Dear reader, thank you for your interest in my blog. I am both proud and happy that more than 1900 Scandinavian colleagues find inspiration in what I write about choice, growth and value creation.
This blog is about patient communication, dental whitening and how this is related to the state of our patients oral health.
A number of years ago, I was faced with a different way of looking at patient needs. The principle is actually very simple, but difficult to accept. If we consider that dentistry originated from the blacksmith who removed painful teeth for the citizens of the city. It's clear that the blacksmith was fulfilling a NEED for his customers. A need to be pain-free.
Wants versus needs
Today's patients still NEED to become pain-free. In other words, there is still a need to extract teeth. The controversial question we should ask ourselves is what other NEEDS our patients actually have. There are no people in the Western world who cannot survive without their teeth. Granted, I realise that an impressive and unique cohort study from Sweden has established that denture wearers lived about 10 years shorter than Swedes who retained a fully functional set of teeth.
But consider this: None of our patients actually NEED anything other than extractions ..... This puts us in a dilemma, as most of us have a different view of our patients' needs. We often see ourselves as healthcare professionals who promote patients' interests by providing needs-based care..... Hmmmm......
I would argue that we do meet some WANTS from patients and I would go so far as to say that few of us meet an objective NEED.
Please note that I am NOT suggesting that we are not healthcare professionals. The ONLY thing I am challenging is our own self-perception of where our profession sits in the healthcare hierarchy.
External influence
Think about how the media and politicians refer to dentists as dental carpenters or dental workshops. Consider how disappointed you have been when the Prime Minister and the Minister of Health during the Corona crisis at one press conference after another have NOT mentioned dentists in connection with the healthcare sector......
Journalists and politicians generally think like the rest of the population. So I would venture to say that they give us a representative picture of the general perception of dentists. Is that a bit harsh? Perhaps it is. But if we accept this, it makes it easier to communicate with patients and the community around us. A discipline we, as a profession, in my opinion, have become increasingly poor at.
If you've followed me this far, it's starting to get a little ticklish for most of you. Because if the majority of our work is about meeting patients' subjective desires. Then we're not running a healthcare business like hospitals and medical centres, but a service business. Before you start thinking about how you can rip my head off the next time you see me. Consider that dentists ARE already officially categorised as a service business.
The service industry
Is it good or bad that we are categorised as a service industry? If we look at the principles by which doctors' surgeries and hospitals are run globally. I'm actually not sorry to be in a service industry. For the sake of argument, let's just call doctors and hospitals "the rest of the healthcare sector" then I've leaned a little towards the healthcare side of things. In general, the rest of the healthcare sector is run on the basis of public finances or insurance payments. In other words, politicians, civil servants and insurance companies define how good or bad treatment patients can receive. For many years, Danish hospitals were among the world's elite. This is no longer the case and they are falling down the rankings relatively quickly due to public management and politicians interferring all the time.
It's one thing to have treatment dictated by the patient, who can choose. It's another to have treatment dictated by the state or an insurance company's conditions. Both entities see patients as a number in a statistical curve and, as we have experienced for a number of years, are completely indifferent to the hospital sector's specialists' indications of an insufficient framework to fulfil the demands made by these same entities.
In this light, I would prefer to work in a private service organisation.
So, if you get the idea, we work in a service organisation that, for the most part, has a fairly large retail element to it. Our patients (or customers?...) have several options to choose from when it comes to dental treatment. When patients have different options, it's all about meeting the patient's WANTS.
Being a professional in a service industry
I know. Many dentists are on the verge of going off the deep end at this point. Most will say something like: "I am a trained, highly educated healthcare professional with a high degree of academic pride. I'm not a shop owner selling treatments. MY patients come to me for the treatment they need, which I provide to the highest professional standards."
This statement would probably be correct IF patients actually come to your dental practice to get the treatment they need. But more often than not, patients come with a desire to have as little work done as possible.
You and I both know that this attitude rarely leads to the best and most professionally optimal treatment. We also know that this shouldn't be the attitude patients should have when they arrive at the practice. Patients with conditions that require treatment have a number of different treatment options, and the range of options is becoming better and more sophisticated as technology advances.
The right solution?
Imagine if a patient with a broken leg came to the doctor and had their leg cut off instead of having it put in a cast or undergoing surgery. There should be no debate about what's right and wrong.
When patients come to us in the dental office with a longitudinal root fracture, there are a number of possible treatments. From a simple extraction to the insertion of an implant, we let the patient choose what they think is right for them. This puts us in the same category as plastic surgeons. They rarely perform treatments based on a pathological need, but on the subjective wishes of the patients.
I hope you agree with my observations. If you do, you'll see how it opens up some amazing opportunities that make being in retail not so bad after all. In fact, the ability to differentiate the different levels of care in our industry is a huge advantage. You can choose to treat your patients well, or exceptionally well. Honestly, none of us want to have our business dictated to us by an insurance company or a bunch of business school graduates. Just think of the hassle you're already experiencing now when dealing with insurance claims related to trauma.
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The big taboo in dentistry
So, if we recognise for a moment the premise that we're in retail. This means that if you want to maximise your clinical and financial success, EVERY employee in the practice needs to work in dental sales. YES I said "the dirty word = sales". I know that most dentists hate the idea of having to sell treatment. None of us went to school to become salespeople. None of us have learnt how to sell anything at dental school, and very few of us have had any further training in sales. Therefore, very few dentists know what sales is all about. Therefore, I almost expect to be labelled a heretic for bringing this up.
But please note that I also mentioned that sales is the way to maximise your clinical and financial success. I know several dentists who are terrible at running a business but have managed to maintain a tolerable income until now. It's not a great income and the way they practice is rarely in line with the way they dreamed of practising when they graduated.
Influence
All I'm asking you to do is to change your perception of the term "sales". I want you to perceive sales as a mutual form of communication for the purpose of influence (influence is NOT manipulation, but a matter of achieving mutual dialogue that opens up the patient's ability to listen and understand your recommendations because you relate them to their subjective desires).
By this definition, you'll find that everyone is selling all the time. When our children get their driving licence and want to borrow their parents' car, they are ready to do anything just to get permission. Similarly, when teenagers want to go out with friends and stay out longer than usual. When we try to convince our spouse that a skiing holiday is better than a beach holiday. When we go out and dress up. We're selling ALL THE TIME. Is selling so bad when you look at it from this perspective? I don't think it is. BUT trying to sell crap is not okay. That's why I always recommend that you stick to selling treatments with a professional indication. If you stray from the narrow path of virtue, you start selling crap.
Basically
I think we sell the best service in the world to our patients.
Remember, selling is about mutual communication with the purpose of exerting influence. In your case, it's about making patients WANT the treatment they, by your treatment standards, need. If you or your dental hygienist(s) want to improve your ability to communicate with patients so they want to invest in optimal oral health, I recommend you take a look at my patient communication 2.0 course.
The overlooked initiative
With this relatively long introduction, we're ready to look at the most overlooked initiative that can improve patients' oral hygiene and interest in optimal dental care ..... It's a system that ensures the dental practice finds 1 patient daily who agrees to teeth whitening. That's probably not the answer you were expecting, but let me elaborate for you:
System to find and perform 1 whitening procedure per day.
Patients desire. Can you accept the claim that the majority of people want white teeth? How often have you heard your patients say they want "more white teeth or straight white teeth"?
In a study conducted in Chicago in 2018, 6000 random people were stopped on the street in downtown Chicago. They were all asked: "If there is one thing you could change about your smile, what would it be?". 86% answered that they wanted whiter teeth. Even though the survey was conducted in the US, I would venture to say that our patients don't differ much in this regard. Virtually all of our patients WANT whiter teeth (The fact that Americans still have a preference for the same white color as a porcelain sink is their problem. Fortunately, most European patients want a natural, white smile) This means that if a total of 16 patients visit the hygienist and the dentist in one day, 13 of them will have a desire for whiter teeth!
Patients who whiten their teeth become better They keep their appointments more often. Their oral hygiene improves. They are more interested in getting the best treatments. In other words, whitening makes patients more aware of the benefits of optimal oral health. So why not try to accommodate patients' wishes? Whitening is probably the least harmful cosmetic procedure we can perform in the practice. As long as you know what you're doing and have a procedure that ensures a good result every time. I don't see a problem with whitening the teeth of your patients. (If you need a good protocol for whitening, feel free to contact me and I'll give you mine) However, our perception of how whitening should be sold in the dental office needs to be revised. Most practices sell bleaching for around 500€ or $. This is typically based on the idea that it should be a profitable business that is priced as a cosmetic product (or because everyone else has the same price). I'd like to change that mindset. Instead, I recommend that you price your whitening solutions to make a relatively modest profit.
I was very happy to use Philips Daywhite and Nitewhite products. They came in a relatively nice package with everything. Including 6 tubes of bleaching gel. If you can implement a system where the dental assistant does 95% of the bleaching procedure, it's possible to sell the treatment for about the same as the average hairdresser charges for coloring and cutting hair. The profit is not very high - but it leads to more patients paying more attention to their teeth. Their hygiene improves and eventually they demand the optimal treatment themselves. Which is the real reason why we want more patients to have their teeth whitened. It simply increases the focus on oral health.
In our online practice development programs, we go through several different models that can make it easier to implement teeth whitening in each participant's practice. After the course, it will be relatively easy to sell 1 whitening a day without it feeling like a sale, but more like a help to patients. With the right strategy, the system can be used to attract more patients to the practice.
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If you have any questions about choices, growth or value-creating strategies in your dental practice, you are always welcome to contact me. Currently, my colleagues and I are helping practices in 6 different countries.
Thank you for your time.
Kind regards
Jesper Hatt DDS
mail@HattConsulting.com
Phone: +41 78 268 00 78