PROBLEM | CONSEQUENCE | SOLUTION | STOP
This Simple Easy To Implement Communication Technique has doubled and in some cases tripled our doctors case acceptance rates.
Traditionally case acceptance presentations focus way too much on the benefits of treatment.
Instead this technique focuses on the consequences of no treatment…..
All human beings have 2 things in common….…..
- we want to avoid pain
- we want to experience pleasure
…….in a tug of war between avoiding pain and pursuing pleasure guess who wins?
Of Course the avoidance of pain!!!! No one wants to experience pain. Whether physiological or psychological in nature.
This is the psychological basis of focusing on consequences vs. benefits…..
Consequence = Pain. Benefits = Pleasure
Here is an example of how this works:
Doctor: John, do you see this crack here?
Patient: Yes, I do.
Doctor: Cracks spread. This will eventually spread into the nerve of your tooth, causing pain, infection and even tooth loss. In these situations, we place a cap/crown on the tooth that will hold it all together.
STOP TALKING. PAUSE FOR AT LEAST FIVE SECONDS and resist the urge to break the silence with further education, or worse, begin talking them out of the ideal treatment by educating them on alternatives or statistics.
Yes. That is it. No fluff. Simple and transparent. Believe it or not, many patients convert without much more dialogue.
If they don’t speak, simply ask, “Do you have any questions?”
Let the patient say the next words. This will be telling and will allow you to determine how to proceed next. For many patients at this stage, they have a crack, the consequence is obvious and the solution is obvious. The intra-oral photo has allowed them to co-diagnose, which is important.
The patient may be tense or concerned because you have elicited an emotional response from them (negative emotion, which is concern associated with pain, infection or tooth loss). They need to understand and feel the consequence so it serves as motivation to solve their problem. This is not trickery or a scare tactic. It is simply transparently and intelligently sharing the potential consequences of not treating the tooth.
Your job is to help patients understand the consequences of their problems and what the worst case scenario would be. I then give them the choice to avoid the worst case in a way every single one of them will unmistakably understand. This is preventative dentistry.
Education for a patient in a chair is much different than the education you received in dental school. They don’t care about most of the technical details you need to know to fix the crack in the tooth. They just want to know enough information to make an informed decision.
After the initial PCSS presentation, which takes a matter of seconds, you can begin a two-way conversation lead by the patient’s objections and questions.
Questions are either objections in disguise or a desire to collect more information or clarity. At this stage, feel free to use statistics (quote university studies), analogies, cartoons and other tools to drive the point home based on the patient’s specific questions–but not before they ask.
If there is no response, simply ask if they have any questions. REMEMBER: Educate to inform. Don’t confuse them with too much chatter and technical jargon. Keep the conversation simple and elicit the emotional response associated with the consequence of no treatment.
Examples of questions/objections:
- What is a crown?
- How much does it cost?
- Are there any other options?
- It doesn’t hurt or cause me pain right now.
Each of these objections or questions can be managed several different ways. Here is how we handle such questions:
- What is a crown? A crown is X,Y,Z (use visual aid and show before/afters of successful cases)
- How much does it cost? I am just straight up here. No beating around the bush. The cost of the crown is $X. The Good News is your insurance (for those with insurance) will typically cover a portion of that. This is a better way to position I
- Are there any other options? Yes. There are other options. You can remove the old filling from this tooth (if amalgam is present) and place a new filling. It is cheaper and quicker, but it doesn’t seal the crack, which still has the potential to spread and cause pain and infection. We can do this or the crown. We will support whatever decision you make***
- It doesn’t hurt or cause me pain right now. I am glad it’s not causing you pain. You’re very lucky, because many patients with a cracked tooth are in pain. Cracks typically don’t hurt until it’s too late, and at that point, the tooth is infected or needs to be removed.
***The goal is to help the patient understand the other option is inferior to the crown, as well to inform them that if they choose that option, we will deliver the treatment with no judgment and only support. This is important! Although we want them to do the crown because we know it’s the most durable option and the one which will solve their problem long-term, we also don’t want them to leave the practice because they feel we are pushing a crown on them. Do the filling and later you can recommend the crown again.
Let’s face it. Most people do not want dentistry–especially when problems are not causing patients discomfort now. Our job is to show them the Problem, Consequence and Solution and then Stop talking. Then we answer all the necessary questions.