The Closing Institute - Peer Mentorship Call

August, 2023

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Bart: Okay, I’m going to go ahead here and share the screen, but before I do it, for anyone that missed the, missed the last call, this is going to be a continuation from, uh, the consultation from Dr. Stuparich. So, um, a guy came in, this was like his third or fourth opinion, I think, for the patient and he’s qualified, but he was kind of like a, he was a very analytical type patient. He had a lot of very pointed questions. Um, and they did, they did a really good job in the first 10. Were kinda like, we got maybe three or four minutes through the second 10. Um, but this is one of those situations where sometimes these people, when they’re, when it’s their second or third or fourth consultation and they start going online, they do all the research and they come in and they have all of these really specific pointed questions for you.

Um, and sometimes you can kind of fall into the trap of getting into those specifics and kind of getting into the weeds with those people. Um, and you really just want to kind of stay big picture, keep ’em big picture because they can, they can kind of psych themselves out and they almost get so much information that’s like, it can be information overload that for someone really analytical, if you give ’em too much information, it almost guarantees that they can’t move forward that day. ’cause their mind’s going to be telling ’em, “Ah, let me think about it. Let me think about it. Lemme think about it.” But this guy is, is, uh, is really qualified and, um, Dr. Stupe Rich came in and built rapport really quickly with him. So we’re going to kind of pick it up in the second 10 where we left off and, um, I’ll stop it before we get into the third 10. And guys, if you have any questions, you guys can type ’em into the, uh, into the chat function here, and then, um, Caitlin will let me know and I can stop and answer ’em or, or I’ll get to ’em at the end.

Okay, here we go. The audio’s pretty good, but make sure the volume is up on your, uh, on your computer so that you guys can hear everything. Okay? Just here. This is right where we left off from last call.

James: When you, like, for example, you have a molar on the upper left side that has about 90% bone loss on the back end of it. I looked at on the, on the full set of x-rays, when you have something round, cleaning something round, which comes out like let’s say your front teeth if you’ve had loss of bone on those two front teeth.

Bart: And quick recap, I forgot to tell you guys this, this guy basically said that he wants something that’s going to last 20 years or more. That function is the most important thing. And, um, he said he is basically just doing his research. So he kind of gave us one of those when he came in, which anybody who says, “Oh, I’m just doing research, or, oh, I’m just getting- here to get information.” They’re kind of telling you I’m not going to buy so they don’t have a whole lot of urgency. But then, uh, we uncovered that he lives half the year in New Zealand and half the year here, and he’s leaving to go back there in September and he wants to have it done. He wants to get to a good place before September or October. So that has some built-in urgency right there just to kind of bring you guys up to speed on, on, uh, what happened in the first 10.

James: But they’re around. So you’ve got a nice smooth surface you can clean that a little bit better. The back teeth where you have the molars they have three roots. Well, when you lose bone, you’ve got all sorts- it’s like Fjords in Norway, you’ll never get there, it’s hard. You can’t get there because a lot of those areas are greater than where a toothbrush or floss can get in there. So you’ve got these nooks and crannies that can’t be cleaned. So, you know, I, I think in, in your case, I’m looking at if you want long-term longevity and you want success, trying to do the periodontal maintenance is not really, and I couldn’t agree with you more in get that out good. Get some good solid foundation with the implants, have good architecture so that you can maintain them, and keep them clean down the road. Okay?

Let’s not duplicate the challenges you had, and that’s kind of what we try and do when we do these restorations, we, we, we level everything off so that you don’t have challenges keeping it clean. Okay?

Garry: Um, you were saying the requirement. Yeah.

James: Okay. So, so I, I do feel, I mean, you do have a bunch of teeth on the upper that are extremely compromised. You have about five or six- well, you, you know what, the two front teeth, they’re very conical and you have a lot of bone loss, so they’re compromised too. So the long-term success is poor. So let’s take those teeth out, place four to six implants in selective areas. You have one implant that I, we’ll, we’ll see, maybe we use, maybe we have to take it out and, and place another implant in a different angle in that area.

Gary: [inaudible].

James: Okay. Not a big deal. I do that all the time because it’s kind of- my, my thought is I did a little construction when I was a kid with my uncle who was a contractor and, you know, sometimes trying to remodel a room that has plumbing and electrical already done is much more challenging than just ripping it all out, starting to crash. So that implant, if, if we can manipulate everything and utilize it, we’ll use it, if not easy, take it out, we change the angle, get a much longer implant. So you got a better foundation in there.

Garry: And you, you trans between the, the landmines of sinus and nerves and all that stuff.

James: So like, you see this implant here, what I typically do is it’s been placed…

Bart: So one thing to keep in mind here, right? Like he’s sitting here talking about- what’s he talking about placing the implant between the sinus and the nerve, all sorts of kind of stuff that he doesn’t really need to know about. But, um, you know, that, that obviously Dr. Stupe Rich is going to do. But here’s the thing, when, if you come in, if the- ’cause typically, right, the doctor’s going to know, “Hey, this is what’s most important for the patient.” They want function, aesthetics, they want something long-term, something fixed. They’ll have a good idea in terms of what they’re going to be recommending. So there’s a couple of different ways to make the recommendation. Um, the way that I like the best to see is when the doctors come in and they say, “Hey, um, you know, based on what I see here and based on what you said was most important, these things, boom, boom, boom. You know, I think you’re a perfect and obvious candidate for something like this.” Here’s how I would approach the case, right? First thing I’m going boom, boom, boom, boom, boom. More telling them what you’re going to do, rather than kind of brainstorming, especially with a very analytical person. You don’t want to brainstorm, you want to really direct ’em, right? Because sometimes, sometimes people with a dominant and analytical personality, they’re trying to figure the whole thing out, but they’re just trying to get comfortable. Um, so if you brainstorm with ’em, right? Like, Hey, there’s a bunch of options, or maybe I would do it like this, or maybe I would do it like that, sometimes you’re, you’re kind of getting their brain moving in the, in the wrong direction, right? Cause the, the way that I want them thinking is just, “Oh, this is figured out. He knows exactly what to do. Oh, this all makes sense, no problem. Okay, this is pretty simple.”

But there’s no discussion of like, “How I’m going to place the implants or what I’m going to do here.” It’s just, “Hey, if you want something long term, you want something fixed, you want something that’s not going to chip that, uh, crack or stain, you know,” then here’s how I’m going to approach the case, right? Because I think this is super straightforward. Here’s how I’d approach it. Boom, and just give ’em bullet points, boom, boom, boom, boom, boom, right down the line with absolute certainty, um, because it’s not, so the, the way that you’re going to approach the case isn’t necessarily up for debate. It’s, it’s not really a brainstorm. We’re not looking for input there. Um, so you want, you want to deliver that message with as much certainty and as much confidence as you can, especially with somebody super analytical ’cause that’s going to get, that’s going to make them feel more comfortable than anything, typically.

James: Uh, and I used to do this too. You place it parallel to the teeth because you have teeth on either side. So that’s kind of where you- what you do. I just did one this morning. I had to do that because they have all their other teeth. When you’re taking everything out and now you’ve got a clean slate, a clean foundation where you can build any way you want. You want to maximize, you know, having good engineering foundational principles. So we would put an implant avoiding the sinus starting from here and angling it all the way up to here. Okay? And you would do the same thing on this side here. And then you’ve got the ones in the front. And so that’s, that’s how what I- I would avoid the sinuses here and go in that direction and that’s actually a technique developed by an Italian, um, you know, in terms of increasing the spread. And then if we have to put some more implants, we go further back if necessary, uh, or not, you know, and that’s part of what I’ll do when I design it. I’m, I, I don’t tell people four for sure, or six. I’m going to put in whatever it takes to make it solid. I want it to last. Okay? The lower, same thing. A lot of periodontal disease, you got this tooth here.

Bart: And that’s a really good opportunity to say, “Hey, whether it’s four or six, yeah, I’m going to put in whatever it takes to give it the best longevity and give you the best outcome. And that doesn’t change the price. You know, and people kind of run into issues if they want to charge four, they want to charge for six, sometimes they charge for four, and you don’t know that you need six or you can fit six until you get in there, right? So we just have one price for the whole thing. We don’t charge anymore. The, the whole point is that this thing’s done one time, it’s done the right way, it’s done to last. Make sense? Boom, and then you just kind of keep going. So any, um, any opportunity you get to interject a competitive advantage is a good idea.

James: Lower left side and I knew already the, the numbering system, because I grew up in Canada. My anthropology class, I learned the international system of [inaudible]. Ah, so I had a downpad, um, and um, so, so that would come out. We would do a similar thing for implants here, possibly one and one in the back area there, depending on what we do back here.

Garry: Yeah. But you know, it’s funny, you know Gary Logan in, in Beline.

James: Oh, I know Gary.

Garry: Great practice over there, a super guy. But he was actually sweating out saying, “Now we should do one bridge here thinking this is going to be three times the labor and you’re leaving me with half of bad mouth and I’m going to be juggling. It’s not going away. I was just shocked and I was thinking, you’re old school, you got real stepped-up practice over there. But he didn’t say absolutely not but he was willing to do that and I thought, “Reminds me of the guy in New Zealand.” It’s like, John…

Bart: Did you guys hear that? He just told you what his objection was at the other doctor’s practice and he said, “Really good doctor, really great practice.” You know, but what’s the, what was the doctor doing with him? He was brainstorming different scenarios. He was saying, “Well, I could possibly do this with some crown and bridge and we might be able to do this if we treat the perio.” And, you know, that would be one way and then the implants, “Yeah, I could do this.” And that would be another way. They’re giving ’em way too many scenarios and it sounds like the doctor doesn’t know what to do. That’s what it sounds like to the consumer if that makes sense. Right? The consumer wants to look at or, or the patient, they want to look at the doctor and they want to see 100% uncertainty that, that’s what makes us feel good, right?

Imagine going to the hospital and you need brain surgery and the neurosurgeon says, “All right, listen, um, I could do this one of three ways. Which way do you want?” Right? That would not make anybody feel good about getting the brain surgery. You don’t want to hear that. You just want to hear, what way do I need to do this? Right? What is the best way to do it? How do you think this thing needs to go? So the other doctor was clearly, um, hypothesizing with him, right? They were talking about theoretically I could do this two or three or four different ways so that all of a sudden put some doubt in the patient’s mind. Like he said. He’s like, “Man, I’m thinking like, man, are you old school now? I thought, you know, this is a pretty up-to-date facility.” But maybe he doesn’t, maybe he’s not up to date cause he’s certainly not very sure about what it is that he- how he wants to approach the case.

And if the doctor’s not sure about what they want to do, the patient’s not going to buy- obviously, the patient’s not going to be sure. So the patient naturally wants the doctor to make a recommendation, say, “Hey, this is the way that we’re going to do this, okay?” Right? Based on what you want. Function, aesthetics, long-term maintenance or, or low maintenance, long-term, something that’s going to last for a long period of time. Here’s how we’re going to do it, right? First thing is this, boom, boom, boom, boom, boom, and you give it to ’em

Gary: Away from implant.

James: You, you have to hit it head-on because you know…

Garry: You got one good shot at it, right?

James: You get one shot at it, then also, if you do individual areas, then what do you do for teeth after you take everything out, right?

Garry: Then you have to build all around what somebody else put in.

James: You know, and for somebody who- and, and, and I’m, I’m thinking I’m putting myself in your shoes. You, you, you’re, you’re, you’re here because you’ve had it with a lot of these challenges. You’re telling me you want to take them out and you want to just move on and let’s get success. Well, if we put solid implants, we’ve got a nice arc cross, we call it cross arch stabilization, we place teeth in right away. You, you leave with teeth. You don’t have to worry about not biting. I mean, you have, you’re going to have to be soft on your chewing things because we have to go through the healing state. But you’re going to have an aesthetic design that’s done. You do it in segments. Much more challenging. I’ve done it many times. Um, I’ve done the 360 in terms of how I treatment plan, but you know what? It was knowledge, it was knowledge that I was trained and I utilize it because, you know, it’s, it’s having different perspectives and understanding which one works and which one doesn’t.

Garry: I think I’ll let you do your job and I, I, all I have to do is feel comfortable mentally. Um, um, a couple of remaining questions, are you finding the computer-assisted, uh, placement apparatus the thing, are you finding that helpful or do you find [inaudible]

James: Huge.

Garry: It’s huge.

James: Huge.

Bart: You see this guy’s asking all sorts of pointed questions here, you know, all sorts of pointed things. But, but what did he just say before? He said, “I just have to get comfortable mentally and I’ll let you do your job.” Right? He’s saying, “I don’t need you to do, I don’t need to do your job.” But yet he’s still asking pointed questions. This is why with somebody like this, taking control and pacing and leading the dialogue with a lot of confidence is going to do more for this guy than anything else. He’s looking for somebody with a lot of confidence. You take somebody like this and you start spitballing ideas with him, oh, it’s, it’s, it’s bad news, right? You want to do the exact opposite of spitballing ideas. You want to go with 100% certainty and they’re j, and this guy’s going to follow you, right? He’s going to follow you. But it’s so easy to fall into the trap because of his pointing questions. You can fall into the trap and all of a sudden half an hour’s gone by then you, you’re, you’re talking about mechanics of a, of the treatment before the treatment itself that we’re recommending is even clear

James: Because we increase our precision. Okay? I, I know…

Garry: Yeah, it’s pretty good three years ago, right? But I mean, all sudden I think these things are pretty new from what I’ve read.

James: Um, yeah, they’re getting new. I mean, I use, uh, a navigation system called X guide and basically, what it does is, I basically using GPS triangulation, I, I have a live x-ray in front of me. So when I’m placing an implant, I am looking at a live x-ray where the bone is and what is a sinus there. I have safety margins. I’ve also done a lot of these surgeries freehand, because I also, you know, you understand the anatomy and you know, where it is, what the navigation does, it helps you increase. So like a good surgeon would probably have about, let’s see if I want to place an implant exactly where I wanted to…

Bart: Now I would be taking this opportunity, you know, for Dr. Stupe Rich, because he’s a prosthodontist. I’ll be taking that opportunity to say, “Yeah, it, it, it’s huge.” I mean the, the navigation and the entire just digital workflow and everything we have now as far as diagnostics make cases that once were much more complicated, makes the surgery much less complicated. But when you look at all the problems that arise in dental implants, for the vast majority of the issues, it’s not because the surgery was done wrong, it was because the prosthetics were done wrong, right? It’s because the teeth don’t fit together properly, put too much pressure on an implant, and they fail. That’s why, you know, from, with a, with my background in pro and, and, uh, prosthetics being a prosthodontist, we reverse engineer everything. We know exactly what teeth need to look like, how they need to fit together, and the surgery only exists to make that happen, to support the right forces and, and to make it stable enough to allow the teeth to do what they do.

Whereas other doctors might look at the surgery first and the prosthetics the afterthought, but that’s backwards as a prosthetist, that’s kind of one of your main core competitive advantages that would make a lot of sense to this guy. So when you’re educating as a doctor, right, you’re also selling, you’re also, you know, that you’re in a competitive situation here, so any opportunity that you have as a doctor to set yourself apart and provide a different perspective that makes a lot of sense that maybe they didn’t hear before, um, is going to be a very good thing. And if there’s one thing you can tell by this guy’s demeanor that I’m sure that he really wants to avoid, it’s an implant failure. So, um, you know, an oral surgeon or a periodontist would have a competitive advantage that’s totally different and you can use any of them to your advantage as long as you know how to frame it.

James: You’d probably get it about 7% of error in where you want it.

Garry: Well, that’s pretty big. [inaudible] Right.

James: With the navigation, we’re looking at 1%. So, hey, if I can gain you 5% of improvement in accuracy when we’re close to the sinus, when we’ve got other limbs…

Garry: Come back crying quite as much. What about the pure zirconia for the final?

Bart: But you know what, that’s, that’s the time, throw it in and say- but you know what, you can use a guided technology and it could be the implants could be in the absolute perfect position. They could heal absolutely perfectly, but when the zirconia goes in, if the occlusion is off, the implants are going to have problems, period, end of story. Doesn’t even matter. Makes sense. You want to throw that in there because this guy, he said during the first 10, “Hey, I need this thing the last 20, 25, 30 years.

Gary: Versus a hybrid, they talk about hybrid breaks, doesn’t last as long as 67. If I get 20 years out of it, I’ll be lucky. Oh, a bigger problem to deal with than that.

James: Yeah. Uh, that, I mean, I think, I mean, the zirconia is, is what the big market promotes. I mean, we do too and it’s, it’s…

Bart: And remember, we don’t promote, we don’t promote anything. We don’t promote anything. The only time we talk about zirconia is if zirconia is the material that’s necessary to achieve the clinical outcome that you want. That’s it. I don’t care if there, there’s a, a time and a place for zirconia. There’s a time and a place for hybrid. There’s a time and a place for a PMMA. Time and a place for a denture. It all depends on what kind of outcome you want and I’m not, I’m not for or against anything. I’m for whatever makes sense to achieve the outcome we’re trying to achieve. So you don’t, you don’t want to show any kind of bias towards one, uh, material or one procedure over another. You guys, you’re all completely agnostic to whatever the material is, whatever the implants are, whatever. It’s really all up to the doctor.

If the doctor knows, “Hey, this is the goal, we’re trying to achieve this,” then whatever it takes to achieve that is what we like, that’s it. But that’s the only thing guiding us. It’s not that, “Hey, is zirconia better than a hybrid?” Well, it depends on what you’re expecting. You know what I mean? They don’t deliver the same exact clinical outcome. That’s, that’s why they’re, they’re two different options, um, at, at two different price points. So again, like this guy is really kind of a difficult patient to deal with, um, because of the type of questions that, that he’s asking. Um, the good thing is Dr. Stupe Rich is in really, really good rapport and he seems to have the man’s trust right here. Um, and, and he’s taken his time because he can see that, that this is somebody that’s qualified. He’s leaving town soon. He’s already been to two or three consultations. So if this takes longer than the 10 minutes, if it takes you 15 or 20, then it’s probably a good investment in, in your time to spin that with this type of patient.

James: …it’s good for bacteria, right? You’re, you’re battling with, with periodontal disease, and that’s bacteria that you don’t want in your mouth. So, because it has a great, um, what’s, what’s, what’s the chemical word now? I’m drawing a blank. Uh, just fear of, uh, it doesn’t collect bacteria. It’s highly polished…

Garry: As opposed to the hybrid, which may…

James: Right. So that can collect a little bit more. But they’re all- once you get the foundation, right, you know, the, the different materials have different place in different people. Like very strong bruxers, people who grind their teeth. There’s times, I mean, I used to do different material…

Bart: Again, this is a lot of information, you know what I mean? If he’s asking me about a hybrid, I say, “Well, listen, in, in your case, you want to get 20 years out of it, you know, then, then you’re, you’re probably not going to want a hybrid.” Right? I wouldn’t recommend a hybrid. If somebody said, “Hey, I want to get 20 years and I want it fixed and I want it to look really good and I want it to be as functional as possible, then I wouldn’t recommend a hybrid. In that situation, you would go zirconia cause you want something that’s harder, something that’s less porous, something that is more resistant to chipping, cracking, breaking, and staining. Does that make sense?” Okay. Boom, and then keep it moving. You know what I mean? But you have to kind of grab ’em, you answer the question, and then you start- then you pace and lead again. But we go into a lot of detail before we’ve made any recommendations. So we’re talking about very specific aspects of the treatment, but the actual treatment that we’re recommending to achieve the clinical outcome, the patient set forth, is still not clear.

James: …so that we could replace things and not damage one material. So like you, you- if you were a high grinder, doing zirconia against zirconia could be a challenge, okay, where you might have fracture down the road, but…

Garry: I don’t think I am.

Stupe: No, I don’t think so and I can kind of tell by also the exercise, but the bottom line is doesn’t even matter the material, it’s always the bite that is kind of the driver of things breaking.

Garry: Okay.

James: Okay. So as long as we correct the bite, we can, we can go from there.

Garry: Okay, great.

James: Okay.

Garry: That does it for me.

James: Okay.

Garry: Yeah. Funny looking pictures.

James: Yeah, it is, right? Isn’t that amazing, we bring you in and we show you this, and now we’re trying to tell you that…

Bart: But keep in mind the, the material is important, right? Because other, otherwise, you know-right? Why not recommend the cheapest option if it doesn’t matter. The material matters. I understand what he’s saying and, and I’m not nitpicking, I’m just kinda showing you guys as an example with somebody really detailed how you want to have a very clear idea in your head in terms of what you’re trying to accomplish with the second 10 and the treatment coordinators. You guys have to be paying very, very close attention to all this during the second 10 because what you’re trying- what you’re thinking the whole time is, “Hey, um, does the patient totally understand what the doctor’s recommending? Does the patient totally get it right now?” You know? And if you feel if you’re getting close to the end here in the second 10, you feel like the patient doesn’t completely get it, um, then sometimes a really good idea to interject and just do a quick summary and it’ll prompt the doctor to kind of tie it all together.

Cause sometimes the doctor’s like, “Yeah, of course, you know, it’s all on for zirconia.” They think that, but they never actually said it to the patient. They talked about how the surgery will go and they talked about the bite and they talked about the healing time and all of these different specific things, but they never kind of brought it all together and made it simple for the patient. So you guys can interject and say, “Okay, so, so in, in summary, we’re basically talking about in an all-on-four with zirconia upper and lower, is that right?” And just act like you’re writing it down and that’ll kind of prompt the doctor because the one thing that you guys really need, you need to come out of the second 10 with one treatment plan that was recommended by the doctor and nothing else, and the patient needs to be very clear on what that is. So the patient has an opportunity to ask any questions if they have it. If they don’t, and you get to the third 10, the first thing you have to do is basically tell ’em what the recommendation is and, and really like, we, we would like for the doctor to do that part and then you guys just come in and you’re just kind of excited for ’em, and you keep going.

James: …trust us.

Garry: Oh yeah, I do. I wouldn’t be here for them. Okay, cool.

James: Is there anything else? I can invite you…

Garry: I think that’s plenty.

James: Yeah.

Garry: Yeah. Keep these on file and they call and ask for later, but talk about schedule, talk about cost. Yeah, talk about moving forward.

James: And then, I mean, one, one thing here, I mean, this is kind of how we can simulate also, I mean this is 2D, um, but um, you know, we can change color, we can do whatever you want with, with your teeth but that’s how…

Garry: You can get me close to that. That’d be perfect.

James: You want to go?

Garry: Absolutely. [crosstalk] Here, look, I’ll show you. Let’s change the color you want to go…

James: Now you’re playing with toys.

Garry: No, but that’s, [crosstalk] it’s, it’s- once you do the foundational, so you can do whatever you want, you want them to look perfect, you make them look perfect. If you want them to have character and some rotation, we can do that.

Ellie: We had a patient who kept his gap because his grandmother loved his gap.

James: Well, actually, and you mentioned Europe, there are the, the typical model women in Europe that want their teeth nice and crooked in the way the Vikings had them. Because they…

Bart: I don’t know what kind of models this guy’s looking at, but I don’t get that.

James: …looking like in America.

Gary: I’m going to share you a little personal story since….

Bart: I don’t get that at all.

Garry: …um, he brought it up. My father in law is British, he’s coming today. I’m delivering upper and lowers. He wants to maintain his British smile in, in the laboratories, the designers that we work with, they’re not used- You know, if you have an American is not used to that, it’s, it is a tragedy. And my partner Dr. Noel, she’s like, “Let’s make them natural. Why can’t they rotate them? It’s very simple.” And she’s the designer. So you- we do whatever you want.

James: Well, you, you’re so strong…

Bart: And again, like guys, when you’re talking about aesthetics, that’s something else that as a patient, when someone says, you know, how do you want your teeth to look? However you want ’em to look, we’ll make ’em look, you’re making them kind of think about it, right? I don’t want them thinking about anything. So if it comes up as aesthetics, say, “Listen, there, there’s not one perfect aesthetic that works for everybody. There’s not. That’s the point of the smile design.” And that’s the point that, that’s where the art side of this comes in for us. That’s why a lot of patients come here from all over the state, from all over the country, specifically for that because we’re not going to say, “Hey, this is the way a smile should look and we do it the same time, then all the teeth would be the same.” It’s all about designing a smile that’s going to fit with your face, your skeletal structure, your smile, your bite to where it looks beautiful and natural.

It doesn’t look beautiful and fake. That’s our job. You don’t have to worry about that. That’s the artistic side that we love here and we’re going to design everything and plan it out digitally and get your input before we ever even start the surgery. “Does that sound good? Cool.” Boom. Done. Move on. You know what I’m saying? I don’t want to give them anything to think about. I don’t want them to think, “Oh God, I need to think about this. I need to tell ’em how I want to look. Oh, they bring up some good points. Do I still want this little thing? Do I not want it.” It’s like you’re getting their mind going. Don’t get their mind going. I don’t want anybody doing any thinking. Right? People thinking that’s, uh, that’s, that’s, that’s a dangerous thing for most people to do, especially in, in a situation where we’re doing a consultation.

I don’t want any, any workload to be on their brain. I want them to think this was the easiest thing ever and you got me and I’m not worried and this was easy. That’s it. Then it’s, it’s super simple for them to make a decision. You know? Cause their brain’s going to go full-time. The second you guys show them the price, they’re going to click into, um, consumer mode, and their brain’s going to be going a million miles an hour and there’s a cumulative effect of this, right? And once they reach a fatigue point, mentally, they’re, they’re just kind of done. And, and you guys have probably experienced it in a consultation where maybe someone reached that point of just, they’ve thought about so many different things that they’re tired of thinking and they just need a break. You, you want to try to avoid getting to that point. Um, Dr. Stupe Rich has really easy ways of explaining all this. So I’m not saying he’s there. I don’t think he’s there. He’s saying all the right things. Let’s talk about costs, let’s talk about scheduling, let’s talk about moving forward. He said, he said those three things. Um, so I think he, he’s in a, he’s in a good place here.

James: Guy in Texas and you’re like, “Some British guy wants to look ugly. We can do that.”

Garry: Yeah. But, you know, we can do that same thing, I mean, I remember being at meetings in the nineties, and in America, it was- you know, everybody at, at that time we were just starting the, the, the bleaching and the lighting, the, the population was interested in that, and going to meetings. It really came down to kind of how I opened up our conversation, what do you want? I’m not here to, to do what I think looks good, I’m here to give you a solid foundation and then we do whatever you want on, on top with limitations, obviously, but color, shape, and all that, that we work together.

James: We’ll work on it.

Garry: Awesome.

James: Thank you so much.

Garry: Good to meet you.

James: Okay.

Garry: Have a great day. Okay. Just left my phone. [inaudible]

Ellie: I mean…

Bart: Okay, so here’s the biggest thing, and Dr. Stupe Rich did a lot of things great right there. But the one, the one thing that we have, I never heard at any time him say, “Hey, here’s what we’re going to do. We’re going to do all on four on the upper, we’re going to do all on four on the zirconia. We’re going to do zirconia on both or we’re going to do zirconia opposed to a different material.” Whatever. I never heard exactly what the treatment is. So that’s the first thing now that, um, that Ellie’s going to have to do is figure that out. So we want to make sure no matter where the conversation goes, that before the doctor leaves the room, do a quick summary and tell the patient that they’re the perfect candidate, that is straightforward and they’re going to get a great result. Um, and just summarize the treatment. That’s, that’s the one part here that didn’t, that didn’t happen. Not super clear, anyway.

Ellie: You might be looking at it, we can get some other stuff.

James: So talk about price, but the shop charges, it did a great job and then talk about scheduling.

Ellie: Okay. Alright, so let’s talk about it. Uh, well, first of all, you’re a candidate for this kind of procedure, which is great and do you feel confident, Dr. Stupe Rich?

James: Yeah. Can I borrow a pen?

Ellie: Actually let me [inaudible]. Okay.

Bart: And I wouldn’t ask if you feel confident, I would assume they feel confident, you know what I mean? And just say, “Hey Dr. Stewart, he’s great, isn’t he? Oh my gosh, he’s like the best. Blah blah blah, blah.” You know what I mean? Just gain their agreement by assuming that they’re going to say that.

Ellie: Um, and does the treatment make sense doing it, uh, a fixed offer and a fixed lower? Does that make sense to you?

James: Yeah.

Ellie: Okay. Alright. So, um, if we were to do every part of this procedure piece by piece can get pretty costly. So there’s- the good thing about our office is that we’ll bundle it together so kind of be- can show you where we would save you costs here. Um, so I guess pretty, pretty pricey. So you have the cost of the exam and the cc scandal or things ever done today. You have the cost of planning of the case…

Bart: Okay. One thing to keep in mind here. So Ellie kind of talks fast, you know what I mean? She naturally talks pretty quick. Did you see the guy, like as she started talking, he, he’s not making eye contact with her at all. It’s like with Dr. Stupe Rich, he was right here, full eye contact. As soon as he left the room, this guy’s like looking down, he’s not looking at her at all, you know? And he literally went from writing, I don’t even know what he was writing, but he is writing something and then he went straight into looking at the uh, at the paper. He’s not looking at her at all. You know, so make sure guys, before you bring the bundle out, you want to look at ’em and connect and be like, “Hey, well that’s great. I mean it’s great anyway that you’re a candidate.” You know, and, and kind of gauge their level of, uh, of enthusiasm.

But it’s really important that you connect with ’em and you guys bring some energy to the table to see if they mirror your energy. Because if you look excited, then that’s how you kind of get them excited is being excited, and if you’re really excited and you can’t get ’em excited, then there’s typically a reason for that, that, you know, we need to try to uncover before we go into, uh, go into the price. So make sure that you guys have, have a way of, you know, commanding their attention. And sometimes that’s just a, a tone change or a volume change or some something that you’re doing differently that gets the patient to look up and, and acknowledge you and connect with you.

Ellie: Depends behind the scenes, bringing out where he’s going to place it at what angles, you have the cost of the surgical guide, and something he uses on the date of surgery once he’s pin to show him where he’s going to drill. You have the extractions, which obviously you still have substantial medical extraction. Bone grafting…

James: Can I take this with me?

Ellie: Yeah, [inaudible]. Um, the bone graft grafting, even if you had a great bone, you would still need bone grafting ’cause you need to solid foundation for those implants to sit, right? So then you have the cost of the implant, then you work from quarter fix on the upper or the lower. Like I said earlier, if he claims you have four and need another one or need two more in the moment, it’s, he’s going to do whatever you have to do, get the job done properly for you.

James: Alright?

Ellie: Okay. So that can change. Uh, you have the cost of- if, if it does change, it is included in the total price.

James: This is- the bone graft unit is a straightforward price. Could, it could, could be upper or lower. Um, the implants could be upper more or less but this is eight to 12. Is that the 12-figure or the eight-figure?

Bart: Now he wouldn’t ask any of these questions, right? If we told him why we have the bundle in the first place. You know, the whole reason for the bundle is because it gives the patient more value, gives them a better deal, but also because it’s, it’s comprehensive. So everything is included, which means any minor changes in terms of number of implants, number of extractions, number of bone grafting sites, we’re not going to come back after the surgery and nickel and dime you, it’s included, meaning whatever’s necessary that’s what’s done. It’s all built into the price. You don’t have to worry about anything for 12 months. There’s no hidden fees in here. It’s not like we get you going with just part of it. You pay it and then every time you come in you’re paying more and more and more. A lot of practices do that.

We don’t like to do it. We like to do the whole thing in one. Everything is built in and you don’t have to worry that, “Hey, after the surgery it took six implants and they’re charging me more.” Or you know, “It was more bone grafting than they thought and they have to balance bill me for it or whatever.” None of that is the case. That’s why we bundle these types of, of, uh, of treatments. You know, and you want to tell ’em that right up front so that they know that the point of, uh, the point of the bundle,

Ellie: Uh, this is, this is- it’s a bundle so it doesn’t- regardless of how many we use, it’s the…

James: Okay. Okay.

Ellie: Okay. Um, the bone graphing obviously is just a general number. Um, honestly, sometimes when we put these surgeries, into the [inaudible] being a lot more costly. Um, but we bundled together. So you have the cost of the abutment, that’s the middle piece that holds the restoration and the first set of teeth. So that first material that you’re in the healing four to six month and then you come back for your final zirconia arches, you have the cost of maintenance visits because like we talked about earlier, it is teamwork. We have to come back and get cleaning. They’re just different types of things. They take the restoration off, they make sure the gums are nice and healthy, they clean the restoration and they put it back on. Okay?

James: Is that a quick procedure?

Ellie: Our hospital [inaudible] come in for like a normal cleaning.

James: Okay. And then the night guard, interesting.

Ellie: And then- so we have the night guard that’s something, um, obviously you’re going to wear at night even if you don’t grind, it just helps to protect the restoration. Okay, so if sometimes people don’t realize they grind, so that can cause, uh, fractures or breaks in the restoration. So we want to make sure that it stays safe.

James: Okay.

Ellie: So it can get pretty costly. A lot of the stuff we can actually throw into the cost of the procedure because we have an in-house lab, you passed it, um, you didn’t really get a good but…

James: Just before the left turn, I saw it.

Ellie: Yeah. So we have the in-house lab. So a lot of workbook happens in that lab. They do it in-house. Um, we get our implants involved, so we pay some costs there. We do a pretty good number of implants. So we get reasonable cost on those. Um, majority of the procedure happens in very few steps. So we save time on the doctor’s schedule. I save the cost of the materials. So we like to pass on our savings to our patients. So I can include the cost of the examiners. That CCS I can include…

Bart: Now you want to sell this right here, right? So you say, “No, we like to pass on these savings to our patients.” And then you go right into like what you’re going to include. So say, “No, we’d like to pass on the savings to our patients. So let me show you what’s going to be included, but you won’t have to pay for it, right? We’re not going to take anything off of this bundle, but there’s several items that you’re actually going to end up getting free of charge because of the, the business model that we’ve adopted here because of the lab and because of the way that we’ve purchased the components and materials, I think you’re going to see that it’s going to add up to a pretty substantial discount, right? And this is how we give a lot of value to our patients without, um, without cutting out anything that’s essential to the clinical outcome.” So let me show you, I think you’re going to like this part, okay? This is where it gets a little bit more fun here, right? And then you start crossing them off, but you want to make sure that you got ’em, right? Before you start doing it make sure they’re connecting all the dots.

James: …cost of the planning the case in the surgical guide, we would throw in the extractions and the bone grafting because the bone graft thing’s going to change…

Bart: Guys, and one other thing, just like you get ’em excited about the treatment, you need them to be excited about the treatment, but guys, right before you start going through what, um, what Ellie’s going through right now, you want them to be excited about the deal. This is a part that a lot of people struggle with, but I want everybody leaving after they have scheduled and paid. I want them leaving thinking they got the best deal in the world. I want them feeling so good about the price. Not that it was a low price, but that they feel like they’re paying less than market value. That they’re getting a really good deal. So you have to get into it. You’ve gotta show ’em that you’re getting an amazing deal because that’s how you prevent patients from price-shopping you to death and that’s how you close the patients that are price-shopping everybody else, right? Because there could be other practices that have a lower fee than you, but it still looks like you’re giving them a better deal and they start questioning the other practice. Cause they’re like, “Oh, well it was less, but man, it didn’t include everything that they’re including. Oh, I bet all these things are extra.” They’ll start doing all of these things in their head but you have to make sure that you’re getting them excited about the deal and that you can, you can see, um, you can see that they’re excited by their, their non-verbal communication.

James: …we’ll use that much as we need to do for your case. We want the restoration to stay safe so we’ll throw that in. Uh, we would cover the first three maintenance visits. Okay? So I can get this number substantially down to $60,000. Okay? That’s start to finish, the only thing that would not be included is restrictions. Okay? So everything start to finish is included in that.

James: Good, good, good.

Ellie: Okay. Um, how did that sound?

James: That sounds great. That sounds great. That’s definitely ballpark. That’s definitely a long call.

Ellie: Okay. And then…

James: What about scheduling?

Ellie: Um, I can probably even get you on the schedule for the first appointment. The first lots of consent forms, they’ll have to fill out. The next appointment after that would be with the doctors and his assistants. Um, they would do the background information, they would do some intraoral scans, they would do a 3D face scan. They would take measurements.

Bart: Okay, so we know that this guy’s got a fixed date and time that he has to have this done by. Okay? So keep this in mind. If somebody has a date, you know, in the next 90 days where they need this done, you guys have to use that. That’s going to be huge in being able to close somebody like this. So you don’t want to go in straight away and say, “Yeah, I could get you in next week.” Don’t everybody’s going to say that. So this is where you play a little bit of- use, a little bit of scarcity say, “Yeah, I, I know you gotta- I know you’re leaving in whatever, two months, um, you know, there’s plenty of times where Dr. Stupe Rich has actually booked two months out. You know, I’m going to, I’m going to look to see if there’s anything I can do. If I can move someone around and maybe kind of fit you in, I’m going to look at the schedule and see if I can do that right.

But then you gotta kind of get back to the close cause I haven’t got an agreement on the price or the close yet either, but I don’t want to put it in his head that we don’t- that I can fit him in at any time. Does that make sense guys? I want him to think we’re so busy that he might not get in here, it’s going to make him want to do it here more than everybody else that can get him in next week, right? So anytime you can create scarcity or exclusivity, um, that’s going to help a lot in a situation like this.

Ellie: And yeah, all the information that they need to plan the case. So that would be a second visit. And then that- as long as everything looks good with the, everything, all the information that they got, then we get you set up for surgery.

James: Okay. You think surgery could happen and I could walk out of here with temporary teeth by the middle of September?

Ellie: I can do it before.

Bart: I don’t know. I don’t know. I don’t know. Like, you don’t wanna say I can do it. You know what I mean? You guys with me? Everyone kind of getting that. Like he, he’s, he’s kind of showing his cards here, you know what I mean? You know, like that, that was a really kind of a bad thing for him to say as a consumer ’cause that just shows like, “Hey, I need to get it done by this date. Can you do it?” And it’s like, um, you know that, that’s cutting it, that’s cutting it close. I, I’m not gonna promise you I can, I, but I’m gonna promise you that if if there’s any way for me to move someone around, I can do it. I mean, ’cause that’s the thing. There are a lot of practices they can get you right in, you know, but why can they get you right in?

Because they don’t do very many of these cases. That’s again, another reason outside of us bundling everything together and, and giving you the best value that you’re gonna get anywhere. That’s another reason why people come here, is because Dr. Stuper is highly sought after for, for these types of cases. Because a lot of people wanna see a prosthodontist for him. You know, like you see every, every competitive advantage. Cause I know this guy’s been to other practices, so I’m using a competitive advantage and then I’m comparing against how other people don’t do what we do. What, do you guys see what I’m doing? Like you’re constantly selling. You know that you’re in a situation where he is weighing his options right now as you speak. So I have to constantly plant seeds and show him that the choice is super simple. Then I gotta show him that there’s exclusivity and scarcity. Right? That, because if I can move somebody around, if I can move somebody around, he’s more likely to, to pull the trigger and move forward now rather than I just say, “Yeah. Yeah, I can, I can do it. Don’t worry about it. Whenever you’re ready, you tell me and I’ll get you in.” That doesn’t help with urgency.

Ellie: Because we would wanna have some time after the surgery so that we can see you for your follow-ups. Okay? Um, we wanna make sure that everything’s feeling well before you go away, right? Because you’re gonna be gone for a while. So we wanna make sure that everything’s good before your, your leaving.

James: Good. Is there any tax for additional expenses on the $60,000 now?

Ellie: Nope. It’s $50,000, the only thing not included is maybe prescriptions. We’ll send all the prescriptions to your pharmacy. There’s only one that we…

Bart: And I have a real question about why he said $60,000. When it’s $50,000 you know what I mean? So again, you guys have to be super clear and know how- you know, make sure you tell ’em like when you go through and you’re taking off these things that you don’t have to to pay for, sum it up for ’em. Don’t make them do any math. Just sum it up and go, “So it actually ends up being, you’re getting $70,000 worth of treatment, but you’re actually only gonna pay $50,000. So it’s really a $20,000 discount. Does that make sense?” Like, make it super easy. Don’t leave anything open for interpretation. You know what I mean? Because he just said, “Yeah. Is there anything outside of the $60,000?” But it’s not $60000, it’s $50,000.

Ellie: It’s not $50,000, it’s $60,000. [crosstalk] [inaudible] with the writing, but no, it’s $60,000.

Bart: Oh, you said 50 here?

Ellie: No, I said $60,0000, but the, like, the translation read it as $50,000.

Bart: Oh, interesting. Okay.

Ellie: Consent forms, they’ll have to fill out. The next equipment….

Bart: So, so what is, what do you start with with the bundle, Ellie?

Ellie: Our bundle starts at $77,0000.

Bart: Okay, cool. So you tell ’em, “Hey listen, it’s actually about a $17,000 discount. So you’re still getting all $77,000 worth of treatment. But because of all the things that, that we’ve talked about, we’re able to do $77,000 in treatment for $60,000 and that’s all in for the next 12 months. No out of- no other out-of-pocket costs, no hidden fees and you’re taken care of and this thing’s done. Does that make sense?” Like with that type of certainty, boom, boom, boom, boom. And you’re looking for an immediate knee-jerk reaction, yes. If you don’t get immediate knee-jerk reaction, yes, then you know, “Hey, I could explain this a little bit differently to where it’s a little bit more clear.” And you guys should constantly- everyone’s constantly refining their presentation to where you’re consistently getting knee-jerk reaction. “Yeah. Got it. Understand.” Right? So every time you don’t, right, or you get kind of a follow-up question, it goes into memory bank and you present it a little bit differently next time because as you present it, you’re also answering questions that you know are inevitably going to follow.

Ellie: That would be with the doctors and his assistants. Um, they would do the background information, they would do some intraoral scans, they would do a 3D face scan. They would take measurements, um, and yeah, all the information that they need to plan the case. So that would be a second visit and then that, as long as everything looks good with the- everything- all the information that they got, then we get you set up for surgery.

James: Okay. You think surgery could happen and I could walk out of here with temporary teeth by the middle of September?

Ellie: I can do it before September.

James: Go ahead. Go ahead.

Ellie: Because we would wanna have some time after the surgery so that we can see you for follow-ups. Okay. Um, we wanna make sure that everything’s…

James: Antibiotics.

Ellie: It’s, um, we…

James: Oh, what about procedure knocked out or not knocked out?

Ellie: Conscious.

James: Okay.

Ellie: So you’ll be alert enough. So if the doctor says open up, you’ll be able to do that, but you’re kind of, kind of dreamy, relaxed state and that actually makes for a better procedure. So everything feels better because you’re more relaxed, okay? Um, obviously you’ll be sedated coming off…

Bart: Now Ellie, um, if somebody asks you specifically, if they say, “Hey, I don’t want, I want, I wanna be knocked out. I want you to start counting back from 10, I don’t remember a thing until it’s over.” Like if they say that, do you guys have the option to bring someone in, bring in an anesthesiologist or something like that?

Ellie: Not currently.

Bart: Okay. That might be something to look at getting just in case somebody’s adamant cause it could be something difficult to overcome. Um, you know, but- and plus, right? I mean you can also say, “Hey, you know, I mean we can do it both ways, but the doctor recommends to do it with conscious sedation so that you are listening to commands. You can open, you can close, and you, you’re not gonna feel you’re gonna be comfortable, but you’re still somewhat coherent. It makes for a better procedure. So we’re gonna- we recommend it that way.” Um, you know, but there, there are certain cases where I’ve seen the treatment coordinators lose the deal just because we don’t have any relationship with an anesthesiologist to bring ’em in and the patient’s like adamant about it and they were ready to go. So that’s just something to think about.

Ellie: We have plans to potentially [inaudible] down road, not currently.

Bart: Cool.

Ellie: Uh, it’s gonna be a long day. So we’ll have out some flexibility and then they deliver the teeth that same day and if they can deliver that same day, you come back the next day. So it all relevant…

James: Did they use that strahman? What, what we kind of abutments…

Bart: Yeah, I know the implant companies forgot this.

James: …from Texas.

Ellie: Um, so we, we have a few different implants that we use. We, uh, a few different companies. We use Novell, we use Neoden, we use Life Horizon. We have a few different ones that we use. And…

Bart: Did you just say strahman from Texas? Yeah. Texas or Zurich, same thing.

Ellie: It depends on, on, [inaudible], yeah.

James: Because strahman is usually the word you hear. Okay, great. Well if you think everything could be done and dusted by the middle of- or maybe the first week of September, that helps me a lot.

Ellie: Yeah, we can definitely get you in. The sooner we get you in and the sooner we get this done, the sooner I can get you on the schedule and ready for surgery.

James: And I can use a Visa card and I can just transfer cash from Fidelity…

Bart: Ellie, what implant system do you guys use?

Ellie: Uh, we mostly at this point are using Nobel.

Bart: Mm-hmm.

Ellie: Um, no Nobel or Neo-Dent.

Bart: Cool. Well, and again, keep in mind like you’re in a competitive situation. The guy’s like, “Yeah, that’s, most of the time what we hear is strahman say, look, Straumann’s a great implant a lot of doctors use it.” The thing is, when it comes to doing these types of procedures, uh, when it comes to doing all on four, uh, they’re hardly even on the map. The, the vast majority of the all-on-fours, over half of ’em are done by Neo-Dent and Nobel is, is the company that really kind of started. They actually own the trademark all-on-foor, um, so you use the implants, the implant companies with the implants that are designed for that specific situation. And for your situation, you’re gonna use an implant that where the vast majority of these are done or are not actually strahman, but there are a lot of doctors that use ’em cause they don’t do a whole lot of arches. Does that make sense? So they just use whatever they have, whatever. It’s all, you’re constantly separating yourself from everybody else in the close.

Ellie: Cash, cards, checks, we can do wire transfers.

James: Okay.

Ellie: We, we can work with, you know, any of that stuff.

James: Okay. Um, good. Well, I hope to hear, um, probably by tomorrow.

Ellie: Tomorrow?

James: Yeah.

Ellie: Okay. Um, is there, is there anything you’d like to hear in addition that would help you to hear decision?

Bart: So, so we just missed the close, right? So she, she did the close and just kind of agreed, you know what I mean? She’s like, “Yeah, we can do a check, we can do cash, whatever. So, you know, but you gotta you gotta nail ’em down.” The whole point is we need to yes or a no, you gotta get to a yes or a no right here. So you say, “So, so how, how do you wanna pay? You wanna pay by a check cash, a wire transfer, how do you wanna do it?” And then I can kind of address the schedule. I’ll figure out a way to move somebody around. Um, but, but how would you like to pay? And then, then we’ll get into the schedule, like very direct cause I wanna get a no or I want to get a, let me think about it, or I want to get something right? But I don’t want to get an ambiguous, um, objection here.

Ellie: Obviously…

James: No, I think at this point your scheduling’s great. Your price is perfectly competitive. Nobody’s gonna be [inaudible] people went higher, some people were lower, but you don’t know about lower. Um, and it’s really just a question of filling out my interview schedule and your solid.

Ellie: Okay, let’s do it.

Bart: So let’s do it.

Ellie: Great. Um…

Bart: So let’s do it.

Ellie: If I don’t hear from you tomorrow….

Bart: No. Right? So let’s do it. Like, you have to get- you, I want a yes or a no. Yes or a no. Don’t tell me I’m the bomb and I’m this and I’m that. It’s not you, it’s me type thing, right? I don’t wanna get dumped like that. Just tell me are we together or not. You know what I’m saying? Don’t tell me how good I am. It is what it is. So like, you wanna make sure if they’re like, “Yeah, you’re solid, you’re great, everything sounds great.” Say, “Okay, well let’s do this, let’s do it. What are we waiting for?” I mean, I’m telling you to get everything done by September, right? To get everything done by September, we should be moving. We should be moving because we gotta do the smile design. We have to get you in. We gotta move patients around, figure out how it’s gonna be on the schedule.

And we don’t wanna run it right up. I know you don’t wanna run it right up to last minute. So, you know, the price is good. Like you said, there are other people that are higher, there are some that are lower, but there’s nobody that’s gonna give you more for the money that you’re spending here. Nobody. So let’s do it. So push ’em, you know? And that’s- you guys can push as long as you’re pushing with some degree of logic and you have, and you, you’ve, you’ve kind of gotten in that rapport with the patient, this is the time where you push. You don’t wanna let ’em get away with like, agreeing with everything and leaving. Um, I, I want- I’m gonna force them to give me a yes or a no. Right? And what I’m guessing the no would be with him is, “Oh yeah, I’m just kind of like weighing my options or whatever.” And I’m not with him because time is of the essence. I feel like, “Hey, there’s probably a couple of different ways that I, that I can push right here.”

Ellie: Whatever they say, whichever direction you, you’re tied to go, I’d love to hear about it. You know, we’d love to be able to work with you. You seem very knowledgeable, I think working with you, I think you’ll have a good time. And like I said, we have the, um, very high-end, uh, technology. We’re one of the few offices in the US that actually has the, uh, navigation…

James: That’s why I asked about that because you don’t often bump into that.

Ellie: Yeah. Yeah. We’re one of- I think there’s like, there’s a very, very small number. I wanna say a couple of percent back.

Bart: See, and guys, that’s, that’s the kind of thing that you don’t wait till the end to use. You use it when the question comes up, use it then. So you answer the question, but then throw in the fact that not everybody has that, right? When he is talking about the surgery, tell him, “Hey, yeah, this helps with the surgery, but not everybody has it but even if surgery is done perfectly right.” If the occlusion is not done correctly, or the Prosthodontic side wasn’t taken care of or wasn’t planned correctly, the whole thing’s gonna go bad anyways. Make sense? So all of these things that she’s saying right now, use ’em throughout the call because you’re, you’re in their head. I want to walk them through to where I know by the time we get to the price, they’ve already ruled out the other practices. Now I just need to use some scarcity to create urgency to get ’em to sign right now.

Ellie: And we’re actually even, uh, we work with Nobel for, for [inaudible] or one their top people in this area. So, but yeah…

James: If you can bring me a copy of that, that’d…

Ellie: I’m just going to write your name on it and I’ll write the date and I’ll make a copy [inaudible], okay?

James: Sure.

Ellie: Do you prefer James or Jim?

James: Jim. I dunno, many people named James want to be called James.

Bart: In a really good way, again with this guy is to use the schedule your advantage and say, “Listen, Dr. Stupe Rich is always booked out for this. If I have to move somebody around, right?” Like if, if, if we were gonna let ’em go, right? At the very least you’re gonna say, “Hey look, if I have to move somebody around, I’m gonna have to do it, I’m gonna have to do it quickly and I don’t even know if I can, but I, I certainly can’t move somebody if you’re not ready to move forward. It sounds to me like you’ve already been to three or four practices you know what you’re gonna do. Like let’s do it.” You know? And at the very least, if they leave, say, “Hey, um, you know, I’m, I’m gonna need to know really quickly in order to, to finesse the schedule to make this happen for you.” You know what I mean?

Ellie: You know, to be fair, I don’t know that many people called James. So, um, and I, I, I, like James and Diane Peach who got reading that book, who would want to be called Diane.

James: Should I follow you?

Ellie: You can hang there for this one.

James: Just one sec.

Bart: So Ellie, did this guy end up closing? Did you guys get ’em, did he come back?

Ellie: He did come back, but he actually, the consult he went to afterwards, they convinced him to save his teeth and so he decided to save his teeth, but then their schedule didn’t work. And when I had- when he communicated with me that he was gonna save his teeth, I told him, “Come on in, we’ll have another discussion well, we can do for you to save with saving your teeth.” Um, and you had to call him back a few days later and then we got him closed.

Bart: So you did close him?

Ellie: Yeah, it took, it took a little extra time with him.

Bart: But you closed him on the $50,000.

Ellie: We closed him on the $60,000. Yep.

Bart: $60,000. Awesome. Yeah. ’cause he- you can tell [crostalk] just from the first 10, this guy didn’t want that. He didn’t, he didn’t wanna mess with that. He was probably just trying to justify it because of the price, um, or something like that. But that, that’s not what he wanted.

Ellie: Yeah, no, it the- I think the saving his teeth was gonna be slightly cheaper. So that was definitely part of the, the reasoning. But it was- the schedule didn’t work.

Bart: Right. Well, hey, it might be cheaper right now, but what happens in six months when you have another problem and in 12 months when you have another problem, he’s in the situation because that’s what he’s done forever, is patchwork. You know? And the whole point is we’re not doing any more patchwork. We do it once. We get it done the right way and, and you’re done. Like let’s be done. You know? And, and so you guys probably pushed just like that with this guy. But this is a guy that is just over analyzing everything and he needs a really strong leader, a figure, a really strong figure of authority in front of him that shows a ton of confidence that he can just follow. That’s what this guy wants to do. He wants to just feel comfortable and have somebody, you know, at the end of the day just tell him what to do.

So Elliot, I thought you did a really, really good job of, of going by the script and um, you know, I think Dr. Stupe Rich did a very good job in terms of building some rapport and some credibility with the patient. And I think you did as good of a job as you could being that you didn’t have a primary recommendation heading into the third 10. Um, just keep in mind like, hey, you know, you’re kind of straight to it as far as your, your tone and everything and sometimes you gotta get into it and you know, you’re constantly- when you’re in a competitive situation, you’re constantly setting yourself apart from everybody else so hit ’em. And with somebody like this, you use the scarcity and um, and speak with a lot of certainty. You know what I mean? Just kind of go for it here because this guy, this is- you, you knew walking in this guy’s qualified, he’s gonna make a decision, you know, and, and this guy can be closed, so, and congratulations by the way for closing ’em.

And when he said, “Hey, I’m gonna do this,” you didn’t give up, you brought ’em back in and you end up getting ’em for the, uh, for the all-on-four, uh, double $60,000 grand. So that’s great. You know, this was, this definitely wasn’t the easiest, but what I want everyone to take away from here is when you have somebody that said they’ve been into two or three different consultations, they’re super detail-oriented, you have to keep ’em big picture. And then you’re everything that you tell ’em, if you tell ’em, “Hey, do we use guided surgery?” “Yeah, we use it, and here’s why we use it and a lot of people don’t use it. And here’s what, here’s what happens when they don’t use it.” Or, “Yes, we are philosophy on this, and here’s what a lot of people don’t think that way, and here’s what happens.” Or blah, blah blah but you’re constantly setting yourself apart.

And if the doctor goes through the second 10 and you guys didn’t get a primary recommendation, um, then do a summary right at the end to prompt the doctor to do a quick recap cause doctors can get lost in dialogue just like anybody else can, especially with somebody like this, you know what I mean? If they’re not pacing and leading, they’re just kind of participating in the dialogue, they can get lost and they can spend 30 minutes or even 45 minutes with a patient and they never told the patient what the treatment’s gonna be. So if that happens before the doctor exits say, “Okay, real quick, before, before we finish up here. So so you’re saying that we’re basically doing an all-on-four upper lower, we’re gonna extract all the teeth, place the implants, and we’re gonna be doing zirconia top and bottom, is that right?” And just get ’em to repeat it so that it’s all clear, right? And then when you guys meet with the doctors later, you know, uh, bring it up to ’em and tell ’em, “Hey, you did a great job. Just make sure that it’s, that it’s really clear, whatever it is that I’m gonna be closing, make sure it’s really clear with the patient so the patient has an opportunity to ask any clarifying questions in the second 10 and that, that would be, that would be a huge help. But other than that it was fabulous. Cool?

Man 1: Is this a referral-based practice?

Bart: No. They, they do, they do a lot of, a lot of advertising. You know, that- it might be a little bit of both, but they do, they do a lot of, a lot of marketing. The vast majority of the, of their all-on-four cases are coming from- direct from the public.

James: That’s the case with this patient.

Bart: Mm-hmm, correct? Yeah. This guy had already been to three practices.

James: We were one of six consults, [laugh]

Bart: Six consults, and he’s qualified. And this is somebody that has the money, you know? So this is, so this is one that nobody can afford to miss, right? He’s going to buy from somewhere. He’s qualified, he’s got a need and he has a date that he has to have it done by. So those are all, I mean, tremendous, tremendous things that you don’t always get. You don’t always get somebody in there that actually has the ability to pay, you know, and you don’t always get somebody in with a deadline. So when you have somebody in front of you like that, it’s really important for you guys to be able to win there. So Ellie, really, really good job on that too, girl. Good job getting ’em back in and closing ’em. You know, a lot of times when they leave like that, you don’t get ’em.

It’s like whoever hit ’em the right way gets ’em, and once they do it, they just don’t return anybody else’s phone calls. That’s kind of usually how that works when they’re getting 3, 4, 5, 6 consultations, they’re just waiting for somebody to, to, to close ’em. Anybody have any other questions? I’m not seeing anything in the chat. Nope. Okay, cool. Alright guys, well then, um, I’ll let y’all go. Go close somebody, sell some arches, you know, don’t let ’em get outta there without a yes or a no. Make ’em tell yes, we’re doing it. No we’re not. If not, why are we not? Okay, then you guys are gonna know what to do, okay? But make sure the whole point of the consultation get all the way to the point where you get a yes or a no. If you get to a yes or a no, then, then the sale starts, right?

But we gotta get a yes or a no out of ’em. Okay? Um, good job Ellie, and um, everybody, make sure you guys are sending in your videos schedule for the power sessions. And hey, if you haven’t talked to your doctor about the, uh, the annual growth conference in December, it’s gonna be awesome. We got Coach K speaking at it from Duke. We’ve got Tim Grover, who was, uh, Michael Jordan, Kobe Bryant’s trainer. Uh, we’ve got Molly Bloom speaking at it, who, um, the movie Molly’s Game, uh, was about her. Uh, we’ve got Anthony Robles. So we’ve got a bunch of really good speakers. It’s gonna be an awesome event. Talk to your doctors about coming down to Miami for that. Um, it’s gonna be awesome. So I hope to see you guys there and if anybody else has any questions, uh, just reach out to, uh, reach out to your account manager and we’ll get right back with you. All right? Okay guys, go close ’em. See ya.

Ellie: Thanks, Bart.

Bart: All, right, thank you. Bye-bye.


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