The 'Blue Marble' Theory of Case Presentation

Imagine a game in which you draw marbles one at a time from a large tub. (This hypothetical comes from a book called “The Tale of the Dueling Neurosurgeons.”) In the game, 80 percent of the marbles are blue; the remaining 20 percent are red. Your job is to guess which color you are going to get each time you pull out a marble.

A majority of people presented with this game take a look at the 80/20 composition of marbles and calibrate their guesses accordingly, predicting blue 80 percent of the time and red for about 20 percent of the draws.

This is a failing strategy. The math says that, using this approach, you can expect to be correct about 68 percent of the time, whereas if you simply say blue before every single draw, you are guaranteed to have an 80 percent success rate.

So what does this have to do with dentistry? It’s just another way of illustrating what I always say about dentists who present their findings and treatment suggestions differently to different patients because they enter the operatory with preconceptions. They assume that a certain percentage of patients are “red marble” patients who just won’t accept or will only do what insurance covers, and they adjust their approach accordingly. But this is a very self-limiting strategy.

The simple fact is that at any given time there are a certain number of patients in your practice who are emotionally and economically ready to move forward with treatment – and you don’t know who they are.

People change. Circumstances change. A patient who has always accepted every one of your recommendations may have now fallen on tough times. Conversely, some of those “insurance only” patients may have taken on a new job or been influenced by new motivations, such as an upcoming wedding.

The only winning strategy, then, is to think “blue marble” every time, and to present your findings and treatments to the best of your capabilities (no holding back) to every patient you see.

Not everyone will accept, of course. But you can be sure of this: By using this consistent strategy, you will capture 100 percent of those who are ready today to accept the best dental care you can provide. And you simply can’t do better than that.

(Click this link to read more articles by Imtiaz Manji. You can also check out this SpearTALK discussion to get insight from fellow dentists on improving case acceptance.)