CASE ACCEPTANCE RATE

Without a doubt this is the most overlooked indicator for most practices.  Think of it as a gauge to determine your ability to build relationships and gain the trust of your patients as well as their approval of the treatment you prescribe, because that is what you should be trying to accomplish in your business. Without case acceptance, poor cash flow and financial stress will follow. Please make sure you read “100% Case Acceptance” located at the bottom of this page 

Here is a maxim that will serve you handsomely for the rest of your career:  if you give your patients what they want, you in turn will get what you want.  Patients look to you to present them with the dental treatment they require to possess optimal dental health.  In some cases, that can be expensive (by the way, “expensive” is a relative term. What may be cost prohibitive for one is readily affordable for the next).

That four letter word is bound to pop up:  SALE.  Marketing and sales are the foundation of any successful business.  I know that you do not view dentistry as having a sales component, but every one has it, for if not , no treatment or services would ever be rendered. 

Do not confuse “selling” with overselling.  If you recommend an extraction of #4 and then a bridge from 3 to 5 when you could have just done an RCT and buildup and crown on #4. That is overselling. Any service that is in the best interest of the patient is what we are referring to and we discourage diagnosis to bulk up your bank account. 

I suggest that you study the sales process by reading books on sales and listening to sales CD’s in your car.  My approach is that I understand that no one wishes to listen to a sales pitch, but everyone loves to buy.  Present their treatment plan and reveal the benefits your patients will enjoy by accepting your treatment plan. Your presentation should bring your patients to an emotional threshold that compels them to accept your treatment plan. 

Buying decisions are based on emotions, not logic. Remember that when you are presenting to your patient. Use affirming language such as “I know you want the best treatment available and you deserve it” or “You deserve the best, don’t you?” or “Wouldn’t it be great to have worry-free dental health?”

Most dentists truly do have their patient’s best interest at heart and their compensation is secondary.  Replace the term “sale” with the term “persuasion” or improving your patient’s dental IQ.  How well you can persuade and educate your patients to accept treatment that is in their best interest will benchmark your effectiveness as a dentist.  Do not confuse “persuasion” with “coercion.” So many dentists I consult tell me that they would never sell dentistry. Every one who has stated that is guilty of underselling dentistry and that does not serve your patient’s best interest.  

Practices that do an excellent job of selling dentistry generally have fewer patient complaints and also better cash flow than offices which focus on “herodontics.” Many of us attended dental schools that attracted lower income patients who could not afford premium dentistry and as such we go to great lengths to save our patients money. 

That tooth with the broken cusp needs a crown--you know it and it is your responsibility to make sure that your patient understands the value of the crown.  Rarely do recipients of crown and bridge complain that they should have gone for the pin retained amalgam and saved some money, but you will get many complaints when that 5 surface composite fractures two months after you place it. 

Another bad choice is the “wait and see” approach.  “I see that the margins on this old filling are starting to break down. We better keep an eye on this tooth.” Replace that monologue with “These margins are breaking down and your tooth has become more susceptible to leakage and decay. We better place a crown on it immediately.”  If your patient objects, you need to make sure they understand their diagnosis, and raise their dental IQ.  Focus on the  benefits to the patient, such as worry free, pain free dentition.

For the patient who objects your treatment plan, realize that it is for one reason and one reason only:  your patient simply doesn’t trust you.  Relationship building is the cornerstone of developing trust.  Dentists with high treatment plan acceptance rate are beloved by their patients.  They have the desirable skill of creating almost instant rapport with their patients. 

In my own practice, on occasion I would have patients who would become angry when I presented their treatment.  I heard arguments like, “I have been going to another dentist for ten years and he never told me I had these problems. I think you just want to take advantage of me.”  The best way to dispel this attitude is to tell the patient, “Understand that you and I are on the same side. We both want the best for you.  Maybe your dental health has deteriorated some since you saw your last dentist. I will show you what treatment you require and I will explain in detail why it is necessary.”   This approach works every time and I suggest you try it for the patient who is hot under the collar.

The following section categorizes your treatment plan presentation metric. Let’s see how you rate in this important category:

>70%: Looks like you are doing a great job of presenting treatment and gaining acceptance from your patients. You are establishing trust with your patients and your treatment plan coordinator is “closing the deal.”  Many offices are very good at this aspect and frankly take it for granted.  Believe me, this is one of the benchmark qualities of a sound dental practice; keep up the good work. 

50 to 69%: Not a bad conversion rate, but certainly some room to improve.  There are two facets of treatment plan acceptance; Doctor presenting the treatment plan and treatment plan coordinator (TPC) arranging the financial element.  Both the Doctor and the TPC have to do their job well in order to gain acceptance.  Revisit your recent unaccepted treatment plans and see if you can re-appoint these patients for another consultation.

35-49%:  Here is an area that you can definitely improve.  Just a 20% improvement in your case acceptance should increase your profit by 100%!  Either the Doctor is not presenting effectively or the TPC is not closing the sale. Work on establishing the TPP protocol by clicking here (100% Treatment Plan Acceptance further down the page)

<35%: Your practice is struggling and even if it isn’t, you can drastically improve your case acceptance rate and your bottom line. Take into account the production. If it is high, then check wages as percentage of collection.  You may be understaffed and not enough time to present to patients. Review this entire section and work on your self esteem and confidence by reading “Law of Success” by Napoleon Hill.

Those who enjoy a high level of case acceptance employ a system that is based on patient education, high level of trust in the practitioner, and sound closing skills of the treatment plan coordinator. This triad is vital to case acceptance; lack of one of these qualities will lead to “I’ll think about it,” which is a polite way to decline your plan. Your very best chance to close the case is during your first encounter. That being said, I like to have the larger cases return on another day when the entire case presentation can be scheduled and orchestrated. 

Remember that your patient relies upon you and your professional judgment.  They will see right through your lack of self confidence or self image.  Even if you lack these qualities, do not forget that in essence we are all actors on a stage and even if we aren’t confident, we can act as if we are confident. 

How many times have you convinced your patient that they should accept your treatment plan and you turn them over to your TPC, confident they will return soon for tx.  A few weeks pass, and you wonder what happened to that big case.  You ask your office manager and she tells you “Oh, they wanted to think about it.”  That should never happen in your office.  If the patient declines, the Doctor needs to be notified before the patient leaves so he can try to save the case.

Your treatment plan coordinator has to possess a high level of confidence and overwhelming confidence in her dentist.  Their own socio-economic status can come into play as well.  If their subconscious is saying, “I couldn’t afford this--therefore this patient cannot afford this.”  They won’t close any cases with that attitude. 

I know you all have dental software that tracks unscheduled or unaccepted treatment, but I question its values for accuracy.  I suggest that you track you treatment plan acceptance rate on a daily basis, using the Daily Trak component of Practice Hawk software.

I know; you spent all this money for Dentrix or EagleSoft or whatever, but tracking your treatment plan acceptance and new patient tracking is a vital component to improving your practice. The program makes it easy, and it will give you an ongoing conversion rate percentage which can even be broken down by who is closing treatment (maybe you rely on several to close treatment--wouldn’t you like to know who does the best job of closing sales in your office?)

100% Treatment Plan Case Acceptance

Every dentist’s goal should be 100% of the treatment you prescribe for your patients. Before you say that isn’t possible, let’s define “acceptance” a little further. Instead of defining acceptance as that treatment that has been already paid for, let us use a different connotation.

Step one in improving your case acceptance rate is establishing rapport and trust with your patient.  If your patient doesn’t trust you, no treatment will be accepted.  If the case is complex or you feel that you are struggling to build rapport with the patient, re-appoint them to present treatment. 

Step two in treatment plan acceptance is presenting the treatment necessary for your patient and that that they accept your treatment in principle. Do not even discuss cost at this point. If the patient asks about cost, tell them you will get to that. At this point, have the patient totally disregard price. If they need 5 crowns and a four unit bridge and 3 RCT’s, that’s what they need. It is paramount that they totally accept your treatment plan. Your goal is to get your patient on the same page as you.

At this point, your TPC can discuss payment options.  If the patient cannot afford the plan, give them the option of completing their treatment in phases over a period of time.  Even if you can only get them to accept one occlusal restoration, it will get them back into your office and give you the chance to continue building a trusting relationship.

Patients will ALWAYS accept treatment they believe they need and that belief is based on their trust in you.  All that is left is figuring our how to pay for it. It is amazing what lengths people will go to find money for the things they need.

Let’s give you an example of a parallel process that occurs in other businesses. Let’s say your car is running poorly and you take it into your local garage.  The mechanic tells you that you need a new transmission and it will cost $3,000.  You will find a way to get the money to fix your car IF you trust and truly believe your mechanic.  If you do not, you will go to another garage for a second opinion.

Your patient MUST trust your clinical judgment, or they will go elsewhere.  Even if they go to another dentist and get the same diagnosis, that dentist will end up with the case; they will never come back. 

In my practice, I tried to put myself in my patient’s place and determine what treatment I would desire if I were them. Tell them that. “If I had your condition, this is what I would have treated.” 

Make the cost secondary--let your TPC work out the financial details.  It is not your responsibility to determine how your patient will pay for their treatment. The primary goal for the dentist is that your patient agrees with your diagnosis and treatment plan.

I see so many practices where the dentist sits down with the patient and says, “These teeth need crowns; we need to do a bridge over here to replace your missing teeth and these teeth need root canals. Now I’ll hand you over to Jennifer, our office manager and she will work out the financial aspect of your treatment.”  That is weak.  Let’s try this again.

“Mary, you have several teeth with large silver fillings that also are developing fracture lines. (Show Mary her intraoral images on your monitor if you have one.)  In my experience, when teeth break, it is always at night or on weekends when I may not be available to help you.  Let’s repair these teeth now and avoid a broken tooth that may be painful and/or really sharp to your tongue. You are missing this bicuspid and molar on the upper left side. As you can see from your X-ray, your lower molar is beginning to erupt into this empty space. We can restore your bite on the left side with a four or five unit bridge (Show Mary a bridge model so she can see what a bridge looks like.) It will feel like these teeth have magically reappeared!  You will be able to chew on both sides again. You also have these teeth that are developing abscesses; you have infection related to these teeth. We can treat these teeth and eliminate the infection and avoid losing these teeth.”

Now the patient understands what treatment she requires and why.  She will find a way to pay for it.  Maybe you complete her work in phases, starting with the RCT’s, build-ups, and crowns.  At a later date you can complete the bridge.

Plant the seeds of necessary future treatment your patient requires so that you have more time and opportunities to get your ultimate treatment plan accepted. 

If you present to a patient and you just are not getting through to them, find a small, inexpensive restoration and re-appoint the patient to come back for that. I don’t care if it is a buccal pit--get them to make another appointment.  The more time you spend with this patient the greater your chance to build a relationship which leads to trust which leads to case acceptance.

Anytime you meet resistance with case acceptance, ask your patient directly, “What is the chief reason that you do not wish to accept your treatment plan?”  It can be a variety of factors, usually it is financial.  But there can be other more compelling issues: extreme fear of dentistry, pain (some people just do not numb profoundly), sound of the drill, claustrophobia, lack of time to see you. It can also be reasons they may not wish to share with you such as they do not trust you or they question your competence. Your job is to determine their chief concern and then do your best to diminish that concern.

If your patient has a case they cannot afford (at least they state they cannot afford it), give them this offer:  If they refer five new patients to your practice, you will give the patient a 20% discount on their treatment plan.  This is a great practice builder that will generate good referrals into your practice.