TREATMENT ACCEPTANCE (WITH SCRIPTS)
Four Step Case Presentation Protocol
VALUE
Creating value is key. Value is created by increasing the Dental IQ of your patient through education. The more you SHOW the more you educate. Effective use of trigger words your and your intra-oral camera is key.
TRUST
Build trust through communication. This is accomplished by asking the patient effective questions during the exam. Discovering possible earlier negative experiences with dentistry builds trust.
Examples:
“What brings you to see us today?”
“How long since your last visit to a dentist? What did they do for you?”
“How have your previous visits to the dentist gone for you?”
Some dentists do not like that question as it might introvert a patient. If this concerns you try:
“At your last dental visit, what did they do for you?"
The patient will likely say something like, "I had a cleaning and a filling".
Then ask,
“How did that go for you?”
This starts a conversation and will build rapport. Make sure to LISTEN.
Tip #1 from a dentist: If a patient tells you they’ve been going to a great dentist every six months for the past ten years, yet you see a half dozen interproximal lesions barely to dentin, what do you do? If you diagnose six fillings, your patient will either think: 1) His last dentist was an idiot, or 2) You are a liar. Perhaps it would make sense in this case to inform the patient of your concern, let them know that fills may be needed in the near future, build a little rapport, and pull the trigger for some work next time. The patient has a history of regular check-ups, so you'll see them again soon enough. If, on the other hand, the exact patient says it's been 10 years since their last visit, I'm more likely to do the fills ASAP. Who knows how they'll look in ten more years?
Tip #2 from a dentist: If it's bad and they say it was bad, then you can follow up with a "Please tell me more” question. If they say that it's been fine but, you know they were to a dentist not long ago then that opens the door for something like, "I'm curious, as to whether something might have occurred that caused you to leave the last office because I want to make as certain as I can, that here in this office we don't repeat a bad incident for you." This almost always draws the incident out. If not, then I let it go at that.”
MORE QUESTIONS
“Do you ever have pain in your jaw joint or frequent headaches?”
“Any areas sensitive when you eat or drink? Hot? Cold? Sweets? Pressure?”
“When you brush or floss do you ever notice your gums bleeding or blood on your toothbrush.”
These questions give a wealth of information but, don't over think it. The idea is to prompt and stimulate the patient to talk. Every patient has a story so, let me tell it! The key and the power are listening after asking simple questions.
Get and let the patient do most of the speaking during this part of the exam.
Dental Goals
• What are your goals for your dental health?
• How important is your smile to your home or work life?
• What do you think your dental health will be like in five years? What do you want it to be like?
Dental Experience
• What has dentistry been like for you?
• Tell me about your past experiences with dentistry?
• Has anything kept you from receiving dental treatment in the past? What was it?
• What was your last dental visit like?
Dental Condition
• What concerns (if any) do you have about your dental health?
• Can you eat anything you want, whenever you want?
• What are the positive aspects of your dental health?
• What are the negative aspects of your dental health?
• What, if anything, have you noticed in your mouth that suggests a need for dental treatment?
• On a scale of 1 to 10, how would you rate your dental health today?
Treatment Expectations
• What ideas do you have to improve the look and feel of your mouth?
• What do you most look for from a dental office?
Four Step Case Presentation
Step 1 Awareness of Problem (using perio as example)
Ask the question or a variation:
“Did you know you have dental disease? “ or “During the examination I found some dental disease. Were you aware of the problems?”
Get an answer.
If answer is no, explain that dental disease is a “silent disease” like high blood pressure, diabetes, etc.
Ask:
“Do you have any pain or discomfort?” If no: “That is not unusual, pain or discomfort show up later in the disease process.
End Result: A patient who knows they have dental disease.
Step 2 Understanding
Go over the disease/problem they have and cover the negatives such bone loss, continued decay, cracked teeth, etc.
End Result: A patient who understands the negatives associated with their condition.
Step 3 Value. Need for Treatment
Stress making sure the patient understands what will happen if the problem is not corrected. Get them to tell you what can happen.
Example:
“Mr. Smith what do see is going to happen if we don’t stop the disease process?”
“Will the condition of the tooth get better or worse.”(Involve the patient)
End Result: A patient that understands their oral health will continue to deteriorate if uncorrected.
Step 4 Commitment
Ask:
“If we could find a way to work within your budget, would you be interested in this type of dentistry?”
Put the patient at ease by simply inquiring:
“Are you concerned that there might be some discomfort involved with this procedure?”
To encourage patient imagination:
“How would you like your new smile to look like? How do you think that new smile would make you feel?”
Understanding patient concerns:
“Are there any other barriers preventing you from scheduling at this time?”
Commitment Question:
“When would you like to have this treatment performed?”
Find out the patient’s purpose for improving their appearance:
“Is there some special event for you this year during which you would like to reveal this new, beautiful smile?”
Provide the patient the opportunity to receive the treatment with an inviting, non-confrontational question:
“When would you like to have this done?”
Even if the patient says, “Never” at least you have given the patient an opportunity to schedule.
So many times, doctors, in their desire not to offend, omit this most essential question:
“When would you like to have this done?”
WORSEN
With value and trust built you will increase acceptance but, doing so is smoother when the patient understands what can happen to their oral health (overall health too) if they do not move forward with the treatment. The patient needs to be aware of what can happen in the future by non-action:
“What do you think will happen if you don't do anything about XYZ?
“Which way are you going on this chart?”
Tip: Avoid "Do you understand?" type questions that can be answered “Yes” or “No”. These are called open-ended questions. Avoid them.
Ask questions that test the patient's understanding.
KEEP IT SIMPLE
Talk to patients in layman terms. Don't assume they know anything about oral health. Many times, I listen to a dentist or hygienist presenting treatment using terms that assume the patient just got back from an advanced course on altering occlusion function and esthetics.
ANALOGIES
Excellent reference book available on Amazon:
Compare periodontal disease to a post trying to hold itself up in a hole where the soil has eroded. There are dozens of different ways to describe dental conditions in terms your patients