How can fee-for-service practices compete with insurance-driven practices?

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Recently, an online dental discussion group brought up this topic:

How can fee-for-service practices compete with those who are in network?

There were a lot of ideas from the group like:

Have the dentist call the new patient the night before to say she is looking forward to meeting them.

Get up from the desk and walking around to greet patients as they enter.

Recognize special events in their lives.

Acknowledge when you are behind schedule.

Provide stellar customer service.

All good suggestions. But if it comes down to numbers, you won’t be able to compete simply on that level. There are TWO DISTINCTIONS above all else that will give you an edge.

The FIRST DISTINCTION is to identify what makes you distinctive. What do you provide that your insurance-driven colleagues can’t or don’t. Are there services that you are particularly known for such as TMJ therapy, sleep apnea solutions or sedation dentistry? Is your specialization one that is unique and notable? Do you offer second opinion consultations? Do you have a comfort dog at the practice?Without something compelling, you are just another dentist. Whatever that distinction is, name it and claim it. Identify who your audience is and above all else, remember the second distinction.

SECOND DISTINCTION: Build your entire practice around this question:”How can we make our patients lives better than when they first walked in?”  You see, no one goes to the dentist for no reason. People have complicated lives and one of the last things on their list is you, the dentist. They only contact you when they believe you can help solve a problem they have – then they want you to go away. And their expectations are usually low because their previous experiences (in an insurance-driven office) were probably less than stellar in part because no one cared to learn about what was important to them. So, the more you and your team develop exceptional behavioral and problem-solving skills, the more you will learn about your patients and what they care about. Everything you do from there is built around that objective: “How can we make your life better than when you walked in?” Identify the answer to this question and remember it throughout each stage of the process. Provide individualized care, fashioned just for them and keep going back to what problem, in quality of life terms, you are helping them solve.

All the other things such as calling patients to find out how they are feeling, acknowledging birthdays or asking about their vacation, even filing insurance on their behalf are nice but it won’t keep a patient from switching practices because they have insurance.

What will make the difference is your unrelenting desire to solve your patient’s problem so they feel good about the experience and can go on with their lives. That is what will distinguish you from everyone else in the marketplace and for a lot of people, that is worth the difference they are willing to pay from what insurance will cover.  It’s really very easy once all the systems and the right people with the right skills are supporting you.

We help dentists evolve their practice to this new model.

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Mercury Aligns With Mars

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Do you promote yourself as a holistic or a mercury-free dentist? If you do, then you know that working with this special group of patients brings a unique set of challenges. Recently, I conducted a Team Teleconference with a group who was struggling with how to best serve these patients.

Their goal:  To better understand these patients and learn how to connect with them more successfully. In other words, how can we align with what they want?

Here’s the email they sent me to establish the agenda for our session:

Holistic calls seem to always be the challenging call in our office. The patients are always very detail oriented  and can really throw us off with some of the questions asked. Another problem we face is they take so much time on the phone. I immediately guide them to our holistic website and walk them through our holistic approach when removing Amalgam.
 
There seems to always be a lack of understanding by the patient about what is involved. What I constantly hear from these patients is that they don’t want to have an exam, (don’t want) x rays and just (want to) have their amalgam removed.
 
How can we efficiently handle these calls? How can we handle these conversations to help the patient better understand why the exam and digital X rays are important? How do I get these patients to understand our process without coming off “rude” or “condescending”?

Keep in mind we do offer the consult as a last resort to help convert the call to a future appointment.

Our session brought about some clarity by breaking down the knowns and unknowns.
To start, the team identified some common themes that emerge when working with these patients:

1) They do a lot of personal research on the Internet.
We know that there is an equal amount of incorrect information as there is accurate information out there and each patient will struggle to discern what is fact and what is fiction. When they call your practice, they already have a set of beliefs which may or may not be correct. If what you tell them goes against what they have begun to believe, they will experience some internal conflict.

2) They self-diagnose or have been told by a trusted authority that the mercury in their mouth is;

1) toxic and 2) may be making them sick.
This may or may not be true in their case but you will not change their belief system in a short phone call. It is what it is. Gaining clarity about what they believe is essential and you must use this as the CONTEXT for which you will begin your relationship with them.

3) They are apprehensive and slow to trust.
They may believe you want to perform other procedures that aren’t necessary or will also be harmful. Some individuals may have had negative experiences with health professionals in the past, which leads to their distrust. They have a story and you must take the time to learn what that is.

4) They are health-focused.
Some of these patients place high importance on their diet and their exercise regimen – sometimes to the point of obsession. On the other hand, they may have a multitude of health issues and their life revolves around illness and doctor appointments. This is a part of the story you will uncover and must understand in order to determine IF you can help them, and if so, HOW you will offer to help them.

Because of these issues, they will consume more time than your typical patient, asking questions  and discussing their unique circumstances. There is no way you will change this. If you are going to serve this special group, you MUST be prepared to take the time required to fully understand them.

Also, there is a BIG difference between being efficient, and being effective. Efficiency relates to paper and processes while effectiveness relates to working with people. And effectiveness can’t be measured by whether or not you convert the phone call to an appointment. Not all callers are ones you will want to invite to become your patients. You must know when to cut your losses.

During our session, we broke it down into bite-size pieces to come up with a more effective way to work with these patients when they call.

What do they want?
In quality of life terms, what are these patients hoping you will help them with?

-They want to feel better
-They want peace of mind in knowing the possible toxins are gone

Above anything else, this is what you are providing. The procedure of removing the amalgam fillings will simply be the means by which you will help them get there.

How do they want you to accomplish this?
-They want it done in the least amount of steps necessary
-They want the safest procedure possible
-They want it done for the least amount of money

What don’t they understand?
-They’ve been told or read something they have come to believe that is different from what we tell them.
-Why xrays are necessary.
-Why a thorough exam is both clinically necessary and required by law.

How can you help them get what they want?

Because you don’t know what might be necessary just by talking with them on the phone and the approach requires a thoughtful process considering their unique situation, you will need to provide the context for why this is important in their case. Experiment with the following process and refine it as you get more successful:

1) Find out more about their unique situation – learn their story
When a caller begins the conversation by asking about mercury-free dentistry or removing amalgam, find out why they have an interest. It’s as simple as saying;

“That’s a great question. You’ve called the right place. Tell me a little more about your situation and let’s see how I can help you.”

2) Be quiet, listen, and take notes.
The patient will choose to tell you those things that are most important and can provide you with the foundation for how you will relate what they want with what you offer.

(Sidenote: if the caller begins by telling you every little detail that happened years ago, there are several ways in which to determine whether you must 1) disengage because of red flags, 2)  focus the caller, or 3) offer to refer them to a source of reliable information (like your web site), and call them back at a later time. More on this in a separate article.)

3) Use what you have discovered to provide context to the solutions you recommend.
It doesn’t matter that the protocol you use for each person is the same. You must make what you recommend unique to their particular situation. Remember to:

-refer to them by name
-acknowledge what you have heard
-explain what you recommend based on what you have heard
-get their approval

Here’s an example:

“Barbara, because you mentioned you suspect the mercury in your mouth may be causing some of your health issues, Dr. Holistic will want to learn all about those concerns. She will also want to evaluate what other things might be occurring in your mouth that you would want to be aware of and whether they may be contributing to your problem. I would like to suggest we arrange a time for you to come in to discuss your concerns with Dr. Holistic and she can to determine what diagnostic tests may be appropriate to discover the best way to help you. These may likely include xrays to see what the human eye can’t see going on under the surface. How does that sound?”

(Another sidenote: the subject of xrays and some patient’s reluctance to allow them is another layer of the story. You must peel back this layer in order to understand why this is a problem for them. Don’t assume you know what it’s about. Stay curious and relate to what they are telling you. If you would like to know more about how to address this issue, contact me for a primer on the subject.)

The TAKE HOME MESSAGEs:

Stop telling and start listening.

Use what you learn to create the framework for how you will help them.

Make it personal and unique to their situation.

You can use this same approach with ANY patient. It will help you connect more personally to each caller, begin to develop trust and help you establish a strong relationship from the very beginning.