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Inside Dentistry
Nov/Dec 2007
Volume 3, Issue 10

Improve Treatment Acceptance: See Fewer Patients, Provide More Care

Robert H. Maccario, MBA

Are you seeing more patients, yet performing fewer treatments? Are you doing “aerobic” dentistry—running from operatory to operatory? Do you commonly hear, “I only want what insurance covers” from your patients? If you and your staff regularly experience difficult situations like these and are ready for a change, the key to improving the daily operations of your office rests in your treatment-presentation process.


Many insurance-based dental practices use a traditional sales model that just does not work in today’s competitive market. After a brief introduction, the dentist jumps right into the examination—sometimes without waiting for a response from the patient. At the conclusion of the examination, the dentist launches into a monologue of what treatment is needed, while simultaneously attempting to educate the patient. The dentist then tries to close on only a portion of the care, either because of time constraints or the patient’s objections regarding insurance coverage.

Because only single-tooth dentistry is accepted, the dentist must run from operatory to operatory and thus no longer has time to perform comprehensive examinations. Because the dentist no longer conducts comprehensive examinations, he or she only receives single-tooth care acceptance. This cycle continues on and on in the classic “hamster wheel” effect, with the hamster wheel increasing in speed, exhausting the dentist and the entire team.


If you want to see fewer patients, yet provide more care—thereby slowing down the pace of your practice—you need a completely different way of presenting treatment. Start with a commitment to clinical excellence, and then give your guests (they are not just your patients anymore) a chance to say “Yes to the Best.” Your guests are presented with an opportunity to buy the best care you can provide—completely unrelated to insurance coverage or a lack of it.

This new, softer approach allows you to stop selling dentistry. Instead, you simply create a buying environment, which increases treatment acceptance. In the “Yes to the Best” model as taught in the Dental Concierge® program, you spend your time developing rapport with your guests—selling is not the focus of the process.


The first step in this process is to find out how your guests buy and why they buy. Your entire team will be involved in developing rapport with your guests while assessing each guest’s personality; when it comes to treatment acceptance, one style does not fit all. People are motivated to purchase based on their own behavioral styles, so your team has to figure out each guest’s style.

The concept I like people like me, and I buy from people I like plays a significant role here. To make sure your guests get a favorable impression, your team should use a behavioral model called DISC that helps identify—and influence—each personality type. “D” represents a dominant personality: someone who moves quickly and does not want to get bogged down in detail; “I” stands for the influential style: someone who enjoys people, moves quickly, and is very outgoing; the “S” represents steadiness: someone uncomfortable with quick changes, slow in decision-making, and looking for a very personal approach; the “C” stands for conscientious: someone very analytical in their decision-making, detail-oriented, and task-centered. Each guest needs to be approached in their own style—the style with which they are the most comfortable.

For example, if you start laying heavy details on the “D” personality, that guest will become impatient; if you try to close hard on an “S” personality, he or she will become uncomfortable. Your entire team needs to become chameleons so they can match styles with each of your guests. In doing so, you are actually showing a great deal of respect for your guests by translating into their style, which makes them comfortable—and thus willing to move ahead with care that is important to their health and well-being.


Now that you have figured out your guest’s personality style, the next step is to understand his or her motivators. People will only do what is important to them, so you must present treatment in terms consistent with their needs and wants to create a buying environment. Over the years, we have found that there are five basic motivators: pain/fear; appearance; time; cost; and health/function. This is known as PATCH. Guests generally tend only to have two motivators: a primary and a secondary. For example, if you have a guest motivated by cost, you must discuss how moving ahead with care is the most cost-effective choice, or provides the best long-term value. If you focus on how much better their teeth will function, they will have little interest—and not accept the treatment plan.

If treatment conferences are regularly running too long, it could mean whoever is presenting treatment is only talking in terms of his or her own motivators, or discussing all five motivators. Either approach will be perceived as impersonal by your guests, which will break rapport and lead to lower acceptance rates.


After the initial communication process, where you have discovered your guest’s DISC (how they buy) and PATCH (why they buy), your staff’s responsibility is now to educate your guest on why your practice is the right one for them. In the Dental Concierge program, it is called creating credibility. At this step, you will need to tie your credentials and practice philosophy to your guest’s motivators. If cost is their motivator, why is your practice the right one for them? Surely it would not be because you are the cheapest—instead, it would be because you offer the best care for the best long-term value.


Next, educate your guest as to what a comprehensive examination involves and why it is important. Your guest certainly does not need a mini dental degree, but you do need to briefly describe the examination procedures in lay person vocabulary before the actual examination and explain why the examination is important to them based on their motivators. If health is their primary motivator, how does periodontal charting help them?

This separation of treatment presentation and education is absolutely key. Most practitioners launch into a monologue of necessary treatment while trying to educate at the same time. When you combine the two, your attempts at education can sound suspicious: are you just spinning the “education” in an attempt to sell the dentistry? But if you describe what you are looking for before doing the examination, your guest knows for sure you are not fabricating information.

Another advantage to this separation: you are not confusing your guest, who can become overwhelmed with information. Yet another benefit is the elimination of “overcoming objections”—because a buying environment means rapport and value are fully developed, most objections never arise. Your best salesperson in this new environment is your best listener, not your best talker. Overcoming objections is a “talking” skill; creating value to eliminate objections is a “listening” skill.


The day of the hard close is over in high-end, finesse practices. This system is known as ACE—where A refers to agenda, or finding the guest’s DISC and PATCH; C refers to creditability, tying practice skills and philosophy to the guest’s motivators; and E refers to educate, raising their dental IQ to appreciate the value of comprehensive care. When implemented by the entire team, guests will close themselves. It becomes a very soft and natural outcome of the entire experience. 

To drastically improve treatment acceptance levels at your practice, (1) begin with a commitment to clinical excellence; (2) understand how your guests buy and why they buy; (3) make your guests so comfortable that they move ahead with care; and (4) watch the pace of your practice slow down—and your productivity and profits go up.


The author is the creator and instructor of the Dental Concierge program. For more information, please contact:

Robert H. Maccario, MBA
Dental Management Sciences, LLC
Virginia City, Nevada

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