Gems Publishing - January 2019

How to Double New Patient Acceptance , Retention, and Your Bank Account

By Dr. Tom “The Gems Guy” Orent

You’ve likely taken one or more of the many high-level, well-known continuing education continuums: Reconstruction, occlusion, aesthetic, TMJ. There are many from which to choose. Most, if not all, deliver an amazing post-doctoral clinical education far beyond anything we learned in dental school.

to my office, I did exactly as I was taught. My new patient exams increased to 90 minutes and included all of the routine steps (FMX, full periodontal probing and charting, photographs, oral cancer screenings, blood pressure, history, etc.) plus models, 3 DeLar bites, mounting every new adult patient case in centric relation, use of the Centri-Check to verify we’d achieved centric, internal, and external muscle palpation, ROM measurements, even a TMJ ultrasound. Yep, every new adult patient! Not done yet … Then I explained that I’d need about a week to review everything and come up with the best possible plan … and of course recommended they bring their spouse or significant other with them to the “case presentation” visit since … “four ears are better than two!” So, what happened? Same thing that’s happened to many other dentists with whom I’ve spoken. New patients walked in my front door and ran out the back, never to return! Sure, we did a few amazing cases. But upon first meeting us, most folks thought we were just over-the-top nuts since their last dentist told them pretty much everything was fine. “Doc, I’m pretty sure all I need at this point is a cleaning and a checkup!” You look in the mouths of new patients who think everything’s “just fine” (because nothing hurts) and what do you see? Periodontal problems, recurrent caries, leaking margins on decades-old, failing- in-place amalgams … and more. Herein lies the problem. If we tell a new patient everything we see and all they need upon first meeting them, many will assume we’re in it only for the money. Remember the Reader’s Digest cover, “Rip Off!” That one article, supposedly an “expos é ” on how badly most dentists rip off their patients, did more harm than just about anything I’ve seen in the four decades I’ve been a dentist (except perhaps for their counterpart … a "60 Minutes" hack job on dentists designed to give the exact same negative impression)! So here’s the dilemma. If you tell an asymptomatic (i.e., unaware of any issues) patient everything you see upon first meeting them, many will never come back. You cannot help them if they don’t THE ETHICAL DILEMMA WE FACE


I remember sitting in my very first session of a two-year continuum wondering if I’d ever understand, and more to the point … would I ever learn to apply occlusion and reconstruction to the level they were teaching? Turns out, like most anything else, it just takes time, practice, and perseverance. First I went through the consciously uncomfortable phase … that time when you realize there’s far more you’ve got to know to do right by your patients, yet you don’t really know how to accomplish that yet. A few more flights, hotels, and weekends of CE, and you get past that stage. Then it all becomes much clearer. Finally you return to your practice with the knowledge that you can perform amazing transformations for your patients. You are developing the care, skill, and judgment to seemingly perform (dental) miracles! After a few years’ practice, I chose to seek out patients who’d suffered undiagnosable, untreatable headache pain, and for many, I was able to give them relief from their suffering. Turns out many of us suffered a familiar post-continuum story. We learned some amazing clinical techniques. We became far better doctors clinically. But when we tried to implement what they taught us from a practice management point of view … many of us sent new patients running out the back door! “Once you have taken your new patient through these 17 steps, after your new patients have experienced the most comprehensive dental examination of their lives, they’ll know they are in a practice unlike anything they’ve ever experienced before!” Well, they got part of that right. The part about knowing that something had just happened unlike anything they’d ever experienced before! After I drank the Kool-Aid and upon returning ALL GOOD SO FAR, SO WHAT’S THE “WOE?”

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