The Real Reason Behind Collection Problems, by Gregory A. Winteregg, D.D.S.
Getting Out or Staying Out of Managed Care, by Gregory A. Winteregg, D.D.S.
I’m Tired of the Headaches – I Just Want to Be a Dentist! by Gregory A. Winteregg, D.D.S.
Why the Customer isn’t Always Right by Gregory A. Winteregg, D.D.S.
MGE’s weekly webletter, Issue 6.
Here is the next edition of MGE’s weekly webletter. The purpose of this webletter is to provide ideas, tips and suggestions to make your practice more successful.
Feel free to send us your comments and suggestions, or requests for future webletter topics you would like to see covered.
The Real Reason Behind Collection Problems
By Gregory A. Winteregg
Vice-President, MGE
You would be hard pressed to find a dentist that would not want to increase his collections without an appreciable increase in overhead. After all, if you are paying your bills now and were to increase your collections by $10,000 to $20,000 per month ? without much of an increase in overhead – that additional money is profit. The question is: How do you go about doing this?
I. Collection Problems
Despite the placards at your front desk or financial arrangement forms patients sign, you still have patients who “forgot their checkbook” or who demand that you “bill them.” Can you imagine telling the cashier at your supermarket to “bill you” for your groceries? Or telling the gas station attendant, “Oops, sorry, forgot my wallet!” This simply does not happen. Why, then, does it happen in your office?
Failure to keep financial arrangements is obviously a contributing factor to collection issues and some offices experience this problem more than others. However, getting people to stick to a financial agreement is not what this article is about. It is also not the primary factor behind low office collections, or profitability. There is another more pressing issue that affects office collections, profitability and most importantly your patient’s health: treatment acceptance.
Let’s take this a step further. Let’s say comprehensive treatment plan acceptance, including actually getting paid for the treatment. This is, in truth, your biggest source of lost practice income. For example:
Dr. Smith presents a case to Mr. Jones. Mr. Jones needs two root canals, two build-ups and crowns and two three-unit bridges. Let’s say Dr. Smith charges $700 for each unit of endo and an average of $800 for a unit of crown and bridge. The treatment plan would look like this:
| Service | Quantity | Unit Price | Total |
| Root canals | 2 | $700.00 | $1,400.00 |
| Build ups | 2 | $160.00 | $ 320.00 |
| Crowns | 2 | $800.00 | $1,600.00 |
| Bridges | 6 | $800.00 | $4,800.00 |
| Treatment plan total: | $8,120.00 |
Dr. Smith presents his estimate, but Mr. Jones only wants to do the root canals now (after all, insurance pays 80%). After Dr. Smith shows him that doing the root canals without the crowns would not be a viable option, Mr. Jones begrudgingly agrees to do the crowns and build-ups as well. He weakly “agrees” to do the remainder of the treatment (bridges) in the next year, or the year after – he’ll talk about it “some other time.” Dr. Smith, not wanting to bother Mr. Jones too much and thinking that “the customer is always right,” agrees with his patient.
Most dentists would consider that Mr. Jones accepted the full treatment plan in the scenario above. In truth, he has not. What he has agreed to is to do a portion of it. Whether he will do the rest remains to be seen. Dr. Smith presented the entire treatment plan to Mr. Jones and suggested that he get it done now. He reasons that if this was his own mouth, he would do it all right now. He explains that opposing teeth will super-erupt, etc. Then after all of this, he agrees with Mr. Jones about putting the additional treatment on “hold.”
Take a closer look: You are talking to a patient about a treatment plan and telling them that it is important to do it all now. And, truthfully it is. The patient balks and “only wants to do what insurance pays” or says “it costs a lot of money” or something of the sort. You don’t know how to “handle” this objection. So (usually against better judgment), you reverse your position about doing it all now and agree to put a portion of the treatment plan on “hold”. What are you in effect saying to the patient about that portion of the treatment plan that is now on “hold”? That it’s not that important. Don’t be surprised if the patient begins to wonder, “How important is the treatment that I did agree to do now?”
Back to our treatment plan above, Mr. Jones has agreed to do the root canals, build-ups and crowns. He has about $1,500 in insurance coverage and a $50 deductible. This would look like this:
| Service | Quantity | Unit Price | Total |
| Root canals | 2 | $700.00 | $1,400.00 |
| Build ups | 2 | $160.00 | $ 320.00 |
| Crowns | 2 | $800.00 | $1,600.00 |
| Total: | $3,320.00 |
Insurance covers 80% on the root canals and 50% on the build-ups and crowns. If you do the math, this would max out Mr. Jones’s yearly benefit ($1,500) and leave him with a balance of $1,820 as his co-payment.
Depending on how Dr. Smith does financial arrangements, Mr. Jones might pay nothing down, 50% down, finance his balance or whatever. Or he may come in, get his work done and give you those famous four words, “I forgot my checkbook.”
The difference in price for the treatment Mr. Jones accepted versus his full treatment plan is $4,800. Had Mr. Jones accepted this it would have been $4,800 added to monthly collections and a more dentally sound patient. In truth, that is $4,800 in lost income for Dr. Smith’s practice, and Mr. Jones did not receive the needed care.
II. Eye-Opener
It is not a bad exercise to sit down and add up how much in treatment was not accepted in a given week or month in your practice. Simply take all of the needed treatment you diagnosed in the last month and add it up. Now, subtract the amount of treatment that was actually accepted and done during that same period. The difference is what could have been produced/collected (without working much harder or longer for that matter) that was not. There’s your profit!
To take the focus off of the money for a minute, as that is not the most important issue, think of this: Would Mr. Jones have been healthier if he had done the full plan? Yes. And what patients are your best referral sources? Usually the ones that did a full treatment plan. Why? They go to work and show their friends, and they are happy that all of the work is done. Lastly, what do you enjoy more – patching a patient up or doing all of the work that is needed so only checkup appointments are required? The net result of Mr. Jones’ failure to do the treatment plan is a less healthy mouth for him and, for Dr. Smith, less profit, fewer referrals, a less healthy patient and little fulfillment.
So what was the problem here? Is Mr. Jones’ “dental IQ” low? Does Mr. Jones not care about himself as much as Dr. Smith does? Can Mr. Jones really not afford it? Maybe. But the problem also is that Mr. Jones is not sold on the necessity of the treatment.
III. Changing Attitudes
Perhaps reading that last four-letter word, “sold,” turned you off. After all, you don’t sell anything. You’re a doctor, right? Well, I hate to break this to you, but you are also a sales person. Selling is simply effectively communicating with a person in such a way as to get them to agree to a service or item that is going to help him or her. Selling is about helping people. There is nothing wrong with that.
So, why is the issue of selling a problem in dentistry? First, because many sales techniques taught in this country are unworkable, or cause you to stray so far from being yourself that you are uncomfortable using them. Second, most dentists never learned the technology of how to sell or communicate effectively.
I did pretty well my first 10 years in practice (1981-1991). I was collecting about $40,000 a month in a small rural community. To give you an idea of the cost of living, my crown fee, which was average for the community was in the $400 range, and the largest house in the county sold for $150,000. My practice was located in a strip mall next to a supermarket. I was getting about 25 to 30 new patients a month. Like many of my colleagues, I spent tens of thousands of dollars on consultants to teach me how to have a great staff meeting, fix my appointment book and get a better collection percentage.
Then, at the end of 1991, the supermarket moved out of the strip mall. My new patients crashed to fewer than 10, and my collections hit about $30,000 a month – my collections were barely covering my overhead. Up to that point I had used six different management companies in 11 years, and each of them agreed that the staff should handle the “financial discussion.” So that’s how we did it in my office. I did not want to do it anyway; it made me uncomfortable.
Then in 1992 I became a client with MGE: Management Experts, Inc. (in 1994 I became a partner). I started with the MGE New Patient Workshop, which taught me the technology of how to develop an effective marketing strategy. From there I did the MGE Sales and Communication Seminars from which I learned a technology of communication and sales that was natural, easy, truthful and actually worked!
I went home and starting presenting treatment plans effectively. In short order, two things happened that simply blew me away: 1. Production and collections shortly hit $54,000 a month and were soon over $65,000, and 2. New patients jumped to over 30, before my marketing even went out! It was all referral. My increased selling had brought my new patients back up. Once the marketing kicked in that I learned from the MGE New Patient Workshop the new patients jumped to about 70 a month. And this was with no managed care (PPOs, HMOs) of any kind.
My patients were getting the optimum care they needed, and I felt that I was in control of my practice, destiny and financial future again. From this I learned that the only safe and secure conclusion to make is that if you aren’t doing the selling, then start! And if you can’t do it, then learn how. It’s easier than learning how to cut a crown prep!
IV. Getting Down to Basics
It’s time for us as a profession to address this issue head on. This is a business basic: You can’t deliver more goods or services than you can sell. Marketing and promotion give you people to sell to. One could then conclude that the amount of services you deliver will be determined by how much you sell, which, in turn, determines your income.
Take any business as an example, whether it is a furniture store, large corporation or health club. If that business cannot sell its goods or services, it will not survive, or will have financial trouble to say the least.
I’ve met so many dentists with incredible clinical skills. They have trained with the best and can really deliver high-quality dentistry. The problem is that the ability to sell dentistry is what will determine the volume and quality of delivery of dentistry. If you can’t sell it, you won’t deliver it. End of story.
Dr. Greg Winteregg provides this general dental practice management advice to furnish you with suggestions of actions that have been shown to have potential to help you improve your practice. Neither MGE nor Dr. Winteregg may be held liable for adverse actions resulting from your implementation of these suggestions, which are provided only as examples of topics covered by the MGE program.
MGE’s weekly webletter, Issue 16.
Here is the next edition of MGE’s weekly webletter. The purpose of this webletter is to provide ideas, tips and suggestions to make your practice more successful.
Feel free to send us your comments and suggestions, or requests for future webletter topics you would like to see covered.
Getting Out or Staying Out of Managed Care
By Gregory A. Winteregg, D.D.S.
Vice President, MGE
What am I going to do?
In 1992, after eleven years in my dental practice, I was asking myself this very question. My practice was in a strip mall and the supermarket moved out. The foot traffic left with it. New patients dropped to fewer than 10 per month and collections were down by 25%. Over the eleven years prior to this, I spent tens of thousands of dollars on consultants to teach me how to have a great staff meeting, run my schedule, etc. But, after all of this consulting, I was still left with no solution to my lowered income and new patients. I was frustrated. I began investigating PPO and HMO plans as a solution. I wasn’t happy about it, but at the time, didn’t know what else to do!
Chances are, most of us have faced this same problem (not busy enough and looking into managed care as a solution). If you are involved with any HMOs, PPOs, discount plans (and want out) or just want to know how to stay out of them, this article is for you.
Why Sign Up For Managed Care?
In looking at an exit strategy, I thought it best to first examine what prompts dentists to join these plans to begin with. The most common reasons I hear are:
1. I needed to be busier. It is better to fill that empty chair time with a patient (even at a reduced fee) than to have it empty.
2. I wanted to join the plan before I got “locked out.”
3. A lot of my patients switched over to this plan.
4. I needed to improve my cash flow.
5. I needed more new patients.
You may find that the reasons you joined or are thinking of joining are similar. While these are all valid reasons, let me pose this question: If I were to ask if you would prefer to be paid your usual full fee for work you are doing, what would be your answer? (I am assuming it would be yes…) The obvious problem with these plans is you are doing the same amount and quality of work at a reduced fee. This would work if your lab, suppliers, landlord and staff were willing to perform their services at a commensurately reduced fee – but we know that this is not going to happen! Generally, the write off percentage begins at 10-25% and goes as high as 60% with some plans. You are reducing your income for a procedure, but not expense. At best you are cutting your profit; in severe cases may find yourself with a busy office having a difficult time paying bills.
What problem is managed care solving? You join a plan, you get more patients. Well, this begs the question: Why not go and just get more new patients without joining a plan? Think about it: If you knew how to attract enough fee-for-service new patients for your practice to be successful, what would be the point of signing up for any plan?
The Way Out
This brings us to the first requirement of getting out of managed care – the ability to attract fee-for-service new patients.
Now, you could look at this and say “Uh…yeah, Greg – this is a no-brainer.”
Well then, let’s look at where things break down:
Generally speaking, anyone, regardless of their skill level, when it comes to marketing or management can recognize the need for more new patients – it’s pretty obvious.
Where this falls apart is at the next step – doing something about it. In order to act and improve the situation, you have to decide on a course of action and then do it.
Most doctors have trouble deciding what to do about this problem as they are not educated in the areas of promotion and marketing. This lack of knowledge normally leads to one of three outcomes:
- They pick a marketing activity that sounds “cool” but doesn’t work.
- They hire someone else to do it for them and it may or may not work.
- They get lucky and pick something that works. I say “lucky” as this activity is not usually picked based on a proper evaluation of soundness of marketing principles – but rather it sounds nice or something to that effect.
In my experience, I see “1” and “2” above far more often than “3.”
The problem with this operating basis is it puts you in a position where you are not in control of the area – rather you are at the mercy of whoever you hire to do it or the “hope” that some marketing idea will work for you, knowing little to nothing about it.
And, after a few (or tens of thousands of) dollars down the drain on unworkable marketing, I find most colleagues drop the idea entirely and slip into a quiet apathy about the subject – i.e., “this is just the way things are…there’s nothing you can do about it.”
Well, what can you really do about it? How do you go about increasing your expertise in an area such as marketing and new patients? The answer is simple: Get trained on the subject so you can handle it yourself. Like it or not, you ARE an EXECUTIVE, by virtue of the fact you own a business. You can try to get around this fact, but it is what it is. An executive needs to know how to handle (competently) any area of his or her organization.
So, while hurdle number one to overcome when looking to get out of managed care is having the ability to attract an adequate volume of fee-for-service new patients, hurdle number two believe it or not is case acceptance. We’ve written a number of articles (Webletter 3 or Webletter 6) that detail the relationship between low collections, case acceptance and of all things – patient referrals. Without going into great detail again, I’ll point out that an inability to “sell” full treatment plans can convince a doctor that the reason for his or her low collections is not enough new patients. In other words, “to increase my collections, I need to more new patients coming in.” It is true that an abundance of new patients is healthy for a practice and should be maintained. But look at it this way: If you have three patients each with a $6,000 treatment plan, only accepting a third of needed treatment presented (i.e., each do $2,000 worth of treatment), this is the same from a collections standpoint of one patient accepting their full plan of $6,000. That one patient who accepts their full plan will also be healthier and more likely to refer!
With all of the above in mind, there is a basic formula that ANY business follows:
- It must Sell its product or service.
- It must Deliver its product or service.
- It must also get new people in to sell and deliver their product or service to.
“Management” coordinates and holds the organization together to continue to sell and deliver more services or goods to the public (i.e., expansion); however, if there is ineffective marketing and sales then there isn’t enough activity in the business to have something to manage.
Dental school and continuing education trains you how to “deliver the product.” Where most practitioners fail is in 1 and 3 above – selling and getting new people to sell and deliver to. The reason for this failure is not hard to see – you will be successful in areas where you are effectively trained. Areas in which you are not trained in or know little to nothing about will be troublesome. You will also have a hard time making informed and workable decisions about these areas. And let me make clear that by effective training I mean learning techniques that actually get a desirable result!
Having difficulty in sales and marketing due to no training, it is easy to see how managed care plans can appear to be a solution. While they will make you busier, they in fact breed the next problem(s) when it comes to overhead and profitability.
The solution to this problem is simple – learn how to properly market and sell in your office. With that ability, you will then have the confidence to start getting off the plans.
To finish my story above, at the same time in 1992 that I was investigating managed care plans, I heard about the MGE New Patient Workshop. I found out more about it and decided to give it a shot. What attracted me to it was the idea that MGE was going to train me to fix the problem myself and that there was minimal risk involved in doing the New Patient Workshop – it came with a money back guarantee and still does to this day. So, with the managed care contracts on my desk, I signed up for the MGE New Patient Workshop. I did the New Patient Workshop and was able to handle my new patient problem on my own – without having to join any plans. From there, I did more sales and executive training with MGE, built a very successful practice and in 1994 sold it and became a partner in the company to help other doctors like me.
So, when I tell you that learning how to do it yourself is a solution, I am not saying this from some detached viewpoint. I lived this experience myself and saw the benefit!
My advice to you – take control of your office! If you want out of managed care, or are looking for ways to build a more successful practice, give us a call! Start with the MGE New Patient Workshop. I look forward to meeting you and tracking your success!
PLEASE NOTE: This article provided by MGE: Management Experts, Inc. consists of suggestions and ideas that could be used to help improve the solvency and viability of a dental practice. There is no guarantee that the information provided is appropriate to your practice. Each practice, their owners, officers and staff are individually responsible for ensuring that any system implemented in the practice complies with the applicable federal, state and local accounting, tax and employment laws, rules and regulations governing the place in which your practice is located. These suggestions do NOT constitute legal or accounting advice. You should seek advice from your own accounting and legal advisors as to what is appropriate to implement in your practice, prior to implementation. MGE: Management Experts, Inc., its officers, directors, shareholders, employees, agents and the writer of this article, are not responsible for any claims, real or otherwise, associated with this material and information or any part thereof.
MGE’s weekly webletter, Issue 17.
Here is the next edition of MGE’s weekly webletter. The purpose of this webletter is to provide ideas, tips and suggestions to make your practice more successful.
Feel free to send us your comments and suggestions, or requests for future webletter topics you would like to see covered.
I’m Tired of the Headaches – I Just Want to Be a Dentist!
By Gregory A. Winteregg
Vice-President, MGE
“I’m tired of the headaches…I just want to be a dentist!”
I can’t tell you how many times I’ve heard that! We go to dental school, rack up lots of debt, open a practice, rack up lots more debt and do more and more continuing education. All for the privilege of being able to: argue with insurance companies, worry about paying the bills, struggle with cancellations and no shows, watch comprehensive treatment plans get reduced to phased care, deal with staff issues and worry about retirement (as well as some time, despite all this to actually enjoy doing some dentistry).
It’s enough to get you thinking “I didn’t sign up for all of this!”
Does it ever seem that every direction you turn and with every move you make that your efforts to build a thriving, profitable practice are being stopped or thwarted? If it’s not “managed care,” it’s the “economy.” Have you ever had the thought: “Is it really possible to have a stress-free, profitable practice anymore? Maybe I should just sell and go to work for someone else as an associate.”
OK. Put down the Aspirin bottle. Time to take a deep breath and remember why we did sign up for this. Wasn’t it something along the lines of: “I really like to help people and I would like a profession where I can make a good living for my family”?
In dental school I had no idea what I was in for after graduation. Growing up, my mom and dad owned a successful family restaurant. I was raised with a good work ethic and liked the idea of owning my own business/dental practice. But the restaurant business isn’t anything like running a dental practice.
When I graduated from the Indiana University School of Dentistry in 1981, prime interest was at 20.5%! My banker did me a favor when he gave me my loan at 19.5%! Then after eleven years of hard work, six consultants and hundreds of hours of continuing education, it was still stressful and unpredictable. The dentistry was great. The business of dentistry was a ball of confusion. I tried everything I could think of to build this practice and nothing seemed to have any kind of predictable result.
Then I became an MGE client and everything changed just about overnight!
I know it sounds “too good to be true” but there is a bona fide recipe for building the type of dental practice you have always dreamed about. MGE has it. All you have to do is follow the recipe. It’s like baking a cake. Follow the recipe and it will turn out great. Alter the recipe and who knows what you’ll have at the end.
Luis Colon (who I later joined as a partner at MGE), interviewed me when I first arrived at MGE. He asked about my frustrations and let me vent. I told him about everything I had tried and how it hadn’t worked the way I wanted. He listened to me without any evaluation or opinion of what I had been through.
Then he did something very brilliant. He asked me “What kind of practice do you want to have? What kind of dentistry do you want to do? How many hours do you want to work? How much money do you want to make?”
At first it sounded like a routine drill that others had put me through. But I noticed that everything I said he was writing down. He was really listening to me. I told him everything I wanted from the practice: I wanted to do the more difficult procedures (larger crown and bridge cases, molar endo, and third molar extractions) and have an associate do the routine crown and bridge, pedo and removable. I wanted an office manager to run the place, to work twenty to twenty-five hours per week, take three to four weeks of vacation per year and make more net income than I had in my best year.
Then he asked me how long I wanted to take to get it. I was thirty-seven at the time and had been in practice for eleven years. Despite trying everything I could think of to have that kind of practice, I wasn’t much closer than the day I graduated. I told him that if I could pull it off in ten years I would be ecstatic. Without any change of expression he asked if I would be upset if I did it faster than that.
I remember that day as if it was yesterday. I just described my “ideal” practice and this guy was giving me the idea that it really was possible. He told me he wasn’t going to do it for me but that he could teach me how to do it for myself if I was willing to learn.
I was willing to learn and nobody was going to out-work me. I applied what I learned at MGE and I had exactly the type of practice I wanted within a year, and mind you this was in 1992 when we were in/coming out of the last recession:
a. I had an excellent MGE trained office manager running my practice.
b. My practice had more than doubled, with my net higher than ever.
c. I had a great associate, who later became my partner.
d. I was working 22.5 hours per week.
When I arrived at MGE I felt as if I had been stopped at every turn. No matter what I tried, nothing was helping me to expand my practice. I graduated with a purpose to help a lot of people by doing great dentistry and have a flourishing practice. I wasn’t achieving that to the degree I thought I was capable of.
When I met with Luis, he gave me confidence that he could teach me how to achieve it. Then he had me talk to doctors who were accomplishing everything I had asked for and more. My viewpoint was simple: If they could do it, I could do it. I was off to the races.
So I’ll ask you the same question: What do want from your practice? How many hours? What kind of procedures? How much free time? Go ahead and write it down.
OK, that exercise was nice. Now what do you do? You have to learn how to promote to bring in fee-for-service new patients, sell comprehensive care, and manage a thriving practice with the help of a trained office manager. Piece of cake! Just follow the recipe.
I really only need two things for you to be successful on our program:
1) Be teachable. Be willing to come in and learn how to do this. We will never see your practice or tell you what to do. You have to be willing to learn how to bake this cake but we are excellent teachers. Learn the recipe!
2) Be motivated to apply what you learn. You can’t pay me enough to call you every week and yell at you for not applying this technology. I’m too old to babysit. But you can call anytime you want and talk to the “teacher.” In other words, we don’t charge an hourly rate for any follow up help by phone, fax or email with me or one of my staff after you have paid your tuition for your customized training program. We’ll help but you have to apply it. Bake the cake!
If you have read this far into my article, my intention is that you are getting just a tiny flicker of HOPE. Maybe you can still achieve all of your goals. Our clients range in age from twenty-seven to seventy-four. It’s not too late to START!
My suggestion: Start with the MGE New Patient Workshop or MGE Communication and Sales Seminars. Or just give us a call at (800) 640-1140 and request to speak with me personally. Have your “grocery list” ready to tell me what you want. We’ll work something out to help you start achieving your goals.
PLEASE NOTE: This article provided by MGE: Management Experts, Inc. consists of suggestions and ideas that could be used to help improve the solvency and viability of a dental practice. There is no guarantee that the information provided is appropriate to your practice. Each practice, their owners, officers and staff are individually responsible for ensuring that any system implemented in the practice complies with the applicable federal, state and local accounting, tax and employment laws, rules and regulations governing the place in which your practice is located. These suggestions do NOT constitute legal or accounting advice. You should seek advice from your own accounting and legal advisors as to what is appropriate to implement in your practice, prior to implementation. MGE: Management Experts, Inc., its officers, directors, shareholders, employees, agents and the writer of this article, are not responsible for any claims, real or otherwise, associated with this material and information or any part thereof.
MGE’s weekly webletter, Issue 23.
Here is the next edition of MGE’s weekly webletter. The purpose of this webletter is to provide ideas, tips and suggestions to make your practice more successful.
Feel free to send us your comments and suggestions, or requests for future webletter topics you would like to see covered.
Why the Customer isn’t Always Right
By Gregory A. Winteregg, D.D.S.
Vice-President, MGE
“The customer is always right.”
For years we have heard this phrase from different quarters of industry. It often carries with it the idea that it is an unalterable guideline that must be followed to be a success in business. After all, that’s how you get the sale, right?
There’s actually a major problem with this. What if the customer is wrong? What if they don’t have enough knowledge to make the correct decision for themselves? Do you just weakly tell them what they should do and then just throw up your hands and say “I tried to tell them!”?
I’ll give you a ridiculous example to make my point: What if I was a parachute salesman and a four-hundred pound man wanted to buy a parachute from me. The parachute for a two-hundred pound man was cheaper and he liked the color better. I explained that it was too risky for him, but ‘the customer is always right’ and I sold it to him anyway. Obviously if he understood why the parachute for a two-hundred pound man would not be a viable option he would opt for the correct choice – a parachute for a four-hundred pound man. Needless to say this would have dire consequences but I could tell myself that “I tried.”
As a responsible parachute salesman, the proper thing to do is sell him a large enough parachute or tell him to go somewhere else, with the reason given that I refuse to sell him something that could lead to his potential demise!
As knowledgeable and responsible dental practitioners we need to take the same viewpoint.
About twenty years ago, I remember hearing a story from a dentist about his first year in practice (we’ll call him “Dr. X”). A patient (we’ll call him “Frank”) presented with numbers 6-11 that were worn down and his remaining maxillary teeth were missing. He also had a very flat palate. He had a full complement of teeth on the lower arch.
Dr. X explained to him it would be in his best interest to crown the six remaining maxillary teeth and make a partial denture. Dr. X reasoned that if this were his mouth that is what he would do. However, Frank’s wife had an upper denture and was happy with it (and a denture was going to be much cheaper), so Frank insisted on going with a full denture. Dr. X explained why he didn’t think that was the best thing in the long run but in the end gave in and did it Frank’s way.
Every time Frank came in after that to get his teeth cleaned he told Dr. X he wished he had listened to him. He just didn’t like the upper denture. He didn’t blame Dr. X as some patients might have. He took responsibility for his decision but the truth of it is Dr. X could have taken more responsibility for Frank and made him understand why he should follow the treatment he recommended. If he felt uncomfortable doing it Frank’s way, he could have refused to do the procedure. The truth is Dr. X was more informed and knowledgeable about dentistry than Frank was and should have been more insistent on his best treatment plan.
On a similar note, what about the patient who needs six crowns and we are doing them two at a time because “that’s what the insurance covers”? If you play that game long enough, you’re going to get burned. You’ll prep two on the upper left in January and have #30 break in July. Now the patient is upset because you didn’t start on the lower right.
What I have found in these types of situations is not that the dentist lacks the willingness or desire to have the patient do their full treatment plan. The problem is usually that the dentist doesn’t know how to communicate with the patient in such a way that they understand and commit to doing the full treatment plan.
This communication ability could also be called selling. (Yes that word again…)
The solution to this problem is too simple. Learn how to properly and professionally sell. Life is so much easier that way. The patient gets what they need and dentistry is much more fun when you aren’t compromising. And I’ll tell you something, as I went over in a previous article, patients who do their full treatment plans are happier and refer you more of their friends and acquaintances. This approach is better for the patient and better for you and your practice.
We usually think that the patient’s decision is based on the cost. Then they turn around and tell you about their trip or their new boat. In my experience, 80% of the time money had nothing to do with it. They were afraid. They heard bad news about root canals. “Joe at the garage said…” Bottom-line in most cases if they decided against your treatment recommendations it was because they did not understand why they needed it.
Our most popular seminars are the MGE Communication and Sales Seminars. They consist of three, three-day seminars that cover the basics of communication and case acceptance. There is a lot to know about these subjects, but you can learn if you decide you’re tired of “just doing what the insurance allows.”
I would like to give you one thing to try that is too simple to have to put in writing. Don’t give up so easily. Stick to your guns a little more and talk to them and find out what’s on their mind. This will work more often than you might think because real or proper selling is caring. Stick to your guns in a very caring manner and you’ll be surprised what happens.
In some cases the customer may know exactly what is best for him, but that is rare in dentistry. They don’t have the proper training and experience to make the proper decision. Learn how to sell them what they need. Don’t sell them the wrong parachute. The customer isn’t always right.
PLEASE NOTE: This article provided by MGE: Management Experts, Inc. consists of suggestions and ideas that could be used to help improve the solvency and viability of a dental practice. There is no guarantee that the information provided is appropriate to your practice. Each practice, their owners, officers and staff are individually responsible for ensuring that any system implemented in the practice complies with the applicable federal, state and local accounting, tax and employment laws, rules and regulations governing the place in which your practice is located. These suggestions do NOT constitute legal or accounting advice. You should seek advice from your own accounting and legal advisors as to what is appropriate to implement in your practice, prior to implementation. MGE: Management Experts, Inc., its officers, directors, shareholders, employees, agents and the writer of this article, are not responsible for any claims, real or otherwise, associated with this material and information or any part thereof.
