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Breaking down the new patient exam

Brett Churnin, October 2018 

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Most patients aren’t really concerned about their missing tooth. It’s long gone and there’s no pain.

But as dentists, we know that it’s effects are causing more problems.

So, we recommend a bridge or an implant.

When we tell our patient "I recommend an implant" what is their typical response?

"How much is that going to cost me?"

"Why do I need it?"

"My other dentist didn't say that!"

This reply puts us, as dentists, on the back foot. We are forced into explaining our recommendation. We begin to educate not realising that is comes across as a justification.

This is the exact reason that many dentists discover their names on dental review sites with the words "She tried to sell me expensive treatment."

Is there a solution to this conundrum. Yes, there is.

Breaking down the new patient exam

If we look at the structure of a New Patient Exam, it's broken into three phases.

Phase 1: The Pre-Clinical Discussion - we talk with the patient before examining the mouth.

Phase 2: The Clinical Exam

Phase 3: The Consultation - the discussion we have before the patient leaves.

Dentists tend to hear most objections during the Consultation phase, just after making a recommendation. When they hear those objections, it's natural to try and handle them by explaining the reasons for our treatment plan.

Here’s the the problem with this approach: it's entirely reactive.

We've actually inadvertently caused a problem and now we are forced to try and rectify the problem. Chances are, we made a recommendation before the patient absorbed the full nature of the problem.

This is the classic error of ‘solution before the problem’ instead of problem before solution.

An alternate approach which we teach in our Primespeak seminar  is to sow seeds of information during the Pre-Clinical Discussion phase and also during the Clinical Exam phase.

The earlier the patient begins to understand their problem, the more they will own it.

In the early phases of the exam, the focus should be on 'priming' the patient with information that relates to a problem, not a solution.

Of course, this process has to be done carefully. If it's done crudely, it can come across as 'this dentist is just trying to scare me', which is not the intention.

However, done well, it will result in a patient developing a clear understanding of her clinical condition as the first step. It's all about sequencing information correctly.

Once he or she is clear that a problem exists; specifically that the problem is not static and it leads to some undesirable outcomes such as…

When presented or communicated in such a manner that the patient comprehends the true problems, most patients will want to know what can be done to prevent an unpleasant outcome.

Find out more about the Primespeak approach to the new patient exam here. 

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