in the same way that we treat the many
other dental plans that we see. This means that we will submit all
of your claims electronically on the same day as your visit so that
(Insurance Company) can reimburse you as soon as possible. We would
expect that patients, who choose to pay for their visits on a credit
card, would receive their (Insurance Company) check before their
credit card statement.
This was a very difficult decision for me but I assure you that
it was made only with my patients in mind, so that I can continue
to deliver the excellent dental care that you deserve and have a
right to expect from me.
If you have ANY questions at all, please call us and we will be
more than happy to help. This change will become effective on (date).
Missed Past Issues of Our e-Motivator Newsletter?
we can come back to the center and visit soon! I also wanted to
brag on our office! Yesterday, my
hygiene department produced $2,025 in one day! We
were so excited! Just thought I would let you know and thank you
for all your advice! Our hygiene department rocks!!*
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