You are probably familiar with the quotation, often attributed to Albert Einstein: "The definition of insanity is doing the same thing over and over and expecting a different result." It is an observation that certainly applies to case presentation and case acceptance.

In a recent article “The First Thing to Say When a Patient Says No”, I talked about a simple way to get patients to accept the idea that you are obligated to revisit tomorrow the treatment they have not accepted today. But revisit can't just mean repeat. You can't just present the same diagnosis and the same treatment in the same way to the same patient, and expect a different result. As soon as the patient says no, you have to start strategizing what you will say and do the next time.

This approach begins with asking yourself some key questions:

  1. Did they really decline, or did they just choose to delay? The fact is, most "no's" are actually "not right now's." Are insurance or economic issues the main stumbling block?
  2. If they did delay, did you ask them when they feel conditions would be better? This is crucial information. The patient needs to know that their untreated oral health condition will only worsen over time.
  3. Have you had similar patients with similar conditions where you were successful? What strategies did you use with them? Could those strategies apply here too?
  4. What did we learn today? It's important to conduct an immediate debrief that day with your team about the patient and their case. Usually, with a little analysis you can determine what did and did not resonate with the patient and why. And internalizing that intelligence will help you with the most important question ...
  5. What will help us connect better next time? The next time you see the patient you should be prepared to try a new approach that highlights different factors and motivations – one that might give you a path to a different result.

Anything less would be insanity.


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