Why Do Patients Really Say No?

David Rice, DDS

Most young dentists and dental students I talk to believe patients say no for money reasons. Most young dentists and students I know are learning very bad lessons from people who mean well, but simply don’t understand human behavior.

Yep - I said it. It’s sad and it’s true.

Your patients come to you and have one of six thoughts in their head:

• Yes, money. Tell me how I can keep more of my money.

• Appearance. I want to look better so talk to me on how you can make that happen.

• Time. I’m busy and I need you to share how you’re going to get me in and out conveniently.

• Trust. Translation, I need to know that I actually need the dentistry and that you’re the one to do it.

• Comfort. I don’t want it to hurt while you’re working on me or after.

• Health. I’ve heard of the whole oral-systemic link and I’m in on staying healthy.

Here’s the trick: Student, young dentist, or seasoned pro, you and I need to understand which one of those six drivers is driving the patient in front of you. Then we need to speak to them in their love language.

I’m going to caveat all of this with certain technologies that give us a greater ability to do this and how we frame those technologies to each patient based on what they value.

Tech That Helps

AI. AI has come a long way in dentistry and has several verticals with mega-impact.

First, let’s take a look at AI and radiographs. A couple of the more well-known are Pearl AI and Overjet. These technologies do a few things that serve us well. They help us calibrate. If you’re a young dentist, that means every assistant, hygienist, and dentist can see and share what the others see and share. There’s power in consistency. There’s an epic failure in multiple opinions from the same practice.

On the student side, this is about you and your faculty being in alignment. Just like team members need to walk the same walk, so do faculty and students, or no is an answer you’re going to hear a lot.

Another vertical I won’t dive into here yet share is AI and answering our phones. The right systems are amazingly trainable and incredibly real/helpful to the average patients who strongly value convenience (that’s everyone!).

Intra-Oral Scanners. I’m guessing you’re either using one now, or at least have used one at some point. In my humble opinion, this is the future’s very upgraded intra-oral camera. In other words, if you have access to enough scanners, you don’t need an intra-oral camera anymore.

What I’m going to highly recommend to you is the healthy patient scan. That means every new patient gets a full-mouth (upper, lower, and bite) scan and every other year, every re-care patient gets one, too. Friends, if a picture’s worth 1000 words, imagine what a 3D model of your patient is worth. Now, you’re going to tell me you don’t have time. You do–you just might not realize it. So if you feel you don’t, reach out to me. I am happy to show you how to create time and I’m going to promise you, when you do, your yes factor is going to climb.

Intra-Oral Cameras. If you don’t have an intra-oral scanner, or you don’t have access as it’s being shared amongst a high number of people, intra-oral cameras are still an excellent option. Like the intra-oral scanner, I’d recommend a photo tour of every new patient’s mouth and the same every other year on your re-care patients.

3D printers. If convenience is top of mind regardless of your patient’s primary focus on money, appearance, time, trust, comfort, or health–printers deliver! They allow us to keep our assistant with us all day and focus on whoever is in our chair. That’s productive. That’s convenient. They also allow us to increase our same-day dentistry and nothing makes for an easier yes than a patient who is already in our chair. No one likes missing more work or more time from all the things they love doing.

LEARNING HOW TO SPEAK TO EACH “WHO.”

Now that we’ve covered tech that helps, let’s talk about speaking to each patient based on what motivates them. This is going to feel like common sense to you - the trick is to intentionally think about what your patients want and to frame every conversation with it. When your patient knows you’re on their side - they will say yes - a lot!

If money is my thing and I’d rather spend mine somewhere else than on you and dentistry, how can you help me get what I want? You can save me money by catching things when they’re smaller and less expensive. The trick is framing what you’re telling me with that. In other words, because we caught this now - we can save you money. This means fluoride, sealants, understanding nutrition, habits, and consistent re-care today keep me from having decay and perio tomorrow. Fillings today keep me from crowns, root canals, tooth loss, and implants tomorrow.

If appearance is my thing , how can you help? Easy peasy if we’re talking any kind of dentistry I see, yes? Plug in that healthy scan and show me. Take those intra-oral camera pictures and show me. So how about functional dentistry? Perio? Occlusion? Is appearance a thing? Of course, it is. Are puffy, bloody gums pretty? Are broken, worn and stained teeth attractive?

If time is my thing and I’d rather be home with family and friends, or I need to be working locally or in another city, how can you help me? What if you frame prevention as the means of keeping me out of the office? Allowing me with more free time?

What if you frame early intervention with saving me from longer and/or multiple appointments?

What if my thing is trust? Principle one–take more CE. Dental school is a solid foundation but that’s it. The more competent you are, the more confident you’ll feel. The more confident you feel, the more you’ll tackle and the more competent you’ll become.

Principle two–maximize tech. The data on AI use as one example is staggering when it comes to patients trusting you, especially as a younger pro. Then, add in slowing down and getting to know me as a patient.

Lastly, when you feel me push back, call it out. Ask me if I trust you. Option one is I’m taken back and share I do, and I apologize. Option two is I say I don’t. That gives you an opportunity to educate me more.

How about comfort? Frame everything you share and do around how you’re not going to hurt me. Sometimes it’s a story about how you’ve done this a hundred times and everyone is comfortable. Sometimes it’s a topical anesthetic and more time for it to work. It could be some very cool tech we haven’t spoken of like a hard tissue laser and now you’re working needle-free.

Last but not least, what if it’s health? Now’s the time to talk all the dental school talk on that oral-systemic link. Show me my perio bacteria under a microscope. Check the pH of my mouth. Give me every home-care opportunity to avoid dental and medical issues and I’ll adore you.

Friends, some patients say no because of money. But if there are six drivers of why people say yes or no, and money is only one of those six, understand that the money side is only a segment. Learn what drives each patient. Learn why it drives them. You’re going to get a lot more yes and thank me later.

Oh yeah… if you want to know more on how to learn who wants what, just reach out and ask. It happens to be one of my favorite topics.

David Rice, DDS, is on a mission to improve our profession by leading the next generation of dentists to grow successful lives and practices. The founder of igniteDDS, Dr. Rice speaks to over 35 dental schools and residency programs a year on practice building, team building and wealth building. Dr. Rice is a private practitioner, educator, author, and mentor who connects students, young dentists, and professionals from diverse dental-related businesses, “fueling passion beyond the classroom.” ignitedds.com