Fontainebleau Miami Beach, FL
September 23rd & 24th
The Closing Institute’s Full-Arch Growth Conference
Bart Knellinger: We got a really cool call from Dr. Martinez. His treatment coordinator, Loy. We have pretty much the whole thing, the first ten, second ten, and the third ten, the whole thing is complete. I thought it was a pretty interesting one. I think you guys are going to get a lot out of it. If you guys have something to take notes on, get out your pen and paper so you can take notes here. Loy did a great job in a lot of different ways on this call, I think there were some little things, just logistical things, that if they are not done in the right order, what can happen is when you have one of those strong personality patients that are in front of you, if we do not have something that is very regimented, a lot of times they can kind of take over the call.
Bart Knellinger: I think that happened and this patient seemed to keep putting himself in the driver’s seat. I am going to give you guys some examples of how we can continue to pace some lead and how we can help that. Because if you are not pacing and leading, we are kind of at their mercy, and we are kind of answering their questions. This call even goes to as far as the patient telling the doctor how to treat the case. I mean, the patient knew all this stuff. I am like, “Who is the doctor here?” Right? He is talking about sinus lifts and how to graft it. It is just like, “Okay, we are way off the line, way off the line.”
Bart Knellinger: But Loy did a great job. You guys will be able to hear the script in terms of what she is saying. She did so many good things right. She talked about the price with him, she tried to overcome objections, she did really, really good. But this is going to be a great example, I think you guys are really going to enjoy this. I am going to start playing it and then I will just stop it periodically, just like always, okay?
Loy: All right. I understand you are interested in getting a couple of implants?
Patient: Yes, possibly two, possibly just one.
Loy: Okay. Can you tell me a little bit about what is going on right now?
Patient: Well, I have two missing teeth there. I had trouble with– first, I had a crown on them, but then they did come out. I had a sutured-
Bart Knellinger: Guys, and one other thing, does everyone have the new patient intake form? If you guys do not have a new patient intake form, you know what I will do? I am going to have Veronica just email out another copy of the patient intake form, to make sure that when they come and the patient checks in, that the first thing you are doing after they submit their new patient paperwork is you give them that new patient intake form and have them fill it out so that you already know why they are there. You already have that basic information, and you already kind of know why they are there. I think by how Loy is asking the questions here, it almost looks like she is kind of reading from it. She is getting the patient intake form filled out with the patient here. But ideally, you already have that. It just speeds everything up.
Patient: -and piece of a bone, fake bone for both of them, the doctor will see that.
Loy: Okay, good. That is very good.
Patient: I can live with what I have but I would rather have another tooth there.
Loy: Of course.
Patient: I have not talked to my own personal dentist. I have discussed this a little bit, but I do not know if any doctors can work on it or not.
Loy: Oh, okay.
Patient: Since I looked up, you guys, I am kind of assuming from what, I cannot remember exactly how I got a hold of your office, but I think Dr. Martinez, it is one of his specialties, his implants?
Loy: It is. He does hundreds of them. He does them daily. He is top of the notch. Can you tell me right now, what impact having those two missing teeth have on you?
Patient: Well, it just makes it I cannot chew on that side very well. But I can get around. I have gotten used to it. It is not that bad that I cannot live with it. Depending upon what he sees about my capability of getting implants and how much it costs? Of course, that would be a big consideration.
Loy: Okay, awesome. Now I understand you had a consultation last Thursday with another practice? How did that go?
Patient: Well, this guy, Dr. Schwartz, if you know who he is?
Loy: I do.
Patient: Okay, he is very good, and he is very thorough. He is the guy that did the CT scan for me and I had to book by a paper ad when I got that one. I might go to him if it was not for the price and the facts. That is not the point. I am trying to find out what is the market price for implants. Because it is very different for each person if you find your needs what is the tooth in your mouth and all that kind of stuff.
Loy: I understand.
Patient: But his price is without beyond anything I had seen.
Loy: Oh, okay. Can you tell me, what it is that you want? Because I see that you mentioned that you may be looking into implants versus a partial? Have you done any research on one versus the other?
Patient: That would be my regular dentist, we have discussed that. We discussed a certain potential price for an implant. I do not think he does it, but we talked about it.
Loy: Who is your regular dentist?
Patient: Dr. Marcelo with Aspen Dental.
Loy: Okay. I do not know if they do that or not.
Patient: Okay. I said, “I probably cannot afford that.” Then, we talk about doing a partial instead of that. I thought, well, I have heard what of that is like, and I do not want something going across [crosstalk]
Loy: Yes. This is what a partial look like. It is removable. Its lips-
Bart Knellinger: Okay. What type of call do we have here? We have got somebody that is on a second opinion and it happens to not be a second opinion for a full arch, which I really wanted to go through for this specific case. Because what we are doing all the time is full arch for a lot of these patients that come in from the marketing associated with dental implants and full arch marketing, except they are not always full arch. Sometimes it is a single, sometimes it is two or three implants, and it can be different cases that can throw off the close a little bit on how you present the bundle. I wanted to go through this one specifically.
Bart Knellinger: But anytime you guys hear they are coming in for a second opinion, he gives you a price point, he says, “You know, I wanted to do it. It was a little high or whatever.” Then you got to be kind of licking your chops here, okay? Whoever has the second shot or the third shot at it, it is so much easier for you to close that case. People do not want to go through a consult after consult after the consult. The more consultations they go through, the closer they are going to be to make a decision either way.
Bart Knellinger: If you can hear by this gentleman’s tone, I think you can tell that he is a pretty straightforward type of guy, right? You do not even have to see him. But you can tell by his tone and the pace in which he speaks, that he is kind of a no-nonsense type of guy. He is also the type of guy that kind of understands what he wants, he knows that he wants these implants. In this for him, I do not think that we really need to sell the implants. This is just more of a negotiation type of a situation with the patient to where we need to figure out what his budget is, and how he is viewing that price. We are going to have to create some urgency.
Bart Knellinger: something to remember with patients, when it is not a full-mouth case, and they are not in any type of pain, remember that urgency is going to be critical to getting them to move forward right now. How do you create urgency with somebody that is only missing one tooth, or they are only missing a couple of teeth. Because in their mind, understand, they are thinking, “Well, I can still eat, I can still kind of function.” They are thinking, “I can live with this.” We have to make sure in the patient education portion of this call that we are really hammering home the fact that he is in a good position.
Bart Knellinger: I see it all the time. It is like, “Hey, I know it can seem like this is a lot, and that is a lot of money. But frankly, most of the people that come in here, they are not in a situation as lucky as you. They are in a situation where they have waited so long to do anything, that they have massive bone loss, just generalized bone loss. The teeth are all mobile, they can barely eat anything, we have to extract the teeth, and they are generally starting from scratch. Meaning, that we replaced all the lower and the upper.” A lot of reasons why are because over the years, when they lose one or two teeth, they do not replace them with implants. The bone continues to erode, and then it erodes the next tooth and the next tooth and the next tooth. All those crowns that you pay for, that partial, and those bridge, eventually they fail.
Bart Knellinger: You are actually in a really good spot right now to fix it and have a good quality of life moving forward. If we can focus on maintaining healthier teeth as best as we can after we get the implants. I think to make that point because if they are super price-focused and they do not have a lot of urgencies, you have to nail the urgency. With people that you do not have to nail the urgency they just desperately want it, it is just a matter of if they can afford it? That is easy. I mean, they are going to get this person financed or not. If I get him financed, they are done. Because their urgency level is so high.
Bart Knellinger: When they are only missing one tooth or they are only missing two, and in their mind, they can still function how they want to every day, it is not so much an emotional purchase, because they are not buying, the teeth are not in the aesthetic zone. If they do not feel like it is affecting their function then I have got to put them in the future where it will be affecting their function, and more importantly, where it is going to affect their wallet in the future if they do not do it. You have to work that into patient education.
Bart Knellinger: I think some of that we have missed in our training. Because we are dealing with full arches, usually. Most of these people with full arches, when they have terminal dentition, they really want to have it done, you know what I mean? They have gotten to the point where they have no choice, and that is why they are there. But with singles and multiples, sometimes they do have options. They can justify just doing a bridge, you know what I mean? They can justify the money to just do a bridge and convince himself, it is going to be okay. They can justify doing a partial for less money because they do not have as acute of a pain point as somebody that is missing all their teeth, or they are losing it, they literally cannot eat or they look horrible. Keep in mind, you are always listening for that complacency, okay?
Loy: It is uncomfortable. Some patients have a hard time getting used to them. Now, between a partial and an implant, there is still another option. We have several options to go over with you today.
Loy: Basically, I gave Dr. Martinez the scan. He is reviewing the scan right now. Basically, we will be talking with Dr. Martinez to make sure you are a candidate for dental implants. Basically, have you done research on implants?
Patient: Some. What do you want to know that I know?
Loy: Well, I just wanted to go over with you the options. Well, there is the removable, which is partial. Basically, a lot of patients do not like it, removable-
Patient: I am not interested in that one.
Loy: Okay. The next option is a bridge, which is still a fixed option, however, you do not replace the roof of your mouth. Basically, it is a crown that goes over those implants just over the other teeth, and they are cemented permanently.
Patient: I have a bridge on one portion of my mouth.
Loy: Oh, okay. You are familiar with it?
Patient: Well, yes. Well, I have no teeth behind it. There are no teeth to bridge to on this side.
Loy: Got it. Okay, yes.
Patient: It is all empty.
Loy: It is a cantilever.
Bart Knellinger: All right. Again, you guys notice his tone, right? He said, “No, not interested in that. No, not interested in that.” Right? This is a straightforward guy. With the patient education section, we have to get to the point really quickly, right? The point is, “Look, you are missing teeth, you know you are missing teeth. You have already had a consultation, okay?” We are going to get a CT scan done. Dr. Martinez is going to look at it, he is going to give you your best options and how he would approach the case. Just keep in mind, you will have options. There are options to replace missing teeth that do not involve dental implants. But they all have the same drawback, right? The drawback is that a partial or a bridge would more so be looked at as a band-aid approach.
Bart Knellinger: The biggest problem with a partial and a bridge is that you are not actually replacing the tooth with anything, there is nothing in the bone. The bone erodes and then you lose the next tooth, then the next tooth, and then the next tooth. What happens with people that are just doing band-aid approaches, this is like how we did dentistry in the ’60s, right? But before dental implants were invented, before they were mainstream, it was bridges and partials. Then eventually, you are going to a denture because the bone is just going to go away.
Bart Knellinger: Those are more of your band-aid approach. A dental implant is more of a permanent solution to replace the tooth. I mean, you are already missing some teeth, I am sure you do not want to miss anymore. When we replace these, we do not want to have any other problem with the other teeth. Then leave it alone and go. You can tell with his tone that he wants to get to the point. He wants to say, “All right, I went to a doctor. Here is what I need. Here is what he said I need. Here is the price I got, what can you guys do?”That is it.
Loy: -a bridge. Got it. Okay.
Patient: Yes. You have the cantilever, but I did have that for a while and I am just wondering out here if you replace it with a full bridge.
Loy: You have some crown right now?
Patient: Lots of crowns.
Loy: Okay. All right. The ideal option as you have researched is implants. The reason I say that is because implants are the closest thing you could come-
Bart Knellinger: I am going to skip ahead because she is selling the implants and she is doing a good job here. Just understand when you need to sell the implant and when you do not. If it is a second opinion, he is there for implants, he wants some. Everything I am going to do for somebody that is in there that wants the implants, the education, I am going to skew the education towards creating urgency, that is it. I am going to create urgency and put it into his head, that waiting is bad. That waiting cost more money, that doing bridges and partials is going to cost more money and cost more time. That is the whole point of education. I do not have to necessarily sell the implant itself, because it is a second opinion, okay? I am going to skip ahead because she actually brings a doctor in and there is something a little kind of out of the ordinary and goofy with this. But I will show you.
Bart Knellinger: What happens is this patient brought in a CT scan from the previous appointment. He brought it in, he emailed it to him, and the file was just too large. Dr. Martinez is here, he is going to do the second time of the consultation, but they ended up not being able to open the file. They could not open the file and that threw the whole second ten off.
Loy: I told him we do the scan for him anyway.
Dr. Martinez: I understand that you need some replacements, which is-
Patient: Yes. I got two teeth missing here, two molars. I had a wisdom tooth that was removed. Two molars in front had been gradually been removed [crosstalk] had problems. I had sutures in, a bone graft. According to what they tell me, I went to Dr. Schwartz, he said, you got enough bone to do this. But the prices were, I felt, way too high. I am shopping.
Dr. Martinez: Okay. All right. Can I take a quick look?
Dr. Martinez: Yes, this is… nice.
Patient: Yes. I paid a lot of money for this.
Bart Knellinger: Do not start the second ten until you have a CT, right? When Loy went out to get Dr. Martinez, Dr. Martinez should look at the CT before he even comes in. If you cannot open the file, then you have to take the patient immediately, take them back, and scan them. You cannot do the second ten without a CT or a panel or something, right? Because if you do, then now we are just talking. We are not actually referencing anything specific and Dr. Martinez has to kind of go by whatever the patient is saying, which just puts this patient in a situation where he is doing more of the pace and leading with the doctor, which we never want to have. That CT anchors everything. Someone brings it in or emails you the file, if you have problems opening it, just immediately do not start the second ten with the doctor until you have your diagnostics.
Dr. Martinez: Did they let you know if they were going to do a sinus graft? Did you happen to have any graft?
Loy: Which teeth is it that you want the implants on?
Dr. Martinez: The last two on the upper right.
Loy: The last two on the upper right.
Patient: Yes. He was going to do one. He thought that I might be satisfied with one only.
Dr. Martinez: Well one implant-
Bart Knellinger: See? Who cares? Who cares what he was going to do? It does not matter. The only thing it really matters about that last consultation, we can get the details. But what is more important is what does Dr. Martinez thinks needs to be done. He has to be given his opinion. You are here, Dr. Martinez, an expert in doing this. We do hundreds and hundreds of implants per year, get the CT scan and allow Dr. Martinez to do a consultation. Because right now you just cannot do a consultation. This is more of a conversation, and I think it lengthens the sales process and also just kind of makes it a little weird. It is just this added layer of confusion where we are trying to decipher what somebody else, another doctor’s treatment plan through the eyes of a patient. That is scary.
Dr. Martinez: -one only?
Patient: One if I would because it started to hurt like hell on the other side. I have a missing [inaudible].
Dr. Martines: Can I take a quick look?
Patient: Yes, sure.
Dr. Martinez: Oh, this one.
Patient: Yes, like they are circular, is that true?
Dr. Martinez: That is good. I think if we have two teeth back here, you will gain the full chewing capacity.
Bart Knellinger: What Dr. Martinez is trying to do is he is trying to do the best he can without a CT, just kind of doing a quick look. But I would not recommend it. I think that you have to have, I mean, you do not have to, but it certainly makes it easier to have a CT, to pull it up, and then to reference the CT. “All right, here is where you are missing the teeth. Here is the bone. Here is where we have to do a bone graft. Here is where we have to do a sinus lift. This is what the case is involved in. This case happens to be something where he needs two implants and he absolutely needs a sinus lift. I will fast forward to more of the conversation.
Patient: Which quiet is for the implant. Well, it is so very dependent upon which teeth.
Dr. Martinez: It does.
Patient: Your particular bone development.
Dr. Martinez: Correct.
Patient: How deep you are going to go on to do that. But I got an average price in the five thousand dollar range, something like that. He was a lot higher than that and I thought the price is out. I would not pay as much money as he wanted to do one too, but it is all I got.
Dr. Martinez: I got you. I understand.
Patient: There is a little bit too over the bounds.
Dr. Martinez: I understand. Just to give you an idea, all right? If it is a straightforward implant, meaning that there is plenty of bone, and we have to just do the surgery where we are going to place the implant, we are going to let it heal, we are going to restore it with the abutment and a crown, okay?
Dr. Martinez: Those fees start as low as thirty-five hundred dollars for a single tooth.
Bart Knellinger: Okay. What mistake did we just make right there? A negotiation. Now we just set a bar, we just set the bar for him. We kind of fell into his trap, right? He said, “Yes, his treatment plan did not turn out to be on average, like five thousand dollars a tooth,” right? But that is probably with bone graft. That is with a sinus lift. He is saying ten thousand dollars for two implants and the sinus lift. Then he said, “I just was not going to pay that much per implant. The patient is not looking at the whole treatment plan, he is just looking at the implants and he is going, “Five thousand dollars an implant is too much.” He is not really putting in place in any value on the bone graft. But he said, “I am not going to pay that much.” What I want to know is what will you pay, right?
Bart Knellinger: What did you think that was reasonable? Do you have a certain dollar amount in mind that you are willing to invest right now? Or that you are looking to invest? Because there are some creative ways that we can approach this, what are you thinking? Obviously, it was ten thousand dollars for two teeth, is that right? Okay. What are you thinking was reasonable? What price are you trying to get to? Let us start there. I would not give them thirty-five hundred because you know that you are not going to charge thirty-five hundred. Thirty-five hundred is not going to be a real number to give him. I will never give a number that is going to be low.
Bart Knellinger: If I am going to give a number, originally, I want to overestimate the cost of the treatment plan. If anything, if it is me, and I am hearing him five thousand a tooth, that is ten thousand dollars for the case, if anything, I am saying, “Well look, if you are placing two implants, you want somebody that has a lot of experience placing them, who are going to use good components, and it is going to be done the right way, and it needs a graft or sinus lift, ten thousand dollars is right there. If not, at markets probably a little bit below market to be honest with you.” Ten thousand dollars, that is not a bad fee. That is absolutely not a bad fee for it.
Bart Knellinger: “But let me see what I can do here.” I want to make it sound like that is good. That way, when I come back to my treatment plan and I beat it, it looks good. I do not want to say, “Oh, he is at ten thousand.” Now, I come in with a thirty-five hundred, what number is going to stick in his head? Thirty-five hundred dollars. Then if you need a bone graft, you are in a situation where thirty-five hundred dollars is not going to work. Now, I put this number, this figure, in his head that is low. That is never going to be realistic for this person. We know we do not want to just do one, we want to do two. But again, this is what happens when you do not have a CT and you cannot reference specifics, you start talking and you get into a conversation, and you are off the line. We are no longer going towards a close because he does not know what to close because there are no diagnostics. Does that make sense?
Bart Knellinger: When you are off the line in this conversation it is called free forming, and it is difficult. It is very difficult to do. I would not even start the conversation. If I cannot open the email, I would not even have seen the patient as a doctor. I would have said, “Okay, Loy, just go ahead and get the patient scanned.” Right? If you are having any trouble with it, just get him scanned, and let us pull it up. I will take a look at it. Then I am coming in with a scan. Then you can kind of take control over the conversation. But be very careful in a negotiation throwing out numbers. If you are going to throw out if you are going to make a mistake if you are going to make an error, error higher than what is going to be always. Always error overestimating, never underestimating, okay?
Dr. Martinez: Now, depending, if it is in the sinus or we need any additional grafting, then the fee can go up.
Patient: Okay. Well, what he discussed was he thought I am calling a [inaudible] depth this way in the sinus. He said, “If you want to be sure that you are going to have a very solid tooth there, he was suggesting we go into the sinus, and we do not break a little-
Bart Knellinger: Do you guys see like, how off track we are? None of this is relevant. These are clinical details that Dr. Martinez should be giving to the patient. That is why you are here. You are here to get a second opinion. I do not need to know everything about what the other doctor said on how he is going to approach it clinically, I first need to look. I am going to look at it and give you my opinion on what we can do. Then I can address any differences between my opinion and the previous opinion that you had. But you do not want to just speculate on the before and not give your take.
Patient: -there where they call it, it is a membrane. There is a membrane. You check that then you put some chips in there.
Dr. Martinez: Some bone there, yes.
Patient: Bone in there. Gradually your bone will replace the chips that he puts in.
Dr. Martinez: Right.
Patient: Then, we are going to go-
Bart Knellinger: Yep, we are talking about chips. I am going to go to the next one. Because that is more of the same. Again, when I say more of the same, it is more of the patient just kind of describing what the other doctor was treatment planning him from a clinical point of view. But he already, basically, gave him them the price. He said, “It is five thousand dollars a tooth,” and he thought that was too high, and he said, “There was no way I am going to pay that much per tooth.” He basically told you straight up what he is there for.
Dr. Martinez: -you got the bone going to the sinus, it would make more sense if you do that surgery together. Because you are basically doing the same surgery at the same time. Then I can be fairer on my pricing if they are done together than if we have to go and do it separately. That is something for you to consider.
Patient: Yes. I understand it. It is just that how much money do I have to do this right now for me to make that [inaudible] money to do it? I probably do, but it might be a little stressful doing two, and it might not be stressful to do one. That is where I am at.
Dr. Martinez: I understand.
Dr. Martinez: I understand. Okay. All right. Then I would just give-
Bart Knellinger: What is that dollar amount? He is trying to tell you, he is trying to tell you, he is saying everything is like, “Well, I probably could do it right now. But I do not want it to be stressful. Maybe it is easier if I do one and not two. He is rationalizing his thoughts outside of his head. Which is what you want to see. That is a dead giveaway of a buyer. Easy. No problem, right? He is rationalizing. We have to know what number he wants it, what number is not stressful. Okay, ten thousand dollars you are saying is just too much heartburn right now, well, would seven thousand, eight thousand, nine thousand, what are you actually thinking? What are you trying to get to here? Because the last thing you want to do is go in, do a graph, place one implant, and then six months later, go through the same thing. Plus, it is going to cost you more money.
Bart Knellinger: I liked what Dr. Martinez said, about, “Hey, if we do this all at once, it can be less.” But do you guys see that he does not have a reference point to negotiate from right now? He does not know what that patient’s number is. He is kind of lost, as far as, “Hmm, well, what is this going to cost? How do I kind of frame this before we give him the price?” and they are trying to think like, how do we avoid the same mistake that the other doctor made. The other practice let this guy walk out and they did not get them. He said it was way too expensive. Obviously, they never knew that or they were not willing to have that conversation, so he left.
Bart Knellinger: But if Dr. Martinez knew right now that the patient said, “Look, I am trying to get within eight thousand dollars.” He has kind of a starting point. Again, without the CT scan, it is more difficult. But we can still say, “Look, it is pretty obvious you are going to need a bone graft and you are going to need a sinus lift and two implants.” But he can start to frame it and say, “Look, that ten thousand dollar price, that is not a high price.” Not at all. Not for somebody good. Not for somebody with experience and you want this thing to last. But there is something I can do. If we do the whole thing at once, I can give you some money off on that second implant. I can make it. I can work with you here to make it palatable and make it comfortable for you. But he would have a frame of reference to negotiate from. It is just hard to tell when someone says this is too expensive. We do not know what is not expensive, what their definition of that is? Then it is really tough to understand how to approach.
Dr. Martinez: -for the implant abutment and a crown. Then that lateral sinus [inaudible] for sinus lift here. Then do it for one, two teeth. Then I will tell you that if we do them together, I am going to give you a better price if we do them at the same time than if we do it individually.
Patient: Yes, I got it. I understand. All right. Any questions for me?
Patient: No. I am done, I think.
Dr. Martinez: As far as the procedure itself, it sounds like you have a pretty good understanding-
Patient: No. I went through that both with Dr. Schwartz and with her, I am sorry, what is your-
Loy: Loy, like Joy but with an L.
Patient: Okay, Loy. Yeah, she has helped me understand some of the things that you do.
Dr. Martinez: Okay. All right. Very good.
Patient: I saw your thing up on the wall and you have an extra degree for implanting?
Dr. Martinez: Yes.
Patient: I think what she showed.
Dr. Martinez: Okay. All right. Very good. Well, I hope that we can help you.
Dr. Martinez: All right. Thanks for coming in.
Patient: Yes, thanks.
Dr. Martinez: I appreciate it.
Loy: Doc, can you skip on his chart, so I can get in?
Dr. Martinez: Yes.
Loy: Okay. All right. What do you think?
Patient: Well, he gave me some prices. That is what is going to control some of these, at least maybe the whole thing even?
Loy: All right.-
Bart Knellinger: make sure on the second opinions that you give an ironclad recommendation. The doctor has to make a recommendation with confidence. It cannot be like, “Okay, well, I am going to make the same recommendation, and kind of here is how we will work it, whatever.” Pull the CT scan up and say, “Look, there are a couple of different ways to approach it, depending on what is most important to you? Tell me what is most important to you? Getting this done as cheap as possible right now? Or do it right now where it is going to avoid problems in the future. How do you want to handle it? Do you want to put a band-aid on it, or do you want to get this fixed?” Both answers are okay. We do a bridge and we do partials as well. But that makes a difference. Do you want something permanent? Do you want something where this thing is done? Is that what you are looking for? Are you looking for a cheap, whatever is fastest, cheapest, and it does not matter if it is short term, or if it causes more issues down the road? Which one?
Bart Knellinger: I would always ask that question before I made the recommendation. Because I want that patient to say “no, I want to get it done right the first time” or if they say, “Well, it really just kind of depends on the price.” Say, “Well, if you are looking at dollars and cents, I mean, how much dental work do you have? I mean, do you have crowns?” “Yep, I got crowns.” You have got crowns, you have got a bridge on, you have already invested a lot of money. The problem is, are you talking about what you are going to pay now, or are you going to pay over the course of the next five or ten years.
Bart Knellinger: Because over the course of the next five or ten years, if we do not get these teeth replaced, the bone is going to erode, that crown is no good without a tooth, and the tooth is no good without bone around it. You start to have more and more problems. In the long term, to get it done the right way, and actually replace the root of the tooth with an implant is the cheapest, it provides the highest quality of life, it is the best investment, and it is the cheapest long term, by far. What is your definition of that? You can have that conversation but then once you say, “Yeah, okay. I definitely want the implants. It is just a matter of if I can afford it right now.” Then treatment-plan it and make your recommendation. “Hey, the best outcome, here is what it is going to be. We are going to do a sinus lift, we will lift both of them at the same time, I am going to try to work with you on the price. But it is going to be in that in the same ballpark. But I will work with you on the price. Loy is going to go through all the details. But I think that you are here at a good time. I think that it is lucky that you have caught it early, that you are here right now, and you are not in a situation where all of the teeth are terminal. You do not have generalized bone loss. You are not in a situation where you have to replace all the teeth. I think we are in a good spot, we can turn this thing around.”
Loy: Basically, with the sinus graft and the two implants, you are looking at about probably nine thousand for both. Were you looking for a monthly budget or were you looking for…?
Patient: No, not necessarily. I mean, I probably do it by-
Bart Knellinger: Just nine thousand. She already kind of gave him a little bit of a discount right there. We never really established the true value of the procedure. All right, keep this in mind, someone is coming in and they say, “I went into another practice and it was too expensive.” We find out how much it was, and you know that they think ten thousand dollars is too expensive. My first goal is to sell that ten thousand is not too expensive. First thing is to establish a market. I want to say ten thousand is at or below the market. It is not a high fee. Most dentists do not even do sinus lifts, okay? This is an advanced procedure that requires precision and training. Ten thousand dollars is absolutely not out of the ballpark nor would that be a poor investment on your behalf.
Bart Knellinger: I want to establish that that is a good price because I know I am going to come in below it. But you still want to set MSRP. I would still create the expectation that is what I would normally charge. I would normally charge ten thousand dollars, that is what this is worth. Or I would go a little further and say, “Our fee to do all of this when you look at the implant, the sinus lift, the components, the abutments, the crowns, everything, and the time that this is going to take, this totals up to about ten thousand five hundred dollars, right? That is about what these costs.” Now, I spoke with Dr. Martinez, but you got to go through the close. If you go straight to nine, we still never got a dollar amount for him that he is shooting for.
Bart Knellinger: Now, we have given them two numbers. The first one was thirty-five hundred. He did preface it and he said, “Well if there is grafting, it is going to be more.” But that does not matter. It sticks with them. It still sticks in their head that is less. We gave him thirty-five hundred and now we gave him nine thousand. He still has not said a number.
Patient: -a dental plan, dental stuff.
Loy: Do you have credit?
Patient: Care credit. Well, they give you an X amount of dollars and you do not pay any interest out on my-
Patient: I think I have seven thousand dollars in there or like that.
Loy: Okay. There is six months interest-free. Basically, that total, let us say it is nine thousand.
Patient: Well, what if it is eighteen months interest-free, he said? That was what I was doing with Aspen Dental.
Loy: Okay. I will take a look.
Loy: Usually we do a six-month interest-free or a year.
Patient: Well, that is not care credit or it is?
Loy: Yes. It is care credit. Every office-
Patient: What, like every office, is the same?
Loy: No. Every office is different.
Patient: Oh, I see.
Loy: Yeah. We have that and then we also have-
Patient: Yes, six months does not help me that much.
Loy: Yeah. Well, we could do a year?
Patient: Yeah. Okay, well, what about if I am going to do one then?
Loy: If you are going to do one, you are looking at about five thousand dollars.
Loy: Yeah. With the sinus lift.
Patient: Yeah. Okay.
Bart Knellinger: Again, this is why it is good to detail it out. For the implant, the crown, the abutment, for all this stuff, this is ten thousand five hundred dollars, and you show it to him on paper. But we just finally got a number out of him. We did get a number that he wants to spend, we got a number that is already pre-approved of care credit. His pre-approved he said seven thousand dollars for eighteen months which means, he does not want to come out of pocket with anything more than that, that is kind of what he is saying. I think they know seven thousand dollars is too low for this type of procedure. But we just now got seven thousand dollars out of him, okay? Now we are actually getting somewhere, okay? She is at nine, he is at seven. Let us see what happens.
Loy: You know. You think a little bit-
Bart Knellinger: Oh, and do not worry about the terms on care credit, or anything that says eighteen months whether eighteen, twelve, six, whatever. Seventy-five percent of the time the patients are mistaken anyways. We just have to look at it. Just dwell with that for the time being.
Loy: – do it all at the same time and recovery too. Because remember, you are going to have to go through the same process twice in the same area. You are going to be numb. The recovery, you are only going to have to go through it once.
Loy: It would be…
Patient: This is like, nine thousand dollars is a lot of money.
Loy: Yeah, so what were you thinking? What is your budget? What are you thinking it should be?
Patient: Well, I was hoping, I think that you said to me first we talk on the phone, it would be like with seven thousand were too low.
Patient: Okay, so.
Bart Knellinger: That is the third number we gave. We gave one over the phone too, seven thousand. All of them have been underestimated. All of them have been underestimated except the nine. We said seven thousand dollars over the phone and then he comes in there is thirty-five, and then we come back with nine thousand dollars. But she handled that perfectly. I would just love to see that in the very first ten. Because now you know what you are dealing with and you know how to approach it from a frame in a dialogue point of view.
Loy: We started thirty-five hundred.
Patient: Because [inaudible] with the grafting.
Loy: The grafting. Correct.
Patient: I was hoping to do one under thirty-five hundred dollars before it was thirty-four thousand dollars.
Patient: You said five.
Patient: It might be out of my range.
Patient: I would have just think about it.
Loy: Okay, so let me go talk to Dr. Martinez and see what I can do. Because we have different options for you as far as-
Bart Knellinger: Again, before you go get Dr. Martinez, you have got to nail the patient down. It is the negotiation at this point. Let us say “Okay. What you are saying is that you would have no problem. Obviously, it is better to do both of them, it is more cost-effective to do both of them than to do one at a time. Do you understand that?” He will say “yes”, and say “Okay. What you are saying is if it was seven thousand dollars and we could use your care credit you were already approved for, that would be easy and you could move forward with that today. Is that what you are saying? Is that what we are shooting for here?” Nail them down on the pricing, get a verbal commitment. The last thing you want to do is have them say, “Why a seven thousand dollar for care credit?” You come back “Yeah, well seven thousand dollars is still too much.” They are going to jerk you around. They are going to be pulling your chain. People will just kind of handle you. You do not want to get handled by a patient or anybody in a negotiation. That is why I want to get a price from you. I want you to tell me a price and once you do, then I am going to nail you on that price and you are going to say, “Yeah. If you hit this price, I am good to go. I am ready to go. I am not doing anything before I get a price and I get an escalation of commitment so that I know your price is serious. Why am I going say I am going to go get the doctor and come down to a price that still may not be low enough?
Bart Knellinger: Then it is just never not low enough, and you do not know where you have to get to and you do not know how serious they are. Once you get a price, then you have to close them right there on that price. Not that we are going to need it, we have to close and get a commitment that they would do it. You are inching them closer to a higher dollar amount. He is the one that said thirty-five hundred. Wonder why? Stuck in his head. He said, “They are going to do one for thirty-five.” He is not thinking about saving money. He is not thinking about function. He is not thinking about squat. He is thinking about dollars and cents, and he has got thirty-five hundred dollars on the brain. But he also told me a seven thousand dollar in care credit eighteen months interest-free, right? What I got to do is get him away from thirty-five, and I have got to creep him towards nine. How do I get him closer to nine? If I can just get them to seven right now then I can come back with another offer and then I can get him from seven to eight, or seven eighty-five hundred or seven and nine. But thirty-five hundred to nine is big, that is big.
Bart Knellinger: When they give you an opportunity to give you another number at seven, get a commitment on the seven. Just get the commitment. If you come down to that price, you can do it when he moved forward. You got to do that first.
Loy: — [inaudible] Because you are not fighting me evenly on all for-
Patient: Well I am not paying for what it might look like, you need to do this because [inaudible]-
Bart Knellinger: Sorry. This is important. I want you guys to hear it. He starts rationalizing his purchase right here, and it gives you an insight. Again, this is stuff you got to know in the first ten. You do not have to, but you are going close so much easier and so much more effectively if you get this information first. Do not let him off the hook. It is his second opinion, figure out what happened. They said it was too expensive, figure out how much. Make sure you understand the state of mind before we bring the doctor into it.
Patient: Okay, yeah. Because I mean, the payment plan is one thing, but-
Patient: How much more I have access to doing whatever. I’m 71 years old.
Patient: Then what else can I do with my money besides put teeth in my mouth? [inaudible]
Loy: Yeah, well, you can eat better, you can chew better. Definitely some benefit to it.
Bart Knellinger: He is not thinking about benefits at all. You can see that. Listen to this.
Loy: You can definitely improve your lifestyle.
Patient: But I am not concerned. When I work out, [inaudible]. But I am not as [inaudible] as it might look like. We might need to do this [inaudible] first six months or more of what we are used to doing with. This is not that bad.
Loy: Yeah, the longer you –
Bart Knellinger: Negotiation. He is doing a takeaway. He is closing her. That is what he is doing. He is running to close to her. This is what you call a takeaway close, which is “I do not really need it, so you take it or leave it. I am indifferent.” You cannot allow them to even pull that card, it is going to make no logical sense to say it. He says, “You know, I am 72. I got better things to do with my money than spend it on putting teeth in my mouth.” I said, “You are absolutely right. The problem is, the path that you are on, you have no choice because you are going to lose teeth. Well, even if you walk out you do not do anything, say ‘I can kind of live with it.’ It is going to deteriorate. Flat out. One hundred percent. It is going to deteriorate and the only thing that is going to happen is that you are not going to have two teeth replaced. You are going to have four or five or a full arch eventually. That is where it is going. Then you are going to lose all the money that you invested in the crowns and you are going to be in the dentists’ office constantly. You are going to spend more money. If you want to not do that, do it right, fix it. Do it one time the right way. Replace the teeth, stop the deterioration of the bones, and move on with your life and go play golf.” You got to make it an airtight logical case for why it makes no financial sense to be indifferent. Because right now he has no urgency.
Bart Knellinger: He is not in pain, he feels like he can eat, even if he cannot, they get used to it. He has no aesthetic defect that is driving him bonkers. We do not have the built-in urgencies that make selling dentistry so easy, so you have to manufacture it. Manufacture it with what they are already focused on. If they are focused on price, I will create urgency around the price. You have to show them how they are going to save money. How it makes no logical sense. Do you know what I mean? If you have got your teeth here and you are missing one of them, what are we going to put? Are we going to put a bridge here, you going to put them apart. What are you going to do? Eventually, this bone is going to go away because there is nothing there, and then what happens? This side of the tooth, this side of the tooth, that has no bones what is going to happen to these teeth? They are going to get loose. They are going to go away and then next tooth, and the next tooth and this is how people wind up in this office. Where we have to extract all of their teeth and start over. Guess what, they are not looking at ten thousand dollars, they are looking at twenty-five to thirty-five thousand dollars per arch.
Bart Knellinger: Fifty to seventy-five thousand dollars for the full mouth. They are going, “Oh, shit!” They have no choice. I cannot save their teeth. I cannot do it. With this type of personality, that is how you have to be to gain control of the conversation in pace and lead. You have to be a figure of authority with a strong personality. They want to tell you what the situation is. His nature is to pace and lead. You can tell. He is constantly trying to dominate and control the dialogue. But he is not the expert here and yet you have to kind of match that and take it over. The only way you can do is by using airtight logic with this guy. Because this is not, right now, an emotional purchase for him. It is not like he cannot look in the mirror, and he covers his mouth. That is not in this situation. Not saying that if he got a full mouth he would look in the mirror and start crying because people just get used to living with problems. But that is not the situation. He is not there out of emotion. He is there because the doctor told him that he needed it and how much it was. He said, “Holy crap!” He is getting a second opinion.
Loy: Well, you are going to start losing bone and then your bite is going to be off. Because you are not biting evenly on all four on top and bottom. It is very early on where you could stop the deterioration of your jaw.
Loy: We can definitely help you with that.
Loy: All right. Let me go talk to Dr. Martinez. I will be right back.
Loy: Okay. Thank you.
Bart Knellinger: She made a good point there. She just stayed connected to the money. She more spoke about it clinically. But it is a good point to say, “If you have got a table with four legs, if you take out one leg, there is more pressure on the three remainings. If you take out another one, there is more pressure on the two remainings. They are going to fall over just like your mouth. You start losing teeth, you are putting more of a load on the other teeth which means that they are going to fail eventually. They are going to fail and break down under the pressure which means what? You have more teeth to be replaced, you have more bone loss, you have more cost. More cost.” You have got to be strong with those recommendations too because you know you cannot close somebody that is complacent. If they do not feel they need it, and they do not want it, then you cannot close them. You have to manufacture urgency, and you are always thinking about that for you to call which is kind of like how committed is this person.
Bart Knellinger: How bad do they want it, how bad do they need it? You are always looking for the urgency. Where am I going to get the urgency from? This guy is saying, he can function pretty good. He is saying, “I do not really care about how I look.” He is saying, “I got better things to spend my money on.” He is telling you every way, seven ways from Sunday that he did not need it, he is telling you he is complacent. Before I close, I have to fix that problem. I have to disturb his complacency. When you are disturbing so much complacency, sometimes you got to shock them. The only way to do it with a D personality. Somebody who has a dominant personality like him, is you have to come off as one thousand percent authentic and a hundred percent just certainty. As a massive amount of certainty. You say, “If you are talking about spending your money elsewhere, I agree. You should. It sucks to just spend your money on just replacing teeth and constantly having problems. But what do you want to do? Do you want to stop the problem? Do you want to want to be a catalyst for the problem to continue? Because if we do not replace the teeth, it is just going to lead to more problems and more time for dentists and more money down the road, and more heartache for you. Let us just fix it. If you fix it, you do it one time and it is done. You move on and you go to play golf and you live your life and you are happy. You are not back here in ten years like all these people are, where we have to take out all your teeth and now you are looking at fifty-sixty grand. Does that make sense? That is what you are paying now is not really what you are going to pay over the next five-ten years.” That would work.
Loy: Including the sinuses.
Loy: You think that is a pretty good deal.
Patient: All right.
Bart Knellinger: She went and talked to the doctor.
Loy: Dr. Martinez says that we can do both for eighty-five hundred if you finance it. If you do cash, cheque, cash, or card, we could do eight thousand for both and including the sinuses. I think that is a pretty good deal. Because you are right about thirty-five, and thirty-five that gives you seven thousand, so he is not charging you a whole lot more.
Patient: Well, [inaudible].
Loy: Yeah. We can really do it for you for eight thousand.
Patient: [inaudible] it will cost it a lot more. Okay. Let me just go and [inaudible].
Loy: All right.
Bart Knellinger: See, what is the main problem? We never got a commitment on the seventh to begin with, so we never inched him up. I am not going to go to the doctor, I am not going about for you if you are at thirty-five hundred dollars. We are not going to do it, let us just agree on doing one tooth. I do not feel like the sale is made there. You have got to get a commitment. “Hey look, I got seven thousand dollars in care credit, if you get to seven grand I will sign today, and we will schedule and we are done.” That is what I want to hear. It is a thousand dollars difference between seven and eight. It is no big deal. He is getting eighteen months or twelve months whatever it ends up being with care credit. If I had to, I would say, “Look, here is what I would do,” if I got an objection, I will say, “How about this, I think the last thousand dollars and we will finance it for you here in house interest-free for twelve months, how about that?” That way you would not have to come out of your pocket with another thousand plus your payment. I will make it even, you do not have to apply for more care credit. Nothing, I will finance it right here in-house for a thousand. Because I would take that risk as a business owner because they are going to pay seven out of eight. I would take the risk of not collecting eight. You are already in the black, it is not bad. You can come up with solutions.
Loy: What is it that you are not liking?
Patient: Well, it is just the total amount of money that I will put that is the whole deal.
Loy: Because we are pretty close to what you wanted to spend. In your situation.
Patient: What I was thinking was getting more about [inaudible].
Loy: Right. Because you want to do one.
Patient: One. Right.
Loy: Right. But in your situation, you will not be able to do that anywhere because we have to do the sinus lift. Regardless because thirty-five hundred dollars for an implant abutment and crown is a steal. The only thing that we are having to calculate is the sinus lift because we have to do that surgery on the top. We need to calculate the sinus lift. We are still giving it to you for thirty-five hundred which is like the bottom price [inaudible]. The only reason we are charging you more is because of the sinus lift. You are not going to have that anywhere.
Patient: I am not prepared. I already know what I needed to know now.
Loy: No, I am just trying to help you. Do you have any questions?
Patient: No, I am good. I am going to look through that and I will just have to qualify and will let you know.
Loy: Okay. All right.
Patient: We are good?
Loy: Yes, and do not forget my name.
Patient: Okay, Loy.
Loy: You remembered. Awesome.
Bart Knellinger: I will ask you guys where you can un-mute. Okay. Do you see how that call ended? We never really had a commitment from the patient. They kind of ended with, “Oh, yeah, looks pretty good. Let me think about it.” They said, “I know you want to know now but I am not prepared to do it.” He kind of closed her. With this type of patient you have to have a lot of [inaudible] never really knew that. Do you guys have any specific questions or comment on that particular treatment plan? What do you guys think?
Woman: I have a question. Can you hear me?
Bart Knellinger: Yes ma’am.
Woman: Hi, good afternoon, when they get nonchalant like that I had a guy recently who the consult took so long because he dominated the shit out of me, and I was coming strong, you can ask for Veronica. It is probably still painful to watch that video. But then he got kind of nonchalant after he was acting as he understood it. He was all on board and then as we are getting towards the end, he gave me that kind of energy that that gentleman gave Loy. How do you get somebody kind of back excited or how do you top that energy with the urgency like when you say the urgency. How do I make it if they are like not given it to me but maybe it is in there somewhere? They are just trying to be nonchalant. How do I put that urgency back on the table for them?
Bart Knellinger: Well.
Woman: What can I say?
Bart Knellinger: It depends on what their motivation for being there in the first place is. That is why it is important to understand that. His motivation for being there is not because he wants to look better, it is not even necessarily because he wants to feel better. He had a doctor telling him he needs the implants, the treat them. The treatment planned actually a bridge, but he did give him the option of implants. It was the doctor in Aspen. Then he sent him to a doctor for a consultation about dental implants. He got it, he is like, “It is too high,” and now it is you. You guys that this was the third stop for this particular patient. His motivation is how do I fix this problem and spend as least money as possible. How do I fix this problem without spending money? He is not there because he wants it. What is his focus? His focus is on money. I am going to create urgency around money. I going to show him how not doing it is going to cost you more money, it is going to cost you more time. As you can see right here, he already has a bridge. He has no teeth behind it. What do you think is going to happen to the bridge over time? You are going to have problems with it.
Bart Knellinger: If I put a partial in, you are going to have problems with it eventually. If we do nothing, you are going to have problems. There is no real option where I can tell you, “You can do nothing and not run into any issues,” which are funny now right here. The good part about it is your teeth are not all terminal. We do not have to do a full arch.
Bart Knellinger: You are not here staring down the barrel fifty-sixty thousand dollars. What do you want to do, you tell me. Because I can do it either way. Do you want to do a band-aid approach and look at a bridge or partial or do you want to do an implant and look at an approach, or something is going to be more permanent that may cost more now but it is going to cost you a hell of a lot less later. Which one do you want?
Woman: Keep the conversation there, do not really go into the clinical. Do not try to build value in other spots because he is just not interested so do not try to beat a dead horse with that, just stay on the money. Okay.
Bart Knellinger: He did not care. You have to stay wherever they are focused on. That is where you want to build urgency. We made a couple of critical mistakes. You cannot give them a price like that. A specific number before they give you one on a second opinion. If you do it, you just eliminated your advantage of being a second or third opinion.
Bart Knellinger: You gave it all back, right? My advantage is that he has a price he is looking to get to already. I just have to get him to verbalize it. Then I know where I am starting from. If he says “Five thousand dollars is what I am starting from.” I know based on what he said that the treatment plan was at ten, my first goal is to sell that ten thousand dollars as a good price. Then I have to get him to create that five thousand dollars up to something that is reasonable. The only way you can do it is with certainty and with logic and sticking to the financials with that type of person. He is a no-nonsense kind of guy, you can tell.
Bart Knellinger: Logical, but he is complacent. You cannot close somebody that complacent. They are going to think about and think about and think about it. They are going to procrastinate forever. This guy might not even go to another consultation. They usually do not do more than three. He is just going to wait until he is in pain, and then he is going to go back and then we will get him when he is in pain.
Bart Knellinger: But that is not what is best for him. You got nothing to lose. If you try to make a close, and you do not know if they said someone else is too expensive, and you try to make clothes without knowing the number that they have committed to right now, then we do not really know how to position and sell it. I do not know how to escalate his level of commitment, and if we are going to go into a close and they say something like they can take it or leave it like, “Well, I do not really need this. I got other stuff to spend my money on blah-blah-blah.” Then do not close, you are not done.
Bart Knellinger: You cannot close without urgency. You have got to get that urgency up. If he said that to me, I would say, “I agree, my god, why would you want to have to mess with this all the time? You want to mess and get crown after crown after crown. You want to mess with the bridge? You want to do a freaking partial, are you nuts? What is going to happen to the partial in five years ten years? It is going to suck. You are going to wind up in here missing more teeth and more money. Let us do this.” I could be wrong, but you strike me as the type of guy that when you do something, you pay your money, your hard-earned money you want the job done right. Am I wrong? No, well then, let us do it right. I will get you the best value for your dollar that you are going to get. But I have to know how you want to approach it. It does not matter to me. You want me to put a band-aid on it? I will put a band-aid on it. You want me to fix this thing permanently, so you have no problems? I will do that too.”
Woman: Because he mentioned his age, and like already 71. “I am 71,” perhaps to build enough value and at the same time address that money factor. Well, when you are 75 and your back seeing us, it is going to be an x amount of dollars more and then you can have multiple more issues. You can just keep staying on that money aspect too and then he is like, “Oh, gosh yes, I do not want to spend five thousand dollars more than five years.”
Bart Knellinger: You just get him [inaudible].
Bart Knellinger: You cannot let him run you over. You have to take certain things, “You are 72, you are right. Who wants to be in here talking about dental implants for ten grand. I am sure you know what to spend ten grand on to have more fun instead of ensuring implants, right? You are 71, so let us stop it. The problem is if we do not do an implant, we are just going to put a band-aid on it, the bones going to erode, and you are going to have more problems and you are going to cost yourself more money and more time in the office. Let us get this damn thing done right.”
Bart Knellinger: Look, you already have care credit at seven thousand. If there is a way that I can work this out where you get it at the seven thousand, would you move forward for now? Would that do it for you, would that make it easy, rather than peace failing this thing? That is a close. I am not going to go to the doctor and work a deal for somebody who is going to tell me, “Let me think about it.” I am not gonna do it. Because they are just going to handle you forever if you let him treat you like that, like, “Yeah this is enough. Go back. Oh, you getting the discount, yeah, it is still not low enough. Give it up. Yeah, let me think about it. No, no, no that is not how this works.” You got to establish a high price and sell the high price, or the discount does not work. That thirty-five hundred dollars she said that is a wholesale fee, he did not believe that. He did not believe that. We gave it to him right off the bat. That is why anytime a second opinion guys, never below the second opinion of the water and say it is too high. Do not do that. Even if it is high, say, “I can definitely see it is not like that fee is out of the realm of what it would be, especially if it is a doctor with a lot of experiences, using good components and doing things the right way and building that so that it will last for the rest of your life. That is not out of the realm, I would not be concerned about that price at all.” I am going to work up a case for him, I am going to work up a treatment plan and a fee but that is not out of the ordinary. Then if they have comments on it, then again you sell, you build value, create urgency, show them why it is not a lot. Then when I show them, when I present them price, when you just kind of throw it out there like, “Yeah, okay we can do it for nine.” Well, if it is thirty-five thousand dollars per implant, it is seven. You are charging a two-thousand dollar for bone graft, then you said, “Well, I can also do that eighty-five hundred. Or I could probably do it at eight.”
Bart Knellinger: It is just kind of loose. The whole structure of that close, it is just a little bit loose. I want to come in and I want to know exactly what they will pay before I give him a price. I am going to get a commitment from them. Then, I am going to come up with the price and we are not going to kill ourselves and give it away either. Not going to do that. I am just going to give it to them for seven thousand dollars, doctor might say, “No, I am going to do it for seven,” say okay. What are we going to do this for? He is going to say, “The lowest I will do is at eight.” I will say, “Okay, cool.” I am going to this patient with a price of ten-five. Ten-five, and I am trying to get him off to eight on the ten. Then I will come down to meet him at the eighty-five or something like that. But you just have to be strong when you have a dominant personality in front of you. You have to have a tone of certainty and you have to know when to push. When do I push and how do I push? Well, you have to push, if you do not have the urgency, you have absolutely nothing to lose. Absolutely nothing to lose. I remember I was in a practice and one guy said during the treatment plan, he said something in the effect of like, “Well, I am 84 years old already what the hell, I mean hell I am going to be dead soon. Why am I going to spend this money? I am not going to be around long enough to even worry about this.” Then I said, “Well shit if you think like that, what would you pull up in that Cadillac? Give me that Cadillac. You are going to be dead a couple of years anyways, give that shit to me. If you want to die, go ahead and die! What are you going to do? Would you want to die or would you want to live? Which one do you want to do? If you want to live, you do not have that long, like you said you are 84. Let us let you live when you can eat your food and not to worry about what the hell you care about the money.”
Bart Knellinger: You could say that to everybody but the type of rapport that I was in, I had to shock the guy and get him out, think about how nuts that is. The psychology to say, “I do not have much longer.” If I was saying, “I do not have much longer, what the hell would I care. I would spend the money. I would spend it quick fast and in a hurry. To be able to go eat a steak and not worry about it. I would want to feel as good as I could possibly feel for the days that I have left. Yeah, that makes logical sense. The only thing that makes no logical, why do you want to suffer? It is stupid. What are you going to do? You going to take the money with you? That cannot happen, the Egyptians found that out, they tried. What happened? They got robbed, all of them.” That is. That is what is going to happen, you cannot take it. You just have to kind of know when to push and how to push. You just cannot be afraid of that. Sometimes you look very proper and very nice, very proper and very nice and that is great. But there comes a time where you have to influence somebody and you have got to push and get him out of their comfort zone. Sometimes they are just not thinking correctly. He is thinking that it is more expensive to do the implants than the partial, and he is just incorrect. If you are looking at long term, he is just incorrect. Does that make sense, guys?
Woman: Oh, absolutely.
Bart Knellinger: Again, sometimes, if they have seven thousand with their care credit, I would ask a question like, “If I can get you to seven, is that the number you want to stay with then just because that is what you are financed for, or is that the number?” Because sometimes like, yeah well, I mean that is maxed out your credit, I do not want to come out of pocket with any more cash. Sometimes I can run through proceed and get them approve for eleven or fifteen and it is a non-issue. It is the eighty-five hundred at that point is a non-issue. If I can and he says yes. Seven thousand, because I do not have to come out of pocket, it is interest-free, it spreads out, it makes it easy for me to say, “Okay, well, look, we will use the seven, I will take the extra fifteen hundred or thousand, I will that break up or over eighteen months too and you can just pay us direct. That way we do not come out of pocket for anything. If I can do that, will that work for you? I am trying to work with you here. Eventually, if you are saying that, as long as you are trying to close on, they are going to have to give you something. Otherwise, it is very uncomfortable for them to just always request, “Well, that is too expensive,” without making some type of commitment. They are basically giving you no way to help them. They are not giving you an option. There is a, “Look, tell me what you want, what price do you want?” The number one mistake with negotiations is not understanding that we are in a negotiation. If we are in a negotiation, it is who needs it more. Do you need to a sell more than he needs the treatment? Who needs it more? We have to establish that. He needs it more. Then we have to establish urgency, in one way or another, you can do it emotionally or you can do it financially, those are the two best ways. Emotionally, he already told you that he does not care, so you have to go the financial route. You have to make him understand. If they come in with a CT, and things went wrong, do not start that second time without a CT, just do not do it. Do not do it.
Bart Knellinger: The whole call kind of went wrong there and I think we wasted about twenty minutes, where we did not need to waste that. Also, keep in mind the second opinions. If they say it was too expensive, you find out how much it was, your first job is to convince them that that is not expensive. Matter of fact, you can convince them that it is low. Tell them it is low. If you are going to make an error — error on that side. Tell them, “That is a great price for a sinus lift too? Do you realize not everybody can do a sinus lift? Why do you think the guy had asked and did not do it? He did not even place an implant, much less do a sinus lift. There is a reason.” It is a different caliber. It is a more difficult case. There could be more complications if it is done wrong. There could be serious complications in place and implant area where there is not enough bone. There are people that try, there are people that have tried, the implant goes into the nerve, what do you think happens? Bad stuff, bad stuff. All trying to save a couple hundred dollars. It is crazy. You can have those conversations, but at the end of the day, this guy was a D personality who is right to it. He got us off our structure of the ten-ten-ten, not having the CT, put Dr. Martinez in this situation of not looking like a figure of authority because it was a lot of conversation. Doctors are not going to have a conversation, you guys do not have to speculate, I would not do any speculation if I was you. I just would not. I would say, “Look, before I can even comment on the situation, the first thing, I cannot look at the CT. We cannot open the file, so first thing, we got to get the CT. Let us get a CT, and then I will tell you what I see and I will say what the best thing to do is. Sound fair? Cool, let us do it.” Bam! Go. Do not engage in discussion or conversation or speculation with people. Because it just shows that you are not an expert on what you do. Not that that is true, it is just that is the perception. Does that make sense? Okay, so a couple of takeaways write this down. You get a second opinion, sell them that that price is not too high. Okay?
Bart Knellinger: That is number one, number two, look for urgency, if you have no urgency, then create it. If there is no pain point or motivating factors aesthetically or emotionally, then it is going to be financial. Then you have to create a scenario where it makes no logical sense to do a partial or a bridge or do nothing to where that is not even a logical option. That is the whole goal with a patient education portion of it, is to take that off the table, okay? Then when you do make a financial presentation, before you make it, you have to get a financial commitment. Because you are price bidding basically, you are bidding for a project, in our world, that is what this would be like. We are bidding for a project. Like, “Hey, this company quoted me this for a website or whatever.” Do you know what I am going to know? I am going to know what the company quoted and I am going to know what they want to pay.
Bart Knellinger: I am going to know that before I give them a price, every single time. That is what you guys have to know, then when you come back with the price, show them the value of the total case. I want the value to be more than what the other guy treatment planned. Because I want to show that clinically, it is better, that you are going to get more value. Then I will come down and I will justify the reason for the discount. Does that make sense?
Woman: Yeah, a lot of times I will ask a patient, “Well, if you feel comfortable you can bring your treatment plan from the other dentist. Because when do you know exactly what you are working at.” Because sometimes, they will say, “Oh it was around a certain amount when it really was not around that.”
Bart Knellinger: Right, yeah. They are going to give you a fee that is low and a lie. Again, in a negotiation, they are going to lie to you. They will tell you, “Look, buddy, it is just you guys are shopping for cars, you do it too, we all do it.” You say “I got a quote for this car, someone is going to sell them to me for thirty-eight.” “No, that is not right.” But it is a negotiation so that is why I said never act like it is low. Makes sense, guys? Do not forget to get the new patient and take form. Have them fill it out beforehand and get it before you go to an appointment with a patient. Do not let the doctor come into the room and so you have a CT and the doctors looked at the CT. Maximize their time, do not put him in front of somebody that is unqualified or somebody that is just there to play games. Do not let him handle you. Okay, guys?
Bart Knellinger: All right. Go call somebody!
Woman 2: Thank you.
Bart Knellinger: All right.
Woman 2: Bye, take care.
Bart Knellinger: Bye.