Is 'sell' a four-letter word?

Feb. 1, 2004
The concept of "selling" dentistry is still a highly controversial issue for many hygienists. Resistance varies from uneasy discomfort to awkward pain to outright, adamant refusal.

By Janet Hagerman

The concept of "selling" dentistry is still a highly controversial issue for many hygienists. Resistance varies from uneasy discomfort to awkward pain to outright, adamant refusal. One frequent request that I receive from dentists whose hygienists I have coached is, "I wish you could get my hygienist to sell more dentistry." From the hygienists' perspective, I hear, "I'm just not comfortable selling to my patients," or, more strongly, "I am a healthcare provider, not a salesman." This is a tough issue, and yet I see light at the end of the tunnel.

First, let's examine what selling actually means. My dictionary defines the word as the following: to exchange goods or services for money, or its equivalent; to promote the sale, acceptance, or adoption of (something).

Isn't this exactly what we want to do as health care providers, promote the acceptance and adoption, (patient compliance) of goods or services (recommended treatment and/or products to increase patient health)?

Perhaps the word itself is distasteful. Enrolling patients sounds so much nicer than selling them. When you think about it though, isn't our whole life spent selling? The wife sells her husband on the idea of painting the living room pink. The kids sell their parents on the idea of taking them to Disneyworld. Your date sells you on the idea of going out again. The parent sells the child the concept that Disneyworld is a possibility provided homework is finished on time for the next two months. You sell the store on accepting your returned item, without a receipt, because the product is defective and you challenge their customer service.

Our entire lives are a series of "sales jobs" whether we recognize it or not. Some of us are more aware of this, some are more conscientious about the process, and some of us are more successful at it. Our entire lives are a series of promoting the acceptance and adoption of what we want from others, whether this is for our own good or the benefit of others.

Whereever you stand on this issue, you must be willing to explore your sales skills. Today's hygienist, and the hygienist of the future, must acquire sales techniques that are both elegant and graceful to serve the needs of the patient. Whether you like it or not, you need to learn how to "sell" or promote in a conscientious manner. Here's why: If you don't, someone else will. And that someone may be much more persuasive than you, and not have the best interest of your patient in mind.

Dentistry is being promoted by Madison Avenue and the media as never before. You can hardly pick up a mainstream magazine or newspaper without reading an article, or seeing an advertisement, about something related to dentistry. It could be implants, whitening products, the perio-heart disease link, or smile design.

Our patients learn about smile designs from TV and on makeover programs. Our patients are learning about dentistry from the media. Where do you want them to go for products and services? Do you want your patients to go to the grocery, drug stores, or retail chains for their health care products? Doesn't it make more sense for them to be advised and purchase from their trusted health care provider — you? Millions of dollars are spent annually by our patients on oral care and breath products. Why shouldn't they spend it with us, where we can guide their choices with clinically based advice?

Not only are our patients being educated by the media, they are informed by friends, family, and other dental offices. I was working as a temp for my friend who happens to be a wonderful dentist. One patient had recently gotten beautiful veneers, which surprised me because I couldn't find any reference to this in her chart. She informed me that she had the procedure done "in Florida." Her sister had gotten cosmetic work done by her dentist and was proudly displaying her beautiful new smile. My patient, mistakenly assuming that Dr. Wonderful didn't do these procedures (because no one had ever told her!), had her smile re-designed by her sister's dentist. My patient had never been informed of the cosmetic procedures that were available to her from her own dentist. So she went elsewhere.

This is what I mean by giving our patients the full menu of choices. Some call this selling. I call it giving your patient enough information to make a well-informed decision. I think that most hygienists who are resistant to this concept of selling dentistry do not do so from neglect. They resist from a misplaced sense of duty, and from a lack of elegant enrollment skills.

Indeed, both dentists and hygienists fear overwhelming their patients with comprehensive treatment. This is a very legitimate concern for any of us who have ever heard that patient complaint, "Well, how come my last dentist never found all this stuff?"

Here is a strategy that will enable you to inform your patients in a way that will impress and educate rather than overwhelm them. I call it the Treatment Triad. It is composed of three elements, which are 911 Urgent, Preventive, and Cosmetic. It sounds like this: "Mrs. Jones, as I examine your mouth today I'll be looking for three types of work."

• 911 — "This is urgent work that must be done immediately to relieve pain. Like your broken tooth that brought you here today."

• Preventive — "This is work that should be done to prevent future pain and problems. Like some of these big, old, dark, metal fillings that are breaking down. We can prioritize this with your dental budget and handle this in stages."

• Cosmetic — "I'll also be exploring cosmetic possibilities for you. We can do so many exciting things in this area. This is not necessary but fun to consider."

Dentists and hygienists have told me their patient enrollment skyrocketed when they laminated this and posted it in their treatment room using it at every exam. Now, instead of being overwhelmed and suspicious, patients say, "Wow! This is the most thorough exam I've ever had." Use this strategy to help you elevate your "sales" skills to elegant patient enrollment. I know that no hygienist wants to feel or sound like a used car salesman. Yet, we must be the ones to offer our patients the full menu of restorative, periodontal, and cosmetic services because we are the ones our patients (hopefully) trust to advise them in the ever changing world of dental options and choices. Take the stigma out of the work "sell" and give it the attention it deserves.

Janet Hagerman, RDH, BS, is a speaker, writer, and the director of dental hygiene for Coast Dental. She can be reached at jhager [email protected].