Over the years I’ve done my share of “big case” dentistry. And, I’m often asked how I get the “big cases.” Yet, I also understand many dentists have no interest in doing big cases. For today’s installment, I’m going to skip the rather broad topic of attracting “big case dentistry” and get to the actual presentation to the patient. Specifically, I’ll show you how I present it in written form.
All practice management software (PMS) conveniently lets you punch in a treatment plan. Then it spits it out in an itemized format on paper. This is fine for small treatment plans that involve basic restorative treatment for a few teeth. But, for extensive restorative and prosthetic treatment plans, I believe it’s a huge mistake. Why? Read on…
A large treatment plan, when spit out by your PMS is a laundry list of codes and fees that means little to nothing to a patient. Worse, it can be very intimidating and confusing. “What’s this ‘P-slash-C’ for, and why does it cost $295?” The patient will tend to look at long list of procedures (looks like a LOT of work!) and each individual fee. Then he or she will start to question each one… if not vocally, at least in his or her mind.
A large treatment plan spit out by your PMS is impersonal and doesn’t answer patients’ questions about their treatment. Sure, you can explain it verbally to the patient face-to-face. But, when the patient goes home, the “significant other” may want an explanation. The patient, unable to relay all that information, will probably just hand over the PMS treatment plan printout. And, that’s not good! If you listen closely, you might even be able to hear the spouse yell out, “WTF!?!?” all the way across town.
You should know that what I will propose here involves more work. Yep… work! And a bit of time. But, it’s WELL WORTH IT. And, you’ll get better and faster at it as you gain more experience doing it. If you want to do “big case dentistry,” I believe this is critical.
A good treatment plan presentation (verbal and written) is one that answers the patient’s questions. We dentists tend to focus on the how and why instead of the BENEFITS to the patient. Of course, we also have to cover alternative treatment options, risks vs. benefits, etc. We can do it in a patient-friendly way, though and still cover our bases.
Answer the questions!
So, what do patients want to know? Do they want to know about osseointegration? Nope! Do they want to know how you’ll be bonding materials to their teeth? Nope! Do they want to hear about how a post and core is placed? Nope! Do they want to know about crown-root ratios? NO! Stop thinking like a dentist. Pretend, for a moment, that you are talking to a non-dentist… a regular person… your patient.
When it comes to treatment options, they want to know about BENEFITS. Patients want three things from dental treatment:
- Look good.
- Feel good.
- Last a long time.
That’s it!! Really! It is!
When it comes to the actual treatment plan, patients want to know three more things:
- How much?
- How long?
- How many appointments?
That’s it!! Really! Don’t bend their ears about anything else! You’ll just talk them out of treatment. Ask me how I know! With 24 years under my belt, I finally figured a few things out.
The secret to your success…
Over the years, I developed a way to present treatment and answer those questions, while covering my “informed consent” bases. I quit printing out those PMS treatment plans. I quit itemizing the fees. It wasn’t working for the big cases. Not at all! I wanted to present treatment options, informed consent, and answer the patients’ questions in one fell swoop. Again… there’s no real automated / lazy way to do this. But, at the end you’ll see that after a while, you can make the process more efficient.
What’s my big secret? It’s not a secret. It’s not rocket surgery. I’ve put this out there on Dentaltown.com a number of times. I am reprising it here for posterity and easy reference.
I present the whole case and a single CASE FEE printed on paper created by a word processor. Remember the patient’s questions (see lists above).
Options, options, options…
Let me back up a bit, though. If the case has a number of options (and they usually do), I’ll present those options first, in general terms, along with pros and cons and fee ranges. So, if you can imagine a case where the patient may have missing teeth and others in need of restoration. Options might include: removable, traditional crown & bridge, and implants. Three basic options. Start there.
Or it could be a cosmetic case that could be an orthodontic + minimally invasive restorative vs. ten or more porcelain restorations. Also remember to include the option of no treatment (and possible consequences).
Here is an example of the Treatment Options Overview. You can click on the image to download a .pdf version that you can see better and save on your computer for future reference.
It helps to print it out in an easy-to-read-and-understand format. And, again, consider a significant other at home may be looking at it (and be involved in the final decision).
Finalizing the plan
Once the patient has decided on a particular option, I write up the treatment plan, again remembering the patient questions. I summarize the treatment. Then I map out the number of appointments (and time between appointments). And, I quote a CASE FEE. I don’t break it down by the tooth. It’s the whole case, soup to nuts. One fee. I also include any “informed consent” caveats that should be mentioned.
Below is an example of a final treatment plan. Click on the image to get the .pdf version.
The “heart” of my written treatment plan answers the patient questions of “how long and how many appointments?” Here’s an example of that:
Below is an example of an extensive treatment plan. This case took about a year to complete. Clicking on the image below will download the .pdf version.
This approach has worked very well for me over the years. In this economy, I’m not doing as many of the “big cases” as I was in years past. But, I expect once the economy turns around (whenever THAT’S going to be!), there will be a pent-up demand for these services.
The question is: Will you be ready to surf that wave when it comes?
So, if you’re not already comfortable doing big cases (but would like to), sharpen that saw by going to as much related CE as you can. And, then when the right patient comes in, you’ll be ready not only to do the case, but effectively present it as well. Remember what the PATIENT wants to know. Keep it simple! Feel free to adopt and adapt my approach on a word processor to suit your own style. Once you’ve got a number of these stored on your hard drive, for any given case, you can go back and modify a previous similar plan (and not have to start over from scratch. So, it does get easier and more efficient.