Creating Value in the New Patient Experience

Every successful and stable dental practice requires a flow of new patients to keep the restorative and hygiene schedules at optimal capacity. But while all dentists are interested in treating more patients, the Spear-trained dentist seeks to treat patients comprehensively. The difficulty can be creating enough value in the new patient experience, so they understand “The Why” behind the recommended treatment.

Creating Value in the New Patient Experience

“Creating value” is a concept that is often explained but can be challenging to implement. Yet it is essential — a dentist must create value before he or she can recommend complex treatment. As Frank Spear has said, “To recommend treatment different than other dental offices, a different experience needs to be created for the patient.” That unique experience starts with the patient's first encounter with the dentist and their team and is solidified during the new patient examination appointment.

Patients are introduced to a dental practice either through hygiene or the dentist’s schedule. While the hygienist creates value for the periodontal portion of the exam, it is challenging to allocate enough time in a hygiene visit for the dentist to build value for restorative treatment recommendations. When the new patient has been introduced to the practice through hygiene, the dentist first meets the patient after the hygienist performs the necessary periodontal procedures. The dentist then conducts the restorative examination, often while in the midst of treating another restorative patient. This model works fine if all the patient needs is basic dentistry. The challenge arises when the patient needs more complex treatment.

One way to address this challenge is to appoint all new patients on the dentist's side of the schedule first, but you can also do it by re-appointing the patient to the dentist's side of the schedule after it is recognized that the patient needs a complete examination. That way, you are using the new patient hygiene appointment to screen for the patients who need more time for you to explain their conditions.

A simple dialogue to help this transition is:

“Mrs. Jones, after the exam, I recognized more going on than we initially anticipated. Since I’m in the middle of treating another patient, I will not have the time you deserve to explain the conditions we recognized. To give you that time, we will need to set up another appointment. Will that be OK with you?”

The patient is unlikely to say no, which sets you up to do a comprehensive, value-driven new patient experience.

The Parts and Processes of a Value-Driven New Patient Experience

The typical new patient examination includes a periodontal, biomechanical, occlusal/TMJ/Airway assessment and an esthetic evaluation. However, there is an additional way to differentiate your practice, and that is to start the process with an initial interview.

The Initial Consultation

An initial consultation interview not only allows the dentist and the team to get to know the patient but also allows the patient to get to know the dentist and the team. This alone can differentiate you from other dental experiences the patient has had because you express interest in what the patient wants before discussing what you think they need. As the author Steven Covey said, “Seek first to understand, then to be understood.” When the dentist understands the patient's needs, the patient will feel heard, more relaxed, and more confident with the dentist.

The Initial Interview

This initial interview can be performed in a consultation room or the treatment room. When it is conducted in the treatment room, I recommend keeping all dental instruments out of the room until they are needed for the clinical examination. Many patients experience anxiety in a dental office, and removing the dental armamentarium from the treatment room during the initial interview eliminates distractions and allows the patient to have a more candid conversation with the dentist. The goal is to uncover the patient’s concerns, understanding first what the patient wants. Once the dentist knows the patient’s concerns, the dentist can tailor the post-exam conversation to discuss the patient's concerns before presenting what was discovered during the examination.

The initial interview also helps you discover the level of the patient's understanding of their dental health. When the dentist understands the patient's dental IQ, it allows them to speak to the patient at a level they can understand. For example, if two new patients present to the office, and one works in the dental field and the other is a carpenter, you may expect their dental IQs to differ. If the dentist speaks to both patients at a high level, you will connect with the one with the higher IQ, but the patient with the lower IQ may feel like the dentist is speaking down to them. On the other hand, if the dentist speaks to a patient with a high dental IQ in a simplified tone, the patient with the high IQ may feel the dentist does not have the knowledge or skills to treat their needs.

So, as we have discussed, the dentist and the team must connect with the new patient to create value by first understanding what the patient wants. To do this, during the initial interview, the dentist will ask questions like:

How can we best help you during your first visit with us?

Are you having any pain?

When was the last time you had your teeth cleaned?

Does your bite feel comfortable?

This is not an extensive list of questions but just a few examples of how to create a conversation in a non-judgmental manner. And the environment and timing can make a significant difference. For example, asking a patient, “When was the last time you had your teeth cleaned?” is perceived differently when asked during the clinical exam than during the initial interview. When asked while performing the examination, it may be perceived as judgmental.

The Clinical Examination

Once the patient has had an opportunity to express their concerns, we will move into the clinical examination. However, before doing that, it is essential to inform the patient of the following steps and to ask permission to share your findings. Here is an example of how to do that:

“Mrs. Jones, do you have any other questions before we move into the treatment room? What will happen next is that Taryn will take a series of X-rays that will allow us to see if there are any infections in or around your teeth. I will then meet you in the treatment room, where we will evaluate four areas of your mouth. The first is the gums and supporting structures, and we will decide what type of cleaning you need. On one end of the spectrum is regular cleaning, the kind we want to get you back to your regular visits with Lisa, our hygienist. On the other end is more specialized cleaning, where Lisa may need to numb your gums to eliminate infections.

The second area we will be evaluating is the teeth. We will look for new cavities, decay around old fillings or crowns, and any infections under the teeth. Third, we will be evaluating how the teeth fit together. This can be affected by the temporomandibular joints or disruptions in how you breathe. And fourth, we will look at how your teeth fit in your mouth and smile.

Once we finish the clinical portion, if it’s OK with you, I will go over everything I found, and it will be up to you to determine how much or how little you want to do. Will that be OK with you”?”

Finally, I recommend that the assistant read each question from the new patient examination form aloud, followed by the answer from the dentist. This will allow the patient to hear the answer to every question and gain an appreciation of the in-depth, comprehensive examination they received.

When the patient experiences this level of examination, they will say, “I’ve never had an examination like that before,” or “that is the most thorough exam I’ve had in a dental or medical office.” That is when the dentist knows they have differentiated themselves from other providers, and they can recommend complex treatment when appropriate.

Dr. Curt Ringhofer is a resident faculty member of Spear Education.