Making It Easy for Patients to Say 'Yes' - The complete guide to case acceptance

Chapter One  Leadership: The “Friendly Spirit” of Case Acceptance: The Role of Leadership In Case Acceptance

 

There used to be times when I’d swear that my dental practice was haunted.  Odd things would happen and nobody could explain why: patient records would vanish, then reappear months later; team members would fight like demons one day and hug each other the next; one day we’d make lots of money, the next day we’d be giving it back.  The biggest mystery, though, was the patients.  Some were angels, others were “phantoms of the operatory”—especially during case presentation.  Some would hear my treatment recommendations, smile, and say “Yes.”  Others would sit there listening to me and as I’d get more into the technical aspects, they’d enter into an altered state as if they were hallucinating. 

 

There was no doubt about it—my office was haunted.  I had poltergeists—mischievous spirits that would make things happen for which there was no explanation.  How about you?  Do you have things going on in your office for which there is no explanation, especially concerning case acceptance?  I’ll bet you do.  This chapter will help you solve some of the “mystery” in your office by introducing a way to get rid of your hidden demons: leadership.  Leadership is the friendly spirit that makes case acceptance—and everything else that’s good—happen in your practice.  Leadership makes it easy for patients to say “Yes.” 

 

What is Leadership?

In Principle-Centered Leadership, author Steven Covey states that “leadership is the organization of people while management is the organization of things (i.e., systems).”  The profit center in dental practices revolves around the dentists doing dentistry, not managing systems.  Thus a dentist’s ability to organize people to manage the systems in the practice is fundamental to his or her profitability.  Let’s further define leadership in dentistry as the ability to organize people to create a blend of clinical, organizational, and relationship/communication expertise.  So the greater the complexity of care you offer, the more necessary it is for you to do this. The fundamental truth about advanced restorative dentistry is this: the greater the complexity of care you offer, the greater the demand for leadership skills.

 

Excellence Versus Leadership

Throughout this book I will make several distinctions.  The first one is excellence versus leadership. Excellence is not a substitute for leadership. Most advanced continuing education (CE) courses do a great job of teaching clinical excellence.  However, there are many aspects of excellence that patients don’t perceive, such as perfect margins, tensionless flap approximations, tertiary anatomy, to name a few.  In many ways, excellence is a personal experience enjoyed by you and your team.  Often we alone know how good our restorations are.  The impact of leadership, on the other hand, is immediately apparent to patients—great teamwork, supportive/nurturing relationship skills, on-time appointments, etc.  Leadership must be the constant companion of excellence because it signals the presence of excellence, which may otherwise be imperceptible to the patient. 

 

Leadership must be the constant companion of excellence because it signals the presence of excellence, which may otherwise be imperceptible to the patient.

 

The Leadership Curve™

The Leadership Curve is a unique way of looking at leadership in dentistry.  It illustrates how leadership requirements advance dramatically as the clinical complexity of care increases.  It demonstrates how leadership is a prerequisite to practicing profitable, low-stress, advanced clinical care.

 

Figure 1-1 shows clinical skills, organizational skills, and relationship/communication skills.  The vertical axis of the Leadership Curve represents the level of leadership.  The horizontal aspect represents clinical range—the level of care you wish to provide.

 

FIGURE 1-1

 

 

 

The Leadership Curve begins at tooth dentistry.  Tooth dentistry means simple operative and general dental procedures, treating one tooth at a time.  The level of leadership required for tooth dentistry is relatively low compared to that for complex care.  Many dentists who are early in their career, exclusively doing tooth dentistry, are associates or are in residencies where they have little or no leadership responsibility.  A good facility, reasonable overhead control, and staff that can manage the processes of delivering simple dentistry can get the job done.

 

As we move from left to right on the complexity of clinical care axis, tooth dentistry evolves into quadrant dentistry, where more than one tooth at a time is restored.  Typically, quadrant dentistry involves two or three teeth.  Fees for quadrant care are higher, laboratory relationships are more critical, and appointment control gets more complicated.  Overall, the leadership requirement for quadrant care is greater than that for tooth dentistry. 

 

Notice how the Leadership Curve turns sharply upward as the clinical complexity of care increases past the vertical line labeled “Centric Relation Dentistry” in Figure 1-1.  It’s at this point that the complexities of the conditions in the patient’s mouth require the dentist to alter one or more of four critical clinical variables: anterior guidance, plane of occlusion, vertical dimension, and condylar position. Typically these alterations are necessary when more than four teeth per quadrant are restored.  When one or more of these variables are changed, the complexity of care dramatically increases, as does the demand for better leadership (organizational and relationship) skills.  Notice the labeled aspects of organizational and relationship skills along the ascending Leadership Curve.  Don’t assume, however, that this implies a rigid implementation sequence of these skills.  Rather, this sequence is marked in a way that makes sense for most dentists.

 

Left-Side Versus Right-Side Patients

Throughout the remainder of this book I will make a distinction between procedures and patients relative to the centric relation line on the Leadership Curve—left-side and right-side (Figure 1-2).

 

FIGURE 1-2

 

Left-side patients are those with minimal conditions who do not require changes in their anterior guidance, plane of occlusion, vertical dimension, and condylar position.  Operative dentistry, single crowns, and quadrant dentistry are examples of left-side procedures and occur to the left of the centric relation line.  Other left-side procedures include simple periodontics, endodontics, and tooth whitening. 

 

Right-side patients are those whose clinical conditions require changes in anterior guidance, plane of occlusion, vertical dimension, and condylar position.  Typically these procedures include cosmetic rehabilitations, partial and full reconstructions, and implant dentistry.

 

The descriptors right-side and left-side are used to make an important distinction between patients.  These descriptors are not intended to suggest that right-side patients are better, smarter, more worthy of high-quality dentistry, or more deserving of your respect.  Right-side and left-side simply are easy-to-remember labels for distinctions among patients.  By making this distinction we can create the best possible experience for both right-side and left-side patients.

 

The “Making It Easy” Process

Most dentists do well with case acceptance for left-side patients; it’s the right-side patient for whom we need a solution.  This book shows you how to make it easy for right-side patients to accept treatment.  You’ll be able to apply the lessons learned here to left-side patients as well, making the entire case acceptance process a better experience for you and your team… and making it much easier for patients to say “Yes.”

 

Different Strokes for Different Folks

Your experience of practicing dentistry is significantly different on the left and the right side of the line (Figure 1-3). 

 

FIGURE 1-3

 

 

The differences between left-side and right-side dentistry are significant both from the perspective of the technical requirements of care and the organizational and relationship aspects.  Right-side dentistry has much higher fees attached to it.  Consequently, the impact of insurance is minimized; how the dentistry (fees, schedule, hassle factors) fits into the patient’s life is pivotal; the level of customer service must be higher; there is a much greater need for relationship skills; and the influence of the team is critical.  Because...