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Practice Profile

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Randy Garland, DDS

Randy Garland, DDS

Exceeding expectations What can you tell us about your background?
I grew up in southern Orange County and earned a bachelor’s degree in biology at San Diego State University in 1983. There I met my future wife, Kim, at the...

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Scott A. Norton, DMD, MSD

Scott A. Norton, DMD, MSD

Focus on family, patients, friends, growth, and community What can you tell us about your background? For as long as I can remember, I wanted to make people smile. I always loved getting the class laughing in grade school. Looking back, I am sure...

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Dr. Fleur A. Blethen

Dr. Fleur A. Blethen

Empathy, tenacity, and perseverance are keys to this clinician’s flourishing practice  What can you tell us about your background? I was born and raised in Seattle, Washington, and lived there until I was 13 years old. My family relocated...

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Clinical Articles

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Management of a tooth with a large internal resorption defect

Management of a tooth with a large internal resorption defect

Dr. Robert Slosberg facilitates accurate mapping and obturation of the resportive defect with CBCT imaging Abstract
A patient presented with advanced internal root resorption of tooth No. 9. The prominent location of this tooth...

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Pulpal diagnosis of teeth presenting with condensing osteitis prior to endodontic treatment — a retrospective study

Pulpal diagnosis of teeth presenting with condensing osteitis prior to endodontic treatment — a retrospective study

Drs. Brian Shaughnessy, Margaret Jones, Ricardo Caicedo, Joseph Morelli, Stephen Clark, and Ms. Jennifer Osborne review the occurrence of teeth presenting with condensing osteitis and their associated pulpal diagnosis over a 2-year period. Introduction Read More...

GuttaCore® system: a step forward in the evolution of endodontics

GuttaCore® system: a step forward in the evolution of endodontics

Dr. Andrei Zoryan dispels some of the common myths surrounding carrier-based obturation Carrier-based gutta percha Carrier-based obturation (such as Thermafil®, GT® obturator, ProTaper® obturator [Dentsply Tulsa Dental Specialties]) is one...

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Practice Management

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Life after root canal — it’s not just about having enough money

Life after root canal — it’s not just about having enough money

Dr. Robert Fleisher ruminates on how to prepare for retirement There are so many articles about everything that you become pretty much overwhelmed and can never expect to read them all. So you pick and choose. You like to learn about the latest and...

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Superior customer service

Superior customer service

Dr. Roger Levin presents the 10 top ways to help create a perfect dental team With the changes brought on by the economy, top companies are bringing in the best resources they can find to evaluate where their organizations stand. They want to know...

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Office Matters: Hard-piped filtered water system vs. self-contained bottled water system

John Bednar helps avert problems coming down the pipe If your office currently has a hard-piped filtered water system, now is a good time to consider if and when you should change to a self-contained bottled water system. A hard-piped filtered water...

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Jacqui Goss explains one way to persuade patients to stop thinking about treatment plans and start acting on them

Let’s face it, as brilliant as your clinical work may be, as far as patients are concerned, a brand new washing machine, bike, or a great vacation will trump it every time. That is why of all your patients who say they’ll think about the treatment plan you offer them, only some ever return. If they get home to find the washing machine has broken, the children want new bikes or electronic games, or there’s a deposit due on a vacation, your treatment plan is history (unless they’re in pain).

Never mind, you’ve still had the examination fee, and 50%, 60%, maybe even 70% of your patients do return for treatment. But think if you could increase that proportion to 80%, 90%, perhaps nearly 100%—suddenly the purchase of that high-tech, state-of-the-art dental chair would no longer be a dream.

To achieve such an increase is, I assure you, simple in concept and only a little trickier in practice. You need to do what has become known as treatment coordination—because it is often carried out by treatment coordinators—so you can concentrate on dentistry.

Few of us like making instant decisions when it comes to spending sizeable sums. Hence, when given the price quote for a new car, three-piece suit or, even, dental treatment, our usual response is: “I’ll think about it.”

To you, as an endodontist, this probably seems perverse. After all, you’ve brought all your training and experience to bear examining a patient, have detailed the treatment essential for their oral health, and given them a fair price for commencing it. Nevertheless, dental treatment is not what retailers term a “distress purchase” —one that requires an instant decision. Replacing a flat car battery or a broken washing machine are distress purchases.

Like it or not, you’ll invariably be obliged to allow your patients to think about it. This is where treatment coordination comes in. Left to their own devices, patients “thinking about it” may come to all sorts of conclusions. A friend may say it sounds expensive. A spouse may be worried about how to pay for it. Any number of people may say: “Ah, but did you ask about....”

Overwhelmed by concerns and unanswered queries, many patients will simply stop “thinking about it,” and you’ll never hear from them again.

Your patients may also not be as loyal as you think. A recent survey commissioned by the dental corporation, Oasis, found that barely more than a third of those aged 16 to 24 described themselves as “loyal” to their dentist. Almost half of patients under 35 admitted to researching treatments online before deciding to go ahead.

Treatment coordination
A good treatment coordinator can significantly improve the acceptance of treatment plans—typically, I see an increase of around 30%. I emphasize good. A number of things are critical.

The person (or persons) doing treatment coordination must be sympathetic and understanding of patients’ concerns. This is not an exercise suggesting the placement of a metaphorical horse’s head in a patient’s bed. They need to understand and be able to explain terminology, such as the difference between an endodontic treatment and an apicectomy procedure or why a crown might be required following treatment. Importantly, they should not be the endodontist or profess to have clinical knowledge—patients are only likely to open up and discuss their concerns with someone “on their level.” Remember also that as a practice you must comply with regulations of informed consent.

Treatment coordinators need to have the time to chat with patients—so forget about giving the task to busy receptionists. Treatment coordination is best undertaken by phone at times convenient to patients and invariably when they are at home, in their own comfort zone, which typically means evenings and weekends. Unless you’ve undertaken treatment coordination, you probably won’t appreciate the topics that come up in conversations and the concerns that have kept patients “thinking about it.”

Real life examples
I recently spoke to a man whom the dental practice had not heard from for some weeks following an examination and the presentation of a treatment plan. It turned out he’d given up smoking, as advised, in order for the dental treatment to be effective. He was giving it several weeks to make sure he didn’t relapse into smoking again. Once I learned this, I offered encouragement over those several weeks, which he much appreciated, and, bingo, he subsequently went ahead with the treatment.

In another case (I have many more examples than there is room to include here), a patient told me he felt he’d been “taken for a ride” about the cost of treatment, having been told $11,379 to $13,000 initially, then referred to a specialist and told $26,009 to $29,260, and then finally given a treatment plan for more than $52,019. He used words such as “a bit negative,” “cocky,” and “blasé” to describe the people he’d dealt with.

A lost cause? Certainly, he would have been without someone contacting him. Worse, he would have told all his friends and colleagues about the way he felt he was treated. As it transpired, he was keen to proceed with some treatment and could afford the amount initially quoted. I relayed this to the principal dentist who offered the patient his apologies, a goodwill appointment, and referral to a different specialist for assessment of treatment within his budget. The patient was very pleased at this outcome. Results!  

The topic of money
Leading on from this last example, the cost of the treatment and how they pay for it will be an important consideration for many patients. The treatment coordinator needs to be prepared for this and should, ideally, be able to offer options such as staged payments, low-interest or interest-free payment terms, and discounts.
In my experience, if the subject is dealt with professionally but sympathetically, patients are happy to provide an insight into their financial circumstances. I have spoken with people who have said they wished to proceed with a treatment but were waiting for probate proceedings to be completed, which would release a financial inheritance. Others have said friends or relatives had offered to pay for the treatment as, for instance, a birthday present.
The point you will have no doubt grasped is that unless you undertake treatment coordination and actually liaise with and speak to your patients post-treatment planning, you can’t possibly know what they are thinking about. And if you don’t contact them to find out and then offer advice, explanations, solutions, sympathy, or whatever, a proportion of them will simply never return.

 

Jacqui Goss is a partner in Yes!RESULTS, which turns good practices into great practices by treatment coordination, patient surveys, mystery callers, and dental team training. For more information, please email This email address is being protected from spambots. You need JavaScript enabled to view it. or visit www.yesresults.co.uk.

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