File Cabinet Millionaires

You've told patients what they need, some of them even agreed to schedule treatment when they were in the chair, but at the end of the day only a fraction of what you've recommended actually gets scheduled.  I think the term that's often used is "File Cabinet Millionaire".  In other words, if everyone did what you recommended you'd have a awesome dental practice filled with perfect smiles.

The impact of under developed cases on dental practice is staggering.  Everything from poor profitability to low doctor self esteem are on the table.  So what's at the heart of this problem?  Actually there are several underlying issues to look at.

First:  Overwhelmed Patients.

Although we often to think of our patients as having low dental IQs, I doubt we would do any better if we were in the same position.  What if you weren't a dentist and found yourself in the chair seeking treatment for a specific tooth, only to be told that you needed thousands of dollars of unanticipated treatment?  I suspect you'd need to go home and think it over (another way of saying you're going to go home of try to forget this ever happened).

I fear that too few doctors or their assistants know where treatment is really sold.  Most believe that it's all about the case presentation or the "close".  Nothing could be farther from the truth.  A common practice is for a doctor to repress a patient's questions during their examination.  This is understandable because the doctor often has another partially treated patient in the next op, and at least one patient waiting to be checked in the hygiene department.  While this is understandable, in the end the overwhelmed patient always has the same response to a perfectly worded treatment plan presentation:  "I want to think it over".  That's another way of saying "Game Over".

So, where IS the treatment really sold, if not during the treatment plan presentation?  Forget where the treatment is sold and focus on where it's bought, that is, where the patient buys it.  The answer to this question is that it's bought during the examination.  When you're examining a patient and you find something, the patient will want to ask questions about what you've found.  A doctor's intuitive response is tell the patient to be patient and wait for the whole picture.  When the patient asks about what you've found and you put off your answer until a time when you can bundle the entire package into an overwhelming, unexpected list of needed dentistry, the outcome can't be anything but "I want to go home and think it over".

Second: Lack of Urgency

While this is often a factor of a doctor's personality, it also comes about as patients are expected to come into our offices already knowing a great deal about their teeth.  Without a smooth and well scripted interaction between staff and patients, most of what a doctor tells patients in the case presentation is not fully understood.

Telling a patient that they have an unexpected problem with a single tooth and that treatment is needed, is usually well received, especially if they are a patient of record.  If the patient is new to the practice and you announce that there are number of teeth in need of expensive treatment, an unprepared patient will naturally flee the office.

Once you've told the patient that unexpected treatment is needed for several teeth, questions about severity and consequences arise in the patients mind.  Add to this a doctor that softens the presentation with waffle words like "you may want to eventually" or "this is a tooth that could cause you problems down the road".  Add these together, waffle words with multiple, unexpected treatments and you've got the perfect formula for patient overwhelm.

Third:  Lack of Team Support

If your assistants fail to portray urgency or value, and your front office staff handle financial arrangements like they're collecting money for a traffic ticket (meaning they don't have to do any more selling), the odds of the patient agreeing to treatment or showing up for their next appointment are weak at best.

While these three points are conceptual, they should help you zero in on aspects of the practice that are contributing to your under developed cases.