Engaging the Patient to Improve Case Presentation

The formal concept of "case presentation" in dentistry originated in the 1980s when selling was first introduced to the profession. Before then, words like "sales" or "selling" typically weren't used and may have even been considered unethical. The doctor or treatment coordinator simply informed patients of what was needed, and the patient usually accepted whatever treatment was offered. There was no systemized approach to presenting cases. The success of the case presentation generally depended on the size and fee of the case along with the persuasiveness of the presenter.

While that decade ushered in a new way of thinking in which selling became more acceptable, case presentation still did not change all that much. Despite the availability of training articles, books, and seminars on the topic, most dentists simply continued to tell patients what they needed and were satisfied with whatever results they got.

Unlike most other practice management systems that can be executed in a step-by-step fashion with excellent results, case presentation is, to a large degree, an art. There are, however, specific techniques that when applied consistently and appropriately can improve case acceptance rates. Certain principles can be followed and mastered to improve case presentation, especially for comprehensive and elective cases. These principles, as outlined in the following paragraphs, are even more important given the present challenging circumstances due to COVID-19 as patients may be experiencing financial difficulties or higher levels of fear about dental procedures, or both.

Build relationship in the first new-patient phone call. Most new-patient calls focus on functional tasks, such as scheduling the patient and acquiring demographic and insurance information. In a new-patient phone call the front desk coordinator should concentrate on building the value of the practice and developing a relationship with the new patient. The conversation should be focused on learning about the patient, finding out who referred the patient, complimenting the referral source, telling a scripted story about the practice to build value in the mind of the patient, scheduling a convenient appointment, and acquiring necessary information. Finally, the front desk coordinator should thank the new patient for calling and encourage them to reach out with any questions they may have.

Warmly welcome the new patient. Prior to COVID-19, it was common to welcome new patients on their first visit by reviewing a hard copy of a "welcome packet." With the current emphasis on "contactless" and "paperless" appointments, dental offices can still reinforce the level of quality and commitment of the practice by remotely reviewing the "welcome packet" during an orientation phone call or virtual appointment. The new-patient orientation can be as short as 5 minutes, but it is a powerful opportunity to establish a solid relationship with a patient.

Foster the doctor-patientrelationship.The doctor should perform the initial examination for most new patients over age 30. The examination process should be highly structured and focused on the doctor getting to know the patient as a person. This fosters the initial building of a relationship in the hope of the doctor gaining trust and the practice creating a lifetime patient.

Create the right environment. Treatment should be presented in a well-designed consult room that allows for social distancing and is uncluttered and comfortable with warm colors. The consult room should be a setting that encourages a calm, relaxed conversation between the doctor and patient.

Display the right body language. Body language is a critical component of successful case presentation. In today's environment, personal protective equipment (PPE) is prevalent. While smaller cases may be discussed in the operatory, for larger cases the doctor needs to overcome the limits of "dense" PPE to be able to display energy and confidence. The patient, therefore, should be moved to a separate consult room, and when the doctor enters the room, he or she should already be smiling and prepared to energetically greet the patient. During the presentation, the doctor should sit at eye-level with the patient (at a proper social distance) and avoid folding his or her arms, hands, and legs.

Traditionally, case presentation has involved the doctor telling the patient what to do. Yet even after the benefits of the treatment and all the other key information have been described, it is still the patient's decision to make. Therefore, the patient needs to be allowed to participate in the conversation. Here are some suggestions on how to facilitate this:

Let the patient talk. The doctor should stop talking every 10 to 12 sentences and ask the patient a question or let the patient talk. Patients should be encouraged to ask questions and let the doctor know what they are thinking. The more patients talk the more likely they are to accept the case.

Never interrupt a patient. By allowing patients to talk, the doctor is engaging them in the conversation and making them part of the process. People want to be involved and know what the treatment will require in terms of time, inconvenience, discomfort, and money. Clinicians should bear in mind that patients are increasingly using the Internet to do their own research and may come prepared with information and questions or intend to do more research after the case presentation.

Take a pause. During the course of the presentation the doctor should pause, allowing the patient to interject and ask a question, express a feeling, or make a point. This can lead the conversation to the main reason for the treatment and give the doctor the opportunity to focus the conversation on that very reason.

Once a good conversation has taken place, the patient will have moved significantly toward accepting treatment. This is the time to ask the patient if he or she would like to move forward with the treatment. By simply asking the patient, "Would you like to have this done?" the doctor is creating an opportunity for the patient to think about a decision. A response of "Let me think about it" typically indicates a financial concern. Letting patients know of the availability of financing options, including interest-free financing, can open their mind to the possibility of having the treatment even if it might be beyond their current financial means.

Case presentation should be viewed as a conversation between a doctor and a patient. Dentists can greatly advance trust when they engage patients with questions and pauses, show energy, build value, and develop a meaningful discussion. This should result in patients understanding the need for the treatment, believing that the doctor and team care about their best interest, and accepting the doctor's recommendations.

Roger P. Levin, DDS
CEO and Founder, Levin Group, Inc. (levingroup.com), a practice management consulting firm that has worked with more than 30,000 dental practices