Fontainebleau Miami Beach, FL
December 1st & 2nd
The Closing Institute’s Full-Arch Growth Conference
Bart: What is up, guys? How is it going?
Erika: How is it going? How are you doing?
Bart: I am doing good. I cannot believe it is December. We had our holiday party last Friday. I am like, “Is this year seriously over?” I know everyone is like, “I hope so. To hell with it.” Every time it is December, it still feels like it went super-fast. I do not know.
Erika: I know. It is like a blank.
Bart: It is crazy. Is Erika on yet?
Erika: I am. That is me talking.
Woman 1: Why can we not see you?
Bart: Oh. I cannot see your face.
Erika: I know you never noticed that until today, did you?
Woman 1: But now, we got to see your face.
Erika: I know. I really do not have a camera though. I am not even being a jerk. I promise.
Bart: You are not even. Okay.
Woman 1: You could do it on your phone?
Bart: You are not even something.
Erika: I could if you want me to. I do have my cell phone here. Can you text me the link? I do not know.
Bart: Just waiting for some of the other people. How has it been for you, guys? Has everybody been busy? Has everyone been closing? I know December can be super busy. Not busy? Did we mute you? Did we mute them?
Erika: I am going to switch to my cell phone. Hold on if you do not hear me for a minute, guys. I will be right back. Okay, hold on.
Man 1: He wants to hear from you [inaudible] which is a stupid thing because [inaudible] uncomfortable.
Bart: There you go. What is up, guys? Now, everyone looks like they are unmuted. Everyone has been busy closing?
Erika: Definitely been busy.
Bart: Good. Well, we have got a pretty good video to show today just a [inaudible] of errors, you know. No, I am kidding.
Erika: You are horrible. I am already sweating bullets over here.
Bart: It is one of Erika’s videos that we are going show. I like it because we are going to get to see a good part of the first ten. You get to see the second ten with the doctor. You get to see the close with the bundle. A lot of things on this call went right. I really enjoyed watching and listening to it. I think we are going to get a lot out of it today.
Bart: Hey, Erika, can you just real quick give everyone a back story? Because where the call starts off is actually during the patient education portion of the 10,10,10. Just give them a background on what happened over the phone because I know it was about 20 minutes spent upfront between you and that patient’s phone.
Erika: Correct. She was really nice over the phone. Actually, I have to pull–if I click on a different screen on my computer, will you guys still be able to hear me eve if I go into my progressive?
Woman 2: Yes.
Erika: Let me know. Can you guys still hear me right now?
Erika: Okay. Awesome. I just wanted to actually pull her up. She was this full arch kind of interested in like a snap-in type of prosthesis kind of from the beginning – very open. We definitely spent… I am going to see how much time we will kind of spend on the phone before she even came in.
Woman 3: 24.
Erika: Okay. Thank you. We tried to get a red fold up. She is very nervous. She made that clear to me in the beginning even when she texted me. When we were texting, she said, “Erika, I am so nervous. I am just a baby. Thank you for easing my mind.” I respond with “We are just hanging out….We are just going over options for you. Nothing surgical is going on…I promise, you will be pleasantly surprised.”
Erika: After that 24-minute phone call, we then had some texting that took place. She was just very anxious to even have the consultation. Then, she has custody of her grandkids who are really little. She had to cancel the first appointment. She texts me “Hey, somebody is sick. I got to pick him up from daycare.” I was not really sure what to think because I knew she was really scared to come in.
Erika: I thought, “Oh, boy. Here we go.” I got her to reschedule right away, but then she did. She came in. She is really a sweet and great lady. I really liked her. Then, we picked up where we left off. But we had already talked tentatively about estimates and stuff like that over the phone.
Bart: Cool. Okay. Guys, remember any kind of questions you have, just type them into the chat function. I will get to them. Then, I will unmute everybody and at the end, we can have a discussion about it. I am going to skip around the consultation because the whole thing from start to finish is about 50 minutes. So, I will kind of skip around a little bit. But, Erika, thank you for giving us that back story. I think you guys are going to learn something here. But Erika, just to let you know, girl, you did a good job. You did a really good job in a lot of areas.
Erika: Thank you.
Bart: I am super proud of you. You did a great job here. Let us go ahead and I will start in on it. Then, I will just stop it and give you guys some feedback along the way. Any questions just write them down.
[Bart plays video he is screen sharing]
Erika: Please, sit in the chair here.
Mrs. Kim Reynolds: Okay.
Erika: I am going to put this down for you because it kind of…
Erika: I do not think they showed you what a [inaudible] tells and what it means to have that as an option.
Erika: So, I want to make sure you got a good visual so it all makes perfectly good sense.
Erika: All right. [inaudible] things here.
Reynolds: Yeah. That was all he said was “Take those [inaudible] out and [inaudible].”
Erika: How did you feel about that? Were you immediately like “Okay that is just my option, that is what I have to do or were you thinking, ‘I have heard of your things and do I just need to qualify as a candidate?'” What were your thoughts?
Reynolds: I was just like no. I mean, at the end of the day, it definitely comes down to I do not want to. [inaudible] I am 54 years old. I cannot.
Erika: No, you are still very young and you have those grandbabies, they are going to keep you young. I know you are still busy. It is so hard.
Reynolds: It is crazy.
Erika: They are so lucky.
Reynolds: They are so cute and temper.
Erika: That is what I am saying. They are going to keep you so young. They are going to take years off you and [inaudible].
Reynolds: Anyway, I cannot. I will lose the dentures. [laughs] I am like, “Stop!” They are not going to take me seriously. So, that is the problem.
Erika: All right, what I am going to show you first is just what an implant looks like. The idea here is that this is what the tooth entails. That is the crown, which is above the gum level. But below the gum, roots are pretty deep and entailed and go into our jaw bone. So, an implant is just a titanium screw that essentially just replacing the root. So, the crown part really has nothing to do with the implant. It will be everything below the gum level.
[Bart paused video]
Bart: Hey, guys. A couple of quick comments right here at this point. If you guys are on the phone with the patient, the more you can do over the phone, the more time it is going to save you on the consultation. I love getting right to it. The one thing that I would definitely do before I kind of started in on the education is do a quick recap on whatever that vision was. Whatever their point of urgency was. Whatever their goals are of the appointment. I would try to do a quick recap because remember, we are not selling the implants or protocol. We are selling a specific outcome. You always want to make sure that you recap that and both of you were clear.
Bart: So, for instance, “Hey, I remember over the phone. The main goal is to stay out of dentures. I want to get you in something to restore the function so that you can eat and just have a really good quality of life. Something to give you that is going to be stable, something better than dentures and certainly light years ahead of where you are right now. Is that right?” It is to quickly recap where it is and build the energy back up.
Bart: I have had experiences where sometimes you would be on the phone with somebody and you would get them so emotionally invested and excited. By the time they come back in, you do not know what happened that day. They could have had a bad morning or kind of a weird mental state or they could be depressed. It could be anything. You want to make sure that we recap on what is most important to them before we start in because that would normally be the first thing that you do. Right?
Bart: You are touching on their pain points, concerns, what is bothering them, and ultimately what they want. What do they want to accomplish is kind of the first thing that we do once we figure out that vision then we can move on. Sometimes you will make it through the entire first 10 over the phone. They are coming back in for the second 10. Again, I would not start until I did a recap on the vision to make sure I got them motivated, right? You do not want them sitting there in a hundred percent consumer mode. You still want them sitting there as a person thinking about an outcome and how it is going to help them and help enrich their life and alleviate their pain.
Bart: Having said that, another challenge I have been seeing with the videos is your ability to connect with the patient wearing a mask. It is tough. It is really difficult and I think Erika does a really good job connecting by using energy and by using tone. You have to get into it. It is just harder when there is no–when they cannot see your face. It is almost like a phone call. So, keep that in mind. You have to really come in with some energy and tonality. She did a really good job of that in terms of grabbing her attention.
[Bart plays video]
Erika: Titanium is a metal that our bodies love. The in-hip replacements are typically done with that sort of metal. Really low infection rate. Kim, do you have a rod or something?
Reynolds: I have three cages.
Erika: Oh wow.
Reynolds: And rods. And one in my neck.
Erika: How did you respond to those?
Reynolds: I am fine…if it did not feel so cold.
Erika: I was going to say. I heard people say that. It is so weird.
Reynolds: It gets cold.
Erika: It is response to the weather. So, that is what it typically looks like in a sense. There are all different sizes when it comes to them but I would say surgically when they are taking something like that and placing it in the jaw bone, that is kind of what they are dealing with.
Erika: The idea is that you can replace something that needs to come out in a more permanent way than just putting in dentures. Then, I will show you how it kind of relates to doing a full set of teeth. Because it turns out that the current teeth just are not in the best state. They are not in the best health. It is going to contribute to your health in a good way overall. Then, they would typically need to be extracted.
Reynolds: This one is a little cracked. They are what is left.
Erika: They are acting up.
Reynolds: Two of the [inaudible] it is a mess. You will see.
Erika: Okay. It is okay though. The good news is there is a way to fix this stuff, right? So, we have come a long way in years with Dentistry over the last like ten I would say.
Erika: So, this is the idea of the traditional denture that they were talking to you about. They take something with a full pallet and somebody applies adhesive, some type of glue. They put it on. They let it set. They are trying to keep it in that way. If that is you know all something that somebody can…
[Bart pauses video]
Bart: Erika, really quick over the phone you went through pricing on these options. You did it almost a triage over the phone. You went through pricing with the patient, right?
Bart: Okay. So, did you give her you gave her pricing on removable and fixed all you’ve already given her the pricing?
Erika: I am pretty sure I do feel typically especially with like Covid people who want to find out as much as they kind of can before coming in. I have been trying to figure out how to have that conversation, and still entice them to come in too. But from what I remember with her, we touched on it lightly. It kind of ranges to different things and trying to actually show her what I was talking about now that I had her in person.
Bart: Right. Did she ask you for the pricing?
Erika: In the initial phone call, I do not fully remember. I feel like she may have? I did not listen to her call before we started this day. I do apologize.
Bart: All right no problem how did she react when you give you the pricing?
Erika: She did not act like, you know, she was not scared off by it. I think it was a matter of figuring out how she was going to work it out and which option was going to be best for her. She was not terrified like, “Oh my god! That is way too–“. Some people immediately act like, “It is just absolutely the craziest thing I have ever heard”. Then, some people” Okay well, I do not know exactly how I am going to go about that. I have to figure this out.” But they are not deterred by it. She definitely was not deterred by any numbers.
Bart: Okay. Got it.
[Bart resumes video]
Erika: …it is better than having no teeth, right? So, it is going to be like step one of finding a way to replace the smile.
Erika: Typically, the second step from now is what they called the snap-in. We talked about this on the phone.
Erika: So they are taking at least four implants, maybe six. They are placing them in the jaw bone and then they take a prosthesis and they are enacting it. It does cover the pallet though and it does not cover fully the way the denture does but it does come about halfway down at least. Then, it sits over the top of the gum line all the way around. When it is in place, you are not using an adhesive at all, it is connecting two attachments to those implants.
Reynolds: I like that.
Erika: So it does not rock or comes out when it is in. To get it out, because some people are concerned like, “Oh my gosh, and then what? Do I just touch it and it is going to come right out?” Not at all. There is usually almost like a little hook that you use to disconnect it and pull it out from the attachment so that it might – you can deep clean the prosthesis using a tissue.
Reynolds: Now, what about if they come out?
Erika: Over the years from wear and tear they could. Then it would be just a quick fix to go back to the doctor that made this prosthesis which would introduce you to another office that makes beautiful teeth and works hand in hand with us. They do not protrude as drastically as they show here. So, this is just for illustration. They would only come up just a tiny bit from the gum line to connect it to this.
Erika: Over the years though, you are right. From putting that pressure on the prosthesis while you are eating and stuff can start making them a little bit loose and then they just replace those attachment pieces and screw on new ones. So, it is pretty minor to you [inaudible].
Reynolds: Okay. That is cool.
Erika: Yeah, so you never got to see a model like this or anything?
Erika: He was slacking.
Reynolds: He is. I did not say it.
Erika: I do not know him personally; I am just messing around. I do see his commercial though.
Reynolds: I cannot even say it.
Erika: Oh, I am so sorry.
Reynolds: No, it is just like he read me the profile.
Reynolds: He did not talk in-depth to me about any of this. Which doctor are we talking about?
Erika: You are so silly.
[Bart skips video]
Erika: …oral surgery here, but they are not going to be your final set because your implants need time to heal. They are not ready for that type of pressure. This is the fixed one. So, the implants are in, this is supposed to be…
Bart: I am going to skip ahead here real quick guys. She does a good job with all of this.
[Bart skips video]
Erika: … [inaudible] here in just a moment. There is a bar that runs underneath there giving it extra stability. You cannot take it out on your own at all. Once your dentist would unscrew it, take this off, they do a deep clean for you. You would do your own type of cleaning each night with brushes that reach underneath here.
Erika: Okay? So just to kind of give you an idea of the different things about thus because I know I only talked about traditional dentures, that is not what you are really here to hear about today. However, I just wanted to show you all three together.
Erika: Okyay. So, I will get Doctor Negali in here in just a moment and I will pull your scan up on the screen so you can see what that type of scan looks like – that will give you an overview of the job. Then, he can see your bone levels and stuff like that in those areas, what we are dealing with and he can talk to you about options and plan out a procedure.
Erika: I know we touched briefly on fees over the phone, but we will depend on what exactly you want to do and what cost point you would fall out.
Reynolds: Yeah, and I have no idea. I looked at my own insurance. It looks good but I am not sure if I am reading it right.
Erika: You have Guardian from what they told me at the front desk so I will tell you the one good thing about Guardian. Even if you are having something done that they do not cover, we are still held to our contract with them because we have a special agreement with Guardian. So let us say to extract a tooth, it is one hundred dollars but they said “Sorry, Margarette, we do not even cover extractions” Then we say “Well, our contract rate with them is eighty dollars and even though they do not cover it, we cannot charge you beyond that for now.” Does that make sense?
Erika: So, you do have that going for you which is super great. If that is your plan.
Erika: You are going to get some type of savings for sure.
Reynolds: Yes. I am scared to death. I [inaudible] to be real.
Erika: No, I understand. I think you are on the right track. The first step is coming in and finding out what are my options and what can I do? The next thing is making a decision and finding what is best for you.
Erika: So we will get your scan pulled up… give me just a moment.
[Bart pauses video]
Bart: Okay. The impression I get from this patient, and it is quite a different jump in here and not having the phone call being a part of the consultation right now, but the feeling that I get is that when she says she is scared to death, I do not get the feeling that she is scared to death of the surgery. I get the feeling that she is scared to death of the price.
Bart: That is what I get from her. Like, oh, God. I do not know. I checked with my insurance and I really do not know. In the phone call, if she prompted me to do triage, remember, ladies, we are not going to or typically we should not bring up pricing, a ballpark pricing, unless the patient prompts us or gives us a reason to think that price is their number one concern then we do not even do it. I am guessing if Erika did it she was prompted in one-way shape or form to do that.
Bart: We are dealing with a couple of different types of situations here. Either it is somebody over the phone who is deeply concerned about the price and we get all the way through triage to where I am quoting ballparks, I am going to gauge her reaction and go, “Okay, is this sale going to be a hundred percent contingent upon financing or does this person actually have money?” I have to put them in one of those categories if I can.
Bart: If the answer is this sale is a hundred percent contingent on financing and they have nothing to put down, then I would probably try to run them and get them pre-approved over the phone. I would try if I already had them online, I was already going through a triage.
Bart: Right now, I am wondering what she wants because she is obviously miserable and super self-conscious. She wants something so bad, but the fact that she is so worried kind of worries me. It does not feel like she is somebody with anxiety from the clinical part rather because of the money.
Bart: She is going “God, I need this. I cannot afford this and I already know it”, do you know what I mean? She is almost anticipating for them to say, “We cannot help you”. The only question that I was thinking, and Erika might not even have the answer to it, but if we had the price conversation, did you ever ask this particular patient over the phone how much she had to put down on treatment?
Erika: No, I do not think I did ask that to her. I know Veronica had mentioned something to me as well. I do not think I asked her flat out, “Have already been saving towards this? Is there something that you have prepared to put down?” I did not. Maybe I should have pushed that a little bit harder before she came in, in order for me to know the kind of the history of what we were going to be dealing with.
Bart: Yes. Okay. Well, everybody, remember this, if you are going to get somebody pre-approved, what I always like to do before I run them through proceed or green sky or anything like that, I will ask them what they want to put down on the treatment. “Okay. We will go ahead and get you pre-approved. How much would you like to put down?” And again, I am just looking to see if I get a real number.
Bart: “How much can you put down? Can you put down fifty percent, ten percent, twenty percent, ten thousand, or twenty thousand? What can you put down on treatment?” Just ask them. I am just seeing if I can get a real number. If the wholesale is contingent on financing and they do not get approved anywhere, it does not make a whole lot of sense to move forward with the consultation, right? But if they tell you, “Look, I have ten thousand dollars to put down. I would like to finance the rest.” Even if they do not get approved, I am still going to bring that person in because thousand dollars is big enough if that is what they can put down easily. If that is the number, they give you, then they can probably afford twelve to fifteen-thousand-dollar treatment even if I have to finance it in-house form for let us say three months.
Bart: You know what I mean? Fifteen grand, take five grand a month for three months, and then do the surgery. I know that ten thousand dollars is worth me bringing them in and spend some time and figuring it out. But if they do not get approved and they have ten thousand dollars, it is probably not going to be a double arch treatment plan. You are probably going to be doing one arch at a time. That is a small piece of information that throughout the whole consultation my brain has been constantly wondering if she has any money or not because we are going to go through an entire consultation and she is showing anxiety about the price. If she has no money and she does not get approved, then we are sunk and it is an hour gone. So, my brain is like, “I am trying to figure that out.” Okay. I am going to skip forward.
[Bart continuously skipping the video]
Bart: She does a really good job of explaining everything – basically just showing her that her teeth are useless which she should know.
Erika: All right, Mrs. Reynolds, this is Doctor Negali.
Doctor Negali: Hello. How are you doing? Nice to meet you.
Reynolds: Nice to meet you.
Doctor: All right. Erika has told me a little bit about what is going on here.
Have you lived here all your life?
Reynolds: I do.
Doctor: Great. I have lived here a long time too.
Reynolds: Yes, me too, I love it.
Doctor: Do you work?
Erika: Well you do, you take care of two grandchildren.
Doctor: Okay, that is like [inaudible] kind of job].
Reynolds: Yes, two and four.
Doctor: I should have said “Do you work outside the home?”
Reynolds: No. I do not anymore because I had back issues and back surgery.
Doctor: Okay. So how old are your grandkids?
Reynolds: They are two and four.
Doctor: Wow. They require a lot of attention.
Doctor: Boys? girls?
Reynolds: Jackson is four and Aubrey is two. My husband and I raised three girls.
[Bart pause video]
Bart: Erika, how long do you spend prepping Doctor Negali before he comes into the room the second time?
Erika: Some quick moment. He is usually pretty busy. I let him know if they have good energy already. I tend to indicate if I really like the person. For example, “She is great and I do not think she has time to take care of herself because of her grandkids. I do not know the situation exactly but she did cancel before it was due to them. We got her in here today…”
Erika: It was just a quick overview to let him know that she seems like she really wants to do something. Because of this, he has an idea of her kind of energy. She is not super hyper but definitely in a great mood and open to everything I was saying. If not, I would tell him. I do not exactly use the words that I probably use but I would indicate for sure that we have a tough crowd in there so he knows. Then, we try to go a little bit harder. But with her, we were able to match her tone because she has such a great personality.
Bart: What I think would help is if you give them a lead-in for rapport building so it does not take so long and it is not awkward. What the doctor is trying to do is build some kind of rapport. He is trying to find some commonality.
Bart: “Are you from here or not from here? Do you work? Do you not work?” If you just tell him before he comes in and say “Hey, she has got custody of her grandkids. She takes care of both of her grandkids. Her teeth are pretty much useless. She does not want dentures and we are probably looking at implanted-support dentures.”
Bart: Then he is going to be able to come in the room and say, “Hey, how are you doing? I am Doctor Negali. Erika tells me that you are pretty busy taking care of two grandchildren, right?” With this, he can lead in with something instead of asking open-ended questions. It is more difficult for some people than it is for others to get in and dry start a conversation and rapport. I think if you just give him a lead-in, he can just lead right in with that and immediately transition to, “I understand that you are missing a lot of teeth and the teeth that you have need to be removed. You will want to get this taken care of with dental implants.” The, he is into the zone and not going to take two to three minutes or longer to get there and you can avoid any awkward moments. Do you know what I mean?
Erika: Okay, definitely.
[Bart resumes video]
Reynolds: …a boy is like such a…
Doctor: It is a different energy – a totally different energy, right?
Reynolds: Yes, I found out. My grandson is so crazy.
Doctor: Oh, boy. Especially at that age, as they get older it levels out obviously but at that age, it is really a different energy.
Reynolds: I cannot get enough of him as he is so funny.
Doctor: Good. All right. As I was saying Erika has told me a little bit about what is going on with you and your concerns about your dental health which is good. It has been pretty tough for you to socialize or?
Doctor: Yes, everything.
Doctor: Sure. It is going to be over hopefully soon. When you take off the mask and it will be like looking at an unveiling.
Reynolds: Yes, there we go.
Doctor: What things do you miss eating?
Reynolds: Honestly, I would say chicken breast. I really eat a lot of it…
[Bart pauses video]
Bart: I would hope right before the doctor walks in he knows what are her main concerns and what service instead of asking open-ended questions. It ends up just kind of dragging out. What we want to do is truncate this, “I understand that it is hard for you to smile and feel good in public. It is getting kind of difficult to eat and chew, is that right? Well, do not worry. We are going to take care of all that for you”. The doctor can get right to his part since Erika already did that in the first ten minutes. So, Erika, it might be better to have a little bit more of a structure. For example, before Dr. Negali comes into the room, these are the three or four pieces of information I need to give him. Make sure it is super structured so he has everything already. The more we can avoid the open-ended questions the better.
Erika: So, should he just really go in and immediately restate? Because I think part of the reason, he is doing it is to make sure the patient knows that he does know or that he is checking for this information too. To get past how long that took, should he really just come in and state that he already knows these things as factual because I have told him?
Bart: Of course.
Erika: So, then they do not feel like confused – like he should just start right with that?
Bart: Of course, otherwise, it is going to feel redundant to the patient. Because you asked these questions and now, he is asking the same questions. It will seem that you two have not communicated. The whole point of him in the consultation right now is to determine if she is a good candidacy, make a primary treatment recommendation, and build confidence. To make a primary recommendation, we have to frame that the recommendation is a reflection of her vision or primary desired outcome. You restate that you understand that they are struggling and their want and so on. “Okay, I have got something you are really going to like. I think you are the perfect candidate for it. There might be some problems, you are missing teeth, and we will extract some other teeth. But all in all, I think you are really a good candidate for this. Let me show you.” Then get into the X-ray and do your thing but control it. We are like four and a half minutes but I would be 20 seconds in and further.
[Bart resumes then paused video]
Bart: But guys, seriously, if we do not prepare the doctors when they come in, what is their alternative? They are not going to feel good. Subconsciously, they are going to feel like they need to build rapport to get to know the patient. If you already have the information, you can restate it or do a quick recap, you are going to be in rapport so much faster. We just have to make sure that we get them ready with the information that they need.
Reynolds: …I feel like we are on the go.
Doctor: So one of the things we find is that as we get older, we are going to eat healthier and eating healthier food typically require some chewing.
Reynolds: Like salads, and I love salads.
Doctor: So getting you something to chew with…
[Bart skips and pauses video]
Bart: Basically what he was trying to do is create the vision so we have something to anchor on. It is not bad if you do not know it. That is where I would start too. But hopefully, he already has it. Now, he is just going to take a quick peek and then kind of get back to the options, basically her three options.
[Bart resumes video]
Erika: Do you need anything?
[Bart skips video]
Doctor: You got to pick one of those three.
Doctor: It has got to be something completely removable [inaudible] or something that is supportive with implants.
Reynolds: Honestly, I would prefer if I can do something that is supported. Emotionally and mentally, with dentures, like I do not have to do that. I prefer not to.
Doctor: Sure. What I always say to patients about replacing your teeth with prosthetic devices, the best chances that you have for success with your own teeth [inaudible] need to be removed but my point is whatever we are replacing it with, you will need better care than what your teeth require. One of the big advantages of doing something that is removable is that the prosthetic attachments can easily be cleaned.
Doctor: So they can be removed at the end of the night or the other day rather than replacing…
[Bart paused video]
Bart: Erika, what is the specific reason that we are really focused in on removable the whole time?
Erika: If he thinks that hygiene is going to be an issue that they are not going to take good care of their prosthesis especially when their teeth are really nasty, and hygiene overall seems to be a little bit of an issue. Thus, he will push a snap-in if he thinks that they are going to blow it with the fixed. You cannot take it off therefore the cleaning is different. If he comments that the patient is not brushing their teeth then you are not able to clean in between this gum line at night, however, I have a better chance of you with these implants and everything staying successful with the snap-in because you are going to take it out.
Erika: That is usually just what the doctor tells me. If he starts talking about that snap-in more during the consultation, I am usually clued in that he thinks by looking at their mouth that their hygiene is really horrible and that they do not even really brush their teeth.
Bart: I mean that is true of anyone with terminal dentition, I would think.
Erika: I know but to some extent – I do not know because if not, I feel like we do talk about the fixed a little bit more? I do not know. I could ask him about that myself and get a little bit more clarification.
Bart: I would just say it is a question for the patient usually. Like, when you are going through the options. Do you have any strong feelings one way or the other? Fixed versus removable? She already ruled out dentures. She is trying to avoid them. That is why she is there. I always try to ask for fixed versus removable and if they have any strong feelings either way to kind of see what they want and why they want because we are trying to frame the treatment plan as though we are not pushing anything. We are not pushing fixed. We are not pushing removable. We are recommending something based on what you told me that you want. If you are describing a solution that is fixed and that does not come in and out and has a maximum function and maximum aesthetics, then the recommendation is going to be fixed.
Bart: If they are describing something that they want to come in and out, and something that is going to be, “What is my full arch implant option for the least amount of money?” if they are saying stuff like that, then it might be removable but all of the options whether it is implant-supported denture or full arch fixed, they are all going to be good treatment recommendations as compared to where she is right now – the state of her health.
Bart: So, again let the patient treatment plan themselves. Just let them. They cannot do any worse than they are doing right now. That is the thing with a full arch. So, it does not matter. Whichever one they pick is better than where they are. I try to ask them questions and based on their answers, then that is what I am going to recommend unless they give me a reason why. For instance, “No, I want maximum function. I want a great-looking smile. I want to look like a movie star, but I want it friggin’ cheap. As cheap as you can give it to me, that is where I want it.” Do you know what I mean? Okay, I will make you look like a cheap movie star then. How about Hasselhoff or something? I ca not do Tom. I will do the Hasselhoff. Okay, let us keep going.
[Bart resumes video]
Doctor: In between, you can easily get in there and clean that. For long-term success, that might be a better option for you.
Doctor: Because it requires a lot of manual dexterity in the [inaudible], a lot of dedication to floss, the prosthetic, appropriately and keep them clean. I am not saying you cannot do it. I am just telling you what my thoughts are in terms of what I think is going to work the best for you long term. Sure, we get any to work for a year or two years or three years, but if it is not being maintained at a very high level, then I am concerned that you are going to be disappointed and not get the outcome that you wanted. You can get a lot of retention with the snap-in or they are called over-dentures.
Doctor: Okay, you can get a lot of retention almost as sometimes to the point where you need – there are actually kinds that they make where it is made of crochet hooks [inaudible].
Reynolds: That is wild.
Doctor: Yes. So they do come out. It is cleanable. They have a tremendous amount of retention. There are parts of them that do need to be replaced every couple of years because you are taking them in and out that the retentive part kind of wears. So, there is that to think about but I think that it will be definitely a step up from conventional dentures.
Reynolds: Okay. [inaudible]
Doctor: Conventional dentures give you twenty to thirty percent of the chewing function of your natural teeth.
Doctor: The removable ones that we are talking about will give you about fifty to sixty percent. The fixed will give you about seventy to eighty percent. So there they do give you more function as you go up, but I want to be able to deliver something to you that is going to be reasonable and hat I think you are going to have the most success with.
[Bart paused video]
Bart: Hey Erika, what does that mean right there when he said ‘reasonable’? Why does it sound to me as if he knows that she cannot afford fixed? It sounds like he is recommending implant-supported dentures because fixed is out of the question financially. I am not saying that is what it was, but it sounds like that.
Erika: I mean, usually it is a hygiene issue and I know you are going to say that their mouth is jacked up if they are in that situation but I just know he will say to me like, “There is no way that a permanent bridge is going to last in their mouth if it is like at a certain level already.” He just does not expect their habits to change enough to be able to long-term down the road for it to last for them.
Bart: So, what does reasonable mean? That was why I stopped it.
Erika: I think reasonable for her upkeep and whatever level of responsibility that she is going to put into maintaining it. Just based on what we usually discuss with it. Before that point, maybe like a minute back from that, he was saying that, “With your hygiene, you really have to clean and you really got to do this. This might be a better option for you.” Like in other words, that was a nice way of saying, “We do not think you are going to take care of this really.”
Bart: Well, actually I like the way that he is presenting it. I like it if the concern was the price. If it was a price thing, then we already knew she cannot afford it and she is not going to buy fixed. Then you want to position it as though, “Hey, it is going to be easier to take care of. It comes in and out you can clean better and do all these things.” But just for hygiene, I think that is probably a discussion that you guys can have because they are offering a warranty and you know, how many people that need full arch had fabulous hygiene habits at home?
Bart: None of them. So, we are going to run it. You guys are never going to sell a full arch case fixed if we are going to do it like this. So, you tie it to the warranty. You say that this full arch fit is something that can and should last for the rest of your life. It can and should – there is no reason why it would not. We over-engineer it to last but in order to last it requires maintenance. Part of the warranty program that you are going to be on, I mean, we guarantee all of our work but you have responsibilities here too and you tie the maintenance visits and their responsibilities with the warranty. Right?
Bart: If they are a smoker, they do not get a warranty, clearly. If they are missing maintenance visits, the warranty is null and void. The only thing you can do is give them the options that they want to allow them to move forward and then give them a decision. Because I do not know how many terminal dentition cases you are going to find that you are going to feel a hundred percent comfortable. I think just tying them to the warranty and giving them some accountability there is really going to help your position, “Oh, no, we will not even warranty it if you do not do this.” So if they do not do it, it is not like they are going to come back and see how it was your fault for the implants.
Bart: In writing, it was explained, you sign this and we have not seen you in seven years.
Bart: Sorry about your luck but we will do it again – but you are going to charge them.
Erika: That makes sense.
Bart: What if the person did give a price objection then this is actually a really good way – that is a good spin on it. You do not want to make it sound like this is just an inferior option to fixed. He is making it sound really good when he says something is reasonable. It felt like that is why he was doing it. If that is the case, I think that is a really good way.
[Bart resumes video]
Doctor: They are not but that is a good way of thinking. They are called over-dentures because they sit on top of…
Erika: Do you want to touch it to try it out? You definitely can.
Doctor: So for instance, the pallet, lot of times can be minimized or even cut out.
Reynolds: I wondered how thick it was and if my tongue would get stuck in there.
Doctor: Oh, your tongue cannot get stuck in there.
Doctor: There are usually small nylon rings in there and that provides the retention needed. I have had patients who were happy with the result of this option.
Reynolds: Yeah, I like that.
Doctor: So, the way we do it here is we use like a lighter type of anesthesia – almost like conscious sedation, almost like what you would get if you had a colonoscopy or something like that. You would either be aware or not aware of what was is going on. Either way you will be relaxed. You may or may not remember. All of those teeth need to be removed. I work with a dentist partner, not a business partner, we are just paired up to do these kinds of cases together. They are down on Sandhurst and [inaudible] similarly do a great really great job. I am not a surgeon so even though I have made dentures you probably do not want me – that denture that you see right there is the one that I made when I was in Middle School. You probably do not want to see that.
Doctor: That was like 10 years ago.
[cross talking and laughing]
Doctor: So you want to see somebody who is skilled to do this for you in an expeditious way. They are the ones that we have chosen to work with because they are really good.
Reynolds: Yeah. I do not know. So, it is full? You cannot do like half, if that makes sense?
Doctor: So, what did you mean by that?
Reynolds: I did not know how it look. It looked faulty.
Erika: Not individual.
Reynolds: I do not know [inaudible] What are you supposed to have?
Doctor: [inaudible] a removable opening looks like that. We want to at least get you to a first molar area.
[Bart pauses video]
Bart: She might be asking if you can do one arch at a time. I do not know but she might be asking can I do the top or can I just do the bottom? Or she could literally be talking about that which would be a first for me I think that is what she is talking about here.
[Bart resumes video]
Doctor: When we are talking about over-denturing, you usually do not get a cold.
Doctor: In order to make that happen for you, we place implants but we actually need to build that bone for you. You do not have a lot of bones. You have lost a lot of bones along with the periodontal gum disease that you had. A lot of time you do cut back the bone to make space for all that stuff. But in your case, it is very long gone. The first phase would be taking out all the teeth and we will give you temporaries. We would probably bring down the lower jaw to make space for that. We would do sinus graft in the upper jaw, then we will place bone between the bridge and the science lining.
[Bart pauses video]
Bart: Okay. I am going to skip ahead to the bundle part, but the only thing I will say here – Erika, do you watch this with Dr. Negali? Did you guys watch this together?
Erika: We definitely did not.
Bart: It is good to watch it together sometimes because you will notice things on video that you are not aware of when you are actually in it. I noticed that the main thing that I need as a treatment coordinator from the doctor is to make a primary recommendation and build confidence which means they need to appear extremely confident in their primary recommendation. Does that make sense?
Bart: If you appear unsure or uncertain, for instance, “I want to do something reasonable. I think you will be happy with it. I think that is probably going to be good”. Though, he does a good job connecting. He is very non-threatening. He is very personable. But there is a certain point in the conversation where the doctor can say, “From looking at your x-rays, a lot of time has passed but honestly as far as a full arch, I think you are still a perfect candidate and there is a lot of people that are not. There is a lot of people who have so much bone loss that you cannot even do the implants but instead need zygomatic implants and go all the way to their cheekbone with the implant. You are not there yet. So I feel super confident. I feel very good about you in this case. I think that you are going to get a phenomenal outcome. Absolutely phenomenal.” Like, I would like to hear that. You know what I mean?
Bart: Above and beyond, anything else just get a hundred percent certainty and tell them, “You are going to do great. You are a great candidate for it. I feel really good about this – really good. I think you are going to love it. So that is Barting They are not going to know. No one knows. That is what the video is for. I think that is what you guys are there for, to provide some feedback. If you think you get through that doctor portion, and you did not get a lot of certainty and they did not really kind of hit it out of the park then just give that feedback later. What I would recommend instead of you giving the feedback, watch the video with them and kind of help them draw their own conclusions there.
Erika: Got it
Bart: …for them to see it and come to that conclusion on their own than for you to give it to them sometimes. Some people can handle that better than others. Okay. So we are going to get to the close here, we will go through the bundle.
[Bart resumes video]
Erika: [inaudible] it is rare to walk in somewhere in life and say “Hey, I have a full amount for this – ready to go right now…”
[Bart skips then pauses]
Bart: Sorry. I skipped over an important part right there.
[Bart is finding the portion of the video clip]
Erika: It is just me and you are good if you are going to take a sip of that. I have my mask on.
Reynolds: This is the scary part.
Erika: No, I do not want you to feel that.
Reynolds: It is scary.
Erika: Keep in mind, that is what finance is for. It is rare to walk somewhere in life and go “Hey, I have a full amount for this – ready to go right now.” I do not know about you but that is usually not my situation.
Erika: So that is where the financing comes into play. Do not be concerned.
Reynolds: [inaudible] I am financially [inaudible].
Erika: [laughs] Okay. I do not want to make you nervous.
Reynolds: You are nobody. I will be like, “Oh, my god!”
Erika: Okay, so we are going through the list of what the entire process entails. From your consultation, down to your–
[Bart pauses video]
Bart: Did you guys hear her say “Oh, God. This is the scary part?”
Bart: So what it felt like at the beginning was exactly the case. The scary part is the price. This scares me because an hour has gone by here and we are not going to get her financed so she is not going to have any money. That is something we could do over the phone.
[Bart resumes video]
Erika: …extraction of the teeth, the angioplasty that will reduce the ridge, the sinus grafting, the Gunnell implants, the sedation, all the x-rays, follow-up visits, the temporary prosthetics you will wear while healing, the final snap-in that you have that you are going to be in love with–everything. This list shows all the individual prices and I am going to show you that we do not necessarily charge you itemized like that. Because Dr. Negali has that partnership with Dr. Papano around that corner, they do kind of have an agreement where they bundle these fees. So, I know what their fees are, I have our fees here, I can put it all together. This will help you know without ever even going to their office. You already know what those final fees are going to be.
Erika: So, we will go through all of these. You have a consultation fee that is usually around that. We are not going to charge you for that. Okay, you will have clinical photography throughout this process, we are not going to charge you for that. We did the 3D scan today, that was complimentary. It is all inclusive with this – a planning session is when the doctor is paying off the surgery. The extractions would be for however many teeth are remaining.
Erika: Angioplasty is when we smooth the ridgeline down.
Erika: Usually you end up paying for like the cost of the implants, the grafting. We do not charge you for uncovering the implants down the road when they heal. That is a fee for X-rays, you usually end up paying that. We do not charge the anesthesia, [inaudible] guarantee. Usually, you do put that kind of what your money is going towards.
Erika: We are not going to charge you for the soft tissue grafting or the other types of [inaudible] after that they are going to do to build up that site.
Erika: We are not charging for any follow-ups, the temporary denture, the final wear, or the attachments that make you go together. When all those things are added up individually, it is thirty-two thousand seven hundred and fifty dollars – two years ago that is exactly how we charged it out.
Erika: So when we started bundling with her and we started this partnership, it brought it down to a total of like around fifteen thousand
Erika: That is per an arch. Usually, before what it costs to do one arch, it was less than to do the full mouth.
Erika: People usually try to finance for the full mouth – for any reason that did not work out, there are other options as well which is mixing and matching. Worst case scenario, if you have to do a traditional denture–
[Bart pauses video]
Bart: Okay, so we are going through the close here. A couple of times she is going through it line by line. Marking things off and the patient is going to “Oh wow. Oh okay.” You are getting good positive response but one thing I am looking for with this patient is hard for me to read. This always makes me nervous. If I am selling somebody, going into a close and I do not know for sure that I have them at the tense. They like and trust me. They love the treatment. They think they are getting a great deal. They loved the company-I do not know what her level of excitement or her level of certainty is. I love to see her, you know, at one point in time, when we are making a recommendation like, “Okay, cool. What do you think? Does this kind of give you everything that you want? Are you excited?” I would be trying to get her as high as I possibly can emotionally so that when I go to the close, I know for sure that she wants it. If she does not want it and she is not emotionally invested in it, then she is always going to look for the cheapest thing. If she is emotionally invested in it, then her brain is going to be trying to figure out different ways to get it.
Bart: With this particular patient. I cannot read her. I just cannot read if she is – maybe it is because she knows in her head, it is going to be too expensive. I cannot gauge her reaction even when you show her the dollar. She is not saying a whole lot which makes it hard for me to read how invested emotionally she is and how committed emotionally she is to move in forward with the treatment. Does that make sense?
Erika: No, yeah, totally. I kind of felt that way too. She is so nice and adorable. I really enjoyed meeting her. I know she wants to do it and then she made that comment, as you caught, about how it was terrifying or whatever to get the fees. But then she did not really come out and give me like objections or cut me off like some people might immediately. So then, I started wondering if she still feels that way, like should I start suggesting that we can mix-and-match so she does not think there is like no way to do this. That is what prompted me to do that. I do not know if that was the right way to do it but that was what I did.
Bart: It is not a bad thing to do but if you are not sure that you have them in a good emotional state then just hang on, on actually going through the bundle and do a quick recap on what they spoke about with the doctor.
Erika: So ask her questions?
Bart: Yeah. For example, “So what do you think about the treatment plan? I mean, that is for the snap-in – you are going to get the implants. You are going to get the prosthetic. I think you are going to look beautiful. What do you think? Are you excited?”
Bart: You got to get them talking. I can talk to them all I want until the words are theirs and they are saying them, they are not going to be committed. That is a tough one. If we are constantly talking, we do not get them to say the right things, then they are not their words. Their level of commitment is not near as high as it could be. There are certain things I have to get them to say. If I cannot get them to say it, I cannot get them to open up to show me that this is exactly what they want, this is exactly what they need, then I am going to go back. I am going to loop back and try to resell it and re-anchor on what their vision was. You can say, “Well, let us remember that the whole point of what we are trying to do here is… So, I think the treatment plan actually is going to give you almost everything that you want. Do you not feel that way? Do you feel like we are missing something there?”
Bart: I will go back and resell it because it does not matter what the price is. The strategy with a bundle is not going to work if emotionally they are not in it. I think she probably is; she just has so much anxiety about the money at this point. But it is hard to tell because she is so difficult to read right now
[Bart plays video]
Erika: In on arch and do the snap-in in the other until a period of time where it can be more feasible to get the snap-in.
Reynolds: So you mean, if I have to do like…
Erika: Yes, you have to do an old school denture. The same as what they were talking about the smile center – in just one of your arches, you can get your snap-in in the other, and eventually get the other arch down the road. You cannot do that. That is option two. The most desirable thing is this is all well taken care of at one time and that is what I want to see happen for you. With the financing that we offer through us, we go through a company called Proceed Finance. I can even do a pre-qualification for you today, if you want to see if there is an option for you without harming your credit to find out if they are. Is that something that you want me to run for you real quick?
Reynolds: Yeah, because I know my economic went down…
[Bart pauses video]
Bart: Okay. So remember with financing, when we close, what I like to do is closing the dollar amount – so it was a 45,000 treatment and you are going to get it for 30,000 plus the warranty – great. Okay. So how would you like to pay for that? And close, just push the close. Financing is something we use as a backup when we get a financial objection. If there is no financial objection, do not go to financing. If we give them the fee and they are like, “I cannot pay for that.” then we ask them, “Okay. Well, would it help if I could take that payment and break it down over a series of months over a period of time to give you a low affordable monthly payment. Is that something that would help?” I am going to ask that question every single time before I get into financing then they say yes. “Okay. Well, we have got several different options. What would you feel comfortable putting down?”
Bart: Cool and then run it or if they say they cannot put anything down, ask them, “So, what type of a payment would be easiest for you? A $1,000 a month, 500 a month, two thousand a month – what is something that you could do financing wise because there are so many different options. Just kind of give me something to shoot for – what would be easy for you?” I am always trying to pull something from them to prove to myself that this is worth more time, you know, if she says, “Yeah, it would help. I can do about $30 a month.” I mean, geez, she is killing me. So I am just going to run it as quickly as possible and if she does not get financed, then it is done. But again like all of this, I do not know what completely happened in the phone call conversation, but if you went as far as pricing, what I would hope is we get a reaction one way or another towards the price and you kind of have an idea like, “Hey, she definitely cannot afford this or this…” or you have an idea like, “This is all about financing; if she gets financing, it is sold. If she does not, I am done.” If that is the case, then go through and do this whole thing there but always make sure – I do not necessarily like to lead with financing because number one: I do not know how much money she has. I do not if she can put anything down. And where do you go? Where do you go if she gets declined?
Bart: You do not know if she has anything to put down on treatment or not, and it is a pretty easy conversation to have which is like, “Well, hey you are scared of the finances, what dollar are you comfortable investing in your smile right now?” this is kind of weird because she has not come right out with her personality. She has not come right out and told you, “Hey, I cannot afford too much. I do not know if I can do this or I do not know if I can do that. They are just things I am picking up on from her vibe, but I can feel that the financing and that the money is a big issue here. So what I want to know is how much money she have and if I can get her financed, what kind of payment can she afford? So I know if I can get this done or not – that way, you know if you have to break the treatment plan up. So if we had that information you might know, “Hey, we are just going to be starting with the lower. She is going to go in a denture on the upper. On the lower, we are just going to do a removable and we are not going to do four implants. We are going to do two and locators to get it down to 12 thousand, whatever…” If you know a ballpark you can easily do that. If you do not, everything is kind of a guess. I do not know how she is going to react by showing her $32,000.
Bart: If the whole thing is contingent on credit, she is already told you it is not great. The whole thing is I am getting nervous because I do not know what I am going to do if she does not get approved. I am going to have to go back and ask these questions so that is what you guys are trying to do the whole time during any consultation. You are trying to figure out what does this patient want, how emotionally invested in the treatment and the outcome are they and what can they buy? What are they qualified to buy? Do they have money or not? Can they obtain financing or not? Those are the two things we have to have an idea of, right? Yes. They have money. Yes. They have a budget. No way in hell they are buying something for 32,000. They will buy something for 12.10 to 20, that is it. So, you know if you show them 32 how they are going to react, so you are going to be ready with something. The point is we kind of just do not know. So you are doing the best you can right now without having the rest of that information.
[Bart plays video]
Erika: Okay, so let us find out if there is an option at least so that what we can we work on. [inaudible] we can start to look at others.
[Bart pauses video]
Bart: Okay, so she pulls it up. She goes through Proceed. This patient gets declined for financing. Now, do you only use Proceed?
Erika: We are partnered up with Proceed and also Care Credit for the two financing companies that we go through so usually like if there are going to be a bigger case like this because Proceed allows then eight years for repayment. I usually will push them over Care Credit if money seems like an issue because Care Credit only gives you five years to pay back. So I know they had a lower monthly rate with proceed if I get them approved, however, sometimes Care Credit will approve for people with a lower credit score. So then I sometimes go that route but I think with her we just went Proceed.
Bart: So I would submit a two or three.
Bart: If I get a decline, I am going to go to another one. You know, whether it is Care Credit or Green Sky or something – I am going to go right from one to another and at least know that I exhausted all my efforts to get this thing financed right there in-house. Just get to the end of it here.
[Bart plays video]
Erika: …. facts with answers and questions and stuff for –
Reynolds: For amount?
Erika: Yes, we can try that right now.
Erika: [inaudible] Yes. [inaudible] Because usually it takes five days to get something in the mail, but if you are like, “No, I kind of want to know if you guys are still in [cross talk]
Reynolds: Yeah, that is how I am.
Erika: Yes. I do not like it so I would do that. So I have that number circled for you over here. I am going to give you that. Then, my card with my information -I will show you just to let you see.
[Bart pauses video]
Bart: So guys, look the call is kind of over. She is just kind of giving her a card, booklet and that is it. If they do not get approved for financing, we have to ask the question how much money do you have to contribute towards it, right? We are going to have to look – it is time to look at alternate sources of financing or liquidating assets. So how much can you put down if you were to get financing? How much do you have in cash and credit? What do you have on your credit cards? What do you have in cash and What is the total amount that you can put down here? Because again, I am trying to gauge, is it worth follow up now, you know what I mean? If she gives you a real number like, “Hey, I can put down like $10,000.” What would you do if she said, “I have been saving for a while. I have $10,000 that I can put down towards treatment.” What would you do?
Erika: Well, then I would probably try to go with the option of what you had said earlier. Like, if you know they have a certain amount of money then you can do a lower snap-in with like two implants and maybe she could do a traditional on top or it is not like we would we would push it and then she only has to come up with away lesser amount. That is where my thoughts go right away if you have that money or financing the however much – I mean, I would try first to find the answer to go for like everything if I know she has got that money, the down payment, because Proceed lets you put in the amount. You can do like a payment calculator. It shows how much do they have that they are putting down? How much are you trying to finance when the payments come out and they can see it right then and there? So I definitely want to try that but I think we definitely need more financing options than the two that we have.
Bart: Was it a worst-case scenario if it is going to cost fifteen thousand to do an arch for removable. It might even be less than that if you are only doing two implants and you are going locators. It could be something you could change there to reduce it, but ten thousand dollars, let us say, “Okay. Well, let us do this. Let us put $10,000 down. Let us get it scheduled and how about we do the other five over four months? And you can just pay us direct; no interest.” Because it is worth it is, she is going to have two thirds of the money. It would not be worth it if she only had two thousand to put down. I would not do it but 10,000 – you can get really close to that. It is a real number. She might only need 60 days to come up with the rest or 90 days. I do not know but it is very hard to follow up without it plus you might be thinking, “Just what do I have in my checking?” They are not thinking about credit cards. They are not thinking about things that they could easily liquidate; things that they could sell that they have sitting in the garage. So do not be afraid to ask them that and just try to make it a habit. When you are going to run finance, you just ask them, “How much do you want to put down on treatments? Is it going to be 30,000? How much can you put down?” and if they say, “Well, I would like to not put down anything.” then you can say, “Okay, no problem” and then run it without putting anything down, but I would always ask them what they can put down and then if they do not get approved, at least you have some frame of reference.
Bart: Does that makes sense?
Bart: Okay, and have you ever just got them pre-approved right over the phone?
Erika: I mean, I have [inaudible] people over the phone. I think I have only ever had one person that I did over the phone that passed – he was still like had all these reservations about moving forward anyways, and the other people I usually just tell them that when the letter comes in the mail, that explains to them the exact reason to figure out if it is something workable still like maybe they just have to work on making more current payments for the next four months or something so it can catch up and they can get a better score. Like, we kind of talked about stuff like that. She did text me, this lady here, can I tell you that yet? I do not want to ruin the massage.
Bart: We saw it coming this morning, right? Yes, we saw he text you.
Erika: So I did write back to her. She had said that, she got a reason in the mail from Proceed that her credit score is just too low so they are not willing to approve her and she is just like, “I do not know where to go from here…” basically, so then I have wrote back and I was like, “Hey, would it maybe be an option to borrow from you or your husband’s 401K. So then you are paying yourself back – that works really well for some people. I do not know, that is what I threw out there. I was like based on their age.
Bart: I saw when it came in. If she said like, “I do not know where to go from here…” the first thing I would ask her is how much can you put down? I do not know. What is the gap here between how much money she has and how much she needs? Is it the whole thing?
Erika: I kind of feel that way, but I do need to clarify that.
Bart: Yeah, I mean, that is the biggest question that we never got answered during the consultation. We still do not have answers. So just ask her say, “Okay. I will help you out. How much can you put down? Can you put down half? Can you put down 25% like what can you put down here?” Then again, if it is nothing the odds of her closing is super-low. If she is like, “I can put down five grand or eight grand” if it is a real number then the odds are getting so much better for you and it is worth you working on a little bit more. Somebody that does not have any money – there are a lot of people that really want things and they do not have any money. It is just not worth a lot of time. So odds are, I do not know but if it is true that she does not have any money, she needs the whole thing financed, she cannot put anything down – then this entire thing could have been avoided probably right over the phone with a triage.
Bart: So if you guys are not sure if they are like, “Oh gosh, I am really nervous about the price – damn, just cut bait and go straight into that and ask them. Are you worried about the price? Well, what kind of dollar amount are you trying to stay within here? It sounds like you might have a specific dollar amount. Sounds like you might have a budget you are trying to stay under, is that right? What is it? What are you looking at? Just ask them. Get straight to it. You do not want the doctor spending thirty minutes and you spending an hour and then more follow-up, more texting or emailing. It is a lot of hard work if the person is unqualified. If they are unqualified, it means Erika, there is nothing in the world that you can do to sell them. They are not qualified to buy. Make sense?
Erika: It does. I want to see it work out for her so bad. So now that I have written back and brought up the 401K option but did not say, “What is the amount that you can put down at this time to go towards us?” Should I wait for her response back and then ask that directly next?
Bart: I would sent her a text right now and say, “How much money can you put down towards the treatment between cash and credit cards?”
Erika: Okay. Between cash and credit cards.
Bart: Unmute everybody. Guys, any questions on it? I think, Erika, just for some feedback with you. I think you did a great job in terms of your energy level and you did a great job of getting into rapport with the patient. You did a great job of just being her advocate and building confidence and really
helping her. You were great during the doctor part, you know, helping doctor and [inaudible] him.
Erika: Thank you.
Bart: So all of those things were really well done. Just remember with the close, always give them opportunity. Our goal is to get all the money up front right now. No financing. Full pay – that is the goal. That is what we are closing on every time, it never changes unless they had told us earlier and there is a specific arrangement. Like, we know it is all about financing and in that case, they are already pre-approved anyways, so go straight into it, utilize the financing to overcome an objection, but we do not want to lead with it and then always ask them what type of monthly payment would work. What would be easy for you… that way you know when you do get them financed, it is already there. So make them say those things and before you go through the close, if you feel like their energy is down and this happens sometimes guys. It should not happen but it does. Sometimes you can do the first 10 and you are in really good rapport and they are in high spirits, the doctor gets in and frickin’ puts them to sleep – knocks them out cold and then they come back for the close and their energy level is like half of where it was when they left you the first time. Well, guess what? If is half, you cannot go in in numbers. Now, you have to get them back excited. In order to do that, you have to be excited. So it is what it is. You have to go and get that energy level back up. And then after that situation, that is when you meet with the doctor and talk to the doctor about what we can do to make sure that we maintain the patient’s energy level. Not maintain, we should actually be increasing their level of certainty in their confidence in the procedure.
Bart: That is where you want it. It should be leaving on a higher note after every single 10, but if it is not for whatever reason, then build it back up before you go into the numbers and you always want to have an idea. Hopefully, you have a good idea of how they are going to respond to a number before you show it to them. Does that make sense?
Erika: Yeah, definitely.
Bart: Cool. Guys, any questions that you have on this?
Man 1: I cannot see anybody here.
Bart: Cool. So guys, a couple things to just take from here: make sure that if you are not meeting with the doctors about these, try to meet with them. Try to get them to watch it, you know, if you can just do it once a month for a 30-minutes or a 45-minutes meeting then go through some certain parts and let them watch it. The more invested you can get them, the better. They are part of the sales process – a big part of the sales process. If you have someone that comes in and they make a primary recommendation with no certainty, it is going to hurt you. You know what I mean? If they overcomplicate things, it is going to hurt you and by hurting you, I mean, hurt your percentages. It is just going to give you more work to do at the end. So utilize it for both of you. You guys are watching it. You want to have the doctor watch it as well and do not miss any opportunities to triage. With this lady, we still do not know to this point if she is unqualified. All we know is she cannot get financing. We do not know how much she has or if she can pay for it though, which is backwards, you know what I mean? When you close, close on the money and make them tell you that they do not have any money. Get that out of them though. Then, we go to financing. That way you know if it is not approved then we know it is pretty much done. The only thing you can do is submit out to someone else, submit out to at least three of them – if all three of them decline then go from there and you can try different dollar amounts with different financing options, too. Okay?
Erika: Yeah, that is very helpful. Thank you.
Bart: Awesome. You did great. Do you guys have any questions or anything happen since our last call? Anything crazy that you want me to address? Nope, whatever. I will shut up then. Go make some money. If you guys need anything, we are here. Let us know. If you get any questions, just write it in. Erika, you did a great job. Everybody else, remember to get your consultations videotaped and sent them in so that we can continue to rotate and continue to see different situations. So Erika, good job girl.
Erika: Thank you. Appreciate it.
Bart: All right. You did good. Bye-bye.