Last updated on August 4th, 2023 at 03:29 pm
Today, I want to discuss a critical aspect of treatment planning and case acceptance. And that is: how much treatment should you present all at once?
To set the stage, picture this scenario:
You’ve just completed a thorough oral exam for a new patient, taken X-rays, and identified their chief complaint. The patient needs some scaling and root planing, 2 root canals, 6 crowns, and several smaller composites.
The total cost for this treatment plan comes to around $13,000. However, upon checking the patient’s insurance benefits, you find that they have a $1,500 yearly maximum, of which $300 has already been used. This means they have $1,200 left to cover the $13,000 treatment.
Now comes the crucial part—presenting the treatment plan to the patient.
Would you discuss all of your findings and present the entire $13,000 treatment plan now?
Or would you determine which parts are most urgent and only present those (figuring that you can bring up the remainder in stages over the next couple of years)?
The Wrong Approach
Recently, I’ve been surprised by how many dentists are still doing the latter—i.e., only presenting what the insurance covers or presenting a bit now and saving the rest for the next time the patient comes in.
I would consider that the wrong approach.
This blog post was actually inspired by an experience a client of ours had when purchasing an office recently. As she was reviewing charts and doing exams, it became clear that there was quite a bit of outstanding treatment that the patients themselves were unaware of. It turns out, the prior doctor had essentially been presenting only what the insurance covers.
This was particularly noticeable when a patient came in with a cracked tooth. The patient thought she cracked it by flossing—but obviously there must have been a preexisting defect. When our client dug up the old x-ray, the problem was right there. Why didn’t the patient know about it at the time? Because it wasn’t covered by insurance!
As the new owner, she started doing things differently. Her approach (which I absolutely agree with) is to present everything now, regardless of insurance coverage. If the patient can’t commit to it all yet, that’s fine. The point is, everything is known up front, and then they can now work together get it done in a way that’s best for the patient.
So, using the tools she learned at the MGE Communication & Sales Seminars, she began presenting the full treatment plans. And wouldn’t you know it, now that the patients were really understanding what was going on in their mouths and what it would take to fix it—they started happily accepting and doing more treatment. The practice’s production quadrupled the very first month!
Boost Your Case Acceptance Today!
Looking to improve case acceptance and production? Check out MGE’s comprehensive eBook, designed to empower dentists with proven strategies for improving case acceptance. Discover valuable insights and effective techniques for presenting treatment plans and increasing patient acceptance rates.
Why It’s Tempting to Present a Smaller Version of the Treatment Plan
Look, I understand why it can be intimidating to present a big treatment plan, especially if the patient isn’t expecting it. Asking the patient to pay a significant out-of-pocket amount can be a difficult conversation, and it may seem easier to break the news to them piece by piece rather than overwhelm them upfront and possibly scare them away.
Not to mention, you may worry that the patient will see you as money-motivated if you present them with a big dollar figure right out of the gate.
In this blog post, I want to show you how withholding a portion of the treatment plan actually accomplishes the opposite of your intended effect—making the patient more distrustful of you and ultimately resulting in doing less of the treatment they need to improve their oral health.
Why It’s Important to Present the Full Treatment Plan
1. Honesty builds trust and confidence.
One of the primary reasons for presenting the complete treatment plan from the start is honesty. Patients value transparency and want to know the truth about their oral health—and they deserve the full truth. Avoiding it can backfire, leading to upsets and negative reviews.
Think of it like this: if you brought your car into a mechanic, wouldn’t you expect them to tell you everything that’s wrong with your car?
And wouldn’t you be a little annoyed if every time you came in for a service, they told you about another problem that needed to be fixed? You would start to wonder why they didn’t find all the problems in the beginning.
You might even start to think they’re a little sleazy, coming up with a new thing to charge you for every time you see them.
And that’s how dentists can unintentionally create the distrust that they were trying to avoid by abbreviating the treatment plan!
By disclosing all necessary treatment, even if they are not covered by insurance, you establish trust with your patients. Believe me, they will appreciate your openness and honesty, which fosters a positive and strong dentist-patient relationship.
2. Preventing complications that can arise from delayed treatment.
If you present the full treatment, maybe the patient will accept all of it now or maybe they won’t. But if you never present it in the first place, you know for a fact that this treatment isn’t getting done now.
And look, clinical decisions are up to you on what is or isn’t urgent. The one thing I’ll say is that very few oral health issues improve with time. In fact, they tend to get worse. There is a reason that there’s no lesson in dental school for “How to put a tooth ‘on watch.’”
It may not happen often, but we’ve all seen a tooth break unexpectedly or some other complication arise that could have been prevented with prompt treatment. We can make informed predictions, but we don’t truly know what’s going to fail first.
So, the goal is always to do all the necessary treatment as promptly as possible. And you can only do that if you present it in the first place.
3. Getting larger treatment plans accepted and increasing efficiency.
Doing three crowns in one appointment takes significantly less time than seating and prepping for three separate appointments.
The more you can consolidate treatment to get more production done in fewer appointments, the easier it is for both you and your patient.
If you’re consistently doing treatment plans in bits and pieces with a lower value per appointment, this is what makes you feel busy and overworked while your production is actually lower than it should be.
I can’t tell you how many times we’ve taken on a new client that thinks they are maxed out and then within just a few months they’re doing double the production while working fewer hours. By getting more full treatment plans accepted, they can do more in each appointment, and the patients appreciate getting everything completed quickly and not needing to continually come in for appointments again and again over the years.
4. Staying true to your mission.
You’re here to provide the best possible oral care to your community and help your patients achieve and maintain ideal health, function, and aesthetic.
And I doubt you got into dentistry to be an insurance benefit technician. After a while of doing just what the insurance covers and not what’s really best for the patient, it can breed a sort of apathy or burnout and you lose sight of why you got into the profession in the first place.
What if Patients Get Upset About the Price?
This is the fear when it comes to presenting a large treatment plan: what if the patient reacts badly or gets scared away?
There are a few different scenarios that can come up here:
a) The patient just came in for a cleaning/checkup and didn’t expect to need much (or any) work.
We’ve all had this happen before. A new patient comes in telling you they were their last dentist’s star patient. Perfect teeth and gums. No problems. Then you begin the exam…and see a very different story. Of course this patient can’t process the idea that they might need work done because their last dentist told them it was fine.
This is where it’s useful to use your intraoral camera and any other tools you have during the exam. Show them what you’re finding. “Do you see that dark spot there?”, “Can you feel that when you run your tongue over it?”, etc.
This way you can start easing them into the idea that their teeth might not be quite as perfect as they’d thought, so later when you present the treatment plan it won’t be so much of a surprise.
b) The patient says, “Wow doctor, that sounds like a lot of money. I’m not in a position to do that right now.”
This is a normal reaction to any treatment plan with a significant co-pay, and if you want to perform comprehensive dentistry, then you’ll need to be comfortable addressing this concern and overcoming it.
In some cases, the patient really can’t afford it, and you’ll have to make that determination. But in many cases, the money isn’t the real problem. The problem is that they don’t understand or want the treatment.
Saying “I can’t afford that” is an easy way to deflect when you don’t really want the thing you’re being sold. But if something is important to you and you want it, you’ll find a way to pay for it if at all possible. So it’s on us to get them to understand and want the treatment.
Sometimes, this can be an emotional experience for the patient and you’ll get a strong reaction. That’s just the nature of being in the healthcare business. If you’re not comfortable communicating with the patient and addressing their concerns, come to the MGE Communication & Sales Seminars.
And you may be surprised how many patients don’t even have any negative reaction at all.
I was just speaking with a client after she attended the MGE Communication & Sales Seminars. She was amazed when she went back to her office and confidently told the patient, “You know, it would really be better to do a fixed denture here instead of a removable one, although there will be a larger co-pay because your insurance doesn’t cover it.” The patient asked how much it would cost and the doctor told her the price. The patient just said, “Okay, let’s do it!”
This client was shocked at how easy it was. She had been missing out on a ton of potential production before because she had been presenting options timidly and assuming her patients wouldn’t want to pay out-of-pocket.
c) The patient gets angry and/or accuses you of being money-hungry
Occasionally you’ll get that patient that says, “Geez, are you trying to get me to pay for your new boat?” or “What kind of scam are you running here?” or “I got a guy down the road that’ll do it for $400. This is a rip-off!”
These types of reactions are rare, but because of human nature, these incidents stand out stronger in our minds and it starts to feel like every patient must feel this way. We forget about the twenty polite patients that were grateful for your service and only remember the one or two that got antagonistic.
If you stop presenting full treatment plans because you fear an occasional reaction like this, you’re doing a disservice to the majority of your good patients in order to cater to the occasional problem patient.
And honestly, getting a reaction like this early on from a patient can be a blessing in disguise. If they really are a problem patient, you may decide to refer them out before a bur ever touches a tooth, and then you don’t have to deal with complaints or lawsuits that may come later on from people that want to make trouble.
So, there I’ve laid out why I always think it’s best to present all your findings and the entire treatment plan to the patient.
Of course, this means your office needs to have good case acceptance protocols in place and design your schedule in a way that gives you enough time to thoroughly present treatment and address the patient’s concerns.
If you need help with any of this, schedule a free consultation here and we’d be happy to give you some pointers.
I hope this helps!