Five Killer Questions to Get Your Patients to Yes

[0:00] You are listening to the Dental Practice Owner's Podcast brought to you by Prosperident. From our unique perspective as dentistry's embezzlement experts, Prosperident's team can bring you the information that is important to practice owners. The Dental Practice Owner's Podcast brings you strategies, tools, and tips that you can use and dentistry's thought leaders as guests. So sit back, relax, and listen to Prosperident's Amber Weber, Wendy Askins, and David Harris

[0:31] talk about the issues that matter to you. Hi everybody. Hello dental family, thank you for spending time with us this evening. We have an amazing guest and I'm going to let David introduce her more because he would be better at that, but we have an amazing guest. We're going to have an amazing time giving great information this evening on growing

[0:59] our practices, but let's take care of some housekeeping issues first. Like always, this is a webinar, so we have some different options for you. If you want to just chat up the entire evening, please feel free to use the chat feature and Sheila is going to be monitoring that for us this evening. If you have actual questions that you would like to ask Deborah, please put them in the Q&A section that way Amber and I can know to focus on those and we can ask Deborah

[1:38] those specific questions at the end of our event this evening during our Q&A time. We're going to be together for about an hour and a half or so. This session is going to be recorded and as always, it will be posted on the Prosperident website for you probably around Monday. If you if you need to go back and hear something or if you want to tell some friends that they need to watch her webinar, have them go to the Prosperident

[2:14] website and they'll be able to watch it on Monday. Also, we are offering continuing education credit this evening thanks to our friends at Altura Paragonics. After the webinar, you're going to be getting an email that will let you know exactly how to get your certificate to prove that you attended the webinar so you'll get your CE credit.

[2:40] Now, oh, also, how could I ever forget Sheila, don't kill me. We love love to have your reviews and it kind of really helps for your peers to see the type of quality material that we're presenting here during our webinars. So if you feel like we've done a great job this evening and you appreciate that, then we ask that you visit one of the many sites that are possible and please give us a five-star review for it.

[3:12] OK, moving on. OK, well, this is the very first webinar that we have had since David Harris, Thielers versus Steelers has come out. And if I know David, he's going to offer you. He's going to offer you a chance to get the book tonight. Although I do have to say it won't be as special as mine because I have a

[3:40] beautiful personal message written to me from David in it. Anyway, but it is an absolutely awesome book. And I'm sure someone will be getting that, right, Dave? Definitely, we will. We will award a book for the most insightful question tonight. And I'll be happy to sign that one as well.

[4:06] And one thing I want to mention about the book, my name is on it, but it really was a total team effort. And a lot of the ideas that are in the book came from these webinars that Amber, Wendy, Sheila and I have been doing for about three years. So so Amber and Wendy were both massive contributors to the book and Sheila's helped in distribution and getting it to the right places.

[4:30] So it's really a team effort. There are a lot of things I could say about our special guest. I've known Deborah for probably 15 years. When I think about the difference between knowledge and wisdom, Deborah's wisdom, she is she is one of the wisest people I've ever encountered. And what she says, even kind of off the cuff is

[4:57] so so wise and so composed and so well thought out that I would listen to her speak about absolutely anything. However, tonight she's going to talk about something near and dear to all of our hearts, our wallets. And her her title is Five Questions to Get Your Patient to Yes. And I can't wait to hear what she has to say.

[5:26] Deborah, it's just an unbelievable pleasure to have you here. I I'm so tickled pink for those of you who don't know, Deborah, she is a is a renowned practice management consultant, a three time president of the Academy of Dental Management Consultants. She's headed other organizations and her husband, Dr. Ross Nash, who's a world famous cosmetic dentist.

[5:53] Deborah and Ross founded something called the Nash Institute that maybe she'll tell us a little bit more about. They have a spectacular facility in in North Carolina. And and yeah, it's it's it's a fabulous place. Deborah, why don't you fire up your screen share and let's listen to you. So hi, everybody.

[6:17] And this is one of my this is something that's near and dear to me. And I will tell you that I kind of threw it's Sheila and David for a little because I mentioned that I was going to talk about five killer questions. And then as I was preparing the program, I said, wait a minute. I it's going to be six killer questions.

[6:36] So let me go ahead and make my get rid of all this other stuff on the bottom. But we're going to talk about six killer questions to get your patients to say yes. And I do want to preface this with talking about I'm going to try and get us out of here, people.

[6:52] There we go. I want to preface this about talking about these questions and how we're going to use them. And I think it's important to note that when we talk about get your patients to say yes, sometimes people, team members get a little concerned about, gee, are we

[7:10] are we trying to convince patients to do something that they shouldn't do? Are we selling to the patients? And I think it's important for us to remember that we are when we are helping our patients understand and appreciate the quality of care that we can provide so that they want to move forward with their treatment. We are not doing them harm.

[7:31] We're doing them good. So when we talk about how how can we improve our skills and how can we hone our techniques so we can help our patients in a more effective way? And that's when we talk about these questions. So these are the questions we're going to go through them all.

[7:47] But the first question is they will all they will all make sense as we go through them. What inspired you to call number one question? And we'll talk about how we're going to use that. May I ask a few questions? May I tell you a little bit more about our practice?

[8:01] Would you allow me to tell you what I would like to do? That's going to be that's a killer one for me. Tell me what's prevented you from moving forward with your care. And if we could find a way to make this affordable for you. What other concerns do you have? And these for me are the killer questions.

[8:15] We are going to review this evening. Now, I know that why am I not moving forward and going anywhere? People. Let's talk about why we can't. Oh, there we go. I think we're going to talk about the six customer service trends that and we're just going to they relate to dentistry.

[8:38] And I'm going to really I'm going to focus on the first one because the other ones we can spend another whole session on these other customer trends. But here's what is I think critical for us to be aware of customer service and experience will be increasingly important differentiator in our in our practices in our future.

[8:57] Most patients will not choose us or unchoose us based on our fees. They will do not choose us based on the tertiary anatomy of our crowns. They don't base that they don't choose us based on our office policies. We'll talk about that word in a little bit. Or our office protocols and they actually the differentiator that we have in our practices, the thing that sets us apart,

[9:22] that the the the thing that that actually establishes our fees will be the customer service experience that we offer our patients. And that's part of the types of questions that that we ask going forward. Here's some it's it's why it's important to ask the right questions. This customer service experience and we want to avoid policy statements, policy statements, and if you have that in writing, if you are saying that,

[9:52] if you have that on your website, the word policy is an unfriendly, uncustomer service oriented word. I hear it sometimes when I still consultant in dental offices and when I go in, I hear team members say I'm sorry, but that's our policy or let me explain our policy or we hand the patient a piece of paper that says this is our financial policy.

[10:17] Well, policy basically is connoting that the patient needs to understand the rules and regulations of being a patient in your practice. That is not a customer service environment in which you in which you want to and you want to work. So we want to avoid the word policy. We also want to avoid apologizing for our policies if we have them words

[10:43] that replace the word policy. We certainly have a financial understanding with our patients. We have financial standards. We have financial protocols. We have financial agreements. And those are terms that our customer service oriented words.

[11:04] So we ask the right questions and we avoid words like policy. We also want to avoid the word just. It's just a recall. It's just a simple feeling. I'm just calling to remind you. I'm just calling to to see if you want to move forward with your care.

[11:23] Just the word and it's hard. Ladies and gentlemen, people are when I I am as guilty as all of us. When I say, hey, I'm just calling. It's so easy to just fall out of our mouth. I'm just calling, but it minimizes what we are doing. I had a client one time who said to the patient, this is it's just a little filling.

[11:45] It's just it's just a little and she said she used the term. She was trying to make it sound like a burr and she was like, this is a little filling. And of course, the patient turned and she said, well, if it's just a little filling, why is it costing me three hundred and eighty two dollars? Very valid point. So we want to avoid words that minimize also minimize what we do.

[12:07] So we want to avoid policy statements. We want to avoid the word just and when we talk about policy, here's why. Eighty percent of the reason why patients choose your treatment, choose your dentistry is your ability to connect with them. It has very little to do with your clinical abilities. I mean, I when I first met my husband,

[12:30] and I know Dr. David mentioned that I married to Ross Nash. And I will tell you, I had my business and my career long before I met him. And if you would have ever told me, I was going to be married to a southern ball dentist and live east of the Mississippi. I would have told you that would not be in my life. But here I am. Love does crazy things.

[12:51] But one of the things that when I first met him and he told me about the kind of work that he did, my comment to him was this. It's one thing to know how to do the dentistry. It's another thing to know how to talk about the dentistry and help your patients understand it, appreciate it and find a way to afford it. Those are different skill sets.

[13:15] So we have to we have to marry. We have to create a hybrid in our practice of obviously having the skill sets to do the to do the treatment to do the work. But we also have to have the communication skills. To be able to help to help the patient understand what we're trying to do. In fact, 85 percent of the time we spend with our patient is in communication.

[13:37] And 15 percent of our time is in clinical application. But we spend so much time learning of our and honing our clinical skills and gaining our clinical aptitude. But how much time do we actually spend on how we talk to the patient and what we say to the patient and how we engage the patient in relationship?

[13:58] So I think it's really critical that we learn how to spend more time on people work than on paperwork. That's why I'm a big fan of outsourcing when I can some of the paperwork. So my my team can become patient ambassadors, treatment ambassadors, treatment coordinators, however you want to name their title. I would much rather see and I would much rather experience the team

[14:26] talking to patients about their dental treatment and spending 45 minutes on the telephone listening to bad music on hold with an insurance company or or trying to to figure out their dental their dental analytics by hand when they can outsource that to an analytics company, a little analytics software company. So but I want to go back to I think it's important to get to know

[14:47] the patient and earn their trust before we start informing them of office standards. People will be more highly more compliant if they like you. I have a quote that I have said for longer than Amber's been alive. And I just I love the quote and it's and I don't even remember where I got it or I would give the that person credit for it, but it goes like this. If you like a person, they could drop a plate of food on your lap

[15:15] and you wouldn't mind. But if you don't like a person, the way they hold their fork will drive you insane. And I think that's very true. So what one of our our objectives is to help our patients establish a relationship with our patients, help them understand who we are

[15:33] and how we want to help them. So then when we do talk about our scheduling protocols and we talk about our financial arrangements, our financial standards, they will find a way to make it happen because they like us. Think about this as a as an example. If you really want to have lunch with David Harris

[15:53] and he is in town and he's an hour away, you'll find a way to to rearrange your schedule and drive an hour to have lunch with David Harris. If you don't want to have lunch with David Harris, you're you're going to have to wash your cat that during that period of time. There's going to you're going to find a reason not to to spend that hour

[16:13] and take that time to be with David Harris. So but because I like David Harris, I would drive the hour and my cat can go dirty. So I think it's important to get get to know the patient, earn their trust before you start informing them of office standards. That comes actually to our first question, which we'll get to.

[16:32] Patients don't care about your busy work. They don't care what you need to make it happen for your work. What they care about is how you are going to take care of them. They don't care about your busy work. They don't care about what goes inside your practice.

[16:48] They care about what are the outcomes? What's in it for them? So many times I will hear an office have this conversation with a patient and it's something like it. I think it comes up in a in a in a slide in just a minute. They tell them they give the patients all the rules to be a patient in the practice.

[17:09] I call the office and I say my name is Deborah Nash and I'd like to make it a play for a new patient exam. And boy, they just launch into a diatribe of the rules and regulations of being a part of that practice and becoming a patient in that practice. And what what rules I'm going to have to follow

[17:27] and what obstacles I'm going to have to overcome in order for you to be there. I think we have to stop and think, you know, we can tell them what our rules are once they understand what we have to offer once we engage in a relationship and once they like us.

[17:44] So I think that's absolutely important. I think it's important to to to know. The minute the patient picks up the phone and dials your dials your number, calls your office, they already chose you. They already chose you.

[17:59] They made a decision this morning I woke up and I wanted to make a difference in my dental life. So I for some reason, I found you, whether I googled you, whether I was referred by someone to your office and then googled you, I found you, I called you. I've already made the decision to choose you.

[18:19] Now it is your responsibility to validate that I made the right decision and it's how we begin. It is how we begin the relationship and the conversation. You are responsible for validating that I made the right decision to call you to make a change in my dental life. And here's what sometimes happens.

[18:42] We have a tendency to tell patients what we expect from them. But we should be telling them what they can expect from us. And what I mean, I call your office and I say, by name is Debra Nash, I'd like to make an appointment for dental and dental examination. And you say, Oh, Debra Nash, let me tell you

[18:58] about what we do for all new patients. All new patients get a full series of radiographs. They get an interoral camera screening exam. They get a oral cancer screening exam. They get the exam. They get full study models.

[19:10] They get periodontal probing, which sounds very scary to, I don't know what probing means, and you actually give me the menu of what you're going to do for me that day. And then you launch into, in order for you to be a patient here, you are going, I'm going to need to gather your information. And yes, we do need to do that.

[19:29] And then you also tell me you say, this is what we expect. We expect you to bring your insurance card when you come in. We expect you to arrive 15 minutes early. We expect you to go on our website and download the forms and have them have them completed so we can put them into your system. We are going to do all that.

[19:44] But it's it's the way we say it and the way we we present it so that we let them know that it's it's we are here to take care of them as opposed to telling them what to what they what we should expect from them. We're going to tell them what they can expect from us. You have about nine to 15 seconds to make a good impression. People are going to start making decisions

[20:09] about whether or not they chose correctly within seconds of calling your office. Sometimes I ask this question in live audience. I will ask how long do you think it takes to establish trust? And sometimes I hear the answer. It takes a recall cycle. Now, not enough time. You know, I mean, that's too long.

[20:27] Sometimes I'll say it takes an hour. It takes 30 minutes. It takes it takes a first appointment. Ladies and gentlemen, you don't have that much time. I am going to establish I have I have the opportunity to establish trust within about 15 seconds of connecting with you

[20:44] and and how and how you make that how you make me feel when I do that. And I know that Maya Angelou has the famous. It's you know, it's it's how you make people feel. And you've got 15 seconds to make a difference. So here's my my challenging question for offices, whether or not you do or you do not have insurance.

[21:05] And we're not going to get into that kind of conversation tonight. But why do we make those first few seconds about insurance coverage, office policies? I've I've listened to offices where the patient will call and we go into 10 minutes about, oh, the first question sometimes is what type of insurance do you have?

[21:27] And I don't know if if that is a qualifier for that dental practice or not. But it goes into, oh, you have Delta plan 2000, well, Delta plan 2000. You need you have a $2,000 maximum allowance per year. You have a $50 deductible. This is what they pay on grounds.

[21:44] This is and we go into a long conversation about what their insurance will and will not do. And that becomes the focal point of the first conversation. And it's interesting to me why we are so concerned that the patient becomes dependent on insurance. Well, think about it in many offices.

[22:05] It's the first conversation we start. We initiate the conversation with our patient about insurance. So, you know, that, you know, they just carry that through. They carry that that they carry that forward. The patient doesn't know about the quality of your dentistry and why your work is exceptional.

[22:22] Why do we make that for those first conversations about insurance and office policies? What patients do understand? What your clients understand is the quality, the exceptional customer service at the first encounter. And that goes back to hospitality is first.

[22:40] We're going to communicate the heart and the soul of the of our organization. And that's going to be the important part. We will get to the office standards, the office protocols. We'll get to what we need the patient to do in order for us to appoint them and make sure they're part of, you know, there that they have an established record.

[22:59] We'll make all that happen after we establish. A relationship and after we actually put our hospitality forward. That's important. And that's when that's why this question for me is number one. Imagine, imagine the difference, you know, once again, you want to you want your patients understand

[23:20] that there's a difference in your practice. That's why your fees are where they are. That's why your protocols are established in such a way because you have there's a differential about you. So think about this, I made a decision today to make a change in my dental life when I call your office.

[23:38] So imagine if I say, Deborah, here's a couple of things. Deborah, so that I am sure that we meet your expectations today or Deborah, I make sure that we schedule the proper appointment for you today. May I ask you a few questions? That's always for me.

[23:54] Always I get permission to ask questions. Once again, we go into sometimes into a standard dental office and we start making the patient's appointment. We start asking all kinds of questions. My name is Deborah Nash. I'd like to make an appointment for a new patient exam.

[24:09] Deborah Nash, what is your address? What is your birthday? What is your social security number? Do you have any sexually transmitted diseases? Do you have any artificial parts? Do you have to be premedicated before your appointment?

[24:18] You start asking me a lot of personal questions and you don't even sometimes you don't even remember my name. So I think what's really important to say, Deborah, so that I'm sure that we schedule the appropriate appointment for you or so that I'm sure that we establish an exceptional experience for you, may I ask you a few questions?

[24:39] And for me, the first question is this, what inspired you to call us today? I think it also helps circumvent the awkwardness that could occur. Let's say that I were a patient of record and I just wrote you a sizable check and I call your office

[24:56] and you say, and I say, my name is Deborah Nash. You say, Deborah, are you a patient of record? And I'm thinking, am I a patient of record? I just funded your overhead last month. Or we say, Deborah, are you a new patient? Are you in pain?

[25:12] And once again, that's that's fairly average. It's very rather plebeian, if you will. It's kind of common. So let's ask the question, what inspired you to call today? And that will start the conversation. The patient can tell you, I want to change my appearance.

[25:30] I have a dental need. I'm uncomfortable. I have a toothache. So we need to find out what inspired them to call because what can also happen when they tell you what inspired them to call your office?

[25:46] You can say, based on what your needs are, I can see why you would choose us for your care. And then that goes back to some of our other questions. May I tell you a little bit more about our office? And so I think it's, these are some of the questions and some of the comments that your business team

[26:05] or your person who's answering the telephone, your patient ambassador, should be able to have these kinds of conversations with our patients. I will walk through as briefly as I can because I could be here until like 11 o'clock at night

[26:18] because this is one of my favorite topics. I love the fact that I could just still answer the phone when I'm working in my husband's practice. Now he has since sold his practice and his new employer who is the buyer, has retained me as his consultant.

[26:35] But when I do have the opportunity to answer the phone, I love it when I can actually kind of walk my talk, when I can say, tell me what inspired you to call today. And so then I can say, I can understand why you would choose us. May I tell you a little bit more about our practice?

[26:51] And I always like to tell the doctor's, the story. So one of the things I might say, not only is Dr. Nash a gifted dental artist and he is a gifted clinician, but he also has a great chair side manner. He is very affable, he's very humble.

[27:11] And one of the things he takes great pride in is giving his patients the time they need to make sure they feel comfortable and confident that they've chosen the right office for their care. So those are some of the conversations that you may want to, you know, when again, spur to get away

[27:27] from the typical, what is your name? What is your address? What's your social security number? Do you need to pre-medicate it? What insurance do you have? And let me tell you what our policies are.

[27:36] So now we become, now it becomes about a relationship and now we have an opportunity to say, may I tell you a little bit more about us? Can I tell you why we are outstanding? I have all kinds of stories about how you can move a patient. We can talk about telephone shoppers

[27:50] and how much do you charge for when a patient asks, how much do you charge for a veneers or how much do you charge for an examination? Those are conversations we can certainly go back to this question. I'd be happy to tell you about our fees

[28:03] before I do, may I ask you a few questions? What inspired you to call us? How did you choose us to be on your list while you are shopping? Or, you know, how much you charge for veneers? I would be happy to tell you about our fees

[28:17] before I do, may I ask you a few questions? What inspired you to call us? How did you learn about us? So I can actually take any of those conversations about insurance, about fees. And once again, I'd be happy to tell you about that.

[28:33] Be happy to tell you how we handle that before I do, may I ask you a few questions? What inspired you to call? So I think that's really important. Once again, may I tell you a little bit about our practice?

[28:43] Is the opportunity we have to endorse the doctor. Everybody should have a story. Why are you there? Why do you work for the person that you work with? Why do you sit knee to knee or why do you answer that person's telephone?

[29:00] You are, the people on the team are the great second opinions. They're the great validators for your patients. I can't imagine, and I've actually, I've never been to a restaurant. This happened to me one time

[29:14] when I was actually hosting a group of doctors in Charlotte. And we went to a restaurant and I turned to the server and I asked her what she would recommend on the menu. And she said, well, and she hesitated. She says, I really wouldn't recommend anything. And I said, excuse me.

[29:37] And she says, yeah, I don't eat here. Wow, I was like, oh, first of all, I was embarrassed. I brought like eight doctors to this restaurant. And I said, well, do you have a restrictive diet that prevents you from the menu? And she said, no, no.

[29:55] Well, what kind of faith do I have in that restaurant and what kind of meal I'm gonna be served? Can you imagine if a patient turned to a team member and said, does the doctor do your dentistry? And you said, yeah, well, no. Their fees are too high or no, no, no.

[30:14] I go to my family dentist I've been going to for years. Wow, my team has a responsibility to ask this question. May I tell you a little bit more about our practice? And can I tell you why I'm here? And I won't go into the whole story about Crystal who works for one of my clients.

[30:34] But one of the things that she talks about when she talks about her doctor, Dr. Curtis, and she talks about him and why she admires him and why she admires his dentistry. But the other thing she adds, she says, you know, not only do I admire

[30:50] how he treats our patients, but I really respect how he treats me as his coworker and he treats me with great respect and integrity and that means a lot to me. Wow, what a great way to validate that doctor to those patients.

[31:08] So there's a question for me, a killer question. May I tell you a little bit more about our practice? Let me tell you about the doctor. Let me tell you about the person who's gonna be seeing you today with whom you're gonna be working.

[31:20] I think that's important. One of my other killer questions, you're gonna probably wonder why I have a picture of this pooch up here and this is gonna make a point. So many times when we talk to our patients

[31:37] about their treatment plans, we present a piece of paper, we print it out from the computer, we give the patient a treatment plan and what happens, the minute we hand the patient a piece of paper, the written treatment plan

[31:54] or we turn our gaze to the computer screen, I have now lost engagement. I've now lost concentration of the patient. The minute I hand the patient a piece of paper with their treatment plan on it or I pull up the computer screen,

[32:11] now we're gonna be looking at what? You all know the answer, we're gonna be looking at the bottom line. They're gonna be scrolling down to see what is on the bottom line. We also have a tendency to say to the patient,

[32:23] we're gonna do a comprehensive examination. We're gonna tell you what we see, we're gonna take radiographs, we're gonna use Perl Artificial Intelligence for second opinion. We're gonna gather all your information

[32:37] and then we're gonna sit down with the diagnosis. We're gonna do our exam, we're gonna sit down with the diagnosis and then here's what I think is a deal breaker. Excuse me, I have the hiccups. This is a deal breaker.

[32:51] We say to the patient, we're gonna tell you what you need. Yikes. People step away from hearing what they need. Most people, they kind of brace themselves a little bit when they hear I'm gonna tell you what you need.

[33:09] So I think the important question, when you are getting ready to present your treatment plan to the patient, then I'm gonna walk you through, this is how we're gonna ask the question. It's would you allow me to tell you

[33:28] what I'd like to do for you? If you were my brother, if you were my sister, if you were my aunt, if you were my mother, would you allow me to tell you

[33:39] what I would like to do for you? If you gave me carte blanche, would you allow me to tell you what I'd like to do? Now, I'm gonna tell you why this picture is telling the story. In our yard years ago,

[33:52] we have about a quarter of an acre here in Charlotte. It looks like we live in the woods just because we have a very wooded backyard and we built a pond way up at the top of the yard. It was constantly breaking down. We really couldn't see it from the house.

[34:07] We couldn't see it from the deck or the screened in porch. It was breaking down. It was constantly needing repair. Finally, my husband said, I want you to call someone and I want you to have them fill in that dang pond.

[34:22] He didn't use the word dang, but he said, I want you to fill in that dang pond, fill in that pond. I'm tired of paying for repairs. We don't even see the pond. There's nothing living in the pond.

[34:31] We don't have any fish in the pond. We don't see it. Get rid of the pond. Just get rid of the pond. And I was like, I like the pond, but I like the pond.

[34:38] Get rid of the pond. But I, and I, a couple of times I went back and tried to fix it myself. I moved rocks. I tried to learn how to, you know, install a pump. And he was just like,

[34:49] he says, Deborah, fill in the pond. Well, I called a company. His name, the fellow's name was Brian. And I called Brian, the name of his company was Peaceful Ponds. And I asked Brian if he would come to my yard

[35:05] and talk about filling in my pond because my husband wanted my pond filled in. And Brian came to my yard and Brian said, I could fill in your pond. I could do that for you. I could also try and repair the pond,

[35:23] but I can't guarantee the repairs because I didn't build it. So I'm not quite sure how they built it, but I could do my best to repair it. No guarantees. How many times do patients come to you to say,

[35:34] could you fix what someone else has done? Yikes. No guarantees on how we could do that. But then he said this, Brian said, would you allow me to tell you what I'd like to do?

[35:47] Now my husband and I are sitting in the backyard or standing in the backyard with Brian. And so was the dog, my dog, that's my dog Lola. And Brian says, would you allow me to tell you what I'd like to do if you gave me carte blanche? He said, you have the perfect yard

[36:04] for a terraced waterfall with a disappearing pond at the bottom moved closer to your house where you could actually hear it from the porch and see it from your deck. We could light it so you could see it at night.

[36:21] We could actually put volume controls under the water. So if you wanna turn down the sound of the water or turn up the sound of the water, you could do so. Well, obviously based on the picture that you see on your screen, what do you think happened? Sure enough, my husband said, I want that.

[36:43] I want that. And we now have this beautiful terraced waterfall with a disappearing pond. It is the largest dog water bowl in my neighborhood. But I want you to think about where it started. And this so many times happens with patients.

[37:06] It started with my husband saying, fill in the pond. Now, what if Brian had come to us and said, yeah, I can fill in the pond. And this is how much it's gonna cost you. What pond insurance do you have? Or he said, you know,

[37:20] I can try and fix the pond that you already have. But he opened up the opportunities for us to explore other possibilities when he asked the question, would you allow me to tell you what I'd like to do? Now, I wanna give my husband credit because my husband has used that question

[37:42] for years in his dental practice. And when I heard Brian say it, I almost snapped my neck when I turned to my husband and looked at him like, oh my gosh, Ross, you say this all the time. So when we say to our patients,

[37:58] would you allow me to tell you what I'd like to do? That gives you the opportunity to present your most comprehensive treatment plan to your patient without restriction. If I have never heard a patient say, no, don't tell me what you can do for me.

[38:16] I have never heard a patient say, no, I don't wanna hear what you'd like to do. I wanna hear what my insurance will cover. I've never in 28 years of working side by side with him, I have never heard a patient not wanna talk about what's possible because here's the reality.

[38:35] Well, Sam, would you allow me to tell you what I'd like to do if you were my brother? If you gave me carte blanche, because here's what I want you to think about. If you don't tell them the best you have to offer, they will never choose it.

[38:51] If you, I'm gonna say that again. If you don't tell your patients what it is the best, the most comprehensive plan that you can offer them, they will never choose it. And we have a tendency to create our own obstacles in presenting our treatment to our patients.

[39:10] We do that a lot in hygiene. We're gonna get to that in just a little bit. But we have a tendency, we sometimes think, oh, well, they have Delta insurance. And Delta insurance only covers $1,000. Oh, they live in this part of town.

[39:23] Oh, I know this person. I know they can't afford it. I know what they are gonna want and what they don't want. If we never explain to them what's possible, they won't ever choose it. So I say shame on us

[39:38] for limiting our patients opportunities. A great analogy, great story and an example. I have a client in New York. He had a patient of record and this kind of segues into hygiene a little bit as well. Patient of record, they were doing the morning huddle.

[39:54] Hygienist in the team, they were looking at their schedules for the day. They saw this patient's name on the schedule. She's been a patient in their practice for years. They have treatment planned two crowns on the upper left side on this patient.

[40:09] They've talked about it apparently for some time. It's been on the schedule, excuse me, it's been in her chart as unscheduled treatment for years. She also had some stained anterior composites. But the assumption was that since the patient was not moving forward with what we consider

[40:27] in quotes necessary dentistry and having the two crowns done, that she probably wasn't even interested in talking about the stained anterior composites. Since she wasn't moving forward with necessary treatment, she probably wasn't interested in elective dentistry.

[40:42] And that was the attitude in which they approached her for her appointment. Well, on this particular day, the patient came in, the hygienist went in to tell Dr. J that she was ready for the examination and she said,

[40:59] Dr. Johnson, I don't want you to be alarmed when you go in for the examination, but the patient has 16 porcelain veneers and she's had the two crowns done in another office. Yikes, yikes. So after reviving Dr. J to go in for the exam,

[41:21] he went in and he said to the patient, I am so glad you finally had those crowns done and your veneers are beautiful. He said, would you mind if I asked you a question? And of course the patient said, of course, of course not. He said, would you tell me

[41:37] why you didn't have us do this for you? And her answer was, gee, Dr. J, I didn't know you did veneers. No one ever talked to me about that. I knew I needed to have those crowns done and I knew my insurance was gonna cover some,

[41:57] but I knew they wouldn't do anything. I hated those ugly, dirty fillings in the front, but I knew my insurance was gonna do anything about them and they weren't gonna cover anything. So I was waiting till I could save up enough cash, so that I could do my veneers at the same time

[42:15] I did my crown so everything would match. My neighbor had veneers done by her dentist and I went there to have it done. Wow, what a missed opportunity. What a missed opportunity to not say to the patient, would you allow me to tell you what I'd like to do for you?

[42:35] What a missed opportunity for having a bias that our patient can't afford, it doesn't want it, won't choose it, and so we never bring it up. If you never bring it up, they will never choose it and they won't know what they didn't choose. They won't know if you're gonna modify the treatment plan

[42:59] or if you're gonna phase the treatment plan, if you're gonna change the treatment plan in any way, they won't know that they had other options. So part of that, I mean, we can spend another hour talking about belief cycle. Sometimes we have a belief cycle in our office

[43:14] and our belief cycle is the patient can't afford it, they don't want it, they won't choose it. And we establish our exam, we establish our consultation, we establish our financial conversation all around those biases that we have. Patient doesn't want it, patient can't afford it,

[43:33] patient won't choose it. And we establish our systems around those biases. And I think if we release those biases and I think this question is a great way to release the bias. Would you allow me to tell you what I'd like to do if you gave me carte blanche?

[43:52] And I think when you ask that question, the patient says, yes. And once again, will I have supportive documents when it's appropriate to present them to the patient? I absolutely will. I also tell you, and I don't think I have this as a slide,

[44:09] but no, I don't, so I'm gonna stop right there and move forward. This may be a myth buster, this may be a challenging question for some of you. The decision to accept treatment is the responsibility of the clinical team,

[44:28] not the financial team. My responsibility as a financial coordinator or as a business manager, whatever my title may be, a financial manager, treatment coordinator, financial coordinator, my responsibility is to negotiate the terms of payment.

[44:49] It is the responsibility of the dentist and his or her treatment ambassador clinically to have the patient choose a dentistry. And experts will tell you that oftentimes, patients will leave confused because they really weren't quite sure

[45:12] which direction they should take. And if we give the patients too many options, then they become confused and the confused mind always says no. If the patient wants to change out the treatment, who is best to make that decision?

[45:29] Well, it would be the dentist, it would be the and or the treatment ambassador, the person who's been working with the dentist on that treatment plan with that patient. So be careful that you don't release the patient too soon to talk about money

[45:46] because they really should be moving forward, they should be moving forward chair side. And then we start negotiating terms of payment. Here would be an interesting quiz question for some of you, maybe for all of you. Challenging question potentially.

[46:04] If the patient starts asking you, the dentist or the clinician about money, what does that mean? Does that mean, is that a barrier? If the patients, you know, if you start talking to the patient

[46:19] about their treatment plan and about what it is you could do for them and the patient says, wait a minute, wait a minute, can you give me an idea of what this is gonna cost me? The question is, is that a barrier? Are they reluctant to move forward with treatment?

[46:34] Are they concerned about the fee? Or are they ready to move forward with treatment because they just wanna get to the bottom line because they already have embraced what you have to offer and they're already to move forward with treatment. So in a non-dental environment,

[46:56] when a consumer starts talking about money, the representative, the sales person, if you will, the person who's talking about the product or the service really gets a little bit giddy about it because typically what they say when the consumer starts talking about money,

[47:15] they're ready to buy. And we have a Tennessee indentistry to think when the consumer starts talking about money, they're reluctant to buy. Once again, change the mindset, change the mindset. So then the question would be,

[47:30] so I've heard doctors that have answered that question in many, many ways. Once again, my husband happens to be an anomaly when patient starts asking about money, he launches into the conversation, doesn't negotiate how it's gonna be paid for,

[47:45] but he will give them a ballpark figure. He'll say, well, we're looking at about X amount of dollars for that treatment and then he pauses and gives the patient an opportunity to respond to say, wow, that's a lot of money. It's a significant investment, isn't it?

[48:02] So let's talk about that. Or I've heard some doctors will say something like, you know what, I'm happy to discuss the treatment with you. If you're ready to talk about the fees, if we're done talking about the treatment and you're wanting to get started

[48:19] and you wanna talk about now how that can be paid for, then let me have Teresa take over and go through that with you. So some people would call that, but they call that in sales speak, that's a test close if they start asking about money.

[48:34] So I think when your patients start asking about money or how it can be paid for or how it can be afforded for them, then be glad because they're ready to move forward with care. Be careful that when you are talking

[48:51] about the treatment plan that you hand them a piece of paper, you start at tooth number one, you end at tooth number 32, or if you're in Canada, you're gonna be using a different tooth grid. And we never get the opportunity to get the patient's permission.

[49:07] So once again, would you allow me to tell you what I'd like to do if you gave me carte blanche? The patients will always say, I guarantee you the patient will always say yes. Now they might say, well, I'd love you to tell me, but we're certainly gonna have to talk about the money part.

[49:21] Absolutely. So let's set that aside for just a moment. Let's talk about what's possible and then let's talk about what is right for you. And I think the other thing when we talk to the patient about we're gonna tell you what,

[49:34] rather than we're gonna tell you what you need, we're gonna give you the information to help you make the right choices for your care. Now let's go back to this. Remember I said, people are reluctant to hear what they need. But when we say we're, you know what?

[49:52] Our objective of a consultation, our objective of the examination is to give you the information to help you make the right choices for your care. And we will take all the time you need to help you make those decisions.

[50:08] So once again, we're not gonna tell you what you need, we're giving you information for you to make the choice. That also gives the patient that comfort that they own that, that they own some of that. So I think that's important.

[50:20] Now, this one, this is important for hygiene. This is really critical that when a hygiene patient who is established, who has an unscheduled treatment plan sitting in the records, it's very important for the hygienist

[50:40] to have this conversation. Excuse me, I'm gonna either choke or cough or hiccup. I can't decide which one. Okay, solve that one. So many times a patient of record, once again, going back to the conversation we had

[50:55] about the patient in Dr. Johnson's office, patient of record, morning huddle, hygienist looks at the schedule, looks at the patient says, oh, I know her. She goes to my church. I know she can't afford it.

[51:05] Oh, I know her. She's not interested. Oh, I know her. We've talked about this treatment before. Oh, I know what her insurance will and will not do. And we have a tendency to no longer bring up

[51:18] the unscheduled treatment plan. Or we make it as a kind of a casual conversation as we're getting out the instruments, as we're setting up the computer, getting to the patient's records. And they say, well, you know, Teresa,

[51:32] you know, Dr. Smegley's talked about those two crowns that you need in the back. Yeah, I know, I know. Okay, well, now I have 50 minutes. So let me clean your teeth now. And we don't take a step back and ask this question.

[51:47] Teresa, I see that there has been treatment, there has been a plan for you that we have yet to complete. Help me understand or tell me what's preventing you from having this done. So I think that's an absolute important question.

[52:04] And my body language has to suggest I am not looking at a computer. I'm not getting my instruments ready. I am leaning to eye, eye level with the patient. I'm leaning slightly forward

[52:18] and I'm asking that question in earnest. I see that there's been treatment that has been planned that we have yet to complete. Help me understand what has prevented you from moving forward with your care. The number one answer is probably gonna be,

[52:33] well, there's gonna be two number one answers. So I guess that'd be one A and one B. Number one answer is expensive, expensive. Wow, you know, it's a lot of money. You know what, it's an investment. That is correct.

[52:47] But think about this, Teresa. Think about if we had done this five years ago when we first, we had first recommended it. And think about if we wait five years from now. So if money is a factor, I'll remember that it will probably never cost you less

[53:03] than now, except if we had done it before. So what other concerns do you have? We sometimes when patients bring up cost where we think we're done with conversation, but what other concerns do you have? Well, you know what?

[53:16] It's not bothering me. So help me understand, you are wanting to wait until it's causing you pain. You know, that's really not our treatment philosophy here. Our treatment philosophy here is to help you avoid it, keep you away from discomfort and away from pain

[53:33] and from potential costly treatment. So if we can take care of this before it causes you discomfort, before it causes you pain, then not only can we make it more, your dentistry more bearable for you,

[53:48] but we can also make it less expensive for you to do that. What other concerns might you have? Time, time would be a factor. Wow, if time is a factor, think about if we waited for it to hurt and we'd have to get you in an emergency

[54:02] and it would take multiple visits that were unplanned. So I think we need to have, once again, conversation about how do we address the patient's concerns, why it hasn't been done. And once again, it goes back to our belief cycle. Do we think this patient isn't interested?

[54:23] Do we think this patient doesn't want it? Do we think this patient can't afford it? Do we think insurance is a barrier? I, you know, it's sort of interesting. I had a conversation. We have, let me back up.

[54:37] Let me start again. Any strength, this is one of my other famous, my other little favorite quotes. I don't even know where I got this. It might have been Abraham Lincoln. I don't know when he and I went to school together.

[54:50] Any strength taken to excess becomes a weakness. And sometimes the strength of relationship with our patients becomes a weakness. And let me explain what I mean. Sometimes Teresa comes in, let's say I come in and I come into Dr. Harris's office

[55:07] and Dr. Harris and I know one another. And let's say, and we're friends. We go to the same church. We go to the same, we play golf together. We live in the same community. Let's say that Mary, the hygienist and I,

[55:21] we have the same interests. We talk about movies and we talk about food and we talk about cats and we talk about what's going on in the world today. And we talk about where is that F-15? We have these conversations

[55:33] and it becomes a little bit too social. Let me say that again. Sometimes our conversation becomes a little too social. Example, my former husband, I hate to say ex because it just sounds like he's an icky person and he's not, he's a great guy.

[55:53] We have a beautiful child together and he is a friend. And he lives in Washington state and he called me one day and he said, Deborah, could you help me with some language skills? Isn't that funny? Yeah, could you help me with some language skills?

[56:08] I'm gonna dispute my dental bill. And I happened to know his dentist. He goes to a very fine dentist and I said, wait a minute, wait a minute. Why are you disputing your dental bill? And John said, well, he charged me for a recall exam

[56:23] and I'm gonna dispute that. And John's not a mean person and he's not, he catches flies and puts them outside. That's how gentle this man is. He's got a very gentle nature. So this is very unusual for him.

[56:37] And I said, wait a minute. Did Don come in the room while you were there? And he said, yes. I said, did he have some little instruments in his hands? And did he go into your mouth while you were there and in the chair?

[56:48] And he said, yes. He said, but Deborah, he said, he asked about you and he asked about Ross. He asked about Sophie, who was our daughter. He asked about the film I'm working on because my former husband's in the film industry.

[57:00] He said, he was asking me about living at ocean shores. He said, it was a social call, Deborah. It wasn't a dental exam, a dental visit. It was social. He says, why am I paying my dentist $130 for a social call? So I went, oh my gosh,

[57:19] that happens in so many offices, ladies and gentlemen, where I'm not saying that we're gonna cut that out, but they wanna talk about how we find once again the balance between them being our friend, but also they came there for your dental expertise.

[57:40] Have you ever had a patient said, I don't want an exam today, I only have my teeth cleaned? And could it be that John had some insight there, that could it be that they don't want an examination because they don't see the value in that and maybe they don't see the value in that examination

[57:56] because they feel like John, they just didn't know how to verbalize it, that they feel like it's really not important because it's a five minute Dine and Dash, how are the kids, how's your golf game? Did you see the latest movie?

[58:13] Are they feeling that it doesn't have merit? It doesn't have the value. So could we increase the value in our patient's perception of that re-care examination? Could we increase that value, the patient's perception of the time

[58:28] that the hygienist is spending with asking that question? I see that we have treatment that has been scheduled that has prevented you, that you haven't had done yet. Help me understand what has prevented you from moving forward with your care. Doctors probably wanna have a conversation about that.

[58:45] Once again, briefly, I'll tell you about, I'm a big firm believer in renewing your patients of records, relationship with your practice, bringing them back in and helping them understand and appreciate that they are as valuable today, 10 years in as a patient,

[59:03] as they were on the day of their new patient examination. And could we increase our treatment acceptance from hygiene by increasing the patient's perception of their value? So I say, you know, sometimes I think it's important and maybe at a five-year interval

[59:23] that we go back to Teresa, the patient, and say, you know what, we're gonna go back through and we're gonna take a look and gather new baseline information today. We think about any kind of tests that your doctors take, whether it be a mammogram or MRI or some sort of vital test,

[59:42] and they typically will schedule an interval in where they will take another one within two years and within five years to measure progress. So I think that once again, we could increase our treatment acceptance from patients of record

[1:00:01] by asking this important question, but also spending a little bit more time in helping the patients perceive and understand and appreciate the time we spend in a re-care examination and maybe minimize the social time. And oh, oh, oh, oh, oh, oh.

[1:00:18] Sometimes it drives me cuckoo for cocoa puffs. I ask this question a lot in my programs. Why does the patient value the relationship with the hygienist more than they value the relationship they have with the dentist? And the answer I typically get

[1:00:35] is because the hygienist spends more time with the patient. Yikes. Well, fix that. Find a way that I would think that I would wanna make sure if I were the dentist, that the allegiance the patient has is to me,

[1:00:51] not to my team, not suggesting that my team is going to be with me forever, but my team may not be with me forever, but I will always be there. I've had some hygienists, and once again, I may be touching a cord with some people.

[1:01:07] I've had some hygienists basically hold their relationships with patients. They hold the doctor hostage based on the relationship they have with the patients and they sometimes threaten things by saying, you know what, the doctor would never let me go

[1:01:23] because he knows or she knows that I would take the patients with me when I leave. Wow, yikes. Why would the allegiance be stronger? So doctors, you may wanna think about, how can I establish some systems in my recared department

[1:01:40] that I can realign the patient to be a legion to me and that my wonderful hygienist is a part of my practice, but the allegiance is to my practice and to me. So you may want to, one of the things you may wanna do after this program is you may wanna sit down and say,

[1:02:00] well, what can we do to increase our treatment acceptance from unscheduled treatment? Oh my gosh, do you even know that number? Do you know how much unscheduled treatment you have in the books? I was visiting with a client in California

[1:02:14] and we did a report of how much unscheduled treatment he has with his patients of record, how much treatment had been planned, had been treatment planned that the patients never moved forward. And it was over $3 million, over $3 million.

[1:02:33] So not only are we wanting to look at how do we grow the practice with new patients, but wow, what do we do about the $3 million that's sitting there in complete and with his patients of record? How do we get those patients back in

[1:02:46] and moving forward with that care? I think this is an important question to ask. I know I kind of got off on that, but that's important to me because I look in so many dental offices and I see how much unscheduled treatment

[1:03:00] is existing in patients' records and doctors are working very, very hard to build their practice with new patients, which is important, but it's also important to take a look at what about the patients you already have

[1:03:14] and what is your attrition rate and what is your patients' rate of moving forward with their, what's your treatment acceptance rate from patients of record? So those are some analytics for another day. Okay, talking one of the last questions

[1:03:29] we talk about money. I hope you guys are taking great notes and I can't believe we're getting near the end and we're gonna open this up for some Q&A in a little bit. But when we talk about communicating financially, once again, I think it's important,

[1:03:45] patients are not interested in how your financial protocol serves you. They are interested in how your financial protocol serves them. So once again, when we are gonna ask the patients the questions about money and finances,

[1:04:01] when we present our financial preferences to the patients, we wanna avoid handing the patient an office financial policy page that gives them four or five options. Because once you do that, you totally lose the ability to negotiate

[1:04:21] with your patient. So if you say option one is pay everything up front with a 10% discount, option two is pay 50% down and 50% at the completion. Option three is three months same as cash. Option four is outside financing with care credit

[1:04:37] or cherry or Wells Fargo or Alfiana, whichever outside lending institution that you're using. Well, then I hand the patient that piece of paper, I'm done because the patient's gonna choose the least resistant. So when I'm asking the patients the questions

[1:04:56] and when I'm negotiating financial arrangements with the patient, one of my recommendations is that we present our preferred option first. And we say this to the patient. Most of our patients prefer to take care of their total treatment fee

[1:05:14] at the initiation of their care. And I'm gonna be quiet in here and do I need to remind you of that total or do we need to talk about what that amount would be? And then have them say, yeah, sure. And then the question may be,

[1:05:31] well, can I make payments on that? You absolutely tell me what you had in mind or because they might rather than thinking, we might be thinking when they say, can I make payments? They're thinking they wanna make 37 payments over the next two years.

[1:05:47] What they might be thinking is they wanna make two payments or we had a patient, it was a substantial, it was a full mouth rehabilitation, it was a substantial fee. And she asked if she could pay it, the total fee, the total fee was about $60,000.

[1:06:04] And she said, can I make payments on that? And some people would think, oh my gosh, oh my gosh, what is she thinking? She wants to make $250 payments for the next 72 years. And I said, well, tell me what you had in mind. And she said, can I make that in three payments?

[1:06:19] Can I pay you $30,000 when we, in the beginning, $30,000 the day of the preparation, $30,000 halfway in the treatment? Yeah, I'd be happy to accept that. So once again, we wanna have conversation with patients. And the question once again is,

[1:06:37] let me go back to this. The question is this, if we could find a way to make this affordable for you, what other concerns do you have? So once again, if we could find a way to make this affordable for you,

[1:06:53] what other concerns do we need to discuss? So we always wanna, we tell our patients, we wanna find a way to make this affordable for you. Tell me what you had in mind. Or once again, if we could find a way to make this affordable for you,

[1:07:07] what other concerns do you have? So I think that's an important piece that when we ask the patient this question. So once again, we want to not lose our negotiation, our ability to negotiate, by handing the patients a financial policy statement,

[1:07:27] we're gonna keep that to ourselves and negotiate. And the question will be, can I make payments on that? Tell me what you had in mind. Or if they say, can I make payments on that? Absolutely.

[1:07:40] Many of our patients prefer to make smaller payments over a period of time. And we do have outside financial resources that will help you do that. So we wanna ask the question as opposed to say, this is our financial policy, here's what we require.

[1:07:55] And here's what you need. Once again, the ability to negotiate financially is just that, it's a negotiation. It's a conversation back and forth. And then we come to an agreement. So tell me what you had in mind.

[1:08:09] Is it really an important question if we could find a way to make this affordable? We would never wanna work in an atmosphere of discomfort. I can spend a whole other time about, I mean, I have a little bit of time left over. So I will tell you this, in our office,

[1:08:24] and in a lot of my clients' offices, we never associate the first appointment with the patient making their initial payment. Because I want to avoid the patient walking in on the day of the appointment saying, oh, was I supposed to pay today?

[1:08:38] I totally forgot I was supposed to bring a check. Oh, I didn't grab my credit card with me. I left my wallet at home. Or they leave you a message night before on the answering service and cancel the appointment. And now you've got a four-hour appointment

[1:08:56] that has been opened up. And typically it's because the patient was not prepared to pay for their treatment on the day of the appointment. So I always schedule a patient for what I call a preoperative visit.

[1:09:10] They come in prior to the restorative appointment. We go ahead and we verify that we have all the radiographs we need. We have all the pictures that we need. We have all the records that we need. We talk about how to prepare for the day of the visit,

[1:09:22] whether or not they need to have breakfast before, not before how they should dress comfortably. And we collect the payment required, whether that be the total fee or the initial payment. We collect that at the preoperative visit, not at the restorative visit.

[1:09:40] Your cancellation no-show rate for major treatment will drop dramatically when you do this. It's called a preoperative visit. It's done prior to the restorative appointment. Also, we're gonna get winding down and gonna open this up for questions

[1:09:57] and probably, I don't know, maybe for five minutes or so. Unscheduled treatment follow-up. This is kind of a bonus, has nothing to do with questions. But I think this is really important.

[1:10:08] It does have a lot to do with questions, as a matter of fact. I take that back. Because oftentimes, the patient comes in and they leave with questions. Patients who don't appoint, they say they have to think about it.

[1:10:22] They say they have to check their schedule. They're gonna need to talk to a significant other to arrange the next appointment. So patients who have been given a treatment plan, whether that be a new patient, or a patient at a re-care visit,

[1:10:39] who walk away without an appointment. Here's one of the things that I would say to them. I would say, Deborah, we shared a lot of information today. And what we have found is that oftentimes, our patients actually start thinking about some of the questions they wish they had asked

[1:11:01] the minute they pulled out of the parking lot. Or when they got home that evening and started telling their family about their experience in our office, their families start asking questions and they didn't think about those questions.

[1:11:13] So as a courtesy, we always like to follow up your new patient experience with a phone call to answer any of those questions that will present themselves after you leave our office. So we're not dialing for dollars. We're not calling to see

[1:11:31] if they want to schedule their appointment. We're calling to follow up with the questions that we know that they're gonna have when they pulled away, when they left the office. Again, I'll use myself as an example. I was diagnosed 2011 with a brain tumor.

[1:11:47] I went in and had my MRI and lo and behold, there's a mass, which explained a whole lot of things about my body behavior. I'd lost the use of my right side. And sure enough, I had a meningioma. I drove away a little bit overwhelmed,

[1:12:03] a little bit in shock. I pulled into, I was leaving for a trip that day. I pulled into the airport parking lot, made two phone calls, called my pastor, called my husband. And my husband started asking me questions. Is it malignant, is it benign?

[1:12:18] What's next? Are you gonna have radiation, chemotherapy? What's happening? And I was like, I was a blithering idiot. I don't know, I didn't think about asking those questions. I was given information that put me in an overwhelm.

[1:12:37] Would it have been great for that doctor to have called me and said, Deborah, we just shared some interesting news with you. What questions can I answer for you? You probably pulled away, you called Ross and he probably started asking you questions.

[1:12:53] You didn't think about asking me. So I'm available to answer those questions for you. Wow, wow. How about doing that for the patients in your practice that don't schedule, that pull away? But rather than doing it,

[1:13:07] and it should be done probably within 72 hours of that new patient examination, these are for patients who didn't appoint. These are not for people who appointed, but for the patients who didn't appoint, say, what questions can I answer for you?

[1:13:21] What questions can I answer for you? We make ourselves available to answer those questions if they don't call back. So take a look at your unscheduled treatment follow-up. I'm gonna, this is gonna be a fire hose. These are some of the things we talked about this evening

[1:13:36] and now we're gonna open it up for questions. And I just put them kind of in these boxes for a brief overview of the things we covered in the last almost hour and a half. I cannot believe it's almost 9.30 already. I'm scary for all of you

[1:13:53] that I could probably talk until midnight and maybe even till 2 a.m. Order a pizza, we're gonna be here for a while. No, so first of all, we talked about, make a memorable first impression with that first question, what inspired you to call?

[1:14:08] And once again, speak a service language, avoid words like policy, and just, I'm just calling. Once again, wear a service word room, look professional, endorse the doctor, hospitality first, communicate the heart and the soul of the organization, who you are, endorse the doctor.

[1:14:25] What, why are you there? Why, how do you validate the doctor and his or her treatment plans and his or her philosophy of care? Listen to your patients to understand. That's not asking a question,

[1:14:39] but that's making sure that you are intent, you are giving your patient eye contact, you're leaning forward, you're being intentional in listening. That's important, building a performance culture that differentiates the practice.

[1:14:53] These killer questions differentiates who you are. They're questions that aren't getting asked by a typical dental practice. And if your fees aren't typical, then you have to behave in an atypical way. So it's important that your fees reflect

[1:15:09] the quality of care, goes back to the very first thing I mentioned and that was about customer service. I pay more, we pay more as consumers for exceptional customer service. So what can you do in your practice

[1:15:23] to up your game, if you will, to increase, to enhance your customer service skills so your patients understand and appreciate that your fees are above usual and customary and your fees are atypical because you behave in an atypical way

[1:15:39] to create that perception of quality, to match what the patient wants is what you can do once again, endorsing the doctor. I'm a big fan of that, huge. It's a validation. Describe how your office systems enhance results.

[1:15:55] This is why we do what we do. Would you allow me to tell you what I'd like to do for you? Would you tell me what you had in mind? It will never cost you less. These are important conversations to have. Make sure that you establish your set

[1:16:08] of performance tips in your practice. I think that those are, if you take just this alone, this is going back to our killer questions, remember what they are, what inspired you to call. May I ask you a few questions? May I tell you a little bit more about our practice?

[1:16:26] Would you allow me to tell you what I'd like to do if you gave me carte blanche? Tell me what has prevented you from moving forward with your care? And once again, if we could find a way to make this affordable for you,

[1:16:36] what other concerns do you have? Those, I think, are killer questions. How do you know if you're doing the right thing? Once again, I started this at the top of the hour, almost an hour and a half ago with, we're not trying to harm the patients.

[1:16:54] We're not trying to sell them something that they don't need or they don't want or something that's not good for them. But if you wanna ask yourself the question, are we doing the right thing? I always ask myself these two questions as a consultant.

[1:17:06] What I'm going in and observing, I'm spending time with a practice. Here's the two questions I asked. Number one, is this system good for the patient? Financial arrangements, scheduling, hygiene, protocols. Is this system good for the patient?

[1:17:21] Is it doing the right, are we doing the right thing? And is the system good for the practice? And if I can answer yes to both of those questions, it's a system that will work. It's a system that will win. So you can actually, if you wanna know

[1:17:37] whether or not you're doing the right thing in your practice, you might wanna run these two filtering questions through your office. And an action plan you may wanna create as a result of this program is, talk about this four or six things,

[1:17:51] four to six things you could do to increase patient engagement, increase your treatment acceptance, to increase your patient becoming more intentional about moving forward with their care. Work on your six killer questions.

[1:18:05] And you might wanna create some of your own. You might create some of your own killer questions. You might have some great killer questions. And if you do, I'd love to hear what they are. So here's a repeat of the killer questions. Think about this.

[1:18:21] If you're not willing to learn, no one can help you. But if you're determined to learn, no one can stop you. You know, one of the ways we grow our practice is that we never stop growing. You know, and I've heard, you've heard this before. When you stop growing, you start dying.

[1:18:37] I think that's important. I also think that you spent an hour and a half listening to this, whether you're doing it tonight or whether you're doing it later on. So the big question for me is, what are you gonna do with this information?

[1:18:47] If you do nothing with it, it was entertainment. If you do something with it, it was education. And education is being told and training is being taught. So how are you gonna use this to train your teams to increase your profitability and your productivity and your professional and your personal satisfaction?

[1:19:09] That's what I do. That's what I'm here. That's what I'm all about. This is who I am. This is, pardon, this is my family, my crazy dog, my southern bald-headed husband.

[1:19:22] You know, I'm here all night, folks, but I'm gonna turn this back over to David and his amazing crew and the amazing people about Prospera Dent. And I know we've got about 10 minutes to answer questions, to have conversation.

[1:19:39] I'm just very honored that they've asked me to be a part of their webinar series. So thank you so much for those of you who are here tonight and for those of you who are gonna listen to this in the future. Wow.

[1:19:54] Perfect. I just cannot believe, you know, when I talked about Deborah conveying wisdom, there was just so much information and knowledge and stuff people can use in that hour and a half. And I cannot believe just how much you managed

[1:20:12] to pack in there. We have a couple of questions and I just wanna start, I guess, with an observation, Deborah, that I'd love your thoughts on what I've found for a long time is when people ask the money question

[1:20:29] and you talked about the money question. I used to get offended when, you know, somebody would email me and say, how much does an investigation cost? You know, because like a dentist, we consider what we do to be craftsmanship

[1:20:45] and not kind of a factory that, you know, rolls things off an assembly line. And I was offended and I used to get angry. And then what I realized one day was that when people ask that question, it's because they don't know what else to ask.

[1:21:02] It's sort of something that they revert to when they don't even know what they don't know. Yeah, and sometimes they don't know where to start. That's a good starting off place for them. They don't know how to start the conversation. Yeah, I mean, we all know, you know,

[1:21:18] whether we're at the garage getting our car fixed or looking at hiring a dental consultant or looking for dentistry. I mean, we all know it costs money. So it's kind of a logical question to ask when you just don't know what else to ask.

[1:21:31] Yeah, and I think it's important. I mean, we get the, you know, once again, I love answering the phone because it's like a practicum for me, but when patients call and say, how much do you charge for? I always say, I would be happy to discuss our fees

[1:21:43] with you when we get into the conversation that I will say something like this, our fees are based on three things. Our fees are based on number one, the skill required to do it right. Number two, the time it takes to do it well.

[1:21:57] And number three, the materials that we use and the laboratories with whom we partner so we know you're gonna get exceptional results. And I always say, and then I always say this, if you are looking for an office for the lowest fee possible,

[1:22:13] we may not be the office that you choose, but if you're looking for the office, it's going to be respectful of your investment. It's gonna take the time to make sure that you are satisfied. It's gonna be using nothing but quality in your care.

[1:22:29] We're gonna be the office that you want. And I think that's true of your services as well. You know, you might be getting, so I think that's a conversation, be happy to discuss our fees. I think in the old days, before Amber was born,

[1:22:42] we would say things like, I'm sorry, we don't quote fees over the phone. Well, that means the patient's gonna hang up and move on to someone else. So I'm comfortable having that conversation. Yeah, I love your answer.

[1:23:00] Wendy, I think we have a great audience question. Yeah, I'm gonna let Amber ask that question, but if I can, sorry, Amber, if I can just slide in here for a moment. I have another really important question that I would actually even like to know the answer to.

[1:23:19] When, if ever, should the doctor talk about money with the patient? Great question. Actually, I had that question last weekend at the National Institute where Dennis said, should I ever have a conversation

[1:23:34] with the patient about money? And once again, and my answer to her was, you should have a conversation about money when, if the patient brings it up. Now, how you have that conversation is dependent on your comfort once again.

[1:23:49] In fact, my husband, who is, don't tell him I like him so much because sometimes he's a crazy, but he doesn't change toilet paper, but he's a brilliant clinician and he's a great, he's got great chair side matter.

[1:24:02] And if the patient doesn't bring it up when he's talking about a big case, he will say, you're probably wondering what your fees will be. And cause he knows that's gonna be a conversation. He says, you're probably wondering

[1:24:12] what your fees are gonna be. And I can give you a range. Rhonda can be more specific about your treatment, about your plan, but I can give you a range if you'd like to talk about that with me.

[1:24:25] Some patients, I mean, I had one doctor, they would always say, oh, I don't know my fees. Well, yeah, you do, you kind of do. So I always say, you know, if the patient starts saying, can you give me an idea of how much it's costing? Give the patient a range and say, you know what?

[1:24:39] I can give you a range. But for more specific information, that's why Teresa's here. Cause she is exceptional at that. And she finds a way to make it affordable for our patients. Perfect.

[1:24:52] So I'm ready to ask the audience question to you, Deborah. Yep. If you see a patient once a year for several years, and they keep telling you that they cannot afford it several times, do you keep repeating it?

[1:25:08] Great question. Yes, I would repeat it because if I stopped repeating it, obviously the treatment didn't matter. So I think, okay, I have a crazy analogy story. We have this, what we call a dry crawl space.

[1:25:27] And years ago, the fellow who came out and serviced the crawl space said, I needed a new dehumidifier down there. And I said, oh, okay. They sent me some paperwork. I think I signed it.

[1:25:39] It got lost in emails. I don't know. But bottom line is that was almost a year and a half ago and no one followed up on it with me. Well, today Alex came and Alex, Alex should be teaching this course.

[1:25:53] Alex said, Ms. Nash, you said, I seen in your records that the last couple of times we were out here to service your crawl space, that there was a conversation about your dehumidifier. And I really wanna check that out for you today

[1:26:08] because apparently it was malfunctioning. And I said, oh my gosh, I'm so glad you reminded me of that. Yes, please do. And sure enough, what do you think happened today? I spent $2,500 on a new dehumidifier and duck work. Had he not, had he said, oh, she's not interested.

[1:26:25] Oh, she doesn't care. Oh, we brought it up before. That dehumidifier wasn't important. So if you stop bringing up treatment, it is no longer necessary in the patient's eyes. So I would find a different way.

[1:26:42] So I might say something to you. I might say, Amber, I know we brought this up before. And we will continue to bring this up until it is no longer necessary. And it will never no longer be necessary. I can guarantee you that if Dr. Wormlinger said

[1:26:59] that this work needed to be done or that this work would benefit you for your dental health and your dental well-being, I can guarantee you that's what should happen. So how can we make this work for you? What do we need to do to make this work?

[1:27:14] So no, so the answer is, I would always bring it up. I would continue to bring it up. It's not offensive. Perfect. There was a guy a long time ago who taught patient consultation named Dick Burns.

[1:27:27] Oh, yes. And whodever probably remembers it. I think I dated him. There's a story now. And Dick used to have a great way of putting it. He would ask a patient,

[1:27:43] is this the smile you would like to have if it fit your budget? And really what he was doing cleverly was separating the clinical from the financial. So, tell me what you want your mouth to look like. And then once we're at that place,

[1:28:01] then the question is how can we make it affordable? So maybe that person who asks who has repeatedly said they can't afford it, maybe it just hasn't been kind of worked out for them in the right way. Well, you do have dental insurance.

[1:28:16] And I totally take your point, Deborah, about us not wanting to be insurance driven, but when affordability is an issue, maybe we can break the treatment up over a couple of years so that we can maximize the insurance. So we give you-

[1:28:29] Absolutely. Here's something else I think is important. This is a very important way of approaching a patient with any kind of level of having to have an uncomfortable conversation. And for some people, this might be uncomfortable.

[1:28:41] You know, we've told him many, many times. So I might say something like this. I might say, David, I have a problem and I need your help. For the last five times you've been in to the office, we have talked about this treatment and it has yet to be completed.

[1:28:57] So help me understand what we need to do, what we could do to move forward with this. So when you say to the patient, I have a problem and I need your help, you have a more compliant listener, as opposed to approaching them in such a way, you know,

[1:29:14] we're gonna talk about that treatment again. That almost sounds like I'm scolding them. Beautiful, my gosh, I love it. Well, folks, we could continue here for a very long time, but out of respect for our audience members who joined us, we're going to wrap this up

[1:29:34] and Deborah, I can't thank you enough. This was just gold. And I think everybody who tuned in is gonna take away something that they can use tomorrow in their practice. So thank you very much.

[1:29:51] I'd like to remind everybody again that if they enjoyed tonight, we would love them if they left a review and you can go to prosperident.com slash review us. We really made it as simple as we possibly could and leave us a five-star review

[1:30:09] so that other people can know that what great information Deborah was able to pass on tonight. We will be back with you in a few months. We'll make an announcement about date and guests and things like that,

[1:30:24] but I'd like to thank you all for tuning in. And again, our special guest, Deborah Engelhardt-Nash, our wonderful team of Wendy Askins, Amber Weber-Gonzales, and Sheila O'Driscoll. Thank you all so much.

[1:30:40] I am lucky to know and work with all of you. Until next time, everybody. Bye. Bye. Bye, everybody. Thank you. Well, hi, everybody.

[1:30:53] Thanks for listening to the Dental Practice Owners Podcast, brought to you by Prosperident. You can contact Prosperident through its website, www.prosperident.com, or by calling 888-398-2327.

[1:31:09] If you have questions about this podcast, if you would like to discuss your practice or there is a topic you would like to see in a future podcast, we would love to hear from you. Amber, Wendy, and David,

[1:31:20] we'll be back soon with another episode.