Inside Dentistry
October 2008
Volume 4, Issue 9

Get the Second Opinion Right the First Time

Roger P. Levin, DDS

Jane had just accepted implant treatment for a missing mandibular second molar. She was impressed by Dr. Washington’s presentation. He emphasized how the implant would restore chewing capacity, prevent future bone loss, and stop any adjacent teeth from shifting. He said implants were now recognized by many practitioners as the standard of care for missing teeth. He highlighted that this treatment would be an investment in her oral health. She liked the sound of those words. Jane was motivated to move forward with treatment, but she had some nagging doubts about the cost. At the front desk, Jane expressed those doubts to the scheduling coordinator: “Dr. Washington said I should get an implant for this missing tooth in the back. I want to, but I’m just not sure. I don’t like having a missing tooth, but the money...it’s a big factor. What would you do?”

How would your scheduling coordinator respond?

Response A: “You could probably wait to get that done, especially if the money is a factor.”

Response B:“I don’t know. I just schedule the appointments.”

Response C: “Jane, I understand your concerns, but with this treatment you’re making an investment in your oral health. Dr. Washington has performed this procedure for years, and patients have loved the results. We have great payment options that make implant treatment very affordable.”

If your team is not saying something similar to Response C, then your case acceptance ratio is probably not as high as it should be.

Support and Validation

Patients often will seek a second opinion from a staff member about proposed or recommended treatment. The more expensive the treatment, the more likely patients will ask one or more staff members for a second opinion. Patients want to be reassured that they made the correct choice, whether the treatment is implants, crown-and-bridge, or veneers. Even though Jane may have agreed with Dr. Washington initially, she still had lingering doubts. This is where the scheduling coordinator and other team members needed to reinforce Dr. Washington’s recommended treatment.

Almost every patient, at some point, will ask the front desk staff’s opinions about proposed treatment. This can be a blessing or a curse. It depends on how well trained the team is on the practice’s services and the staff’s ability to reinforce what the dentist has outlined as best options for care. The front desk staff is often the last line of defense and can make a significant difference in the amount of case acceptance. They can act as more of a friend to patients than the dentist, who comes across as the expert.

Training the Team

Levin Group has observed that every patient has a minimum of four contacts with individuals in the dental practice during a regular visit: (1) the front office staff; (2) the operatory assistant and hygienist; (3) the dentist; and (4) the financial coordinator or scheduling coordinator at the appointment’s end. Each of these contacts is an opportunity to enhance the relationship and add value to the patient’s overall practice experience. This will not happen, however, without clear and consistent communication from the entire team.

The way you and your team communicate with patients affects every practice operation, especially scheduling, case presentation, and account receivables. With the right training and coaching, staff members can learn to improve their verbal skills, which will benefit both the team and the practice.

The Power of Scripting

Practices are always searching for effective ways to train their teams. For more than 23 years, Levin Group has advocated the use of scripting as one of the best training tools practices can provide their team members. With scripting, nearly every aspect of the patient experience can be documented and scripted. The more scripts your practice uses, the better trained your staff will be. It may seem difficult and time-consuming to script every type of patient interaction, but the payoff is well worth it. The more information you can give to your team members, the more empowered they will be to provide high-quality customer service to your patients.

While scripts must be adapted to the speaking style of each team member, scripting conveys a consistent message to patients and sets a tone on how to address issues and develop solutions. The ability of your dental team to communicate effectively and efficiently will have a positive impact on the financial health of your practice. When well-trained team members effectively communicate the benefits of treatment, the staff reinforces the recommendations of the dentist, resulting in increased case acceptance.

When scripting is implemented consistently throughout the practice, practice owners see marked improvement in three critical areas: (1) patient trust; (2) treatment knowledge; and (3) staff enthusiasm.

Patient Trust
In most situations, patients are willing to accept major treatment plans only after building a strong relationship with the practice based on mutual trust. The dentist may motivate an individual to accept treatment, but it is often the team who persuades the patient to follow through with treatment.

Even if a tremendously positive relationship exists between the patient and the dentist, the individual will not automatically accept a comprehensive restorative or cosmetic treatment plan without having more questions. Often, when the dentist finishes the case presentation, the patient will turn to an assistant or hygienist and ask for his or her opinion on the treatment plan. Relying on the trust factor the patient has for the practice, the team member should reinforce treatment benefits as well as the dentist’s clinical skills by using positive statements to answer any remaining patient questions. Scripting can help team members properly handle these and other patient interactions.

Treatment Knowledge
Scripting trains the team to provide accurate information to patients consistently. As staff members role-play and learn their scripts, they become more knowledgeable about all the practice’s services. Team members become more confident in presenting treatment information to patients.

Scripting keeps all team members on the same page. When patients have concerns or ask questions, team members can provide consistent and accurate answers. If patients hear conflicting information from staff members about recommended treatment, patients become confused and may turn down the recommended treatment. When team members fully communicate the treatment benefits in a coordinated manner, the staff reinforces the dentist’s recommendations, resulting in increased case acceptance.

Staff Enthusiasm
Enthusiasm is one example of how a dental team not only needs to be trained in what to say to a patient, but also how to talk to a patient about a specific treatment. If a member of the dental team does not believe in the treatment, the patient likely will pick up on that negative feeling and may decline the recommended treatment plan.

The dental team will develop a positive, enthusiastic attitude toward treatment plans through a combination of education and motivation. In addition to scripting, coaching is another technique to help the staff stay focused, positive, and motivated. Structured morning meetings represent one of the best opportunities for the dentist and senior team members to emphasize and reinforce the benefits of superior customer service. Coaching should occur before and after patient interactions, especially when the practice has new team members on board.

An educated and motivated staff is able to positively present and reinforce treatment plans with patients. For example, if a patient asks about whitening and the team member can reinforce the benefits of having a beautiful smile enthusiastically and confidently, the patient often will accept treatment. Using power words like “great,” “fantastic,” and “terrific,” is a critical way to build this sense of enthusiasm with patients.

Here’s an example from Levin Group’s extensive script library:

Scheduling Coordinator: Mrs. Jones, I hear you’ll be getting some smile enhance-ment. Congratulations! You’ll love the results.

Patient: You think so? I don’t know. I’m having some second thoughts. It seems a bit self-indulgent.

Scheduling Coordinator: You deserve a great smile. After it’s done, you’ll look terrific and you’ll feel even better. All of Dr. Washington’s patients rave about the results.

Patient: Well, I do need something to rave about. Thanks.

Scheduling Coordinator: Okay, let’s make that appointment.

Notice how the scheduling coordinator reinforced the dentist’s recommendations by emphasizing the benefits of a whiter smile and using power words and phrases (“love the results,” “deserve a great smile,” “terrific,” etc). The journey from case acceptance to case completion can be a challenging one, unless you have a team who can support you with the right communication skills.


Patients really do seek a second opinion in dentistry—usually not from another dentist, but rather from a staff member. When trained in verbal skills and scripting, the dental team can provide the enthusiastic, positive reinforcement patients need to make critical case acceptance decisions. When “Jane” turns to your assistant or scheduling coordinator and asks about whether she should go through with the recommended treatment, how will your team member respond? Do you know? Don’t let the second opinion give your patients second thoughts. Get it right the first time.

About the Author

Roger P. Levin, DDS
CEO, Levin Group
Owings Mills, Maryland

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