Who Do You Trust?

How to build trust and urgency, and get case acceptance

by Tyson Steele

In our last newsletter, we discussed the two most important reasons patients say "no" to treatment -- a lack of trust and a lack of urgency.

We discussed the fact that patients often tell us that they're afraid or that they don't have the money or the time. However, we can be fairly certain that these objections aren't their REAL reasons. Let me give an example:

Let's say that a patient comes into your practice. She is experiencing no discomfort, but she has a large, leaking amalgam on a posterior tooth. You indicate that the tooth should be crowned to protect it from further decay or fracture. You then send the patient up front to make an appointment. The patient tells your treatment coordinator that she "just don't have the money right now." She wants to wait until next time.

Of course, you think the objection is a lack of money. After all, that's what the patient said, right?

However, the next day, at your morning meeting, your scheduler tells you that that the patient broke her tooth on a piece of ice last night. It's really painful, and the patient wants to know how soon she can have the tooth crowned.

Remember the money she didn't have yesterday? It appears to no longer be an issue.

But, of course, money never really was the issue! The patient's real objection was a lack of urgency. Once that urgency was created (in this case by pain) the patient accepted treatment.

IMPORTANCE OF TRUST

The most important objection in dentistry is a lack of trust. Clearly, if your patient had placed a great deal of trust in you in the first place, she would have been far more likely to get the crown even before the fracture.

In fact, trust is your most powerful tool to get patients to accept treatment. If trust is there, all the other objections are overcome.

You have patients who trust you so much that you just casually mention that they need a crown, and they say "okay Doc, whatever you say." They may not even know what a crown is, they may not have a lot of money -- but they trust you, and that's good enough for them.

Trust is the foundation. Trust can overcome every other objection, whether it's a perceived lack of urgency, money, need or desire. Without trust, you will never get case acceptance. Because of this, you must build a trusting relationship your patients. Everything else comes second.

But how do you build trust? After all, aren't you already doing everything you can to be honest, friendly and ethical? Why wouldn't patients trust you? You've got "Doctor" in front of your name. You've got diplomas on the wall. You're an expert!

Well, those things are good, but they are only part of building a trusting relationship. So, let's begin here …

A LITTLE HELP FROM MY FRIENDS

Friends are people you can trust. Certainly, you can trust them more than acquaintances or strangers. But have you ever considered why people become friends? If you're like most people, you probably assume that it's because they have something in common or maybe they have similar values. After all, that seems logical.

However, common interests are NOT the main reason that friendships develop. The main reason friendships develop is due to something called "proximity." Proximity is a measurement of two things -- your FREQUENCY of contact with someone else and the CONSISTENCY of that contact. Of course, common interests can enhance the relationship, but you need some level of frequency before you can even determine your common interests. This is the reason that people become friends with co-workers and neighbors but fail to maintain the relationship if one of the parties moves away.

The other aspect of proximity is consistency. Consistency is a measurement of one's ability to maintain a standard "quality" of contact. In other words, you are less likely to become friends with someone whose personality changes every time you see them. Their inconsistent personality reduces your trust in them, reducing the level of friendship.

TRUST ME

We have a unique problem in dentistry. We know that proximity builds trust, but we see our best patients only twice each year. In other words, we have a limited opportunity to build trust because we don't have enough frequency of contact. In addition, our contact with patients is often inconsistent. Staff members change. We run early or late. We offer a blanket one time and don't the next. We're relaxed. We're stressed. Who knows how we're going to act?

INCREASING YOUR FREQUENCY

If you want to increase trust, you must start by increasing your frequency of contact with patients. Of course, you can do this in many ways. You can make more after care calls -- an additional contact. You can send handwritten notes -- an additional contact. You can send gifts to referring patients -- an additional contact. If you have several patients who work at the same place, you can send them a basket of cookies -- an additional contact. (I know you've used these tactics, but I'll bet you never realized why they work so well.)

Cookie-cutter patient newsletters and stock birthday cards can be used to build frequency, but it's better to target your best patients with more personalized, yet simple systems of contact. After all, a care call only takes a few minutes, but the value can last years. No one's going to talk about your newsletter at the next holiday party.

Because you see patients so infrequently, a few additional contacts can dramatically accelerate your relationship and go a long way toward building trust. One of the top producers in the northwest is Dr. Brian Work. He calls his new patients BEFORE their scheduled new patient appointment and introduces himself -- an additional contact. He then gives them his website address and urges them to check it out before their first visit -- another contact. By the time the patients come in, they feel like they know him. Can you see why he has a high level of case acceptance?

Of course, these "high-touch" contacts take effort. But, hey, when was the last time you found something useful that didn't require some effort on your part?

BE CONSISTENT

When it comes to consistency, you have to remember just one thing: today is the ONLY day most of your patients will see you for another 6 months. Because of this, the experience your patients have today will define their feelings about you for a long time. Sure, to you dentistry is old hat, but to your patient it's a big deal. Remember that.

Set up systems that allow you to be consistent with patients. How do you greet patients? What do you say to a patient in the reception area if you're running late? When do you say it? When do you use your intra-oral camera? How do you keep the restroom clean all day? How good are you at discussing the "watch" you told the patient about last time?

Just be consistent. Today is the patient's day. Give them the service you would expect. (And remember, it's better to be consistently good than occassionally great.)

BUILDING URGENCY

The second most important objection in dentistry is a perceived lack of urgency. This is a tough one to address because you have to build urgency without reducing trust. In addition, many dentists find it difficult to build urgency into their case presentations when the patient's situation isn't immediately threatening.

However, these issues can be overcome if you remember your long-term goal -- to get your patients healthy. It doesn't really matter if it takes a week or three years as long as you get them healthy. If you scare them off with a monster case presentation and they leave, you've failed. If you let the patient into your practice but never get them healthy, you've failed.

Ultimately, like the tortoise and the hare, slow and steady will win the race.

So, take your time. Focus on building trust and slowly building urgency around it. Show your patients the items you are concerned about. Tell your patients that your long-term goal is to get them completely healthy. Tell them that some items have a greater priority than others, so you're going to watch those items more carefully. Educate your patient.

At future visits you can talk about those priority items you discussed last time. Eventually, you will let the patient know that "it's time." You're building urgency, because the patient knows about the treatment in advance. You're building trust, because you aren't trying to "corner" or rush the patient. Ultimately, this strategy increases the odds that you will eventually get your patient healthy. And remember, that was your goal in the first place.

Above all, remember that you're not a used car salesman. Your relationship with your patient is more important than the verbal skills you use to "manipulate" them to accept treatment. So treat them the way you would like to be treated -- both as a person and clinically.