What’s to think about?

Jacqui Goss explains one way to persuade patients to stop thinking about treatment plans and start actioning them

Let’s face it, as brilliant as your clinical work may be, as far as patients are concerned, a brand new washing machine, bike or holiday will trump it every time. Which is why of all your patients who say they’ll think about the treatment plan you offer them, only some ever return. If they get home to find the washing machine has broken, the children want new bikes for Christmas or there’s a deposit due on a holiday, your treatment plan is history (unless they’re in pain).

Never mind, you’ve still had the examination fee and 50, 60, maybe even 70% of your patients do return for treatment. But think if you could increase that proportion to 80, 90 perhaps nearly 100% – suddenly that £25k high-tech, state-of-the-art dental chair would no longer be a dream.

To achieve such an increase is, I assure you, simple in concept and only a little trickier in practice. You need to do what has become known as treatment co-ordination – because it is often carried out by treatment co-ordinators (TCOs) – so you can concentrate on dentistry.

Few of us like making instant decisions when it comes to spending sizeable sums. Hence, when given the price quote for a new car, three-piece suite or, even, dental treatment, our usual response is: ‘I’ll think about it’.

To you, as a dentist, this probably seems perverse. After all, you’ve brought all your training and experience to bear examining a patient, have detailed the dental work essential for their oral health and given them a fair price for undertaking it. Nevertheless, dental treatment is not what retailers term a ‘distress purchase’ – one that requires an instant decision. Replacing a flat car battery or a broken washing machine are distress purchases.

Like it or not, you’ll invariably be obliged to allow your patients to think about it. Which is where treatment co-ordination comes in. Left to their own devices, patients ‘thinking about it’ may come to all sorts of conclusions. A friend may say it sounds expensive. A spouse may be worried about how to pay for it. Any number of people may say: ‘Ah but did you ask about…’

Overwhelmed by concerns and unanswered queries, many patients will simply stop ‘thinking about it’ and you’ll never hear from them again.

Your patients may also not be as loyal as you think. A recent survey commissioned by dental corporate, Oasis, found that barely more than a third of those aged 16 to 24 described themselves as ‘loyal’ to their dentist. Almost half of patients under 35 admitted to researching treatments online before deciding to go ahead.

Treatment co-ordination
A good treatment co-ordinator can significantly improve the take-up of treatment plans – typically, I see an increase of around 30%. I emphasize good. A number of things are critical.

The person (or persons) doing treatment co-ordination must be sympathetic and understanding of patients’ concerns. This is not an exercise suggesting the placement of a metaphorical horse’s head in a patient’s bed. They need to understand and be able to explain terminology – such as the difference between an endodontic treatment and an apicectomy procedure or why a crown might be required following treatment. Importantly, they should not be the endodontist or profess to have clinical knowledge – patients are only likely to open up and discuss their concerns with someone ‘on their level’. Remember also that as a practice you must comply with CQC regulations of informed consent – Outcomes 1, 2 and 3.

Treatment co-ordinators need to have the time to chat with patients – so forget about giving the task to busy receptionists. Treatment co-ordination is best undertaken by phone at times convenient to patients and invariably when they are at home, in their own ‘comfort zone’, which typically means evenings and weekends. Unless you’ve undertaken treatment co-ordination, you probably won’t appreciate the topics that come up in conversations and the concerns that have kept patients ‘thinking about it’.

Real life examples
I recently spoke to a man whom the dental practice had not heard from for some weeks following an examination and the presentation of a treatment plan. It turns out he’d given up smoking as advised – in order for the dental treatment to be effective. He was giving it several weeks to make sure he didn’t relapse into smoking again. Once I learned this, I offered encouragement over those several weeks, which he much appreciated, and, bingo, he subsequently went ahead with the treatment.

In another case (I have many more examples than there is room to include here), a patient told me he felt he’d been ‘taken for a ride’ about the cost of treatment, having been told £7k to £8k initially, referred to a specialist and told £16k to £18k and then finally given a treatment plan for more than £32k. He used words such as ‘a bit negative’, ‘cocky’ and ‘blasé’ to describe the people he’d dealt with.

A lost cause? Certainly, he would have been without someone contacting him. Worse, he would have told all his friends and colleagues about the way he felt he was treated. As it transpired, he was keen to proceed with some treatment and could afford the amount initially quoted. I relayed this to the principal dentist who offered the patient his apologies, a goodwill appointment and referral to a different specialist for assessment of treatment within his budget. The patient was very pleased at this outcome. Result!

The topic of money
Leading on from this last example, the cost of the treatment and how they pay for it will be an important consideration for many patients. The treatment co-ordinator needs to be prepared for this and should, ideally, be able to offer options such as staged payments, low interest or interest-free payment terms and discounts.

In my experience, if the subject is dealt with professionally but sympathetically, patients are happy to provide an insight into their financial circumstances. I have spoken with people who have said they wish to proceed with a treatment but are waiting for probate proceedings to be completed, which will release a financial inheritance. Others have said friends or relatives have offered to pay for the treatment as, for instance, a birthday present.

The point you will have no doubt grasped is that unless you undertake treatment co-ordination and actually liaise with and speak to your patients post-treatment planning, you can’t possibly know what they are thinking about. And if you don’t contact them to find out and then offer advice, explanations, solutions, sympathy or whatever, a proportion will simply never return.

Something to think about?