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3.21.08 Issue #315 Forward This Newsletter To A Colleague

Nancy Caudill
Senior Consultant
McKenzie Management
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Seeing is Believing

Dr. Charles Gurney – Case Study #211

Dr. Gurney was concerned with an apparent plateau in practice production, no accountability for team performance and no systems in place to measure where the practice was heading. Dr. Gurney was averaging about 25 new patients a month but his production figures were not going up. With so many new patients, surely there should be higher production.

Like Dr. Gurney, most dentists are not trained sales people. The profession of dentistry is scientific and clinical in focus. It is assumed that patients will be motivated by the evidenced need and make appointments for the treatment. More and more dentists find out, once they open the doors to their practice, that there is more to it than that. The reasons a person may choose the profession of dentistry may entail the following:

  • Make a fair income to support a family
  • Help people obtain optimum health
  • Become a business owner
  • Work in a respected profession
  • Work flexible hours that support a balanced lifestyle

“Selling” is not on the list. Dental school does not offer “Sales 101” in its curriculum. The assumption is that patients are shown what they need and they will then say, I am sold--when can we get started?” Though some patients will respond this way, it is not the norm.

Much of dentistry is elective. Even a patient that visits the dental office in pain can elect to wait or choose to go elsewhere. Dr. Gurney was fortunate enough to be able to consult with 25 new patients a month but was not able to “close the sale.”

What does a patient consider when “buying” dentistry?
Patients make decisions to accept or reject treatment based on the following agendas:

  • Perceived value
  • Time away from work or family
  • Discomfort/healing time
  • Cost/ long-term value

This article is addressing “perceived value”. After evaluating Dr. Gurney’s chairside presentation to the patient needing a crown, the follow-up conversation by the assistant and the exit interview by the Scheduling Coordinator, the following observations were noted.


  • No intra-oral camera
  • No digital radiography
  • No educational DVD presentations
  • No presentation models
  • No digital photos
  • Poor “closing” statements
  • Lack of involvement by the patient

His conversation with the patient went something like this:
“Mrs. Jones, on tooth #31, I think that there is a small fracture of the distal cusp as well as recipient decay. I can probably place a crown on the tooth and that should hold you for a while. Good seeing you again. Take care.”
The diagnosis sounds skeptical at best, especially when the fee for the crown is $900.00.

Observations of Susan the Chairside Assistant:
“Mrs. Jones, I will walk you up to Jill, our Scheduling Coordinator, and she will schedule this appointment for you.”

  • No offer to acknowledge the patient’s concerns or answer any questions
  • No attempt to enhance the procedures’ benefits or explain the appointments necessary to make the crown

Susan’s primary goal was to get Mrs. Jones out of the chair and up to the front desk as quickly as possible so she could seat the next patient.

Observations of Jill, the Scheduling Coordinator:
“Hello Mrs. Jones. Would you like to schedule the appointment for your crown?” OK. Just call us when you are ready.”

Dr. Gurney’s Case Presentation
“Mrs. Jones, your tooth on the lower right side has an old silver filling that has served you well over the years.  However, there is a large break in the tooth now.  I also see a cavity as well.  Did you bite down on something hard recently?”

The appointment did not get scheduled because the patient was not given a professional treatment presentation by the doctor or the assistant. It is not the responsibility of the Scheduling Coordinator to “sell” the dentistry. His/her focus is to schedule the appointment and discuss the financial arrangements. Let’s review what should have happened by the doctor and assistant:

Dr. Gurney’s Case Presentation:
“Mrs. Jones, your tooth on the lower right side has an old silver filling that has served you well over the years. However, there is a large break in the tooth now. I also see a cavity as well. Did you bite down on something hard recently? The good news is that we can save this tooth! It won’t need to be removed! I will remove the cavity, reshape the tooth and place a beautiful porcelain crown on it.  It will last for a long time and look great.  How does that sound?

You will be here about 90 minutes.  I will make sure that you are comfortable at all times.  When your new crown returns from the lab, we will call you and schedule about 30 minutes to remove your temporary crown and place your new crown on the tooth.

What questions do you have for me?

I look forward to seeing you soon so we can save that broken tooth for you. I will turn you over to Susan for any additional questions you may have.”

Susan’s “Close”
“Mrs. Jones, I know that this was a lot of information. We want to make sure that you understand what has happened to your tooth and how we help you to save it. Do you have any questions for me that you need answered before we schedule your appointment?”

Jill’s Confirmation
“Mrs. Jones, I am so happy that Dr. Gurney will be able to save your tooth for you.  I understand that we need to make an appointment for you for about 90 minutes.  I have an appointment on Monday at 8:00 or Wednesday at 9:30; which one works best for you?”

Patient Education and the “Close”
Imagine how much easier it would have been for everyone if Mrs. Jones could “co-diagnose” her own treatment. She could SEE her broken tooth with a digital photo or intra-oral camera view. She could HEAR about a crown through an educational video and she could FEEL what a crown is by the dental model that she is given.

Seeing, hearing and feeling all increase the perceived value of any dental procedure, helping the patient to make an educated decision. 

When your patient says, “I need to think about it,” to the Scheduling Coordinator, the doctor and the chairside assistant did not “sell” the treatment to the patient. The patient still has questions that have not been answered.

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