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Stating The Case — Here's a reminder that selling dentistry is also about education.

July 1, 2003
Selling is the process of education and motivation. Educating and motivating patients is an essential process in which you must excel.

by Angela M. Pickett, RDH, MAS

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Selling is the process of education and motivation. Educating and motivating patients is an essential process in which you must excel. Each patient who turns down necessary treatment loses an opportunity for better oral health, while each patient who turns down elective treatment loses an opportunity for life-enhancement.

When you provide patients with optimal dental health and exceptional service, everyone wins. Patients will appreciate your care and concern for their health and well-being. They will share their experiences with their friends and family, and they will accept more treatment upon your recommendation.

For years, the traditional role of the dental hygienist was limited to "teeth cleaning." Over time, expansion of the soft tissue therapy protocol and advancements in clinical technology and training has afforded hygienists the opportunity to play a more significant role in periodontal care. This evolution introduced dental hygienists to a key role in the practice, namely that of patient educator.

Art vs. science

Case presentation is vital to practice success. Many clinicians find this is challenging because the process is more an art than a science. To increase case acceptance, you must understand how to present information to patients in a manner that reinforces your clinical expertise, showcases your knowledge, and capitalizes on the relationship you have established with each patient. A professional presentation combined with easy-to-understand explanations of the diagnosis and treatment options is effective in influencing patients to move toward treatment acceptance.

The Levin Group has observed among its clients that the average time length of a dental hygiene appointment for an adult prophy with radiographs is about 40 to 50 minutes. This appointment can include use of the intraoral camera, charting of hard and soft tissue, prophylaxis, polishing, and fluoride treatment. While providing these services, you have the opportunity to highlight all of the oral health findings, home care requirements, and treatment options your patients may consider. In addition, the hygiene appointment provides an excellent opportunity to continually educate patients about exciting new services and elective procedures such as esthetic options.

The demand for esthetic services has increased dramatically in recent years. This area of services provides an excellent study of case presentation in the hygiene department. Esthetic options typically include whitening, veneers, inlays, bonding, and composite resin fillings. If you build an effective educational dialogue into your appointments, you will find that patients will relate to your knowledge and enthusiasm and be motivated to consider their esthetic and dental treatment options.

Topic of conversation

More than 80 percent of the hygienist's time with a patient should be spent highlighting the needs and services that could benefit the patients. When presenting treatment to your patients, start by answering these four questions:

• What is the procedure? The question refers to the clinical aspects of the case. However, this clinical information must be presented in an exciting way to capture the patient's attention. One way to do this is to follow each clinical statement with a reference to the procedure's benefits. For example, "Ms. Jones, laminated veneers are the best and easiest way to perfect your smile, close the gap between your teeth and create a bright white healthy look.

"A thin layer of enamel is removed from your teeth in preparation for veneers. Impressions are taken and then the lab customizes veneers in the shade selected to fit your mouth. The end result is natural looking, healthy teeth."

The more benefits you can present while addressing the patient's needs, the better the chance to close the case. While patients are interested in the clinical aspects of treatment, they are more interested in the benefits.

• What will it do for me — the patient? Dental cases are never sold on the basis of extensive clinical explanations of procedures. Rather, they are closed-based on easy-to-understand explanations of the benefits of treatment. By carefully explaining each life and health-enhancing benefit of treatment, you can motivate patients to accept treatment. The Levin Group suggests that dental hygienists state the major benefits of any treatment at least three times throughout each case presentation. The consequences of delaying treatment also should be reinforced during the treatment presentation.

• How long will it take? Most patients feel inconvenienced by the time required for dental treatment. Merely telling patients that treatment will require a specific amount of time may not close the case. Therefore, it is important to explain to patients that the time stated is necessary to complete their treatment effectively and with excellent quality.

If necessary, divide the treatment into steps or phases so patients will not feel as if treatment is a never-ending process. For example, "Dr. Smith will coordinate your treatment, and it usually includes two visits. For the procedure, the first visit will... The second visit will ... These steps are designed to guarantee the final result is excellent." Always let patients know that treatment will be scheduled in convenient yet timely appointments, while emphasizing that quality is more important than the time required to complete the procedure.

• How much will it cost? Ultimately, this is the question that determines whether or not treatment will be rendered. Generally, the meaning behind this question is not, "How much does it cost?" but rather, "How am I going to pay for it?" Flexible payment options are critical, and patients should be aware that they have alternatives so they can take advantage of treatment. While the office may have a financial coordinator on staff for the discussion of specific details, the hygienist certainly can help support the patient's awareness of financial options. For example, "This is definitely an important investment in your long-term oral health and esthetic appearance. Our practice financial coordinator will be happy to discuss fees with you and work to provide you with an affordable payment plan."

When presenting treatment options to patients, you should think of yourself as a typical consumer. What do you evaluate each time you make a significant purchase, particularly one for yourself? Your patients are the typical consumer! Make a note for your next staff meeting to answer these questions for your top elective services the practice provides. Role-play the scripting with team members and then implement the new scripts and monitor the increase of case acceptance on treatment pre-presented in your room.

The doctor and hygienist must take time to jointly develop the practice's "selling" style. Before you initiate any of these steps, the two of you should sit down to review his or her philosophy on dental care as it pertains to preventive, restorative, elective, and esthetic services. All too often, the Levin Group has found that dentists and hygienists rarely review their own personal philosophy on treatment before they enter into an employer/employee relationship. A meeting on the top 10 procedures and answering the question above is a good start. However, the two of you should have a more involved discussion surrounding benefits of treatment.

Never explain to a patient why you want them to do something — instead, tell them why they should want to have it done. Real education will build value and leave the patient with a clear understanding of what they are to do to correct or improve any dental situation in which you have facilitated the creation of a treatment plan for them.

The ability of the practice to provide optimal dental care depends on case presentation and patient acceptance of proposed treatment options. My clinical and management consulting career has clearly demonstrated that the hygienist can play a pivotal role in moving patients toward oral health. Using your education and motivation skills is important in case presentation. You must be able to effectively explain the procedure, benefits, time and cost to patients while easing their worries and motivating them toward treatment.

Be sure to set up a meeting with your doctor to jointly develop a treatment philosophy and case presentation system with which you are both comfortable. Work with the entire team to identify the motivational factors and benefits of your top 10 elective procedures and develop effective scripting to communicate these benefits effectively to patients. Lastly, work to implement this system into the practice in a consistent manner. The practice will experience an increase in the production it sees because of your efforts and, in the end, you will have a more fulfilling and stimulating dental hygiene career.

The pitfalls of case presentation

Most hygiene departments should generate at least 25 to 30 percent of a practice's gross production. One way to ensure this is by becoming a master at "pre-presenting" cases to patients. While there are many approaches to case presentations, there are also many obstacles that you should avoid. Below are seven of the most common pitfalls that you should steer clear of as you become more comfortable with your role as an educator and motivator:

1. Providing Only Clinical FactsWhile you understand clinical jargon, your patients do not. Concentrate on explaining procedures and their benefits to patients clearly and in layman terms.2. Assuming Who Can and Cannot Afford TreatmentIt is difficult to assess whether or not a patient can afford to pay for treatment. Present optimal treatment options to every patient as if money is not an object. You will often be surprised by the patient's response. Provided with good information and motivation, and attractive financial options, patients will tend to accept presented treatment.3. Waiting for the Patient to AskThe patient is not going to ask you to present various options. Patients have limited understanding of their oral health, what their treatment options are, or what is available to them. It is the role of you and the rest of the dental team to proactively educate them. 4. Not Using Scripts for Training and Role-playingTo deliver a clear, concise and consistent message, treatment presentation must be scripted. However, scripts will be of no use if you do not practice by role-playing to become comfortable with the conversation.5. Not Cultivating RelationshipsThe dental hygienist/patient relationship should be built on trust and mutual respect. If patients do not like or trust you, they will not accept treatment, regardless of your selling and presentation skills.6. Being too Busy to Identify or Discuss Larger CasesMost hygienists find their work days extremely full and hectic. It is important to make sure that you must not be too busy to identify treatment requirements and educate patients about their choices. With a good case presentation system, you can pre-present small as well as large and higher revenue-generating treatment plans.7. Becoming Complacent
You cannot afford to become complacent with your case presentation skills. Even if your case presentation system works well, you can always learn new skills and approaches for effectively pre-presenting treatment options to patients. The more you present cases, the better you will become at it.

Angela M. Pickett, RDH, MAS, is vice president of consulting for Levin Group, a national dental practice consulting firm. She brings leading edge, strategic business solutions to dental practices worldwide. Ms. Pickett and her team of consultants are dedicated to what has become known as the Levin Group Method, which provides all clients with superior service to improve the quality of their lives and practices. You may contact Levin Group, Inc. at (888) 973-0000 or consulting@