Ep. 174: Treatment Plans: 5 Biggest Mistakes
Do you ever find yourself struggling to get patients on board with your treatment plan? You're not alone. Many doctors face challenges when presenting cases, often unknowingly making mistakes that can undermine patient trust and lead to treatment delays. Join us as we explore the 5 biggest mistakes doctors commonly make when discussing treatment plans!
ABCs Seminars- https://www.mgeonline.com/mge-communication-and-sales-seminars/
DDS Success - https://ddssuccess.com/
MGE Power Program - https://www.mgeonline.com/power-program
New Patient Intake Form - https://www.mgeonline.com/np-intake-form/
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Questions From This Episode
What's the biggest mistake dentists make before they even start a treatment presentation?
Not assessing the patient's frame of mind first. If a patient walks in believing their oral health is fine and the exam reveals otherwise, presenting a long list of problems without any warning feels like an ambush. Dropping small, low-pressure hints during the exam itself, pointing out a missing cusp or a dark margin on camera, prepares the patient so the actual treatment presentation isn't a total shock.
How much dental terminology should I actually use when explaining treatment to a patient?
As little as possible. Terms like RCT, SRP, or periapical radiolucency mean nothing to most patients, and rather than asking what they mean, patients tend to stay quiet because they don't want to feel or look uninformed. Plain language, models, lab cases, and visual aids like an intraoral camera make the treatment feel real and understandable instead of abstract and intimidating.
Why is it better to not start a treatment presentation than to start one and not finish it?
Because a half-finished presentation leaves the patient sitting in unresolved sales resistance with no real chance to work through it, and they leave still thinking about it rather than deciding. Building dedicated consult time into the schedule, ideally first thing in the morning or right after lunch, and bringing patients back within one to three days when there isn't time to present same day, produces far better outcomes than rushing an incomplete conversation.
Should the dentist personally discuss the fee, or can the treatment coordinator handle that?
The dentist should be the one to state the fee, even at a bare minimum, here's what this treatment costs, here's what we expect insurance to cover, here's your portion, before handing off further financial details to a treatment coordinator. Patients are more likely to listen to and trust a number that comes directly from the doctor, and practices that stop discussing fees at the doctor level often see a measurable, immediate drop in collections.
What should I check before getting into a financing or payment conversation with a patient?
Confirm the patient actually wants the treatment first. If a patient's answer to do you want to do this is hesitant or unclear, no amount of payment plan options or financing discussion will resolve that, since the real issue isn't the money, it's that they haven't been sold on the treatment itself. If a financial conversation starts looping without progress, stop and go back to confirming genuine interest before continuing.
Episode Transcript
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Improving case acceptance in your practice is a bigger game changer than you might imagine. For one, it can radically impact your collections, and we see this constantly, especially with newer clients attending the MGE Communication and Sales Seminars. The average client sees about a 300,000 dollar increase in just the first year. I'll put a link to that on the episode webpage, but the point stands on its own: getting better at case acceptance will drastically impact your collections.
Beyond that, there are several other benefits. First, job satisfaction, you're not just doing what insurance covers, you're doing the treatment patients actually need, the kind of dentistry you genuinely enjoy doing. The increased revenue also benefits the practice as a whole, better staff compensation, that promotion you've been wanting to run, more new patients, upgraded equipment. Most importantly, the biggest benefit is for your patients, healthier patients who are actually getting the full treatment they need and genuinely restoring their oral health. It's a real win-win for everyone involved.
That's exactly why we address case acceptance early in a client's program, starting with the Communication and Sales Seminars, then moving into more comprehensive case presentation training once a client progresses into the MGE Power Program. Interestingly, once you learn workable techniques, case size stops mattering much. Talk to MGE clients doing all-on-X or full mouth reconstruction cases in the 40,000 to 60,000 dollar range, and they'll tell you the techniques that close those cases are fundamentally the same ones that close a four-crown case. The presentation may take longer, and the qualification process might involve more steps for a larger case, but the underlying sales technique stays consistent.
Having been in the sales and management training business for about 30 years, we have a strong sense of what works and what doesn't with treatment acceptance, which also means we have a clear view of the biggest mistakes dentists make in this area. That's what I want to cover this week. My name is Jeff Blumberg, and I'm your host, and I want to walk through the five biggest treatment presentation and acceptance mistakes we've identified, and more importantly, how to fix each one. There are certainly more than five possible mistakes, I could probably list fifty, but these are the most common and most impactful.
Mistake number one: not assessing a patient's frame of mind before moving into a treatment presentation. Here's the most common version of this. You have a new patient, and beyond the clinical exam itself, maybe with a bit of rapport building, you never really get into how they actually feel about dentistry, what they hope to get out of today's visit, how important their oral health is to them, what past dental experiences were like, or how they currently feel about the condition of their own teeth.
Here's why that matters. Say this patient believes they're in great shape, and your exam reveals otherwise. Now you have a real problem. At some point you have to present a substantial list of issues to someone who walked in assuming everything was fine. You're about to contradict their entire self-assessment. Since you never established where their headspace actually was, the treatment presentation lands as a total ambush. They expected good news, you're delivering a long list of problems instead. In my experience, at least half the time, that patient accepts nothing, leaves the practice, and leaves a negative review. A large share of negative reviews trace directly back to the treatment presentation process, the classic my last dentist said everything was fine, then this office told me I needed thousands of dollars of work, stay away, they just want your money.
How do you avoid this? Get a read on where the patient actually stands, ideally during the exam itself, since it doesn't take long. Say the patient's in for a new patient initial, hygiene has already done the charting, scans, and X-rays, and you step in to do your exam. Introduce yourself, then ask a few questions: what brought you in today, when was your last dental visit, how did your last few visits go, was there anything that felt unaddressed, is there anything specific you want to discuss today.
If they tell you they've always taken great care of their teeth and their last doctor said their oral health was perfect, and then your exam turns up real problems, start dropping small hints as you go. You don't need to diagnose out loud, I wouldn't say something like you're definitely going to need a crown here, but you might pull out an intraoral camera and say, have you ever noticed this cusp is missing here, take a look, do you know when that happened? Or, see this dark area under the margin of this crown, do you see that? Use plain language, not clinical terminology, for this.
If the patient starts asking what that means or how it gets fixed, simply say you'll go over everything together once you've finished gathering your findings. This is essentially foreshadowing, planting the idea that not everything is perfect, so when you do get to the actual treatment presentation, it isn't a complete surprise. That surprise is exactly what causes the shock and the negative reaction. You can do the same thing with something like unaddressed periodontal pockets, when was your last cleaning, has scaling ever been discussed with you, did anyone point this out before, explaining briefly why it matters as you go, all before any formal treatment presentation begins.
This process also tells you a lot about the patient's general mindset heading into the actual sales conversation. If someone mentions early on that they only do what insurance covers, that doesn't disqualify them from anything, it just tells you they may need a bit more time and a different approach during the presentation itself, which you can plan for. The goal is genuinely getting to know the patient during the exam, not just performing diagnostics, so that when you present treatment, you have an accurate sense of how much explanation and care that conversation is actually going to require. Skipping this step is a mistake we see constantly, and if you want proof, look at negative reviews tied to treatment presentations online, you'll see this exact pattern repeatedly.
Mistake number two: relying heavily on dental terminology without making sure the patient actually understands. Every profession develops its own shorthand, RCT instead of root canal, SRP instead of scaling and root planing, and so on. Patients aren't part of that world, and using that language with them creates distance, not credibility. When you're talking to a patient, you're not talking to a dental assistant or another dentist, so keep the language accessible. Terms like periapical radiolucency, distal, buccal, or occlusal may sound authoritative, but the only real effect is confusion. Say infection instead of abscess. If a specific term is genuinely necessary, explain it in plain language right there.
Here's why this matters more than it might seem: patients generally don't ask clarifying questions. My working theory, based on years of this, is that when you use unfamiliar terminology, patients assume they're supposed to already understand it, so asking would make them feel uninformed, and most people would rather stay quiet than risk feeling that way. So if you're going to use technical language at all, explain it immediately and plainly.
There's a second issue too: heavy terminology doesn't make the treatment feel any more real or tangible to the patient, and remember, you're ultimately selling a service. If you're explaining that a missing cusp needs a crown or an onlay, and the patient asks what an onlay even is, that's your moment to show them, not just describe it. Keep old lab cases or models around if you can, so you can physically show them: this is what we're building, and afterward, your tooth will look essentially identical to the one right next to it. You're selling something the patient can't see, touch, or sit on the way they could a couch in a showroom, so anything that makes the outcome feel real and concrete, models, lab cases, before-and-after photos, an actual implant they can hold and examine, meaningfully increases their interest in moving forward. The more real it feels, the more invested they become.
Mistake number three: not allocating enough time for the sales conversation itself. This is a significant one, and I've touched on it before. Dental practices routinely allocate time for the exam and time for the actual treatment, but almost never allocate dedicated time for the sales conversation that has to happen in between, which is genuinely strange when you think about it. You've done the work to diagnose the problem, and you've scheduled time to treat it, but you're leaving little to no time for the one step that determines whether the patient agrees to move forward at all.
Here's how this typically plays out in practice. Take a standard one-hour new patient initial: hygiene handles charting, scans, and X-rays for the first 40 minutes, and the doctor gets the final 20 minutes for the exam. A proper exam alone takes 10 to 15 minutes. If that patient needs, say, 8,000 to 12,000 dollars of treatment, which might not sound large to you, but represents a genuinely significant decision for someone earning 60,000 to 70,000 dollars a year, you're left with roughly five minutes to explain all of it. That's simply not enough time in most cases.
The same problem shows up at recall visits. A patient who declined three crowns at their last visit comes back for their four or six month recall. After the recall exam, how much time do you actually have to re-present that treatment? Again, typically two to five minutes, not enough. And here's the key principle: it is better not to start a treatment presentation at all than to start one you can't finish. If you begin explaining a case and run out of time before working through the patient's questions or resistance, you leave them sitting in unresolved doubt, and they leave the practice still undecided, which functionally means they don't come back for it.
So what's the fix? Build dedicated time into your schedule specifically for treatment presentations, what we call consult time. Explaining a problem, the solution, the consequences of inaction, discussing fees, and answering questions properly for a meaningful case takes at least 20 minutes. I typically recommend scheduling this first thing in the morning and right after lunch. For larger cases, full mouth reconstructions or all-on-X cases that might need a full hour, consider a dedicated block, say Friday mornings if you don't normally see patients that day.
Morning consults have real practical advantages. You're not mid-treatment with another patient, so you can give full, distraction-free attention. And if you also schedule your larger primary procedures in the morning, a last-minute cancellation can sometimes be filled immediately, if a consult patient agrees to proceed, they may be able to start treatment that same morning, salvaging what would have been lost production. Post-lunch consults work well for similar reasons, less likely to be interrupted by other patients cycling through.
So build consult time into the schedule, and when you don't have time to present same day, bring the patient back within one to three days, ideally with the doctor personally involved in setting that up. It might sound like: I want to review everything I've gathered today, your X-rays, charting, and scans, and then sit down with you personally to go over what I found and what I'd recommend. I'd like to see you again within the next day or two. You can even coordinate live: ask your assistant when the next consult slot is open, then ask the patient directly if that time works for them.
If a patient pushes back and asks why you can't just explain it now, it's fine to say you want to make sure you've reviewed everything thoroughly so you can recommend the best possible course of action, and that when you do sit down together, it'll just be the two of you, fully focused. Most patients respect both the one-on-one attention and the extra care being taken with their case.
That said, presenting the same day remains the ideal whenever it's genuinely possible, this isn't a suggestion to always delay treatment presentations. If you can present now, present now. There are two practical ways to make same-day presentations more achievable, particularly for new patients. First, most new patient initials run an hour, with the doctor handling the final 20 minutes, assuming your front desk staff and new patient intake process are strong. A thorough intake form, we have a free one available on DDS Success, linked on the episode page, lets you gather enough information upfront to get a reasonable sense, not a diagnosis, just a reasonable sense, of whether a patient likely needs minor or more extensive work.
This isn't your receptionist diagnosing anything, they're simply asking useful questions: when was your last dental visit, was any treatment recommended that you didn't complete, are you missing any teeth, are you experiencing any pain or sensitivity, is there anything specific you'd like addressed today. If every answer comes back essentially clean, no missing teeth, no pain, a recent uneventful checkup, that patient gets the standard one-hour slot, and if something does turn up during the exam, you simply bring them back for a consult.
But if the intake reveals real signals, missing teeth someone previously discussed implants for, ongoing pain in a specific area, sensitivity to hot or cold, that patient gets scheduled for an hour and a half instead: the standard hour with hygiene and the doctor's exam, plus an additional 30 minutes built in specifically for the doctor or treatment coordinator to present a likely more involved treatment plan. You've effectively pre-built sales time directly into the schedule. The main risk with this approach is running into an objection at the very end, like needing to consult a spouse who isn't present and can't be reached quickly, that's really the main scenario where it can fall short, though even then, you can ask upfront during intake whether healthcare decisions are typically made solo or jointly with a spouse, and schedule both partners together from the start, which sometimes yields an additional new patient in the process.
Not building in enough time for the treatment presentation, half-presenting and sending the patient off mid-resistance, is a significant and very avoidable mistake. When someone is in the middle of real sales resistance, cutting the conversation short rarely resolves in your favor later. You're generally better off working through to either a clear yes or a clear no in that sitting. As a rough guide, a typical case takes about 20 minutes to present properly, a larger or more resistant case might run 30 to 40 minutes, though that ultimately depends on the specific patient and case.
Mistake number four: the doctor not personally discussing the fee. Doctors trained through MGE are specifically trained to discuss fees directly with patients, and skipping this step is a real mistake. Here's why it matters so much: ask your own staff who a patient is most likely to genuinely listen to, and the answer is almost always the doctor. A fee stated by the doctor carries meaningfully more weight than the same number delivered by anyone else in the practice. I've seen this affect collections in fairly dramatic ways, a doctor who stops discussing fees directly can see collections drop by 20,000 to 30,000 dollars, and resuming that practice brings the number right back up. It's genuinely that impactful.
Assuming you've had adequate time to properly explain the problem, the recommended solution, and the consequences of not addressing it, there comes a natural point to discuss the fee, whether the patient asks directly or you simply reach the point where cost is the remaining topic. At an absolute minimum, I'd expect a doctor to state the number directly: this treatment plan comes to 10,700 dollars, we expect insurance to cover roughly 1,500, leaving your portion around 9,200. That's the floor, the bare minimum version of this conversation.
Patients will respond in a range of ways, that's a lot of money, I wasn't expecting that, or occasionally, that's actually less than I thought. Whatever the reaction, from there you can hand off financial logistics to your treatment coordinator, ideally someone who's been present throughout the presentation. But there's a stronger version of this conversation worth aiming for. After stating the fee and hearing a reaction like that's really expensive, you might ask: do you understand the treatment we've discussed? Do you genuinely want to move forward with it? How would you typically handle a cost like this? The patient might mention a credit card, a specific card even, at which point you confirm they have no remaining questions about the treatment itself, confirm they want to proceed, and then hand them off to your treatment coordinator by name, with a warm, specific introduction, framing coordination of payment as the only remaining step, not whether to proceed at all.
You can even take it slightly further: if you prefer scheduling primary procedures in the mornings, ask your coordinator directly, in front of the patient, when the next morning slot is open, and ask the patient if that timing works. You're not finalizing the appointment yourself, your scheduler will handle the specifics, but you've planted a concrete next step directly with the patient before you've even left the room.
Skipping fee discussion at the doctor level is a mistake we correct quickly with clients whenever we see it slip, precisely because the statistical impact is so significant. If discussing cost directly feels uncomfortable, practice it deliberately, literally rehearse saying specific numbers out loud until it feels natural, since some doctors visibly brace or stumble when stating a number, which patients pick up on. Simply state the amount clearly and move forward, you'll often find patients respond calmly, even when the number is substantial, and you can always hand off further financial detail from there. Some doctors will always find a percentage of patients who react negatively to direct fee discussion, but in most cases, those tend to be patients who weren't a strong fit for the practice regardless.
Mistake number five, and the final one: discussing financing before confirming the patient genuinely wants the treatment. Notice in the fee conversation example earlier, before ever mentioning cost, the actual first question was simply, do you want to move forward with this treatment plan, do you have any remaining questions, is this something you genuinely want to do. That sequencing matters.
Here's the problem this prevents: some doctors are perfectly comfortable discussing fees but skip verifying genuine interest first, and then the financial conversation spirals without resolution, I can't afford that, have you considered financing, I really can't right now, what about this option, still can't, on and on. If you circle back and simply ask directly, do you actually want this treatment, and the answer is a hesitant maybe or I guess, that tells you the real issue was never the money. There's no reason to keep negotiating financing for something the patient hasn't actually committed to wanting in the first place, that's simply wasted effort for everyone.
So before getting into financial specifics, confirm genuine interest directly: do you understand what I've explained, do you want to move forward with this? If the patient hesitates or says they need to think about it, that's a signal there are still unanswered questions or unaddressed concerns, worth revisiting the treatment explanation itself before returning to cost. Similarly, if a financial conversation starts looping without resolution, pause and ask directly whether the patient genuinely wants to proceed. If they're still not certain, return to explaining the treatment and its importance rather than continuing to negotiate payment logistics.
Generally speaking, when someone genuinely wants something, they tend to find a way to make it work, a co-signer, a different payment approach, whatever it takes. So avoid getting pulled into an extended financial back-and-forth, and if that conversation stalls, redirect to confirming genuine interest before continuing.
That covers all five mistakes. There's obviously a great deal more to treatment planning, case acceptance, and patient communication broadly, which is exactly why we've built extensive training around it, including the Communication and Sales Seminars mentioned earlier, linked on the episode page. If improving case acceptance or collections is something you've been considering, this is genuinely where I'd recommend starting, and we're glad to help further if you're interested.
I hope this was useful. Links for everything mentioned are on the episode webpage: the Communication and Sales Seminars, the Power Program, DDS Success, and the free new patient intake form download. If you want to learn more about MGE, visit us online at mgeonline.com or call 800-640-1140. Have a great week, and we'll see you at the next episode.