The last two years have certainly been challenging times, and many of us have been understandably worried about what it all means for the future of our businesses. The additional weakness of systems that were already struggling prior to the COVID-19 pandemic have become even more magnified and that certainly is not helping us regain our patient numbers.
Since the beginning of the pandemic, we as dental professionals have put a great deal of effort into making our patients feel safe and protected so that they can properly maintain their oral health by receiving any necessary treatment. However, knowing how to execute excellent dental treatment and having the opportunity to provide treatment to our patients are two different things. Getting patients to schedule the treatment we recommend can be difficult, but it is vital to our practices’ success. The acceptance rate should be greater than 80% for existing patients and between 50% and 75% for new patients.1
It is imperative to take the time to explain to each patient why he or she needs the particular treatment, and we must do our best to answer all of his or her questions. Despite receiving all the necessary information concerning the proposed treatment, many patients leave the office without scheduling an appointment for the treatment—some never to be heard from again. While this can be quite a frustrating situation, it can also be an opportunity to make improvements to our systems to raise case acceptance rates.
If we want patients to accept treatment, we need to fully understand what it is they really desire. When we have the same priorities as our patients, our practices’ retention and case acceptance rates will go up. Patients will feel more in control of the process and appreciate that we have really understood their needs and values—thereby fostering loyalty and trust.2 They will not feel pressured into accepting treatment they do not really want. Instead, they will gladly accept treatment that will help them meet their oral health goals.
Engagement with patients
Effective listening is the key to finding out what motivates patients, what they think about their smiles and what it is that they would like to improve.3 It is not about selling dentistry; it is about getting to know our patients and even partnering with them so that we can create a win-win situation. Asking questions, particularly open-ended ones, can help encourage patients to communicate their oral health-related desires; for example:
- On a scale of 1–10 (1 being poor and 10 being excellent), what level of oral health would you like to achieve?
- Have you ever encountered problems with chewing, or have you had mouth or tooth pain?
- How important is your smile to you and to your confidence when interacting with people, both personally and professionally?
- If you had a magic wand, what would you like to change about your smile, if anything?
- Diet affects oral health. Could you please tell me about your diet?
We dentists may be excellent clinicians and superior at treatment planning, but presenting treatment plans to the patient is something better delegated to a well-trained staff member. For example, having a treatment coordinator who goes over every detail with the patient in a comfortable, quiet environment, giving him or her the opportunity to ask questions without feeling rushed, can be very effective. Conversations supported with digital tools to demonstrate treatment options visually also help patients understand the benefits of the suggested treatment and help them feel more connected to the practice, which of course makes them more comfortable about scheduling treatment. If we want to improve case acceptance in our practice, we should ask for the patient’s final decision after presentation of the suggested treatment and explore any barriers to acceptance with the patient.
Unfortunately, dental fears are common and often keep patients from getting the treatment they need. When patients look at before and after photographs of similar cases we have completed, it can help to ease their fear and earn their trust, making them much more likely to accept the treatment. It is imperative that the patient understands exactly what the treatment involves and how we plan to keep him or her comfortable. This includes enquiring about his or her concerns, covering the possible consequences of not receiving treatment and focusing on the advantages of the proposed treatment.
Research has found that nearly 68% of those who avoided or delayed visits to the dentist gave the expense as the primary reason.4 While multiple reasons were given, the cost of going to the dentist was mentioned more than twice as often as anything else.4 Most patients do not put money away specifically for dental care and have no idea how they are going to pay for treatment.5 In my experience, if they are not in pain, patients often convince themselves that they do not need treatment, which inevitably leads to more complicated problems and additional costs down the road.
We should take the time to educate patients in detail before talking about costs, making sure that they understand the value of the care we provide. If it is because they do not really see the value of the treatment, we should educate them about their condition and the possible consequences of not receiving the treatment. Once patients understand why they need treatment, price becomes less of a barrier. In our clinic policies, we should offer different financing options for our patients, showing them that we are also ready to support them.
Lack of time
Lack of time is a common reason for treatment delay. Like most people, our patients are often very busy and may forget to call to schedule treatment once they leave the practice, sometimes despite knowing the importance of their dental health and the importance or urgency of the proposed treatment. To overcome this, we can train our treatment coordinator to follow up with the patient two days or a week after the initial case presentation is made. That way, the conversation is still fresh in the patient’s mind. We can use these calls as an opportunity to educate patients even further and address any lingering concerns. Patients will appreciate the extra effort and gain a better understanding of the recommended treatment and why it is necessary.
Efficient recall and retention programme
Retaining a current patient is far easier and more cost-effective than attracting a new patient, so investing time and effort in an efficient patient recall and retention strategy is essential. In an effective recall and retention programme, patients should visit twice a year.
The recall and retention strategy should involve making patients aware of the practice’s services and the value of the ongoing care that the team provides. This includes the amazing advancements in dental materials and digital technologies and the treatment options available. It is important to emphasise the improved patient experience and faster results that can be achieved with these tools.
In summary, an efficient, structured case presentation policy ensures that patients say yes to our treatment plans. It also addresses one of the core values of dentistry, which is commitment to oral health as a component of the general health of our patients. When we gain and retain patients who value our practice, we will have the opportunity to practise with less stress and more joy in our clinics.
- Philhower J. Measuring case acceptance. Dent Econ. 2015 Sep;105(9):62.
- Dunning DG, Lange BM, editors. Dental practice transition: A practical guide to management. 2nd ed. Ames: Wiley; 2016. 528 p.
- Jameson C. Great communication = great production. 2nd ed. Tulsa: PennWell; 2002. 319 p.
- Armfield J. The avoidance and delaying of dental visits in Australia. Aust Dent J. 2012 Jun;57(2):243–7. doi: 10.1111/j.1834-7819.2012.01697.x.
- Jameson C. Collect what you produce. 2nd ed. Tulsa: PennWell; 2005. 283 p.