I Can Afford It - Secrets of Financial Arrangements that Get a "Yes!"

You're listening to The Dr. Phil Klein Dental Podcast from Viva Learning.com. Welcome to the show. I'm Dr. Phil Klein. Today we'll be discussing financial arrangements and treatment presentation skills to increase your case acceptance success. Our guest is Steven J. Anderson, who coaches some of the highest performing teams in dentistry with proven systems that create a yes to comprehensive care. He is founder of the Total Patient Service Institute. Crown Council, and Smiles for Life Foundation, and the author of numerous books and learning programs. Before we get started, I would like to mention that Steven will be presenting a live webinar on VivaLearning.com titled, I Can Afford It, Secrets of Financial Arrangements That Get a Yes. It is scheduled for Tuesday, September 20th at 7 p.m. Eastern Time. If you're on the West Coast, it's 4 p.m. Simply visit VivaLearning.com to register. Steven, it's a pleasure to have you on Dental Talk. Thank you, Phil. Great to be with you. So you recommend when you teach and mentor doctors and practices around the country and the world, you recommend that the financial coordinator present in the operatory. That's one approach, which you found very successful. What if that particular office doesn't work that way and the financial coordinator is unable to present in the actual treatment room? You think about being in a dental chair for an hour, an hour and a half, however long it is. And Phil, you've had this experience, I'm sure you're like all of us, is the moment that you change your physical posture, there's this link between your physiology and your psychology. So your physiology and psychology are linked. So the moment you change your posture, you're going to think differently and feel differently. So if you've been in a chair for an hour, an hour and a half, you're in one train of thought, the moment your feet hit the ground, your mind goes out the door, in your car, and on to the next five things you're going to do. So it becomes a lot more challenging to present anything once we change that physical posture. So that's why we say the ideal place to present financial arrangements, if at all possible, is, yes, in the treatment room, chair side with the patient. So it's one continuous conversation. The treatment coordinator goes to the patient. We have the financial discussion, the treatment discussion. If it's at all possible, let's get it all done there. Now, if that's not possible for whatever limitations, or maybe it's a larger case and it's more involved, then the second best would be to do that in a consult room where it's quiet, where you can sit down, maybe have pictures up on the screen, where you can have a face-to-face conversation with the patient. The least favorable place. is to do it at the front desk. This is a psychological thing, right? 100%. This is 100% psychological in how people make decisions. If you are standing, you feel, let's say you're the patient, you're standing at the front desk and you've already been there for an hour, an hour and a half, and you're eyeing the front door and you're standing there, your whole mindset is, I got to get out of here and get on my way because I got a podcast to do and my guest is waiting for me, right? So that would be the order. I'm a retired endodontist, but as a dental patient, I do remember many times going into a... consultation room, which I found a little business-like. The reality is a dental practice is a business and everybody's got to pay the bills. I agree. As a patient, I feel more dentally, medically cared for in an operatory. And so when a doctor is talking to me about what treatment I need, I'm definitely more in the mindset of saying, yeah, let's go forward with this. And that's the idea, right? You want the patient to accept that treatment plan. This is all about how people make decisions. And one of the things at Total Patient Service, Phil, that we talk about a lot, and you can relate to this because you practiced for one or two years, right? Yeah, sure did. Is that a lot of times clinical dentistry runs contrary to psychology in terms of how people... typically make decisions the whole diagnose treatment plan present tell patients everything that's wrong and then they're supposed to get excited about getting it fixed when they didn't know anything necessarily was wrong in the first place versus really understanding where the patient's coming from and presenting things in a way that naturally ties in to what they want to do there's a whole body of work just on the whole psychology of motivation and how people make decisions so that's all of this is based on that how we naturally make decisions now we have a situation where the doctors gathered all the information came up with a diagnosis now when that doctor presents the treatment plan to the patient do you recommend that that doctor has several treatment plan options at the same time now i don't know how that would play out i guess they feel the body language or they hear what the patient has to say and they go you know what let's switch to plan b so what's your feeling about that Yeah, so here's what we find a lot. So we work with hundreds of practices all over the country, and this is a common mistake we see. is that there's multiple treatment plans for the patient. So it's like, okay, well, let's do this treatment plan. But if they don't like that, then let's have this one as a backup. And if that doesn't work, then let's try this one. So they have kind of this whole stage, different treatment plans in case this, in case of that. So it's kind of like, Phil, if you were the patient, the feeling is, well, Phil, how about this? Well, if you don't like this, how about that? It's kind of like, let's see what works. And hopefully in all of this, we'll find something that they'll like. Now, I want you to contrast that to a patient experience where on the front end, the practitioner sits down and takes a moment to really understand what you want, what your goals are. what you're trying to achieve, and what the ideal would be for you, including what potential limitations there might be. It's understanding you first, what your objectives are. And then my job as the practitioner is to help you find the ideal solution that will help you get what you want. That's a whole different mentality and a whole different patient experience. So in an ideal world, which we subscribe to the 80-20 rule, which is, you know, 80% of the time you should be able to do what is ideal. There's always going to be exceptions, but 80% of the time you should be able to make it work. So to take the time up front, and then when you present treatment, it is in this. spirit to say, Phil, based on what you said you wanted and the outcome that you want to achieve and the limitations that we talked about, based on that and what I know, this is the route that I would recommend. Is finances involved with that decision to go that route? Potentially, absolutely, because that's going to be part of the discussion on the front end. If this is an endodontic procedure, for example, and you dealt with a lot of those. And I probably didn't ever deal with one that was expected. Nobody expects to have a root canal, right? So yeah, there's expected and there's the unexpected. So that's going to be a part of the dialogue on the front end. And then a big, big part of the financial discussion is not just how much. costs, but how it's going to fit into the budget and how the patient's going to pay for it. And there's a lot of, you know, that's a whole body of work that we talk about is how the difference between total costs and budget, they're related, but they're two different things. So if you've got that worked into the equation, then that fits. in that whole discussion. So you're saying 80% of the time when you go in with a very concrete treatment plan, present it to the patient and do exactly what you just explained, you're better off than having a plan B and a plan C at that visit and saying, well, it looks to me like you're not really looking to do all this work now and you have to send a kid through college and I didn't know about that. So here's another option. I would say the best, the ideal situation, do your homework on the front end. So what you present to the patient is something that fits them. You're not putting them in a position where they have to think through different alternatives. The hardest work we do, Phil, as human beings is think. We will do almost anything to keep from having to think. Because if I say, well, you could do this, Phil, or you could do that, now you've got to think through, okay, what are all the considerations? What are all the options? What are all the potential? Downsize the whole deal. And our philosophy is I'm coming to you. Let's say you're the dentist, the doctor. I'm coming to you as the expert to map out the ideal solution for my situation. So I don't have to think through it that much. If I wanted to know what you know, I would have gone to endodontic school. What happens in the 20% of the cases where you do get some pushback, do you say, well, let me think up another plan for you and we'll see you in the next visit? Or how do you handle that? Yeah, same visit. So what I would say, if there are things that come up that we weren't aware of, then I would say this. Okay, so Phil, based on what you said you wanted, There are other options. Now, I will say before we get into them, they may not get you the ideal that you said you wanted, but there are options. So with your permission, would you like to take a look at some other options? And I'll make sure that we walk through pros and cons and what you get. Does that make sense? Is that done at that visit or another visit? There's an inverse law. I'm what I call a natural laws guy. So there's all kinds of natural laws in psychology and physics and nature when you understand the natural law. So here's a natural law. There is an inverse relationship between time and acceptance. So what that means is the longer the time, the lower the case acceptance. So there won't be any more higher level of urgency for most types of dental treatment than there is today. short of having some crisis like a root canal or some type of crisis that's going to come up in the future. But if we're talking about it today, then we need to figure out the solution today. I'm not going to go home and think about it. I mean, when was the last time any patient ever called up a dental office and said, you know, I've been thinking about it for the last four weeks and I've decided to go ahead and get started? That rarely happens. So in the event, you do get some pushback. I'm just talking about the 20% again. Do you find that most of that pushback is due to limited resources financially? Sure. So there's a difference between what we call a condition and an objection. So a condition is a currently existing fact. Like a fact might be, I just filed for bankruptcy. Okay, that's a fact. That's a condition versus an objection is not moving ahead because I just don't know enough. I don't know what all my options are. So I might say, well, I can't afford it. But as we get and talk about that, what that really might mean for that patient is I can't write you a check for the full treatment today. But if I could pay it out over a period of time, then, yeah, I could afford it. So that's an objection. So as we talk through it. I need to determine whether it's a condition. It's just like an insurmountable fact, and there are very, very few things like that, versus an objection where we just need more information to be able to make a correct decision. Do you recommend, Steve, that a dental team member presents the office financial agreement a second time prior to the treatment being delivered, even though the patient already signed it with the new patient paperwork? So what we recommend is that yes, when you're presenting financial arrangements for specific treatment, that you review that financial agreement, all of those things that the patient agrees to do, you review that with them again so that that's top of mind and they understand what their responsibility is. So for example, if let's say we do... some third-party financing. Here's what our recommendation is, especially in today's economy, if you want to increase your financial arrangement success, you need to have prepared different options for payment. So for example, I give you one that we recommend in most cases that if patients want to prepay, so if they want to prepay their treatment, before it gets started and just take care of the whole thing, that you offer a prepayment courtesy. It might be something like 5% prepayment courtesy so they can save some money. And we present that by saying, if you were the patient, Phil, I'd say, so Phil, would you be interested in saving a little bit of money? Well, everybody wants to save money, right? So if you'd like to save some money, then for our patients who would like to prepay the total amount today, We offer 5% courtesy, which in this case would be, and I'd give them the amount of money. So this is what you would save. You'd save $50 or $150 or whatever it is. Then with different financial options, we don't recommend that a practice be the bank. If they need help fitting the treatment into their budget, then you're going to opt for a third-party financing solution where they can pay that out over a period of time that fits into your budget. So one, for example, there's a lot out on the market. One of the newest ones is a company called Sunvit that has been very, very popular in the consumer finance world. They've done a lot of work in other industries. They've just gotten started in dentistry. And they have... One of the fastest approval processes that I have ever seen. You have a driver's license and put in the amount of money and you get back in less than 30 seconds. It's a matter of seconds you get a response back. So then I'm going to present to you, Phil, here's what your monthly payment would be. And we can get started immediately. Right. So it's quick. It's easy. I'm helping you fit it into your budget. and everybody wins. Our recommendation is that you present one fee. So one of the biggest challenges in dental financial arrangements is if you print out your practice management software what is typically there, which is an itemized treatment plan of how much everything costs, you are... yourself up for disaster because we've all done it first thing you do when you see something like that as a consumer first thing you do is you go to the highest priced item that's on that list and you go well do we have to do the build up let's not do the build up right or you know you start eliminating things so we recommend there's there's one fee you present one fee it's one number and then here's what your insurance savings will be not your out of pocket We don't ever say out of pocket. So, Phil, here's the fee for the treatment is, let's say, $1,500. Your insurance savings is $500. And so your portion is $1,000. Now, we've gone ahead. And if you'd like to pay this out over time, then your monthly payment would be, you know, $100 or whatever it is. How does that sound? Now, before you have that conversation, do you work with Sunbit through their computer system to get that? monthly payment because you need that information you can do and in fact what we what we suggest is the ask the patients would you be interested in fitting this into your budget and paying it out over time so we just ask them that say great and then you can walk them through the process it's really easy one of the things that that i love about it is that there's no hard hit to their credit so it won't ever show up on their credit report it doesn't you know so it doesn't ding their credit it's a soft pull on their credit so it doesn't damage that you can explain that to them and it's very very fast so that's yeah that's an option so if it comes to needing financing, you have that information already available to you by running it through Sunbit first without it dinging their credit. And then you can finish the conversation as far as what their portion is and what their monthly payments are. And that's pretty fast, apparently. It's very fast and it works in almost any situation. So it's just a real quick and easy question is, Would you be interested in fitting this into your budget and paying it out over a period of time? If so, we have a quick process that we can walk you through. How do you suggest we measure success in the area of financial arrangements? All right. So are you a baseball fan, Phil? I was a Yankee fan most of my life until 1969. Then I was a Met fan. okay i was a new yorker mostly new yorker i love it okay so one of the things i love about baseball this is true in any sport but i think it's more visible in baseball is yeah baseball tracks the fine you know how many runs but baseball tracks everything every kind of statistic imaginable rbis and and all they track everything So I love competing against myself. I mean, competing against competition is great, but I love competing against myself. So how do you keep score? So there's a number of different ways to keep score in financial arena. One is total dollars presented versus total dollars accepted, right? So what do we represent? What is it that we got accepted? So that's one way. Second way is treatment plans. So how many treatment plans did we present? How many treatment plans were accepted? And then a third way is how many patients did we present something to? How many patients accepted something, got started with something? Those are all three related numbers, but they're different. They tell a little bit different story in different circumstances. One number doesn't tell the whole story, and numbers are, you know, practice isn't just about the numbers, but it is a way to understand what's going on so that you can improve your performance and do a better job of presenting treatment in a way that makes sense to your patients so that they say yes. In that metric gathering that you're aggregating over the course of your weeks and months presenting cases, would you include a section on that information where it says why they declined? What's the main objection or condition? I love that because then over... matter of a week or a month or a couple weeks, then you can look down and see, gee, maybe there is a concern here that we need to work on, on how to address it. So if the standard reason they didn't accept treatment is they couldn't afford it, well, that's only the tip of the conversation. Why did they perceive they couldn't afford it? So maybe we need to do some training around that particular comment to figure out how we can better address their concerns. Well, Steven J Anderson is with us here, and we're very happy to have him on our podcast. Like I mentioned in the introduction, he's involved with a lot of mentoring. He is the founder of Total Patient Service Institute, Crown Council, and of course, Smiles for Life Foundation, and the author of numerous books and learning programs. So we're very happy to have him on our show. Thank you very much, Steve, for your input. Great information. I hope our audience takes advantage of it. Thanks, Phil. Good to be with you.