June, 2024
Press Play
[Silence]
Bart Knellinger: Check, check, check. Can you hear me? Yeah. Okay, cool.
Assistant: Okay.
Bart: Cool. Hmm. What’s the treatment coordinator’s name?
Assistant: Tanya.
Bart: Tanya.
Assistant: And Dr. Jernigan.
Bart: Tanya and Dr…
Assistant: Jernigan.
Bart: Jernigan.
Assistant: J-E-R-N-I-G-A-N. She will be on the call, he will not. But her audio doesn’t-doesn’t [inaudible] her audio or her video [inaudible].
Bart: [humming]. [Pause] Who’s letting everybody in?
Assistant: Me.
Bart: Okay.
Assistant: In just a minute.
Bart: Okay.
Assistant: [inaudible].
[Silence]
Bart: Okay. Go ahead and let him in. [clears throat]. Hello. What’s up? How guys doing?
Female Student 1: Hey, how’s it going?
Bart: Hey, hey, hey. You guys closing some arches over there or what?
Female Student 1: We’re trying.
Bart: Yeah?
Female Student 1: Yes.
Bart: All right. Good. Good, good, good. I’m just giving everybody a chance here to log in. [humming] We got kind of a unique scenario today ’cause we’re gonna review a call of like, “Hey, what happens if you’ve got a consult and the doctor is-is busy?” Right? Or they have a surgery running over and we have to do the whole thing. You know, what do we do? So, I know that, I know that has happened, [chuckle], uh, more than one occasion to everybody. So we’ll kind of be going through that. Just letting everybody log on here. [Humming] Anyone have any good consults this last couple weeks? Good consults or any, anything weird or anything you guys were kind of struggling with any, like one-off situation? Anyone have any consult they wanna share while we’re waiting for everyone to log in? Anybody have anything good? Who wants to entertain me? Come on. [Laughter].
Who’s going to Vegas? Are you guys gonna go to Vegas next week? Who’s going to Vegas? No. Oh, you guys are party poopers, man. We’re in Vegas. In the Fontainebleau. The-the new Fontainebleau. It’s gonna be fun. Just talk to your doctors, get a last minute plane ticket and come home. Still got a bunch of people here just signing in, but… [Humming]. Okay guys. Hey, if you can in the chat area, if you guys can go in that chat area and just type in your name and the practice name. That’ll help us a lot. And then anybody that’s got the, uh… You guys have access to the camera on your laptop, turn it on. It’s, uh… I’d rather talk to you than talk to my own face. Talk to a bunch of names and squares. It’s more fun. More fun looking at you guys. All right?
Male Student 1: Hmm.
Bart: Okay, look, we’re gonna, we’re gonna get going, but let me ask you do… And you guys ever run into the issue where you’ve got consultation scheduled and the doctor gets pulled away, and the doctor can’t come back in to do the second 10, and you’re kinda left in the consultation? Anybody run into that before? You guys ever run into that? What do you, what do you do if the doctor’s running behind on surgery or something happens and you guys are doing the consultation by yourself? Do you just re-, do you reschedule it or you guys just try to do it?
Female Student 1: We try to just wait it out and still have ’em come in even if it takes a while.
Bart: You just try to wait it out? Anyone tried to do one, just like start to finish? What if the doctor can’t even come in that day? Something comes up, they can’t come in the office. You got consultations scheduled.
Judah Beepathring: I’ve done it by myself a couple times. Mm-hmm.
Bart: Cool. It will. You do this long enough, you’re doing this many consultations, the doctor’s doing surgery, sooner or later something’s gonna come up, or they got a complication, or they’re just running way behind and you have to kind of jump in there. So this is kind of an example of that. This is where Tanya, um, is kind of left without the doctor. So she’s taken it…
Female Student 2: Yeah.
Bart: … um, start, from start to end, kind of all of herself. Um, and I think there’s a, there’s a lot that we can learn from this particular consultation, um, in terms of, uh, i-in terms of framing and also kind of keeping ourself outta trouble. But I’m not gonna talk too much ’cause I want to get into the video. It’s not a super long one, but again, I’ll be stopping along the way and kind of critiquing it and showing you guys.
Um, but just remember if-if the doctor’s not there, our goal is not really to close the treatment usually, right? Our goal is to close conceptually. We wanna close on a concept or an idea. Um, and then we can work up the treatment plan. But I’ll go through and everybody turn up the volume. Um, the audio’s a little bit low on this particular video, but if you crank the volume up, you’ll be okay. And there’s uh, there’s subtitles. And then anything, if you guys have a question or something comes up, I say something, just write it into the chat, and type the questions in and then I’ll get to, I’ll get around to all the questions at the end, okay? Okay, here we go. Turn the volume up.
[Video Playing]
Tanya: So basically, I’m Tanya, nice to meet you.
Patient: [inaudible].
Tanya: I’m the office implant coordinator. So what my role is here in the offices, sort of to listen to you find out what kind of issues you have, concerns you have, where you’re trying to go with your overall goals and-and-and the outcomes look like. Because tooth replacement is not a one size fits all.
Patient: No.
Tanya: So basically, um, we try to customize a solution just for you. Um, us having our lab right here in the building allows us to make 95% of what we do here. So that helps, um, in terms of for us being able to communicate, going right across the hall. But in terms of for the patient, most of the time you don’t have to go without teeth because we are doing everything in house. So that makes it pretty convenient for everybody involved. Um, so let… Talk to me. Let me know what’s going on. You’re not missing a lot of teeth.
Patient: Well, I’m missing five. Not including the wisdom teeth. Um, and also I’m in this bottom left, um, that one is, uh, it needs to be extracted.
Tanya: Okay.
Patient: [inaudible] way to save it. But I’m not going to spend $5,000 and then still have a chance to lose it.
Tanya: Okay. Yeah.
Patient: [inaudible]. And-and that’s pretty much what I said. The root’s cracked off. Uh, it-it hasn’t had a root to now, but if I have a root canal, she says that still a good probability within a year and a half, two years, it’s gonna come out.
Tanya: Okay.
Patient: yeah.
Tanya: So they didn’t give you a good long-term prognosis for it?
Patient: No.
Tanya: Okay.
Patient: So, um, um, I know that one’s gotta come out. Um, I’m not having any problems with any of my other teeth except I’m just missing them.
Tanya: Okay.
Patient: Um, so I’m looking for a solution to where I can eat my food.
Tanya: Okay.
Patient: You know, because I need [inaudible].
Tanya: Yeah, you’re missing chewing teeth.
Patient: Yeah-yeah. I need… I feel like I don’t… I’m sure I can m-manage without it, but, you know, uh, I lost this tooth out here in the back because, um, you know, I had the other two pulled and then I was chewing on that one and it broke off. It had a root canal.
Tanya: Okay.
Patient: And it broke off. So then I started chewing on this side [crosstalk] [inaudible] there. And now I’m chewing with that one and it’s giving me problems. So I just, I need a solution for these.
Tanya: Mm-hmm.
Patient: If you follow what I’m saying.
Tanya: Yes sir. Yes sir.
Patient: I’m not having any problems anywhere else.
Tanya: Okay. So it’s mainly just replacing what you’re missing to get you back to a good level of function?
Patient: Right. That’s right.
Tanya: So it sounds like function is the most important thing to you.
Patient: Yeah, that’s right.
Tanya: Okay. As well it should be, right?
Patient: Yeah.
Tanya: Everybody loves to eat.
Patient: Yeah. I just want to be able to eat without, you know, having to struggle and, you know, look funny, kinda, you know, [inaudible].
Tanya: Exactly. Just [laughter] pushing it everywhere that you can. Exactly.
Patient: [inaudible].
Tanya: How do you feel about, in terms of the replacement teeth in terms of, um, something removable versus something fixed?
[Video Paused]
Bart: So everything went kind of okay till right here. Okay? So what do you guys hear right now from this guy? This guy’s a, it’s a little bit different, ’cause it doesn’t sound like this is gonna be a standard, you know, all on four. There’s not a standard like, “Hey, all the teeth are hopeless,” or he’s a dentialist and we’re gonna be, we’re gonna be doing all extractions and we’re gonna be doing implants and with a fixed prosthetic. It doesn’t sound like that, right? Said he’s been, he’s lost five teeth. Um, you know, he said they-they kind of made some recommendations the last dentist, but he’s like, uh, you know, “I’m not gonna do endo and then do a crown on. I’m not gonna spend 5,000 bucks if it’s not gonna, if it’s not gonna last.” Right? So remember, the doctor’s not coming in for this particular consultation, so we’re not gonna get that treatment plan recommendation necessarily.
So what does this guy need to be sold? And guys, this is like, this is, uh, a classic frame. This is what we go through in the power session August when it’s-it’s, uh, it’s all on framing. It’s for this, right? What-what is the frame here with this guy? What is it that, what is it that we’re trying to, that we need him to agree on? This is how you need to be thinking when you’re sitting in the consultations. Here’s… I’ll-I’ll-I’ll share with you what I heard from this guy. What I heard from him, and I don’t know how long this lasted, I would’ve dug a little bit more here. But what I’m hearing is that he has a tendency to go into the dental, into the, uh, into speak with his dentist, and he has a tendency to kind of do the minimum.
“Oh, I got a problem here. Everything else is fine, but I got a problem here. Just do this.” They do a root canal. Oh, the next visit, “Hey, I got a problem here. Just pull that tooth. I don’t have a problem with anything else. Now pull this tooth. I don’t have a problem with anything else. Now pull this tooth. I don’t have a problem with anything else. Now pull this tooth. I don’t have a problem with anything else.” That’s what I’m hearing. It seems like his pattern, which is very similar to a lot of patients that are all on four candidates, we’re just catching this guy about eight years before he turns out to be an all on four candidate. That’s all. We just caught him about eight years earlier, which is a good thing. But it sounds to me like his pattern is go in and get a quick fix.
Just do Band-Aid, Band-Aid, Band-Aid, Band-Aid. Do you guys agree with that? That’s kind of how he’s gotten here. Okay? So if that’s true that his pattern is go into the dentist and put a Band-Aid on it, right? Gimme the minimum just to eliminate this particular pain point. The-the dots he’s not connecting is that, yeah, he eliminated that pain point, but in a year he has another one, and then a year he has another one. And then in a year he-he has another one. So what I’m thinking, when I have a patient sitting in front of me that is saying those types of things, when I’m thinking, “Okay, what-what concept do I need to sell?” I need to sell to this guy, I need to sell the concept that what he wants is not just function, but he wants longevity and he wants some, and he wants to stop the progression that-that he’s been on, right?
So he doesn’t want a Band-Aid approach. He wants to get it done once and get it done right? He wants function, he wants it to last for a long period of time. And he wants something financially that makes sense. He doesn’t just wanna waste money. That’s the, that’s what I have to get him to say to me here. Does that make sense? Because I guarantee you, if-if you don’t, if we go on with a treatment, I don’t care what it is, you’re gonna treatment plan of implants, he’s gonna be asking about, he’s gonna be asking about everything under the sun. “Well, can we do endo there?” “Can we do a partial?” “Can we do this?” “Can we do that?” Blah, blah, blah, blah. Because that-that’s how he’s gotten in hi-, in this seat so far. So you’re always thinking about conceptual-, conceptualizing the sale.
If they buy into the concept, the treatment plan is simple, right? So it’s like, “Okay, here’s where you are, now where do you want to be? Where do you want to be? You wanna have function, you want to, you wanna be able to eat? But more than that, you wanna stop the progression of consistent events happening in the future, right?” Again, I would make that part of the vision for him. That instead of continuing on the path of a Band-Aid approach, that we just get it done. We get it done one time, we do it the best way. And we want to preserve the teeth that you have, maintain the health of the teeth, and the teeth that we don’t have, we wanna replace those and we want to mitigate any bone loss and protect the bone structure that you do have. Is that what we’re looking for?
And we want to prevent you from having to come in here every year or every other year, right? And have another extraction, another root canal, another partial, right? We wanna prevent that. Is that what we’re trying to do? I’ve gotta get buy-in on that concept. That concept. If he buys in and he agrees, it renders the partial obsolete. That’s not gonna do anything to help bone loss. It renders the denture obsolete, right? All of these little Band-Aid approaches that may help him out chew on the left side of his mouth today, in a year from now, or two or three years from now, he’s going to need more dental work. So I can also show him how getting it done once and doing it right is also by far the cheapest option. And the money… And-and that’s the smart money. Not throwing good money after bad. And he already kind of led you to believe that that’s what he wants. He turned them down on last treatment plan. It was 5,000 bucks to do endo and a crown on a tooth. And he didn’t want to do it, ’cause they told him they didn’t know how long it would last when they did.
So now he’s sitting in front of you. This other, the other treatment coordinator, the other doctor, they kind of blew it, right? That’s why he’s looking elsewhere. And this is classic example of a practice that is… His previous practice was treatment focused. They’re product focused, they’re problem focused. Here’s the problem, here’s how I can fix it. Here’s the problem, here’s how I can fix it. And I can do one of two or three different ways. Instead of saying, okay, here’s the problem, here’s how we got here. What type of situation do we want to create long term? Forget the problem. That goes without saying, but if we just focus on the problem, we’re just fixing problems. It’s one problem after another, after another, after another into infinity. Makes sense? So we don’t treatment plan to the problem or the pain point, we treatment plan to the result. And that’s the whole sale here with this guy. That’s the whole thing. If he buys into the concept, if he connects the dots and says, “Oh crap, the Band-Aid approach costs more money. Oh man, the Band-Aid approach costs more time and energy. Oh man, the Band-Aid approach is not going to give me the same degree of function.”
If he can connect those dots, and I can get him to say it right, and take ownership that, “Hey, I don’t want to make the same decisions I’ve made. I want you to get this thing done once. I want you to do it right. And I wanna do this the right way. Because not only is function important, longevity is just as important as function. I do not want to have problems with it in the future.” I get him to say that I got ’em, the sales made. If you don’t, he’s going to want different options. And what is gonna be the biggest driving factor in his decision making? What’s it gonna be?
What do y’all think me?
Judah: Money.
Female Student 1: The cost.
Bart: It’s gonna be money of course.
Male Student 1: Price.
Bart: Yep. It’s gonna be price, right? History’s just going to repeat itself. History’s gonna repeat itself. And this is the problem with a lot of, with a lot of dental practices, is they don’t do comprehensive treatment planning because they’re not treatment planning to a future result. They’re just fixing problems all day long from people. And it doesn’t do ’em any favors either. It doesn’t do ’em any favors. They just need more and more and more dental work and-and they spend more time, more energy, um, and-and they have a lower quality of life because of it. So we’re always outcome focused. And you’re, you wanna watch and pay attention to what their buying profile is. What are their habits? How do they make purchases? And if someone’s sitting in front of me like this guy, “I wanna know kind of how long… When did this start, right? So when did you first start losing teeth? When did you lose the first tooth?”
You know? And I’m gonna try to get him to kind of tell me the story, “Okay. And you… were you someone that would go back to the dentist consistently? I mean you had a root canal. Kind of just fill me up to speed in terms of when you lost your first tooth to like, kind of how we got to here. Just kind of fill me in on that.” And just through telling that story, you’re gonna get a lot of insight into how he buys and what his psychology is. And then you’re gonna know how you… What changes you need to make in his perspective. But if he buys into the concept, if I conceptually close him now, that getting it done once and getting it done the right way is less expensive, it requires less time, it’s smarter, right? And it’s gonna provide him with better function, better aesthetics, better everything, the treatment’s already closed. Does that make sense? All right, here we go. I’m gonna keep going.
[Video Playing]
Patient: Well, I mean, you know, my wife has a partial in front here, and uh, she pretty much doesn’t have any problem, except she can’t like bite something straight down.
Tanya: Does it move on her?
Patient: Yeah. Um, well no, she just…
[Video Paused]
Bart: She doesn’t have any problem except she can’t bike down straight. Well, that’s a pretty big damn problem, right? Your teeth go up and down. If they don’t come down, you can’t even bite down straight. That’s not like a small issue. It’s like, “Oh, you know, my car’s fine. I don’t have much of a problem. It’s just that the engine doesn’t work.” I mean, what in the hell? Here we go. You guys hear it all?
[Video Playing]
Patient: She has dental disease, like in her, uh, in her bone.
Tanya: Okay.
Patient: Um, so that’s why she lost those teeth right there. So for 30 years she hasn’t chewed on them, you know. Now she’s got this partial one and-and she’s afraid to chew. [crosstalk] [inaudible].
Tanya: Okay, so then she’s holding back a little bit.
Patient: Yeah, she’s holding back a little bit.
Tanya: Okay.
Patient: I-I think that she has no complaints about it.
Tanya: Okay.
Patient: Um…
[Video Paused]
Bart: That just means she doesn’t complain, you know? But I mean, she doesn’t even wanna bite down. I-I’d have both these guys in I’d close… We’re gonna close both of them. This is a good, this is a good consult here.
[Video Playing]
Patient: So I’m not against um, I reckon you can call it a partial or…
Tanya: Yes sir.
Patient: Yeah, I’m not against that. Um…
[Video Paused]
Bart: You see, what is he doing here? You gotta watch this because what they have a tendency to do when price is their driving… when prices kind of driving their decision making, is they have a tendency to downplay the pain points of things like a denture or a partial, you know what I mean? And you guys don’t wanna agree with it and you don’t want to downplay it, right? Say, “Well it sounds like your wife’s just kind of a saint?” [Chuckles]. It doesn’t sound like… I mean, who would be happy with anything? Uh, we’re talking about your teeth. If you can’t bite down or you’re afraid to bite down, that’s something that’s in your mind every single day. That’s gonna wear on you. I don’t care who you are, that’s no quality of life. Why the hell would anybody live like that? That’s not good.
And there’s no need, there’s no reason for it. There’s so many different ways that we can do it better than that. Alleviate that whole thing. There’s a… You got enough to worry about in life without worrying about biting down on a, on a fricking Chipotle burrito. This is insane. We got bigger things to worry about than that. This is a fixable problem, right? So let’s not go into it looking for a solution that is-is less than ideal. You know what I mean? We can fix that. But I-I wouldn’t agree with him and normalize it, ’cause he’s only normalizing ’cause he knows good and well that it’s less expensive for a partial kind of, kind of. What happens to people that are in dentures and partials, long-term? People that have been in a denture or partial for say 20 years, what happens to ’em? What happens?
Female Student 1: They start to lose bone and then they may not be a candidate.
Bart: Yeah. And then what happens? Does the denture fit?
Female Student 1: Nope. If you get it to fit…
Bart: It gets worse and worse and worse and worse and worse. Right? And then what do we have to do? Now we’re dealing with, dealing with a situation where it’s a difficult case, right? You might have to graft, you might have to build the bone back up. You might not be able to do it. You might have to do zygos, you might have to do pterygoids. It’s a whole ‘nother deal, right? But it’s not something… It’s just a temporary fix because it does nothing to address the underlying issue, right? Or the progression of bone loss, which is the biggest problem here. When you don’t have a tooth, the bone is going to continue to erode. So it’s like pay now or pay later. You pay now more, you save later or you pay a little now and you’re gonna pay a lot later, right? That’s kinda what this is.
But the-the guy seems like he uses logic and I-I think speaking in logical terms would resonate. He does… He’s not… Is this guy showing a ton of emotion? He’s not showing a lot of emotion. Does he seem like the aesthetics or a big pain foint, point for him, like he’s embarrassed and things like that? No. So the-the empathy part is, you know, and-and that-that emotional aesthetic pull, it’s not here with him, but I can tell just by the way that he’s speaking and how he’s thinking, uh, that he’s using logic in his decision making process. It’s just that he’s, his logic is kind of flawed in terms of thinking that a partial is gonna do something is not gonna do. Or acting like, “Hey, not being able to bite down on foods is acceptable.” That’s not acceptable. And why the hell would… Why would you wanna knowingly go into that situation? Why?
You know, that’s crazy. So don’t play along with somebody trying to minimize their pain points or their downsides. They need to know that that’s not normal. That’s not normal. If you can’t bite down or you’re having problems, the occlusion is wrong or it’s loose. If it’s mobile and you can’t eat, what are we doing? That’s a problem you’re gonna deal with and live with every single day for no reason. That’s not normal, you know. So you wanna, you wanna push back right there. Somebody that minimizes downside or they minimize the pain points, um, they’re trying to create a situation where there’s no urgency. They’re trying to tell you they don’t need it. They’re kind of subconsciously entering into a negotiation saying, “Hey, I’d be fine with this and I don’t think that result’s that bad. I could live with it.” They’re almost kind of teeing up for a negotiation there.
[Video Playing]
Patient: If it’s something that, you know, in your opinion would stay in place, you know.
Tanya: Well we try to make ’em so they stay in place. And they have little clasp that-that hook onto your natural teeth [inaudible].
Patient: Right. So that’s another thing.
Tanya: Mm-Hmm.
Patient: That is another thing. I think that this tooth here, the next one and this tooth here have had a root canal. So I was just told that if I get a partial, you know, by another dentist that it’s going to impact that tooth, and probably with the stress it’s, I’m willing to [inaudible] that tooth. But I want hear you a bit.
Tanya: Okay.
Patient: [laughter].
Tanya: Well we put, we put the clasp around root canal and crown teeth all the time.
[Video Paused]
Bart: See, but now we’re all into this treatments, you know what I mean? Like we’re talking about the treatments now. And this happens all the time. This happens absolutely all the time. But it’s like, “Alright, you gotta gain agreement with the patient in terms of what we’re trying to accomplish.” What are we trying to accomplish with this guy? He needs to say it. That’s the frame. That’s that-that… the-the equation X plus Y equals Z. The X the current state. Okay, cool. Got it. Right? But what’s the Z? What are we trying to accomplish here? He said function is important, but that’s not enough here. What are we trying to accomplish? We’re trying to say any teeth that are in good health, we want to hold onto ’em and put me in a situation where they are disease free, they’re not mobile and-and I’m not gonna lose any more teeth.
So number one, our goal, stop the progress-, the consistent progression of losing teeth over the last five years. We wanna stop that, correct? Yes. Okay. Number two, any teeth that are hopeless, we want to replace them or restore them with something that’s going to be, um, that’s gonna restore the function, and that’s going to last long term. Meaning we’re gonna do this thing once and we’re gonna do it right. Is that the goal? Yep, that’s the goal. Okay. Like that’s the sale. That’s the sale. And then there-there’s no brainstorming, there’s no brainstorming with these people. You can’t brainstorm in front of ’em. You know what I mean? If you find yourself in a situation where it’s not a case that’s right down the middle, and it’s a multidisciplinary case, it’s gonna be a combination, right? It’s a perio pros combo, or it’s, um, it’s, you know, a couple implants and then it’s some restorations, whatever the case may be.
If you’re not sure exactly what it is, you gain agreement on what the goals are. And they tell you what the goals are, you understand what the pain points are, and then you let it be. “Alright, I’ve got all the information that I need for the doctor. So just to do a quick recap, what we wanna do is we’re… We don’t wanna do the Band-Aid approach. You don’t want something that’s only gonna last a year or two years, right? We want to restore as much function as possible. We want to put you in a situation where the remaining teeth are stable, they’re healthy, and they’re easy to maintain, right? And we’re gonna put you in a situation where basically we’re gonna get it done and get it done right? Is that what we’re trying to accomplish here?” “Yes ma’am. That’s what we’re trying to accomplish.”
“Okay, I got it. I’m gonna put together a plan with the doctor. I’m gonna give him all this information. He’s gonna look at your CT, he’s gonna look at, um, he’s gonna look at everything and we’re gonna put together a plan. Um, and then I’m gonna have you back. I’m gonna have you back and then we will be ready to present the entire treatment plan that’s gonna get you all of those things and accomplish all those things for you. Does that sound fair?” But I wouldn’t get into this. Like, you start going back and forth and, um, you know, these hypothetical situations. What do you think it is? Like put yourself in the patient’s point of view. You know, put-put yourself in the patient’s shoes. If I start talking about, “Well, you know, we could do a partial and here’s what it looks like.
Well, yeah, you could endo and you could do crown, right? We-we could do that. Well, we could extract… This is probably better if we extract and we do an implant there.” And it’s like, you know, it’s-it’s like, “Okay, what do I do?” At the end of it, they’re gonna look at you and be like, “What-what-what am I doing here?” It’s just one big conversation. And we don’t wanna have conversations. We don’t. We want to find out where they are and we want to gain agreement on what we’re trying to accomplish. And then we want to get to a formal presentation of what the solution is to this problem, or a formal presentation in-in regards to what the vehicle is that we’re gonna use to bring you from where you are now to where you want to be. And most-most of the time, the-the doctor treatment coordinators, you know, anywhere in the world, they don’t do that.
Um, so they don’t treatment plan comprehensively. So they’ll look at it and go, “Okay, we’re gonna put a tooth here and we’re gonna put a partial,” you know, but they’ve got some anterior teeth that have mobility. They didn’t even look at ’em. They said, “Oh, a decent bone.” But they didn’t put that in the treatment plan. They didn’t splint ’em, they didn’t address the mobility, they didn’t address the occlusion, they didn’t put ’em in a bite guard. It’s like they’re not doing anything to stop the progression of losing teeth, maintain the health, replace the missing teeth and progre-, and prevent further bone loss. They’re not… That’s not all together in one treatment plan, and that’s the way it needs to be. So you’re not piecemealing it. I don’t wanna give him an option to do this today and do this next year. Let’s do it all right now.
It’s the cheapest. It’s the cheapest way to do it. And I know I’m gonna need that logic with him when I get to the close. I’m gonna need him to recognize that, “Hey, a Band-Aid approach over the long term costs more money.” I need him to recognize that and say that. If I get him to recognize it and say it, even if he doesn’t have the capital to do it all, it’s an easy close with financing if he’s approved. Easy close. Does that make sense guys? Any questions on that before I move on? Super, super, super important. No. Okay, here we go.
[Video Playing]
Patient: Okay.
Tanya: Can-can it give extra stress? Yes. If it’s not adjusted properly.
Patient: Right.
Tanya: There’s no guarantees ever with any kind of removable.
Patient: I got you.
Tanya: But we work very hard to make sure that it’s done properly so that it doesn’t put too much stress on a natural tooth.
Patient: Right.
Tanya: If that’s the route we need to go.
Patient: Right.
Tanya: Um, with dental implants, you have a couple other ways that you can go. That’s why I’m sort of trying to gauge if you would prefer something fixed versus something removable or…
Patient: I would prefer something fixed.
Tanya: Most-most people do.
[Video Paused]
Bart: N-no, doesn’t matter. He doesn’t… He would prefer not to need fix or removal. He’d prefer to be fishing right now. He’d prefer to be a lot of places. Nobody wants to be there in the first place. Nobody wants anything that you guys do. They don’t want it, not when it comes to implants, right? So we have to be clear on what-what do you really want? What you want is to stop wasting money. He wants that. I guarantee it. What you want is to stop wasting time. He wants that, I guarantee. What you want is to not worry about what you want to eat. I guarantee it. Those are the things that he wants. How you achieve those things he is not qualified to tell you how to, how to accomplish the goals here. You guys tell him how we’re going to accomplish the goals, not the other way around.
So I don’t care what they say they want, to me, it’s-it’s in one ear out the other, ’cause I haven’t gotten to a formal presentation yet. That’s not… They’re out of their… They’re out of their element when they start talking about, “Oh, here’s how you need to do the case.” Does that make sense guys? But it’s all where you steer ’em when you’re pacing and leading. Are we pacing and leading to an outcome or are we pacing and leading to treatments? 99% of practice, they’re treatment focused. And that’s like any other salesman being completely product focused. We’re product focused. You know, you-you talk to a product focused salesperson, what do they do? What do they talk about the whole time? The features and benefits of the product. “Oh, it’s so good because of this and it’s this and it’s this and it’s this. And oh, this product and we got this product. And we got this product and we got this product.”
It’s this same thing, and that’s what is so ironic about people within dentistry saying, “Oh geez, you know, sales training, we don’t sell here.” When you sell just like [chuckles] any other product based salesperson, right? High-end consultants don’t do that ’cause they’re creating solutions for a specific purpose. But all the focus is on the outcome. And that’s where it needs to be right here. And you don’t… No brainstorming, no spit balling with these guys. You’ll confuse ’em. How the heck did that happen? You see that? Oh, oh, if I do this, it does something. That’s weird. Do y’all see that? I’m like, whoa, I got balloons coming at me, you know? I guess I talk with my hands. Sometimes I do, uh, stuff… I don’t know. All right, here we go. Continue on. Here we go.
[Video Playing]
Tanya: Um, especially in situations where you just kind of, a lot of people just don’t wanna have to wear a denture if they…
Patient: Yeah, yeah.
Tanya: … don’t need to. So I’m gonna take a look at your scan, but I’m glad you had a chance to sort of research some things with dental implants, ’cause it’s important for you to make the most educated decision for yourself…
Patient: Right.
Tanya: … um, to get to your overall outcome. Um, so they’re just little titanium screws. But…
[Video Paused]
Bart: And that’s another thing, they can’t really… Can they really make an educated decision? It really doesn’t make a whole lot of sense. We-we’re educated, they’re not educated in this. Do you know what I mean? In terms of the treatments how educated could they possibly be? You know? So they’re trusting you guys as the expert and the authority here to deliver the results and achieve the expectation that they’re setting. That’s it. That’s basically as far as it goes.
[Video Playing]
Tanya: Basically the purpose that they’re serving, number one is to replace a tooth root. The minute you lo-, you lost those teeth, you lost bone in that area, and it continues to go away ’cause your jaw bone just wants to be stimulated to take care of a root.
Patient: Right.
Tanya: So it’s a good thing when you do put a dental implant in there for stabilizing the bone loss everywhere you put ’em.
Patient: Okay.
Tanya: Um, if you’re missing one tooth and you-you’ve got some areas where just one, you would put that screw in there and you put the crown on top of it. It doesn’t come in and out in the mouth. Nobody knows the difference. In cases like yours where even up on this upper right where you’re missing…
[Video Paused]
Bart: The thing is, Tanya’s super knowledgeable. She’s super, super, super knowledgeable. She’s obviously been doing this. She’s got a lot of experience doing it. She’s very, very knowledgeable and she’s trying, like the doctor’s not coming in, right? So she’s just kind of going the whole way. What happens is the-the second 10, it kind of morphs in with the first 10. There’s no transition there, and there’s no thought of, “Okay, what is the treatment actually gonna be?” And there’s no formal presentation. If you don’t have a formal presentation, you don’t have a real frame, and the whole call starts to really sound similar, and it’s hard for the patient to be super clear on, “Okay, what are you recommending? Why are you recommending this to me? And am I clear that this makes total sense, that if you do this, that’s going to achieve what we’re setting out to achieve?” And sometimes… And if they don’t connect those dots, what do you think you’re gonna get at the end of this consultation? What objection you think you’re gonna get if those dots aren’t connected here? If they just don’t say anything and they just stare at you, it’s real bad. By the way. What are you get… What are they gonna say?
Female Student 3: Let me think about it.
Bart: Of course. Clearly. That’s exactly what’s gonna happen. Here we go.
[Video Playing]
Tanya: Several teeth in a row. So like a single tooth implant would be ideal for you down here if the bone’s appropriate.
Patient: Mm-Hmm.
Tanya: Um, but up here at the top, instead of… You-you could do one or two single tooth implants and get you some chewing teeth back, or there is a way to actually utilize two implants to do like a bridge. And so you’re replacing three to four teeth with just two implants.
Patient: Alright. So let me just tell you what my plan would be.
Tanya: Okay.
Patient: My plan would be is to have that single tooth…
Tanya: In that bottom?
Patient: … removed.
Tanya: That back tooth?
Patient: Yeah.
Tanya: When you say, because you said…
Patient: Right here.
Tanya: It’s the lower left, that back molar that needs to come out.
Patient: Yeah. Uh-huh.
Tanya: Mm-Hmm.
Patient: Because it, when I bite on it, it, uh, it’s… I-I have just a little bit of discomfort.
Tanya: Okay.
Patient: Okay. So I would have that one removed.
Tanya: So then that’s gonna open up to have a couple spaces open there.
Patient: Right.
Tanya: So again, most people chew from second molar forward. You don’t really come…
[Video Paused]
Bart: But how do we get in this situation where he needs to have that removed? And after we remove it, what’s going to prevent the next one from needing to be removed? So is it important to you that once we remove it, we replace it with something permanent? How important is that to you? And how important is it to you to prevent the next tooth from needing to be extracted? Is that part of the overall mission here that we’re trying to accomplish? Stop the progression, make a permanent replacement and stop any further pro-progression? Would that be fair to say or no? ‘Cause that what he just said, “Let me tell you what my plan is.” That’s not a plan. “The tooth is hurting me, pull it.” That’s not a plan. That’s not a plan that’s designed to get anywhere. So you can tell he’s not thinking at all about a future outcome or result.
He’s completely stuck in current state, address this pain point, move on. He’s not, he has not put it together yet, that he didn’t lose all these teeth at once. It’s not like he just lost him in a car accident. Boom. And they’re gone. He lost these teeth, these teeth one by one, he said over the last five years, one by one. After we lost the first one, why didn’t we replace it with something permanent and then, and then put a processor or a treatment in place that would stop the next one from needing to be extracted?
You know why? Because the dentist that he was working with was not outcome focused. They were not goal focused. They’re treating a problem doing exactly what the patient tells ’em to do. And it’s the, um, it-it’s the tail wagging the dog. You know what I mean? And-and that-that’s- that’s not how we, that’s not how you want to do it. That’s not how you wanna sell, right? Because it doesn’t make sense, right? Let’s do things in the most efficient manner. It’s given the best quality of life with the best long-term plan. In my… For me, that’s why I came up with that little equation, ’cause that’s how I think about it. Like, I can’t make a presentation if it doesn’t make any sense. If I make a presentation that’s going nowhere, my mind can’t even reconcile it. I can’t even really put the presentation together until I’m really clear on what the long-term goals are.
If I know what the long-term goals are and I know what the current state is, the presentation for me, it becomes very easy. I know that he’s got some teeth that are healthy. Okay? So I know a part of the treatment needs to be preserving them. So you have to address any mobility. You have to address the occlusion. Okay, cool. I know that he’s missing… I know that there’s some teeth that are not in the best of shape, that probably need to be extracted, and then he is missing some teeth. So how do we handle the extractions and the missing teeth in the most permanent best way? And then what do we put in place to preserve the teeth that he has left? There’s your presentation. But if you don’t sell and gain agreement on the concept that that is what he’s there for, that he doesn’t want to Band-Aid approach. That he wants longevity and wants to get it done and do it right, you’re gonna run in a, in a circle talking to somebody like this. Make sense?
[Video Playing]
Tanya: Gonna do all the molars. We could take-take that out and do one, maybe two single tooth implants there.
Patient: Mm-hmm.
Tanya: That might be ideal for you. It wouldn’t come in and out. Um, and get you some solid chewing teeth. Same thing for the top right there. Um…
Patient: So you would put one pin and three teeth…
Tanya: It would be…
Patient: … or one pin and two teeth.
Tanya: Well it’s… They’re-they’re little screws, so you could do… I wouldn’t do a bridge there. I would probably just do two single tooth implants…
Patient: Oh okay.
Tanya: … just like this.
Patient: Oh, okay.
Tanya: Just two of ’em side by side.
Patient: Alright.
Tanya: You don’t necessarily need to go back as far as the third molar back there.
Patient: Oh, okay.
Tanya: Yeah…
[Video Paused]
Bart: I would kind of avoid this whole thing. You know what I mean? Once I sold the concept right, and I know I’m in full agreeance, then I’m gonna say, “Hey, I’ve got everything that I need. We’ve got your CT, I’ve got everything you need. I’m crystal clear on what we’re trying to accomplish. What I’m gonna do is get all of this information to the doctor. I’m gonna meet with the doctor. The doctor’s gonna put together the treatment plan from start to finish. And I’m gonna have you back, let’s say tomorrow. What’s your schedule look like for tomorrow? And by the way, if you can bring your wife, that would be great because [chuckles], you know we’re gonna take care of you. But there’s abso-, it is absolutely ridiculous that she can’t bite down.
I don’t care if she’s in a partial or a denture or with full teeth, you got teeth you should be able to bite down. We’ll get her squared away too. You might wanna bring… If-if she can come, you can bring her too.” But I would just do that and then go ahead and schedule it. That way you make a formal presentation. Okay? It’s like, in order to do that, here are the main factors we have to address. We have to address your current teeth that are healthy, right? To make sure that they are healthy and they’re stable. We have to address the missing teeth, and we have to address these teeth that are on the line.
Here’s what we’re gonna do, and this is the best long-term plan, right? Here’s what we’re gonna do. Boom, boom, boom. And then you make a presentation. It’s not a discussion. I am presenting the treatment plan to get you from where you are to accomplish the goals that you wanna accomplish. And then that’s it. If you have gained agreement on concept, it’s easy ’cause it’s already done. If you have not gained agreement on concept, they’re gonna say, “Okay, well what about a partial? What about this?” ‘Cause they’re thinking about the money. He hasn’t connected the dots that my way is cheaper and smarter and better. Here we go.
[Video Playing]
Tanya: Yeah.
Patient: Oh okay.
Tanya: And in this case, the same thing. It would be… So maybe a, possibly a bridge on this side where it would be two implants with…
Patient: Okay.
Tanya: … with a bridge and that would fill in that space and not come in and out.
Patient: Okay. Right. Mm-Hmm.
Tanya: Um, that would be the closest you could get to natural teeth…
Patient: Right.
Tanya: And then it’s not something removable.
Patient: Right, right.
Tanya: So that’s what I’m looking at on the scan to make sure you’ve got the bone to do that. We check at the top of the sinuses…
Patient: Uh-huh.
Tanya: … and on the bottom. Now in this case where you take the tooth out, we would take the tooth out and graft it. We would pack some bone into the site and have it heal for about four months…
Patient: Uh-huh.
Tanya: … to see if-if the bone is ideal for putting in the implant.
Patient: Mm-hmm.
Tanya: But again, probably don’t need an implant that far back.
Patient: Okay. Right.
Tanya: So that shouldn’t affect us doing one or two implants on this side.
Patient: Okay.
[Video Paused]
Bart: Do you think this guy’s clear? Because it’s not a presentation, we’re talking about a lot of different scenarios. We’re running different scenarios. And-and guys, doctors do this all the time. Exactly what Tanya’s doing here, doctors do it constantly. They look at it and they start running scenarios in front of the patient, you know. And it doesn’t matter how many scenarios there are, the question is, what are we trying to accomplish and what is the best way for me to do it? What’s the most efficient way that I can predictably deliver the results? What is it? ‘Cause it’s one way. And if you don’t know what that way is, don’t brainstorm. Tell ’em you need a min-… you need time to put it together. And then put it all together and then make the presentation. You wanna… That-that’s why… That’s the biggest reason guys, why we can do these all on four consultations so quickly.
Because most of ’em, you can look at the CT and you can tell like, “Hey, this is a belt-high fastball.” And even though they can have different scenarios, it doesn’t really affect the price, and it doesn’t affect your workflow so much that we can go ahead and we can get right to it. Because even though there’s variables, there’s not variables to the point where the price changes, or the number of visits change or anything like that. That’s the reason. Once you get into complex occlusal cases, full mouth restorations, big cosmetic, cosmetic smile makeovers, sometimes from the point where you first meet somebody, a-a patient in the consultation room, in order to get to the presentation, sometimes there is a collaboration that takes place in-in a little bit more thought that has to go into how you want to approach it. ‘Cause there are multiple ways and you gotta think about it. And you know, my advice is always to think about it and get it down on paper, where the whole thing is well thought out so that you can make a formal presentation that makes sense, that’s compelling, that’s simple, right? That’s showing full confidence and certainty. When you start brainstorming running scenarios, you’re not showing certainty. You’re… What you’re actually showing is uncertainty in regards to what to do. Because you’re not saying this is the way to go. You’re kind of thinking out loud.
And when you put yourself in a patient’s perspective, you go to a doctor and you need heart surgery and the doctor started talking to you like, “Well, you know what? Ah, shoot, I could put in one stint, probably need one. Should probably do two. But yeah, you might be able to get by without that second one for a little while. I might be able to do this. I might be able to do that. What are you thinking?” I’d be like, “Are you kidding me right now?” You know, I’m-I’m running out the door. You know what I mean? You talk to a neurosurgeon. “Now look, you need brain surgery. I could do this one out of five different ways. Eh, I could do that. Uh, nah, probably not. I could do that.” You don’t want to hear any of that stuff from the doctor. You don’t want to hear it.
You usually wanna hear the doctor say, “I know what you’re trying to accomplish. Here’s where you are. Here are the things we gotta control. Here’s what I’m gonna do. Boom, boom, boom, boom, boom.” Full confidence. So if you don’t know what the treatment is going to be, then no brainstorming, just tell ’em you need a day to work the case up. You have all you need. The first 10, your job is not talking about treatments. First 10, your job is where are they and what are we trying to accomplish? What’s the, what’s the vision here? What are we trying to accomplish? Those two things. You gather that intel, you meet with a doctor. The doctor’s job is what? Create one treatment plan, right? That solves that equation, X plus Y equal Z. It proves out. This is how I can achieve these goals given this scenario. Boom, it’s one way. And then we make a formal presentation. We get to the close, and it’s one close with one price and that’s it. That’s the entire process in a nutshell. Do you guys see how simple my way is?
It’s so simple. You see how complicated it can get for the patient? Like, listen to this guy how he’s talking. You can tell the last practice did the same thing. The last practice was talking to him about all kinds of different scenarios, “And we could do this, and we could do that, and blah, blah, blah.” And every time this guy chose the least expensive Band-Aid approach and went forward with it. And now he’s at another practice. He doesn’t trust his old dentist anymore. Now he’s at another practice and he’s getting ready to do the same thing, because we’re communicating in a very similar fashion. “Hey, all these different ways will work. Which one do you want?” Type deal. Right? And he’s thinking, he’s already been quoted. This guy… Don’t let him fool you. This guy knows the pricing pro-… I would, I would venture to bet this guy’s already been quoted and knows the pricing for implants. He knows they’re significantly more expensive. He knows the cheapest option for him is probably gonna be the partial. He knows his wife hates it and he’s trying to talk himself into it, because he’s financially motivated. Does that make sense?
So this, the-the-the place where you have to exert your influence, is influencing his perspective on what we’re trying to accomplish. That’s gonna solve so many different issues here. You can tell by how he talks.
[Video Playing]
Tanya: Now, I’m not a doctor and I don’t play one on TV, but it does look like you’ve got plenty of bones there. Um, I’ll have… I upload this to… My doctor works, um, in Raleigh on Fridays. So I will upload this for him to look and just verify behind me. But it looks pretty good to me.
[Video Paused]
Bart: And if I was gonna say it, I probably wouldn’t… Uh, I wouldn’t necessarily… Right, what’s this guy doing? He is minimizing everything. So if you were going to point to that, which by the way it wouldn’t really happen until you’re making the presentation. Typically the doc-, the doctors do it. He is not here. But let’s say the doctor was going to do it. I wouldn’t say the bone’s great. I’d say the good news is you haven’t experienced a tremendous amount of bone loss, yet. If there’s nothing in this bone, if we don’t restore it and put something in here, it’s going to continue to deteriorate. And that’s why you’re going to continue to lose adjacent teeth. You know what I mean? You don’t want to minimize anything with somebody that shows no emotion and shows no urgency. That’s what they’re going to try to do. But you’re not gonna do that. It’s is a tough spot for a treatment coordinator to try to do the whole thing. Puts ‘em in a tough… It’s re-, it’s really hard. Especially when the case isn’t straightforward. It’s not a straightforward all on four. It’s tough.
[Video Playing]
Tanya: You’ve lost a lot of bone below the sinus on this upper… But again, I don’t know that necessarily you would need to have a implant that far back. So I’ll have Dr. Jernigan look and let me know what he thinks is the most ideal plan. I can give you an idea of what that would look like monetarily, if we… Let’s just say we did two single teeth down there and two single teeth up there.
Patient: Oh, [inaudible] that’s not bad.
Tanya: And um, two single teeth up on the top. Let me write down that I told you that. That’s all the surgical fees for the guides and everything that we need start to finish. I don’t believe in hiding any fees anywhere.
Patient: Right.
Tanya: Um, that would be getting you sort of everywhere you need to be.
[Video Paused]
Bart: So the first tenant kind of flows right into the second, and then the second just turns into the third. You know what I mean? Everything just goes together here. Um, and it al-… It always makes me nervous to start to just kind of like shoot from the hip, and make a, and make a pitch and give a price. Because I never really got… Like, look at this guy’s body language. Does… Do-do you think, do we have buy-in from this guy? We don’t have buy-in with concept. I don’t have buy-in with body [chuckles] language. I don’t have any degree of excitement or enthusiasm. I don’t really have any signs of even a generalized understanding from his point of view yet. Tanya’s doing the best she can do because there… You know, you… She… You can’t run the 10-10-10 without the doctor. But she’s doing the best that she can do. But you guys can see the cl-, the clear challenges that you have here, right? You look at his body language, not telling me that he’s on the same page at all. He kind of sounds like he’s a bit confused in terms of what he’s supposed to do here.
[Video Playing]
Tanya: Um, that’s also including all the follow up visits, adjustments, anything that we need to do in the meantime. Would you want to wear a partial in the meantime? ‘Cause you have to heal for about six months.
Patient: Mm-hmm.
Tanya: Um, at once we put the implants in before you’re putting the crowns on.
[Video Paused]
Bart: That’s another decision, right? You see the, these-these patient consultations, it turns into a situation where we’re asking the patient to make multiple decisions. Multiple decisions. “You wanna do this? You wanna do that? You wanna do that? You wanna do that?” It’s just a cognitive burden on ’em.
[Video Playing]
Tanya: And that way we could instantly get your teeth back. You don’t have to. You’ve clearly gone for quite a little bit without ’em, but it is a solid six months that you’re healing before you’re getting the crowns.
Patient: Right.
Tanya: I would leave that up to you. Um, it would be an additional 755 if you wanted to do a partial. Um, but you don’t have to. You’re kinda in a position where you didn’t just lose the teeth you already have sort of…
Patient: Right.
Tanya: … dealing with that. How long have you been dealing with this?
Patient: Um, you know, I-I have lost all these teeth over three years.
Tanya: Okay.
[Video Paused]
Bart: So now we’re back in the first 10. You see? That’s what you want to ask like right up front. You wanna dig there and get the backstory. So we’re kinda like, we went, we’re closing, we’re closing. Do you wanna do this? This is an extra 755. You know, it’s just not a… It’s not a real presentation. It’s very difficult for the patient. This is a very difficult scenario for the patient to say yes and purchase.
[Video Playing]
Patient: Yeah.
Tanya: So it’s just been gradually building up. Okay. Does that sound like something you want to try to do?
Patient: Um, yes it does. Um, but also what-what would renewables cost?
[Video Paused]
Bart: I mean, classic, classic, right? Now you close conceptually. You get to a formal presentation, you make the presentation. This question does not come up. ‘Cause he already knows the partial is a Band-Aid approach. He already knows it’s not gonna have the same degree of function. He already knows it’s gonna cost him more over time. He already knows all of that because our strategy is to avoid Band-Aids. It’s to avoid multiple visits. It’s to avoid further progression of bone loss. It’s to avoid all of those things. And when we make the presentation, we’re going to explain the reason why we’re doing implants is to avoid further bone loss. If we were to do something like a partial or-or-or a denture here, something like that. We’re s-, we’re gonna do a partial over time, the bone is going to continue to erode and sooner or later the adjacent teeth are going to fail and we’re gonna be right back here.
That’s something we wanna avoid. That’s why we’re gonna do an immediate implant, right? So that question, this would never come up, if we gain agreement in concept and we make a formal presentation and link the treatment to the goals. In terms of you’re-you’re just justifying what the treatment is, saying, “Here’s how I’m gonna, I’m gonna achieve all of these things. So here’s why I’m doing this, here’s why I’m doing this and here’s why I’m doing this.” And then it’s like, it’s crystal clear these things are never gonna come up. This guy’s price driven from the, from jump street. And what he doesn’t understand is that he’s his own worst enemy. He’s not happy with save his teeth, he can’t eat and he’s now gonna make decisions to put himself right back in the same room in another 12 to 24 months, ’cause nobody’s helping him. Make sense?
[Video Playing]
Tanya: That if-if we take the one tooth out, it needs to be an immediate on the bottom.
Patient: Okay.
Tanya: So it starts at 755 each…
Patient: Mm-hmm.
Tanya: … for partial.
Patient: But each meaning the partial or the [inaudible].
Tanya: Uh-huh, just the partial. [Pause] It’d be about 1,600 for the bottom, taking that one tooth out…
Patient: Uh-huh.
Tanya: … and putting a partial in.
Patient: Oh, so y’all could take the tooth out?
Tanya: Yes sir.
Patient: Oh, okay.
Tanya: We take tooth out.
Patient: O-okay. Okay.
Tanya: Absolutely.
Patient: Good, good, good.
Tanya: That’s when I, when I say one stop shop…
Patient: Yeah, yeah.
Tanya: … we do everything here.
Patient: Well that-that’s a good [inaudible].
Tanya: Yeah. It makes it nice for the patients not to have to go here and there and all over the place.
Patient: Yeah, because my dentist, you know, they’re all for not taking the teeth out.
Tanya: Yeah.
Patient: Let’s do this, let’s do this.
Tanya: Well, and-and-and I respect that.
Patient: Yeah, I understand. Yeah I…
Tanya: There’s nothing like your natural teeth, and everybody here…
Patient: Yeah.
Tanya: … is gonna encourage keeping natural teeth if you can. But…
Patient: Yeah, I’d rather do [inaudible].
Tanya: You make a very good argument when you say, “Look, I’ve already done all this stuff and-and I…
Patient: Yeah.
Tanya: And if I don’t get a good long term prognosis, why would I put all this money into a root canal and a crown?
Patient: Yeah. Um, I think for right now that I would be more interested in the partial.
[Video Paused]
Bart: Hmm. How’s he more interested in the partial? [Pause] Because the partials cheap. That’s it. The partial, it doesn’t matter what you pay, if it doesn’t make sense, then-then-then it’s-it’s money, it’s money wasted. It’s money and time wasted. But this guy, we’re not… Nothing is being done as far as like, “These are the results we’re trying to generate here.” Here’s the long-term goals we’re trying to achieve. If a partial, uh, is going to work to achieve the long-term goals of the patient, then let’s do it. I got no problem. Right? But if it doesn’t, then there’s no… It doesn’t matter if it was free, you wouldn’t want to do it. If I could do a free partial, you don’t want to do it.
You guys have any questions? Oh, and I’ll-I’ll-I’ll-I’ll just kind of spoil it here at the end. I mean, they go through and they get, um, you know… She kind of does the close. He says, he’s like, “Hey, I don’t have like all that money right now.” She says, “Hey, what about payments?” He said, “Yeah, I’d like to look into that.” He got approved for 75,000 bucks through proceed. Um, and then he said, “Let me think about it.” So I mean that’s… Money’s not the issue. And this is, everybody thinks it’s-it’s always money. It’s always money. It’s always money. It’s-it’s not. It’s almost always the fact that there’s no conceptualize sale and there’s no formal presentation. That by far and away… Nobody’s watched more of these videos than we have. Thousands of ’em. Okay? And the-the one thing that is without question, the biggest issue is that we think in terms of treatments, and we communicate in terms of treatments. We look at a-a-a situation, we look at a patient and we immediately think, how can I solve that problem?
And we talk about how… all the different ways that we have to solve the problem. And we don’t ever get to a formal presentation, and we’re not ever comprehensively treatment planning to accomplish goals in the future. That’s by far a bigger problem than price, by far. ‘Cause it doesn’t matter the price. This guy ge-, just got approved, he can afford the payments. He said, “Let me think about it.” ‘Cause he’s not sure what to do. This guy has a tough… This is a tough consultation for him. We’re asking a lot of the patient to make all these different decisions right now.
You know what I mean? We’re asking a lot of ’em. And Tanya’s doing the best job that she can do without the doctor. But I think, you know, if it was, if it was me, I would’ve sold the concept as much as I could, and I would’ve escalated his level of commitment as high as I possibly could. Getting him as… to go as far as saying, “Yeah, I don’t want to do this Band-Aid approach. I don’t want to do that. Yeah, my number one goal now that I think about it, is to stop the consistent progression of tooth loss. That is my number one goal. Because if we don’t do that, I’m gonna be right back here in two years.” I’m gonna get him to say that to me, then I’m gonna let him go and I’m gonna bring him back the next day. And I’m gonna have this thing laid out, and I’m gonna have a presentation that’s fully baked, and I’m gonna close him, and then I’m gonna close his wife and his mother and his two cousins. I’m gonna close everybody. You know what I mean? Everybody that he knows. But we’re gonna do it deliberately. Does that make sense? Anybody have any questions here, questions, comments before I let y’all go?
You guys got anything? Yeah. You guys, you guys need some, uh, some coffee, some espresso, t-tequila something. My goodness gracious. Hey, y’all are coming to Vegas. I’m gonna remember all the faces right here. I’m pick… I’m calling. You’re coming up on stage.
Dawn: I have a question.
Bart: Right? You do. Okay, let’s go.
Dawn: Are patients usually okay with coming back for that presentation, or is it too many appointments? What-what do you think?
Bart: It doesn’t matter if they’re okay with it or not. What’s the alternative? You don’t know what the treatment is, you know what I mean? If you don’t know and have full certainty of how we need to approach the case to achieve the results, there really is no alternative. The alternative, is just to go through scenarios with ’em and that’s not gonna work. I would say if you don’t do it and you schedule them back…
Dawn: Mm-hmm.
Bart: … there is a much higher percentage chance that they’re going to come back versus getting a, “Let me think about it.” I think a, “Let me think about it,” is gonna come back at a much lower percentage than somebody that I never got to a presentation. ‘Cause they wanna at least come back and hear what I have to say. They want to at least come back and hear how much it’s gonna cost and what we’re gonna recommend. You know? But at-at the end of the day, there’s… If you’re not sure what the treatment plan’s gonna be, it’s a multidisciplinary type of case. The alternatives warrant the risk of it, you know what I mean? The risk of not doing it is higher than the risk of them never showing back up. Which is a risk. It’s not ideal. But hey, Tanya doesn’t have the doctor there, right?
So she can’t make the presentation with any type of certainty. She’s doing the best she can. But you can see when the doctor’s not there and there’s no like, “Hey, this is how we’re gonna do it. Boom, boom, boom.” What’s she gonna do? She either does this or she says, “I got everything I need. I’m gonna talk to the doctor. I’m gonna have you back in tomorrow and we’re gonna have everything lai-laid out.”
Dawn: Got it.
Bart: Cool.
Dawn: Wait, I have another question.
Bart: Yes.
Dawn: I’m sorry.
Leslie Ramos: I do ha-… Oh.
Dawn: Oh, I’m sorry. Go ahead. You’re, you were waiting. [Laughter].
Leslie: [laughter] I do have a question. Um, so recently I did a consultation, and I was only left with like doing the third 10. I didn’t get to do like my first 10. Would it be repetitive to redo like the first 10 since I wasn’t in… sitting in the first 10. And just do it at the point where like… Because I would just hand it off because the patient spoke Spanish, and I would just hand it off to do the financing and everything. So how would you approach that so it’s not… they’re not just sitting there like waiting. And so I can like, I guess redeem the first 10 in order for me to close on the third?
Bart: The question is, are they, are they already sold or not? Are they sold? Are they conceptually sold? Do they understand…
Leslie: Yeah.
Bart: … the treatment and understand how the treatment’s going to achieve the results that they want? Has… Is that, is that been done or not? Like are you gonna present the pricing and get an objection or are they done?
Leslie: So I presented, so I presented the treatment, um, but he was still like hesitant on, you know, everything. So…
Bart: Well, hold on, hold on. The doctor didn’t present the treatment?
Leslie: No, they presented it like they… So they presented him like the treatment. But as far as like me knowing like kind of what he’s there for… Like getting all their pain points in order for me to do the close, I-I can’t do it properly if I’m not, you know?
Bart: No, the thing is you weren’t, you weren’t there. So…
Leslie: Yeah.
Bart: … it’s not an ideal situation, but when they come into the back, you have to assume that conceptually they’ve agreed on the treatment, and you have to assume they’re gonna move forward, and you have to get right into the close. If you get an objection and you realize, “Oh man, they’re not clear on the treatment,” or “Hey, they don’t really want this.” Or, we’re… You know, they’re saying things that-that forces you to handle ’em well. That-that’s where you loop back.
Leslie: Okay.
Bart: You know what I mean?
Leslie: Yeah.
Bart: But I would go ahead and move forward with the close, and I’m hoping, “Hey, the doctor’s got this case done. This case is done…
Leslie: Yeah.
Bart: … I’m gonna move forward, do a quick recap of the treatment and look for the excitement and look for the understanding. If I do a quick recap of the treatment and they’ve got kind of, uh, basic questions that they should already know, then I might do a little bit more in terms of a recap. And I’m trying to make su-… I’m trying to look and see, do they know what the heck the doctor just recommended or not?
Leslie: Okay.
Bart: Or am I making this recommendation for the first time in their eyes? So you just have to adjust. But I would go into it thinking, they already got ’em sold. I do a recap. You look for the excitement and enthusiasm, and you look for the generalized understanding, and then get right to the bundle and the price. And if they don’t have an understanding of what it is, they’re missing any enthusiasm, um, and-and it’s not done, then you have to loop back.
Leslie: Okay.
Bart: That’s the only way to do it, you know?
Leslie: Okay. Okay.
Bart: Okay. What was the other question?
Dawn: Okay, I’m sorry. I’m here.
Bart: Okay.
Dawn: Can you hear me?
Bart: Yes, ma’am.
Dawn: Okay. Um, do you recommend to that, um, consultation as to ask people to bring their significant others so they can, the other person is gonna have additional understanding of our proposal and therefore they can make the financial decisions?
Bart: Sure. Like I said, I mean with this guy, I was more saying because it-it sounds like his wife really needs help, you know what I mean? And-and he… Just because she doesn’t complain doesn’t mean that she’s not suffering. You know what I mean? And that’s-that’s… There’s no reason for her to suffer. “You bring her in, we’ll take a look at her for you for free, because she should not have to worry about biting down on food. Whether she has a partial or a denture or whatever the situation is, we should be able to get her to the point of doing that. It sounds like she’s just a saint. Bring her in. We’ll help her. I’ll… We’ll look at her, free of cost.” You know what I mean? That… I would get her in for that. This guy strikes me as a decision maker personally.
Um, I think that he could easily make a decision independent of his wife. Uh, he hasn’t led on that, that’s a thing. Uh, so… But if they ever do, yeah, you want to encourage both of ’em to be there if they ever said that that’s an issue. Um, but anytime someone tells you that they know somebody that’s struggling, tell ’em, say, “Well that’s not normal. And just ’cause she doesn’t, you know, complain doesn’t mean that she’s not suffering. Doesn’t mean it’s not bothering her every single day. And you know, how about this, if you can bring her in with you, I’ll talk to the doctor and we’ll look at her for free. And we’ll see what we can do to at least help her to where she can bite down without worrying about it. I mean, that’s ridiculous. We’ll bring both you guys in at the same time. How’s that sound?”
And get ’em both in. I’d be selling implants to both of them. The guy just got approved for $75,000, he can do both cases.
Dawn: Hmm.
Bart: You know what I mean? Mm-hmm. Any other questions with this? Tanya did the best she can. It’s just very difficult without-without the doctor. And it’s even more difficult when it’s a curve ball case. It’s not a straight up all on four. There-there are multiple different ways to approach it. And last thing you wanna do is make like a recommendation and then the doctor looks at it and-and he doesn’t necessarily, he or she doesn’t agree with it and they have to put something else together, and then we gotta change it with the patient. You know what I mean?
Erin: We-we have one question too.
Bart: Mm-hmm.
Erin: Um, we’re still newbies coming off of that level one certified, you know, and, uh, no pre-quals during, prior to level one. Like just get some practice, all those things. But we have so many and I could foresee it happening with the case like this, doctor’s maybe not coming in, um, and they’re sitting there saying, “Okay, yeah, and I’ll do whatever. It just depends on my monthly budget. Depends on financing, depends on the monthly budget.” And so I assume in a case like this, it’s cool to go ahead and run them through financing, um, before we get all the information to doctors. Stop at the first 10 run through financing. But then where we get tripped up is we’ve never wanted to let them see that number at the end, especially an account like this. So yes, they’re saying, “Yeah, I’m all in.” They haven’t seen the bundle yet, but we wanna pre-qual them. How [inaudible] it-it can range from anything best of the best is this and run that number through?
Bart: Depends on what they’re saying, you know, um…
Erin: Yeah.
Bart: This guy didn’t s-, didn’t straight up say like, “Hey, I don’t have any money,” for me to…
Erin: Right.
Bart: … for me to just pre-qualify him.
Erin: Mm-Hmm.
Bart: So with him, I’m not sure this would’ve come up in the first 10, if you didn’t get all the way into the treatments.
Erin: Right.
Bart: But let’s say that he comes back and you make a presentation or here… I’ll-I’ll go your example first.
Erin: Yeah.
Bart: So let’s say he did come in and he said, “Listen, I want something with high function. And I agree, I don’t want the Band-Aid approach. The only reason why I ever did the Band-Aid approach was because I have financial constraints. So I was just doing the best that I could do with the money that I have available.”
Erin: Right.
Bart: If someone were to say that to me, I’d say, “Okay, so the goal is that we want something that’s gonna restore the most amount of function. Something that’s as long term as we possibly get it, and something that you can afford, right?
Erin: Mm-hmm.
Bart: So the best for what you can do. Is that fair to say?” “Yep. That’s fair to say.” “Okay, cool.” Um, and I’d say, “Now let me ask you, are you thinking about it in terms of like capital outlay or are you thinking about it in terms of monthly payments?” ‘Cause some people look at it and go, “Hey, I only have X amount of cash to put into the, to put into the treatment.” And other people say, “Well, you know, I could do something that would give me a little bit better results long term and save me a lot of time and energy, if you guys have payment options available.”
Erin: Right.
Bart: So when you’re thinking more in terms of cash or payment options, and that will a lot of times prompt them to say, “Well, if you have payment options that would work. Then the next goal is for you to figure out whether this person has any money. So the question is, well the idea is that you need to know whether or not this entire treatment hangs in the balance of them being financed or not. So you ask ’em, say, “Okay, as far as payments go, would you prefer putting more money down, and having a lower monthly payment or putting less money down and having a higher monthly payment? Which would you prefer?”
They say, “Well, I’d rather put less money down and have a higher monthly payment.” “Okay, what type of down payment would be ideal for you? What… Are you talking, you know, 5,000 bucks, 10,000 bucks, 2000 bucks? Like hypothetically, what could you put down where it wouldn’t be any heartburn? You know what I mean? Where it wouldn’t cause you to be stressed out? And I only ask ’cause there’s tons of different options and I can, I can take a look at that and try to get you exact… something that will work for you.” And if we’re on financial constraints, sometimes it’s easier for me to back into it, right? “So I can see what kind of payment options we have available and then see what works for you financially and then we can back into what’s the best outcome we can achieve that you can afford.” So I ask ’em that. And if you have someone that says, “Oh, I can’t put any money down, I don’t have any money.”
Female Student: Mm-hmm.
Erin: Mm-hmm.
Bart: Then you go ahead and you run ’em through proceed. You run it through all your financing options and if they don’t get approved, that’s a straight triage. ‘Cause they were straight up front, they don’t have any money so you have no Plan B close you. There is no secondary close. However, if it’s somebody like this guy, this guy really wasn’t even considering monthly payments. He’s considering cash.
Erin: Mm-hmm. Yes.
Bart: This guy’s got 10, 15 grand. So even if he gets declined, you have 10 to $15,000 to work with, you’re gonna get this done. That you have a Plan B close here. So if they are upfront and they tell you there’s a financial problem, they want the best, but they don’t have a lot of money, that prompts you that you need to pre-qualify them. However, if they just kind of dance around it, and they’re not saying that. They’re just kind of alluding to the fact that they’re price shopping, I would stay away from it. ‘Cause like this guy, he’s saying cost, he’s alluding to it, he’s focused on it, but it doesn’t mean that there’s a high probability that he’s unqualified to make a purchase or he has no credit.
Erin: Okay.
Bart: Becau-because their idea of what’s expensive and what they will or won’t do is gonna completely change when I conceptualize the sale, and then I make a formal presentation. By the end of it, they’re in, they want it. He-he will spend more money than he would have had I not done it that way. So price shoppers is different than somebody that is raising red flags to you going, “Oh man, this guy doesn’t have any money.” If they’re screaming, “I don’t have any money,” run ’em through proceed and-and pre-qualify ’em. But don’t do that before you figure out if they have any cash. That’s a pre-qual. A price shopper’s not a pre-qual. I’m saying, I’m guessing this person is qualified, they just want the cheapest.
Doesn’t mean that they can’t afford the best, it just means that they’re not in that mind frame. But you can change that once you change the perspective of what it is that we’re trying to accomplish. And guys, something else to keep in mind here, you wanna talk about with a patient. If you have a patient that’s really focused in on price, a good question to ask is, “Listen, what’s more important to you upfront? Transactional cost or lifetime cost? What you’re going to pay now or what you’re going to pay over the long term with the treatment. Because those differ dramatically.” And if they come in and they have like say a cheap quote from a competitor and they come in with it and they’re like, “Hey, I went down the street and this guy gave me a treatment plan and he said all on four at, you know, 14,995, all the same things.” And say, “Okay. So he said 14,995. Now that’s the amount that they’re charging you upfront or is that, is that the lifetime cost? Which one was it?” “Uh, I think that’s just what I pay up front.” “Okay, cool. So it’s 14,000. And what did they say in-in regards to the lifetime cost? How much was that gonna be?”
And they’re gonna be like, “What do you mean?” Say, “Well, are they leading you to believe that you’re gonna pay that and that’s, you’re done?” “Uh, yeah.” “Ooh, okay. Alright, well let’s talk about that. The difference between lifetime cost and upfront cost, right? Because you’ve seen this before where you go, ‘Oh, okay, I can get into this.’ The 14,500 or 14,900, that’s just how much it costs you to start. It’s not over. That’s what it is to start.” You guys see what I’m saying? So that’s a really good question to get them to start thinking about it. And what happens is sometimes the lowest upfront transactional costs equal the highest lifetime costs, and the highest lifetime costs equal… No. The lowest or the highest upfront costs equal the lowest lifetime cost. But which one’s more important to you?
Meaning if upfront cost is the most important thing when it comes to this type of thing, 15,000 is way too high. Way too high. There are clinics that you can go to, there are places you can go to. I know a place in Mexico that’ll do it for five grand, if we’re just trying to get it for as cheap as possible. If it doesn’t matter how long it lasts, and it doesn’t matter that the lifetime cost’s be, gonna be significantly higher, it’s all about upfront cost, 15,000 is too much. But this is how you change perspective. Does that make sense guys? Okay.
So just a quick recap to make it super crystal clear for you, Aaron, if you have somebody in front of you, and price comes up at all, you think, “Is this a pre-qualify or is this a price shopper?” If you think it’s a pre-qualify, the-the-the red flags, the dead giveaways for prequalification is are they desperate?
Erin: Right.
Bart: If someone’s desperate, most people that are desperate, they’ve been to like four practices and they just haven’t gotten improved, and they’re just hoping to God that you can do something for ’em. So desperation is one. Um, and then, um, them saying things like, “I don’t have a lot of money,” or, “I don’t have good credit,” or this, that or the other. Those are pre-quals. Somebody just dancing around it or saying, “Hey, I want to… I need to get information on pricing. I wanna see what my options are.” That is not a pre-qual that is a price shopper.
Erin: Mm-hmm.
Bart: And what they te-… There-there’s no expensive and there’s no cheap, right?
Erin: Right.
Bart: It’s just how much… Like how much… How important is this result to me? The more important the result to them, the more they’re going to pay for the vehicle to reach that result.
Erin: Mm-Hmm.
Bart: So a price shopper, I’m not gonna play the price game if I don’t feel like they’re… If I feel like they’re qualified and they’re just price shopping, I’m gonna go through and go ahead and run through the process.
Erin: Yeah.
Bart: And what I’m gonna do while I’m going through the process, I’m going to render all of these other options obsolete, because they make no sense to achieve the results. That’s why the patient has to be articulate in describing the results. And that’s what separates the best treatment coordinators and salespeople from mediocre. The… And that’s the long and the short of it guys. ‘Cause the best ones know how to ask the right questions and lead the patient away, where the patient is saying, “Yeah, I don’t want a Band-Aid approach.” “Yeah, that’s what I didn’t like.” “Yeah, I get it. So if you extract the tooth, you put another one in… It’s like, if you don’t put another one in the bone’s gonna go… Yeah, I don’t want that. So yeah, I don’t want the Band-Aid approach. I want something long term. I want to restore my function and I want to get this done once and I want it done right.”
The best ones know how to get the patient to say that. They’re never going to say that without your help, because the patient’s only there ’cause they’re experiencing a pain point and he says, “This is what hurts. Don’t look at anything else, just look at this and fix it.” That’s one tooth at a time dentistry, and people let ’em get away with it because they don’t know how to create a vision for the future. Does that make sense?
Erin: Yes, it does.
Bart: That’s the key. That is without question the key. Everyone says, I say, “What’s the biggest objection you get?” “Oh, they always say it’s money, it’s finance, it’s money, it’s finances.” Baloney. It’s just not. That it… I-it’s a lie. It’s just not true. You think it’s true, but it’s not true. They just, they just never really saw the point in paying all that money. The finance is dr-driving them to do the cheapest thing. These people are gonna go somewhere and get help. That’s why doctors and-and-and-and treatment coordinators struggle with price shoppers, because they all sell the same. And you-you commoditize what you do, and it kills you in a price negotiation. The patient has all the power because everyone refers to the implants and the treatments and the price. So if you’re not the cheapest in town, you have a hard time with second opinions. If you learn how to do it my way, all of those other options are obsolete. They look at it through, its completely different lens. So when you hear it, you’re looking for, “Okay, what is my frame to do the, to make a present… How do I make a presentation?”
Gotta get clear on the results. Then you’re thinking, “How did he get to this point? What decisions did he make?” I have to open his eyes that he put himself in the chair, based on what he wanted to do. And that it wasn’t even the dentist’s fault. The dentists were just doing what he wanted to do and they weren’t guiding him. We’re gonna do it differently so that it’s affordable, so that it’s not a constant liability. So that it’s not a constant strain on your quality of life. So that you don’t have visits and problems and-and situations to deal with over and over and over and over again. That’s what we’re trying to accomplish, right? “Yes sir. That’s what we’re trying to accomplish.” Boom. Got ’em. Sales done. Sales done. Then I just gotta get with the doctor, put the treatment plan together and make it simple. And I’m not asking them if they want any part of it. This is what it’s gonna take to achieve the results that we’re after. This is what we’re gonna do. Boom, boom, boom, boom. And you’re pacing and leading. It’s full certainty, it’s full excitement, and you make the presentation as simple as possible and the patient has nothing to think about.
Absolutely nothing to think about. Because the X plus Y equal Z is an easy equation. Alright? Five plus five equals 10. Got it. That’s a no-brainer. Let’s do it. That’s where you have to get to. Are we at a no-brainer right here with this, with this case? Far from a no-brainer. Matter of fact, there’s a lot to think about. But the… this is the ma-majority, the overwhelming majority of the consultations. The sale is already over when we agree on the results and the goals. And we agree that their situation will not heal itself on its own. That it is going to progressively get worse if we don’t do something. I gain agreement on those two things, sales over, it’s done. Now it’s just a matter of trust. Do they trust that we know what we’re doing? Do they trust that we’re the best in the area?
Do they trust that we are going to guide ’em in the right way? Do they trust that we can actually deliver? That this treatment plan makes sense? The whole thing’s about trust from that-that point forward, but the sale’s over. Make sense? I’m sorry I got on a soapbox there, but this is super, super important. This is the whole thing. I’m gonna be going into this even more in, um, in Las Vegas and we’re putting more lessons in, uh, in-in regards to this, uh, this concept because it’s really, really important guys. Don’t be a product based salesperson. Be a results oriented consultant. Cool? Alright. Get your butts to Las Vegas. Come on.
Leslie: [laughter].
Bart: Tell-tell your docs you need a vacay, flying private. Let’s go. Okay? Those of you who are gonna be in Las Vegas, I’ll see you there. Those of you that aren’t, I’ll see you on the, uh, the next power session or the next call. Okay.
Leslie: Bye.
Bart: All right, bye-bye guys. See you.
[END]