The ‘Got Milk?’ Approach to Patient Communication

The use of strong communication skills is one of the most effective keys to increasing case acceptance in today’s strained economic times. How do you clearly know what someone wants? You ask them.

We’ve all seen the successful “Got Milk?” ads on billboards and magazines. We see our favorite sports stars, actors, and musicians in easily recognizable advertisements. These ads may be the key to increasing case acceptance.

These ads have proven significantly effective over time. The reason? The use of curiosity! As adults, we know that when asked a question, we’ll search (in our head) for an answer. The result? Milk product sales have shown to increase when these ads are utilized.

So, what does this have to do with your practice? Learning how to ask more effective questions will do the same for your case acceptance. So … Got Treatment?

It’s important to emphasize that the opportunity to ask effective questions begins with the first contact with the patient on the phone. It is vital that your front office team can take the time during that first call to ask appropriate “We Care” questions.

“We Care” questions provide valuable insight and information about the new patient, their interests, history, initial motivators, and concerns. The information is shared at the morning huddle before the patient being seen in the practice and is used by the doctor to ask deeper, more profound questions during the preclinical interview.

The focus in this article will be on the doctor’s preclinical interview, because we know asking the right questions during this relationship-building time is the make-or-break point for the patient saying “yes” to treatment. The secret is asking new, more effective questions and hearing the answers with nothing but curiosity.

Asking patients the right questions

Traditionally, during a new patient evaluation, the doctor focuses on the chief complaint, health history, and clinical questions, followed by a thorough examination. The dentist then presents a treatment plan based upon the patient’s clinical needs only. In this old model, the doctor is delivering a solution (or solutions) without knowing the patient’s true wants and needs.

What does an ideal preclinical interview look like? During the first part of the patient’s experience, the doctor must do something to ignite trust and confidence. Yet, in a typical interview, the patient may only reveal what they think the doctor wants to hear (e.g., “Yes, my son always uses his retainer”).

In order to get “Got Milk?” impact, the dentist must ask questions that will deepen the conversation so the patient reveals deeper needs, wants, and desires. With curiosity, the doctor can then follow up with even more probing questions based on what the patient is sharing, such as, “Tell me more about your fear of the dentist” or, “How does not feeling comfortable with that gap in your front teeth affect your life?” The easiest way to learn this vital skill is to separate the kinds of questions you ask into two categories.

Level I questions

Level I questions reveal whether the patient has a chief complaint or desire and is willing to tell the dentist about it. But the patient might be holding back or even unaware of other needs, and if the dentist simply stays at Level I, other possibilities, fears, and needs aren’t uncovered. Here are some Level I questions that work well:

• What would you like to accomplish in today’s visit and overall?
• What are your most pressing concerns about your dental health?
• What qualities are you hoping to find in me as your dentist?
• How do you feel about taking care of your teeth?

Level II questions

Level II questions reveal the unexpressed or subconscious needs and wants. These may be unrealized, but they are the driving force behind any patient’s decision to pursue dental care. When a patient refuses treatment and the dentist and team are mystified by this decision, it’s because Level II needs have not been uncovered. You can’t simply ask the patient, “What are your other dental needs?” because most people don’t know how to answer. Their only frame of reference might be what they got or didn’t get from other dentists or specialists, which limits their focus to the past.

The goal is to get patients to see future possibilities. For example, “I have a dark spot on my upper right tooth and I believe it keeps me from being more social, because I’m embarrassed by my smile” or, “My gums bleed when I floss and I am afraid I’ll lose my teeth.” Here are some questions that work well:

• How have these concerns affected your life?
• How have those experiences affected your decision to come here today?
• You’ve said that you’re concerned about how you’ll look in braces. Can you tell me more about that? Why do you think this is happening?
• Is there anything happening in your life right now that might affect your dental decisions?

Case acceptance through engagement

Recently, while visiting a practice, I evaluated a doctor’s new patient experience from the initial greeting to the treatment conference. Let’s fast-forward to the treatment conference, where the doctor did an excellent job showing the patient pictures of their teeth.

He beautifully explained the treatment that was appropriate for the patient, yet the patient, Ms. X, was not engaged in the conversation. She seemed disinterested and was looking away while fiddling with her keys in her hands. Paying attention to her lack of engagement, the doctor excused himself for a minute and asked me, “What am I not doing? She just doesn’t seem interested and she really needs this treatment!”

The problem? The doctor had not done any real in-depth preclinical interview. And the questions he did ask only revealed surface responses like, “I know my teeth could be in better shape.” He never really got her “Got Milk?” a-ha, so he was providing solutions and Ms. X was never engaged in the true problems associated with her failure to pursue care.

I sent the doctor back in with two simple questions.

1. What was Ms. X’s goal for her teeth a year from now?
2. Did she want to preserve her natural smile or is she comfortable with the way her smile is right now? (Please note: the way to ask this question is important in tone, sincerity, and curiosity.)

As soon as the doctor asked more significant questions, the patient could easily describe what she wanted and didn’t want. The response from Ms. X was so significant, she immediately asked the doctor, “So when can we get the treatment started?” Got Milk? (a.k.a. success!)

This dentist immediately saw the impact of a few specific, deeper preclinical questions. Could you learn from this doctor’s experience? Have you seen a new patient who did not accept treatment? Pull their chart and brainstorm with the team to figure out one or two additional questions you could ask. You want milk, then follow up!