Practice Management Toolkit

Effective Case Presentations: Internal Marketing at its Best

David Schwab, Ph.D

If time were circular, patients could first experience the benefits of treatment and then, after the fact, decide to proceed with treatment based on their positive experience. But because we experience time as a linear phenomenon (with a sense of past, present, and future), patients need to be able to envision future benefits from a present perspective. An excellent case presentation provides the patient with a vision of those future benefits.

The goal of every case presentation is to help the patient view oral health concerns (e.g., periodontal disease, missing teeth, malocclusion) as unmet needs. An unmet need is a problem that requires a solution. If the unmet need is perceived as significant, then the patient will translate that need into a demand. The demand will be for a solution to the problem, a way to meet the need, a course of action that will provide benefits—and that is exactly how the proposed treatment should be presented.

To help patients view their dental problems as unmet needs and then translate those needs into a demand for treatment, here are some case presentation tips:

• Conduct the case presentation in a non-clinical setting. Moving the discussion out of the operatory and into a consultation room facilitates communication between doctor and patient. The use of a consultation room signals the patient that the doctor wants to take the time to explain clinical findings and proposed treatment to the patient in a non-threatening setting.
• Make an organized presentation using visual aids, such as radiographs, study models, and, most important, photographs. When patients see photographs of their smile and teeth, they are better able to comprehend and appreciate proposed treatment.
• Track the dollar value of dentistry presented and accepted each month. Every dentist has a handle on production, but many practitioners do not know the dollar amount of dentistry presented each month. As management guru Tom Peters says, "If you can measure it, you can improve it."
• Provide a written treatment plan. Even when the case presentation is a masterpiece of communication, patients are bombarded with so much information that they cannot absorb everything they see and hear. Send patients a post-consultation letter that explains the treatment and stresses benefits.
• Sequence the treatment according to clinical needs and then according to financial impact. Some patients need months or even years to complete a complex treatment plan. Completing treatment over a long period of time is better than not completing treatment at all.
• Present the findings in a way that stresses benefits. There once was a man who ran an advertisement for a dog obedience school. The ad listed all the behaviors he could teach dogs, including how to stay, sit, come, etc. Few dog owners responded to his ad. When he changed the ad to talk about the benefits to the dog owner, response improved tremendously. How did he do this? Instead of focusing on the dog, he concentrated on the owner. He presented benefits such as no more soiled carpets, no more chewed furniture or slippers, no more tug-of-wars with the leash, etc. In a similar fashion, the patient is looking for "What's in it for me?" This may mean better appearance, a younger look, freedom from conventional dentures, ability to eat, confidence when smiling, etc. Determine the main benefit from the patient's point of view, and stress that point.
• Don't just talk—communicate. Watch the patient's eyes and body language. If the patient seems interested and engaged, you are on track. If the patient seems barely able to stay awake, or if they are suffering from the MEGO syndrome (My Eyes Glaze Over), stop talking, ask for questions, and re-engage the patient's interest.
• Stay on message. You are giving a case presentation, so small talk should be eliminated. The time to talk about the weather or the patient's son's wedding is over. Stay focused on the subject at hand.
• Control the conversation, even though some patients interrupt with questions. While you certainly want to encourage questions, you need to provide brief answers and then steer the conversation back to your presentation. Otherwise, the patient will ask multiple questions which will interrupt the flow of your presentation and take far too much of your time.
• Keep it short. You should allow thirty to forty-five minutes for the presentation and questions. Even the most complex case can be explained in that amount of time.
• Avoid technical terms such as "gingiva" and "lateral incisor." When you use words that the patient does not understand, two things happen: first, the patient does not comprehend; and second, the patient is left wondering what "lateral incisor" means and they miss the next part of your presentation.
• Show great enthusiasm. The best sales people report that one secret of success in a case presentation is demonstrating that you cannot wait to get started. Enthusiasm truly is contagious.
• Avoid giving the patient permission to delay treatment. When the patient asks if they can delay treatment, you need to say something like this: "Mrs. Jones, I want to give you all the information, so you can make an informed decision about your dental health. The treatment I have described to you will never be more conservative than it is today. If you delay, the treatment plan may need to be modified to include more invasive and costly procedures."
• If the patient does not accept treatment, use the underlined words: "I am going to make a note in your chart that you have elected not to pursue treatment at this time. However, periodically, I am going to monitor you, assess your oral health, and recommend treatment options to you so you can make an informed decision. You have thus set the stage to discuss treatment options with the patient at their next appointment.
• Quote the fee. The patient needs to hear the fee, and you need to quote it with confidence.
• Listen carefully to patient objections. Objections may be a sign of interest! Stay calm, paraphrase their concerns, stay on message, and repeat the benefits. "Mrs. Jones, I understand that you are concerned about the cost and the time it will take to complete treatment. I can tell you that in our practice, we offer you an excellent value for your dollar, and we will work with you to complete treatment as quickly as possible with the least possible inconvenience to you. The implant treatment we discussed will solve the problems you are now having with your dentures."
• Ask a staff member to go over financial options. The message to the patient should be that the doctor is interested in the patient's oral health, and that the staff person is available to handle the business and financial aspects of treatment.
• Be prepared to present the case again if treatment is not accepted. If the patient does not accept treatment, have a staff member call within two weeks and ask the following question: "What questions do you have?" (as opposed to "Do you have any questions?") The second question can be answered "No," but the first question may prompt the patient to begin a dialogue. If the team member cannot answer the question, then the doctor should call the patient at a mutually convenient time to answer the question. If the patient does not accept treatment within thirty days, then send a friendly letter reminding the patient of the benefits of treatment and include the following: "If you would like to return to my office to discuss this treatment and ask me additional questions, please feel free to do so. As a courtesy to you, there is no charge for this visit." A patient who returns with additional questions is trying to convince themselves to accept treatment. Imagine a real estate agent who shows a house to a young couple. Both the husband and wife love the house, but they cannot make a decision to buy the house immediately. What should the real estate agent do? He or she should not say to the couple: "Either buy the house now or get out!" On the contrary, the agent should invite the couple back to see the house again and again, if necessary. Every time the couple returns to the house, they can better envision themselves living there. Successful sales people know that it often takes multiple presentations to close a single sale.

To get beyond "drill, fill, and bill" dentistry, doctors need to have the confidence and communications skills necessary to present complex treatment plans. By stressing benefits and presenting patients with a vision of how their oral health and self-confidence will be improved, the chances that a patient will accept proposed treatment are greatly increased.

David Schwab, Ph.D., Lake Mary, FL