Ep. 27: One Thing You Can Do Right Now to Increase Case Acceptance
How you design your schedule is one of the biggest factors in determining your success or failure with case acceptance. By simply making a few adjustments to the way you schedule, you could see your case acceptance rate skyrocket—and that’s exactly what Jeff covers in this week’s episode!
Links:
The MGE Communication & Sales Seminars - https://www.mgeonline.com/mge-communication-and-sales-seminars
Learn more about MGE – https://www.mgeonline.com
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Questions From This Episode
What's the one immediate fix that can meaningfully raise case acceptance?
Scheduling adequate time to actually present treatment. Practices routinely build schedule time for diagnosis and for the clinical procedure itself, but almost never build in dedicated time to help the patient actually decide to move forward, even though that decision is what makes the rest of the schedule possible in the first place.
Why can even a skilled communicator fail to close a case?
Time matters as much as skill. A genuinely excellent communicator given only five rushed minutes to explain a case may close nothing, while an average communicator given a proper amount of time will close some of those same cases, making the average one look like the better salesperson purely because of how much time they were given.
When should a consult actually be scheduled, and is it only for huge cases?
Consults aren't just for full arch reconstructions or all-on-four cases, they're appropriate any time a patient needs real time to process a decision, since even a $5,000 or $10,000 treatment plan represents a meaningful fraction of most people's income. First thing in the morning and right after lunch tend to work best, since those slots are distraction free and, as a bonus, can often absorb a same-day cancellation from later in the schedule.
How do you decide whether to present treatment immediately or bring the patient back for a consult?
Check how much time is left in that appointment and how much time the patient actually has available. If either side is short on time, the case is large, or the patient's own expectations suggest they'll need more explanation than the moment allows, bring them back for a dedicated consultation rather than starting a presentation that can't be finished properly.
What should actually happen once the doctor sits down with the patient to discuss treatment?
Six things: explain what's going on in plain language, explain how it will be fixed, explain why it needs to be fixed, explain what happens if it isn't addressed, state the cost, and leave enough time afterward to answer every question the patient has. Skipping the fee specifically, out of discomfort talking about money, quietly hurts case acceptance more than most doctors realize.
Episode Transcript
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I want to start this episode by looking at a day in the life of an average dentist. Say you have a new patient, and new patients come into your practice through hygiene, there's no right or wrong way, you might see them yourself instead, but either way you'll have to do an exam. This patient is in your hygiene chair, your hygienist has taken a full mouth x-ray and done perio probing, and now it's time for you to come in and do the new patient exam. You've scheduled about 20 minutes for this. You walk into the operatory and spend the first 15 minutes meeting the patient, since this is a new patient after all, and doing the exam. In that 15 minutes you determine this patient needs an implant, four crowns, and some fillings. That leaves five minutes in the appointment, and your next patient is already being seated in another treatment room. So you spend those five minutes explaining the treatment plan, telling them what they need, and because you only have five minutes, you let them know they'll discuss financing and scheduling with the front desk or the treatment coordinator.
At the end of the day, you check in on what happened with that new patient. Your office manager or treatment coordinator tells you they said they wanted to think about it, and they've been added to the incomplete treatment plan list. Has that scenario ever happened to you? There's a really good chance it has, this happens constantly. So what went wrong here? A lot could be said, but one thing stands out immediately, and it's actually a very easy fix. That's what I want to talk about in this week's episode of Dental Business Rx. My name is Jeff Blumberg, and I'm your host, and I've structured this episode around one specific point about treatment presentation and acceptance that you could fix immediately and potentially start seeing real results from right away.
As with anything on this podcast, you have to do what genuinely feels right for your own practice, so take what's useful here and apply it as you see fit, but ultimately you're the one responsible for how you implement it. So what's this one thing you could fix immediately? It's simple: scheduling adequate time to present treatment.
Let me explain how this actually shows up in a practice. Look at a dentist's schedule, and you'll see time built in for diagnosis and time built in for actual clinical treatment. The exam is diagnosis time, and it's right there on the book, and then there's time to actually perform whatever procedures the patient has agreed to. But what time is built into the schedule to make sure the patient actually agrees to that treatment in the first place? Very rarely is any time set aside for that at all.
This gets into the subject of sales, and I know sell can feel like a four letter word in dentistry, but there's genuinely nothing wrong with it. When you sell ethically, you're simply showing someone why they need something so that they understand it and choose to move forward. There's a skill side to sales and an organizational side. The skill side is obvious, how good a communicator you are. The organizational side has to do with scheduling, with treatment plan workups, with putting together a clear sheet, figuring out what insurance does and doesn't cover, and so on.
What I want to cover in this episode is how to build out that organizational side of sales in your practice, because here's how this plays out. Take the best communicator in the world and put them in a situation where they only have five minutes to explain something, and that may not be enough time to close the case, no matter how skilled they are. Take a mediocre communicator and give them the proper amount of time, and they'll close some of those same cases. Suddenly the mediocre communicator looks like the better one, purely because of how much time each was given. Time is a major factor here, which is why I want to focus on this organizational side of sales.
So what would count as adequate time in your schedule, from a business standpoint, to actually sell? We'd call that a sales opportunity. And by adequate, I mean enough time to sit down with someone, explain what they need and why they need it, go over a summary at the end, and answer whatever questions they might have so they can actually make a decision. For some people that's 10 minutes, for others 20, for others 30, it depends on the person, but you'll develop a rough default amount of time you want scheduled for this. In dentistry, we call this sales opportunity a consult.
Most of us think of a consult as something reserved for a full arch restoration or an all-on-four case, where you bring the patient in on a dedicated day because it's such a large case. That's certainly one use for it, but consults work for smaller cases too. I wouldn't schedule a consult for two occlusal composites, you'd just tell the patient they need fillings. But go back to the scenario from earlier, that patient needed about $10,000 worth of treatment. Say that patient earns $50,000 a year. The doctor in that example spent five minutes explaining something that will cost this patient a fifth of their annual income. That's simply not going to work. Even with a smaller treatment plan, say $5,000 against that same $50,000 income, that's still a tenth of their annual earnings, still a significant purchase.
Try a quick thought experiment. Think about what you personally earn in a year, you don't have to say it out loud, obviously, but hold the number in your head. Now imagine someone you just met spends five minutes explaining something that will cost a fifth of that annual income. Are you making that decision in five minutes? Probably not. And in a lot of practices, if this is how treatment gets presented, that's exactly the position patients are being put in. You might say your treatment coordinator handles sales rather than you, and that's fine, but as we've discussed before, one of the core tenets of the MGE program is that as a doctor owner, you wear several hats: doctor, owner or executive, and salesperson. From that sales hat specifically, this absolutely is your responsibility. And realistically, if treatment isn't being sold, there's no treatment for the doctor to actually perform, so it matters quite a bit. We've also talked before about the doctor being the one to mention fees, which I'll get into shortly, that's a critical piece here too, even if you have a treatment coordinator handling other parts of the process.
So how do you start creating real time to sell in your practice right away? There are a few things you can do. First, carve out dedicated time in the schedule for consultations. One clarification here, this is a fairly freeform episode, so I'll say it now: if you have time to present the treatment immediately, do so. I've had people assume that scheduling consultation time means always bringing patients back for a separate appointment. Not at all, if you have the time, present it now, I'll get into how to judge that in a moment. Otherwise, bring them back.
So the first move is setting up consultation time on the schedule. Where would I put it? First thing in the morning, anywhere from 20 minutes to an hour, and again right after lunch. Why first thing in the morning specifically? A couple of reasons. First, you're not yet in the middle of anything else, and when presenting treatment you want to be completely distraction free, no one coming in and out of the room, fully focused on this one patient so you can answer their questions and make sure they truly understand what you're explaining. Second, if you do larger primary procedures in the morning already, think about what happens if a patient scheduled for, say, four veneer preps at 10 o'clock calls that morning with a family emergency and cancels. If you've got two consults coming in, one at nine and one at nine twenty, there's a good chance one of those two patients could actually move into that newly open 10 o'clock slot, maybe one of them happens to be off work that day, and you've just saved that day's production. Scheduling consult time right after lunch works for a similar reason, even if you end up working through lunch, you can still sit down with that patient completely distraction free.
Once this time is built into the schedule, a couple of things start happening naturally. You now have specific slots that need to be filled, and they're meant to be filled with treatment presentations. Think about the sequence: to actually produce a clinical procedure, the patient first has to agree to it, and before that, they have to need it. So it's diagnosis, then sales, then the actual treatment. If you want to do more treatment, you have to sell more of the treatment that's genuinely needed, and if you have more sales opportunities built into the schedule, your ability to sell treatment goes up. You can always keep improving the skill side of sales too, and for that I'd recommend our Communication and Sales Seminars, I'll put a link in the description, that's where we cover that skill side directly. But the organizational side requires having the time built in to sell in the first place. Those slots tend to get filled, and that's where your future production on the schedule actually comes from.
So say you're doing a new patient exam, how do you decide your next move? Let's go back to the same scenario from the start of the episode, you've got five minutes left and a patient already being seated in the next chair. That's an easy call, bring this patient back for a consultation. Now say there's no patient waiting in the next chair. You might present the treatment right then, but check a couple of things first. How much time do you actually have? If it's a full hour, you're in good shape. Then find out how much time the patient has. At the end of the exam, they're naturally going to want to know what's going on, so if you have the time, you might say something like, Bill, we could go over this now, how much time do you have? If Bill says he's off for the rest of the day, great, you both have time. But if Bill has to head to work right away, bring him back for a consultation instead of starting a presentation you won't be able to finish.
This is critical, and it's something we tell every client early on: if you don't have time to present a case properly, don't start the presentation. You're better off not starting at all than getting halfway through and having the patient leave before you're done, that's a near guaranteed way to torpedo your case acceptance.
Other factors matter too, like the size of the case. A couple of fillings or a single crown might be perfectly explainable in five minutes. A genuinely large case in that same five minutes is not enough time, bring the patient back. The patient's own mindset matters as well, even a moderate case, say two crowns, might need more time than you'd expect if the patient has always believed their teeth were in great shape and their last dentist told them they had no problems. Learning they suddenly need two crowns can be a real shock, and that might call for a full 20 minutes you simply don't have in that moment, which again means bringing them back for a consult and slotting them into one of those dedicated openings.
So how do you actually get them to come back, since there's always a risk they schedule a follow-up and never show? A couple of things help. First, get them back in as soon as humanly possible, ideally tomorrow morning or the morning after, don't add a lot of extra wait time. Second, don't get into the specifics of their treatment plan before they come back. Don't say, you need an implant and four crowns, and I'll explain why when you return, because at that point there's a good chance they won't come back at all. Instead, explain that you want real time to properly review their treatment plan and make sure you've worked out exactly the right approach to help them, and that you'll sit down together at the consultation to answer every question they have. As the doctor, and remember, patients are generally most receptive to hearing this directly from the doctor, you're essentially asking for a little time to get it exactly right for them, and offering your own time for free to sit down and walk through everything together. That's the framing that gets people to actually come back, and to come back quickly.
Now, whether you're doing this at the follow-up consultation or right there on the spot because you both have the time, what actually needs to happen? Our sales seminars go deeper into the communication skill side of this, but at minimum, six things need to happen. First, explain exactly what's going on in a way the patient can actually follow, don't bury them in technical language they won't understand, make sure they genuinely get what you're telling them. Second, explain how you plan to fix it. Third, explain why it needs to be fixed at all, if they've been missing a tooth for three years, show them that the adjacent teeth are starting to shift inward, or that the opposing tooth is beginning to over-erupt, in other words, make the why concrete. Fourth, go over what happens if it isn't addressed, here's what could happen if we don't take care of this. Fifth, go over the cost. Yes, the actual cost. The doctor should be the one to mention the fee, I generally like the doctor to go a bit further than that, but at minimum, tell the patient plainly that this is going to cost around $10,000, or whatever the number actually is.
Why do so many doctors hate mentioning the fee? Usually because talking about money sometimes makes people uncomfortable, or worse, upset. But it's your business, there's no reason you shouldn't be able to discuss it directly, and you'll often see a real jump in case acceptance simply by telling patients plainly what something costs. I'm not saying you need to work out payment plans or figure out which credit card they'll use, your treatment coordinator can handle that part, but you should personally tell them the cost. And finally, sixth, make sure enough time is built in afterward to answer whatever questions they have about the treatment plan. Again, if you don't have time to do all of this properly, don't start the presentation, that's exactly how people end up half informed, walk out, and you never hear from them again.
And to repeat the earlier point, if you can present it now, present it now. When MGE clients are first starting out, they typically walk through this entire process personally with every patient, going over the fee and discussing how they might pay for it directly. Eventually, once you genuinely know how to sell yourself, you can bring on a treatment coordinator who also knows how to sell and start delegating some of this. But I wouldn't delegate it before you know how to do it yourself, otherwise you're in a fairly weak position. If you personally have no idea how to discuss finances with a patient, and only your staff member does, you're now completely dependent on that person. There's nothing wrong with a staff member being competent and responsible for this, but if they ever leave, you're in real trouble trying to find a replacement who can do what they did. You should know how to do this yourself, it's your business.
I know I went on a bit there, but the general message is this: start building real time into your schedule to actually sell. If you track how many of these opportunities you're creating, you'll start to see a direct relationship between that number and how much treatment you're actually closing and completing. And once that time is on the schedule and your staff understands exactly what it's for, they'll work to keep those slots filled, which becomes exactly where your future production comes from.
This was a fairly specific episode, but it's something you can start changing right now. I hope this helped. I've put links to everything mentioned in the description. Otherwise, that does it for this week's episode, I'll see you at the next one.