Fontainebleau Miami Beach, FL
December 1st & 2nd
The Closing Institute’s Full-Arch Growth Conference
Bart Knellinger: I’m sure you’ll remember really, really quickly.
McKenzie: Yeah [laughter].
Bart: Who it is. Okay, [hums] we still got people logging in here real quick – [hums]. Did any– has anyone had any- any good uh– any good treatment plans or any tough treatment plans that you guys had this last week? Anyone have anything interesting?
Meeting member 1: I sold 2 cases this week so far.
Bart: Did you?
Meeting member 1: Yeah.[keyboard typing]
Bart: It’s hot right now, isn’t it? My goodness. Crazy right now. Crazy.
Everyone’s getting tons of leads right now. It’s just really, really, really good.
Okay. Listen, I’m going to go ahead and start this because it’s kind of a longer video, um, but I’m just going to play very specific parts of it. Um, we haven’t really gone through one like this, where these things had happened. Um, but you’re going to be able to see a lot on here. So I’m gonna go ahead and share the screen, okay, and you guys can make sure that you uh… Yeah, I think about everybody is muted. If you have a question, type your question then. Okay, so I’m going to try to get through everything and get you guys out, um, on time.
Alright, okay, go ahead and fast forward and start here. Okay. So this is the- this is the beginning of uh, of the 10-10-10. And I’m gonna kind of hop around here, um but you guys are going to find this pretty interesting. We actually- we didn’t end up closing this patient, um, but it was a really good call.
McKenzie: Here. So my job is to help find um a solution to your problems or issues and stay within three things: function, budget, and aesthetics. Okay? So I’m not going to give you a Lamborghini if you’re like, I just want the Camry. Okay?
McKenzie: So I just like to be very clear on those things. Um, I saw that you’re interested in a snap-on denture?
McKenzie: Okay, great. So can you tell me um, your current situation? Pain, sensitivity, missing teeth? What’s going on, what you’re happy with, not happy with?
Patient: All of it. [laughter]
McKenzie: All of it? Okay! Love it.
Patient: Um, so when I was like a teenager, I got a bunch of dental work that wasn’t necessary.
McKenzie: Oh goodness.
Patient: Um, come to find out, I was part of some kind of Medicaid scam going on. So I’ve been, like, trying to fix everything that happened as a teenager, now that I’m an adult without insurance, and it’s been hell.
Patient: So, when I was in my early twenties, I was like, “I’m gonna get dentures now, while I’m still young”. That didn’t work out, but I went ahead and started pulling teeth left and right anyways because it didn’t matter.
Patient: Um, but a lot of their shoddy work left my teeth broken.
Patient: So I’ve had, I have like no back teeth anymore.
Patient: Um, and the showers[?] are not great. I just don’t like them. I have crooked teeth.
McKenzie: Do you mind if I see?
McKenzie: Okay. So you don’t like the looks?
Patient: I don’t, I don’t like any, any part of it.
Patient: So I’m like, at this age, it doesn’t even make sense trying to save them. I don’t want to do braces. I’m way too old for that.
Patient: They’re not in great shape anyway, like I see no point in keeping them.
Patient: But I want to do it while I’m still young and healing time will be easier. I just quit smoking.
McKenzie: Oh, good for you! How long?
Patient: Um uh, it will be a year next month.
McKenzie: Oh my gosh. Congratulations!
Patient: Thank you. It’s been hell [laughter]. Because I was also like, I’m gonna quit, I’m gonna lose weight and I’m gonna quit smoking.
McKenzie: Aw…well, you’re on the right path to making yourself healthier.
McKenzie: So um dental, oral, you know, hygiene and health are linked to the major organs in your body. So, not smoking and getting what we have going on fixed is going to help you all around.
McKenzie: Um great. So have you done research on a Snap-on denture?
McKenzie: Okay. And what do you know?
Patient: I know that- you know, you’d get the implants, and they just kind of snap-in rather than like the full palate. So it will help with like, the not just leaping out at people.
Bart: So what’s– one thing that’s interesting about this patient, you guys can tell, she’s um, she’s very aesthetically driven, right? That’s why- the- she’s there, said, she’s missing all the back teeth. She doesn’t like the way her front ones look. And it sounds to me like this is a person that doesn’t have a whole lot of value at all for her teeth. She just doesn’t value them. She was talking about, well, just going into straight dentures while you’re young, which is like, crazy, you know? That’s, that’s kind of the opposite of what people even dream about doing ty-typically. I mean, the idea of going in dentures would scare people half to death. Um, she doesn’t have much value for her teeth.
A lot of times, if you have somebody coming in that’s younger, they don’t have any value for the teeth. They talk about dentures like it’s no big deal. Odds are they come from a long line of denture wearers, that’s usually the case. They’ve got a mom or dad that’s in dentures, grandparents in dentures, brothers and sisters in dentures, and it’s almost like a foregone conclusion that you know, you’re going to lose your teeth. So, she figures, “Hey, I don’t like the way my smile looks. I might as well just go into ’em right now”.
It’s a little bit of a- of a different situation, but she’s obviously very aesthetically driven. We always want to make sure after we understand, okay, she’s here, aesthetically driven. We also want to make sure, she said she’s missed the back teeth, um, we definitely want to ask about function as well. Is she having trouble eating? Is she having trouble chewing? Um, you know, what’s important to her, as far as function, but right now, she sounds like she has quite a bit of urgency. Um, just keep in mind, this is somebody that doesn’t have a whole lot of value for keeping her natural teeth.
McKenzie: [laughs] I like that term! I’ve never heard that before. Okay, um, so you don’t want a traditional denture.
Patient: But I am open to a traditional if it would be better…
McKenzie: Okay, well, we’ll go over like, cost and kind of pros and cons.
Bart: Let’s skip forward real quick. Kinda goes through all the different options with her here.
McKenzie: This is a good guide for us. It’s- I’m just showing you examples, um, that sometimes we go off of. So do you have a picture of what your teeth used to look like that you love, or a movie star, or a brother or sister?
Patient: Oh, no.
McKenzie: Sometimes people will bring in a picture of like, “I want my teeth to look like this”, and we’re like, “okay!”
Bart: And guys she asked her, um… you know, “what do you envision your smile to look like in the future after this is done? And she responded with “Well, geez, I can’t go anywhere except up. You know, I’m, I can only go up from here”. Um when you get that, when you get that kind of a response, what’s really important to understand when they give you that kind of response is they don’t picture themselves with a- with a beautiful smile. They can’t even see that, right? They can’t even envision it. They’re like, anything is better.
That means we want to continue the whole time that we’re speaking to the patient, want to try to build confidence to say they’re going to look great. We just want to make sure that they know hey, as long as you’re a candidate, which is what we’re going to find out with the doctor, it sounds like you’re probably going to be, um no matter which option you end up going with aesthetically, you know, you’re going to be much better off. I mean, you’re going to be, you’re going to be super happy with any. You’re gonna look absolutely beautiful. Just kind of give them a little bit of confidence and people that can envision that, that really inspires them and gets them emotionally invested into it. So you don’t want to be afraid to tell them they’re going to look great.
Patient: I’m more open-minded than that.
McKenzie: Okay good. Love that [chuckle].
Patient: My siblings… they all, they all have jacked teeth too, so.
McKenzie: Ah, never mind, then. I’m sorry I said that.
Patient: I actually have the best ones out of the three [laughter].
McKenzie: Well good! Um.. so yes, everything is customizable.
Patient: Yes, cause I, I feel like with-
Patient: I mean, like in these ones, for example, I find when they’re all like the same shape and length, that’s kind of a dead giveaway that they’re fake?
McKenzie: Right. Yeah.
Patient: And being so young.
McKenzie: Not so much.
Patient: Yeah. Yeah.
McKenzie: These are just models, So yeah, absolutely, you know, some of these [inaudible] more…
Patient: You see, I do kind of like those.
Patient: Because I feel like those actually kind of match my current teeth shape?
McKenzie: Okay, okay, I’ll tell Dr. B that.
Patient: And they don’t, they don’t look like they would be huge.
Bart: Everything she’s talking about, aesthetics. Everything.
McKenzie: And, he is an expert in that. He will help you design your teeth with you. I just kinda want to show you that just so you have a little idea of different things we can do. Great. Do you have a price point for me to stick in?
Patient: I’d say, under twenty-five thousand would be nice.
McKenzie: For all of it?
Patient: Yes [laughter]
McKenzie: Okay. Great. Awesome. Okay. Well, our next step is to take that CT scan. After we do that, it takes about five to seven minutes to load. I have some patient testimonial videos if that’s okay for you to watch kind of in that meantime. Dr. B will go over all that, your scans, we’ll come in here together, tell you what you’re a candidate for, and kind of go from there, okay? You and I will discuss the finances part and all that good stuff, okay?
Patient: Now, the CT scan, is that covered by my insurance?
Meeting member: It’s free.
Bart: So when she asked, “Hey, you know, do you have a price point you want me to stick within?” It’s not a bad thing to do. But remember, the whole point, right, of the first ten is to find out where they are and where they want to be and then ask questions to allow that patient to almost treatment plan themself, right? What do you want in terms of aesthetics? What do you want in terms of function? What do you want in terms of maintenance, right?
And we can always fall back on, hey, it sounds to- I mean, it sounds to me like, you’re going to be a good candidate for a lot of different types of treatments. We have different types of treatments with different pros and cons at different price points. I’m going to go through and hit the high nails um, of some of them. What’s the difference? The fixed versus the removable versus a regular denture, and just kind of get you ready. And you can prompt and say at different price points when you go through and you do the patient education, a lot of times, they’ll stop, you and they’ll ask, “Well, how much is this? How much is that?”
Usually, if they come in asking about dentures or implant-supported dentures, um generally, they’re doing that because they already know that it’s less, but not always. So I like, for the, I like to- um to handle it that way and wait for the patient to prompt me, but this worked fine. I mean, she got a big number. She said, you know, something under twenty-five thousand um, would be great, which no problem.
So, you know from that standpoint, she sounds qualified and we’re moving forward so it wasn’t uh, it wasn’t a big deal. She gave you a straight answer really, really quickly. Um, and this person’s got a- a very talkative personality, and she kind of speaks with a lot of certainty right now in terms of what she wants and she’s ready and all of this stuff. Um, so all those, all of those things are good.
McKenzie: A limited offer right now. All implant consultations, um, including our 3D x-ray is complimentary.
McKenzie: Okay. Do you have anything removable in your mouth? Or metal?
Bart: Fast forward here, to the doctor part. She’s watching [inaudible] testimonials [inaudible].
Dr. Brittingham: How are you today?
Dr. Brittingham: What’s your shirt say?
Patient: Oh, it says “Be chill or whatever”. [crosstalk]
Dr. Brittingham: Be chill or whatever? Okay, nice.
Bart: You guys, remember, lean on the doctor before the doctor comes in. Tell them, say, hey, you know, again, our job is to make sure that you’re going to go from where you are to where you want to be. It sounds like you’re gonna be a great candidate. Next thing is to find out what you are a good candidate for and then make sure that treatment matches up with everything that you want.
So, doctor’s going to come in, talk to you, look at your uh, look at your CT scan, take a look at you and talk to you about some of the different options, and we’ll just go from there. And always lean on that so they can’t kind of nail you down on one particular treatment in the first ten. The first ten is just about emotionally connecting with the patient, creating a vision, qualifying them, and making sure that they have urgency.
Once you’ve done all that, you’re ready for the doctor to come in. And the one thing that you have to remember when the doctor- when the doctor comes in, the most important thing… and this is where you guys can help coach the doctors. One of the most important things is to make sure that they have a good pulse on what the energy of the patient is, and they can manage the energy and the urgency throughout the second ten. So, we’ll have a couple of things to point out and talk about over the course of this second ten, because it’s kind of a unique situation here.
Dr. Brittingham: I haven’t had the chance to talk to McKenzie yet so you have to catch me up with it.
Dr. Brittingham: Well, that’s okay. Just tell me what she’s [inaudible]
McKenzie: Yeah! Ms. Denver, as a teen, had some dental work that was not needed. She’s now [inaudible] has had multiple broken teeth, fills are crowded, doesn’t wear braces, doesn’t want to keep her teeth.
McKenzie: Um, she…
Dr. Brittingham: You don’t want to keep any of your teeth?
Patient: No. I want to- I want to get rid of all of them.
Dr. Brittingham: Okay. You’re pretty young to make a decision like that. How old are you?
Patient: I will be 34 in May, so…
Dr. Brittingham: Okay.
Patient: But I’m ready. I’m tired of dealing with them. I’m tired of the problems, and breaking, and getting them pulled, and the pain and…
Dr. Brittingham: So you’ve been trying to do things, it just, nothing’s working.
Patient: Yeah. I’ve been, like, trying to fix them up for like ten years now and it’s just, it’s not worth it to me in the end because I’m like, I’m not happy with them. So I’d rather just get something that I am happy with.
Bart: Okay. So now what, what Dr. Dostal said right there, it is not, is not wrong, right? Saying hey, well, you’re pretty young to make that decision, you sure you don’t want to keep any of your teeth? Surprised because she’s so young, you know, and nobody wants to just go through and extract, you know, teeth that don’t need to be extracted. Nobody wants to do that.
I think that what we want to do is be careful to make sure we come in, right? When the doctor comes in, we give it a second, and really just listen to the patient. Sometimes they’ll say something that just doesn’t sound right, but you give it a second and we want to connect with the patient right there, right? So, the patient says, “Yeah, I don’t want to keep any of them. I don’t wanna do this.” Okay, you know, explain, but tell me a little bit more, tell me why, right? What is it exactly that you don’t like about it, you know? And kind of get into it, and then no matter what they say, what’s really important is that the patient feels like we understand their point of view.
Now, sometimes their point of view is not… we wouldn’t say it’s the right decision. Let’s just say that we don’t agree with their point of view, doesn’t mean that we can’t understand their point of view, and we want to make sure that we’re building trust all the time, right? So, one of the easiest ways to build trust is to listen and then relate. You know, listen to what the patient’s saying, relate to the patient– say “Yeah, I understand. I understand exactly what you’re, what you’re saying. You know, it makes sense. I’m going to take a look at this CT. Let’s fill– let’s kind of go from there and figure it out.”
Because after you’re looking at the CT you can go through and say, “Hey, there’s a lot of these teeth that wouldn’t necessarily be hopeless”, you know. Um, and there are a couple of different ways that we can approach it but we want to make sure we’re in rapport. We get in rapport. We start to build trust. We see what they see.
And then there’s a, there’s a time and a place throughout the second ten to really, really set the expectation, um, but that was a very natural response- reaction from, uh, from Dr. Dostal, wasn’t wrong. It’s not the time in the consultation that I would have said it, like right off the gate, uh, right out of the gate uh and especially something like um, well, you’re very young to be making that decision. Well, maybe she doesn’t think she’s young to make that decision, right? Those are certain things that could be taken the wrong way, they could be.
And I like to not see anything that could be taken the wrong way, right? I mean, in the first minute of meeting somebody, it’s best, no matter what they say, how crazy it is, we just listen and try to relate, you know, before, before giving, giving our take on it, you know what I mean? That– so you can kind of gauge who it is you’re talking to, what their personality is, and it doesn’t get off on the wrong foot. Not saying it did, just saying that it could.
Dr. Brittingham: Top and bottom? We’re talking everything so… [crosstalk]
Patient: Top and bottom.
McKenzie: She wants snap-on dentures, she’s had a little bit of research on that.
Dr. Brittingham: Okay.
McKenzie: Um, questions would be like, healing time. Uh, she wants to know if she has a lot of bone loss. She quit smoking about a year, next month.
Dr. Brittingham: Congratulations.
McKenzie: Yup. She’s been going to Comfort Dental for extractions. Um, we do have a budget to work with, and then… now she’s ready to get started.
Dr. Brittingham: Okay. Well, let me just look here. So what we’re looking at, if you look in this window is the cross-section where these crosshairs are. So this is the upper right. So, not a lot of bone where you’ve had those molars removed. Just from here to here and then we’re into the sinuses.
Bart: So, right now, the- you have to assume every patient that’s coming in that needs this has- has quite a bit of anxiety. Even if they act like they don’t, we need to assume they have some type of anxiety. So, making sure that we have some type of connection with the patient is really, really important.
So what I like to see is when the doctor comes in, gets the information from the treatment coordinator- they sit down, listen to the patient, relate to the patient. I understand it. I see what you see. I understand how you feel. That’s no problem. The first thing to make sure of is that you’re going to be a good candidate for some type of procedure. First thing is that.
I understand what you’re talking about- about aesthetics, I understand you’re talking about where you’ve had some previous experiences that haven’t been good. You’re over it. You’re fed up.
I’ve heard that before and I totally get it, and we’re going to be able to help you in one way, shape, or form, okay?
There may be two or three different options that you’re a candidate from. My goal is just to figure out what’s going to be the best fit and what’s going to be clinically the best thing for you. And then I would get, the-then you can kind of get in to, um, you can get into the CT. But you want to make sure that- I want- you always want the patient to feel comfortable that the doctor feels like they’re doing the right thing, you know what I mean? That you always want the patient to feel, to feel comfortable there. Number one, and number two, we want the doctor to do as good of a job as they can at creating urgency in the fact that the patient needs to do something, right?
So, there is a situation going on, you are missing a lot of teeth. There are issues here that are concerning that need to be addressed. Want to make sure that we continue to address urgency even if they end up doing a, you know, um moving forward, the treatment plan that includes two or three implants, you know, and then, that’s a combination of restorative treatment, or perio, or ortho, or whatever the treatment plan ends up being. Want to make sure they have urgency to do something so it doesn’t become a take-it-or-leave-it, which is really important when it’s a borderline case that may, that could or could not be an all on four.
Dr. Brittingham: Quite 8 millimeters of bone there…
Bart: Fast forward.
Dr. Brittingham: We’re doing the locators, which that dozen of gold pieces screw into the implants.
Dr. Brittingham: Okay, so you’re a good candidate for implants. Um, the on, four in the on. So you- generally we do four of those implants on the top. It gives the pro- a prosthesis that we can take in or take out. And once it’s healed, we can take away the palate up in here too. But it is-
Bart: Now we’re going into, now we’re going into treatment options, right? So a good thing to ask you, after you say, “Hey, I think you’re going to be a good candidate. Looks like you’re a good candidate for implants, got plenty of bone. There’re some areas that are obviously concerning. We have to address them in all ways, shapes, or forms, or this is just going to continue to get worse and worse. So it’s a good thing that you’re here, but it looks to me like you’re going to be a really good candidate for implants”. So that’s a good thing.
Now when it comes to implants, we have a couple of different ways that we can address this, okay? And it all depends on what your preferences are. So let me ask you in terms of aesthetics, on a scale of one to ten, how important is it? In terms of function, on a scale of one to ten, how important is it? The scale of maintenance, one to ten, how important is it?
Ask those questions. I like the patient to try to almost sell themself, right? The more the patient is talking about what they want, the closer to a close that you’re getting. The more we’re talking, and quote-unquote, educating the patient, the more we’re selling almost, right? So we’re talking about this procedure in this product versus this procedure in this product. I just like the patient to try to self-select, and then I can just match it up and we can kind of go from there, but it can be a little bit more interactive. Sometimes, if we don’t know, if we don’t have any questions to ask, um, you can run in a situation where we find ourselves talking for four, five minutes straight, you know um, without allowing any areas of interjection, um, or any type of elaboration from the patient, um which, which isn’t ideal. We want to try to make it as- as interactive as possible here.
Dr. Brittingham: Movable prosthesis, um, it goes on.
Patient: Hopefully this happened a little bit there. [laughter]
Dr. Brittingham: [inaudible] This is more how we make them with what’s called locators. This is a little different system. We need to get a better model cause this isn’t really what we’re doing anymore. We’re doing the locators, which that- those little gold pieces screw into the implants, and this is an example of a lower on. This is almost exactly how we would do it in your mouth. It goes in. It clips in. It holds it in. When you just have two, you’re going to still have a little bit of movement with the implant. Even with four, you’re going to have a little bit of movement with the denture, but with two, you know, it creates a rotation point.
So, but, the lower denture…
Dr. Brittingham: To finish, but from the time we take your impressions, it’s two weeks before we can schedule the surgery. Then the surgery, all your teeth come out. Implants go in. You leave with your new smile on the top and the bottom. You’re going to heal for about three months. At that point, we start making final teeth, which generally takes us a couple of visits in about a month and a month and a half. So start to finish, it’s roughly about six months, okay? You have teeth the whole time, your new smile’s there the whole time, you’re just- you’re not going to love the healing period because the- you just have the traditional dentures.
Patient: Oh, I’m quite familiar. [laughs]
Dr. Brittingham: But it may be better than what you’ve been dealing with now. Just because you should be out of pain, and your teeth, they’ll be in better shape.
Patient: Yeah. Because as you can see, I had a problem with one of the back ones at a root canal, but there is like a constant infection underneath and it’s great, I can’t feel it but I…
Dr. Brittingham: But it’s still here on…
Patient: It seems dangerous to have uh, an infection for years and years and years that you just can’t get rid of. And I think with the shoddy dental work that was done- like something wasn’t done right or something was left or… And then like these teeth, they did root canals, never even finished them. So, it’s just a filling or cement or whatever they put in there.
Dr. Dostal: I’m sure. Well, um, I don’t see any infection in these existing teeth with the exception of these two, I can see infection on both of those teeth that have had the root canals.
Patient: Which seems so weird.
Dr. Brittingham: Yeah, it seems like that should be the opposite, but that’s what we’re seeing is we kind of scroll through this… See how that up in there, the end of the root, the back one, because-
Too, so, you’re going to see yourself a lot differently.
You don’t just think, oh, they need to come out. Based on what I’m seeing here, there’s not a lot of infection around these teeth, on the ones that are left. And being as young as you are, it’s a pretty aggressive move to do what you’re talking about doing. So, I understand what you’re saying. I just want to make sure you’ve thought it all through because…
Patient: I was trying to do this at twenty. So, I’ve had time to think.
Dr. Brittingham: But the day after the teeth are all out versus today is a different day. Especially for my female clients. I mean, it could be quite a psychological thing too, so, you’re going to see yourself a lot different when you don’t have teeth in there than you do now, even though you don’t like your teeth cause I just wanna make sure…
Patient: I’m halfway toothless, anyways.
Dr. Brittingham: In the back, but your front teeth are there, and so I just want to make sure that you really thought that all through, you know we have some consent forms and stuff for you to sign. Because, you know, but you’re in that situation where it’s hard because there’s not a lot of room to do stuff in the back and the front teeth are…
Bart: Okay. So, we’re in a situation, right? So, if I’m the treatment coordinator in the room, I’m getting a little worried at this point because we’re putting a lot of doubt in the patient’s mind.
I don’t think the doctor’s doing anything wrong here. I think that how we can, how it can be frank- because he’s telling her the truth. She might not have thought this whole thing through, right? She not, she may very well not understand the gravity of what it is that she’s asking for.
But that’s why it’s really important for us to understand what the patient is saying, right? So if her number one concern is aesthetics, and she doesn’t like the way her teeth look, and she’s already missing her back teeth, okay? From a treatment point- planning point of view, a good question might be listen, if I could get you, if I could improve your aesthetics, right, substantially, and also, fix the problem of not having your back teeth. If I could do that without extracting, all of your teeth, is that something that you would be interested in? Right?
Because listen, if the whole goal is to get you to the point where you have a beautiful smile, there’s a couple of different ways that I can do it. There might be a way that I can do it without having to extract all of your teeth. There may be a way that I can, and there’s definitely I can do it where we do extract all of your teeth, but there’s a couple of different options. Would you be open to that?
You know- and ask her, and sometimes what it boils down to for a lot of people, and I’ve had this discussion with several doctors, is the patients, they kind of do the math. Like, hey, my teeth are messed up and they look horrible. So for me to get the restorative work done or the cosmetic work done, the price point’s going to be up around the same ballpark, right?
Once you, once you take into account all of the crowns and veneers, the ortho, everything that needs to be done money-wise. If it’s all gonna be in the same ballpark, sometimes their- their point of view is hey, just go, you know what I mean? Just go. Just go and extract them all, which, but with that logic, it makes sense, but there’re other cases where patients have come in and their teeth were super healthy and they just didn’t like them because, because they weren’t straight or something and they’re coming in asking about an all-on-four, right?
Which is crazy. But if I’m the doctor, I want to try, I don’t want to sound like- or the treatment coordinator, right? Anybody. I don’t want to sound like they’re asking for something that’s not good for ’em, right? What they’re asking for and what they’re, what they’re saying is, they want a better-looking smile and they don’t have it right now, right? So there’re a couple of different ways that I can do it. Does it matter so much to you how we do it, as long as I’m accomplishing the goal, right? Of giving you a smile that’s more healthy, that’s more stable and that looks great, you know? Because that’s really what they’re asking for. They might only be asking for the treatment. Maybe they got bad information from somebody, maybe you have a family member that’s told them to go do it. Who knows, right?
But at the end of the day, most of the time, what they’re after is a result, not a specific product. Did that make sense? Um, and with cases like this, if they’re fixated on a product- when we’re kind of setting the expectation and none of this is wrong, you can say all of this. We would just want to say it while we’re maintaining their level of enthusiasm if we can. And I don’t want to put so much doubt in their mind that now they’re questioning everything. I want there to be no doubt that I can help this person get the aesthetic look that they’re, that they’re trying to achieve. That’s a- I want there to be no doubt that I can do that, but I can do that, several different ways. I might be able to do it. If I can do it without extracting all the teeth, is that something you would be interested in? Or are you dead set on just extracting all of the teeth? Because I think that there’s a, there’s a good play for both and there’s pros and cons to both. That would kind of be how I would, I would like to position it um so that it doesn’t cast doubt that they’re, they’re doing the wrong thing. That make sense?
Because what she’s really saying is, I don’t like my smile, I want a better smile. And what she’s asking for is a snap-in denture to achieve it, but she doesn’t know what she’s talking about in all of these different areas. So, we all just keep in mind, what are they really asking for?
Sometimes, they’re really asking for teeth that feel more natural, than their ability to eat, chew, and speak. Sometimes they’re asking for an aesthetic look. And sometimes from a clinical standpoint, there’s got to be different ways that you can, that you can achieve the goal. So, I like to anchor everything on the clinical outcome, okay?
If it’s somebody young asking about something that you’re like, jeez man, I wouldn’t do this. I wouldn’t recommend my kid or my friends or anything to start extracting all these teeth. There’s a better way to do it. Then I’d ask the question, “Hey, I understand what tried- what type of look that you’re going for here, what you want your smile to look like. I think that there’re probably a couple of different ways that I can achieve that for you. If there’s a way that I could achieve that without extracting the teeth and still give you a beautiful-looking smile, but preserve some of your natural teeth in the process, is that something that you would be interested in, given that I can get you that result?” And I would ask that question, you know? So that where- we don’t create a situation where we’re opposed to the patient in terms of mentality. We don’t want them thinking they’re doing something wrong by being there, or that they’re asking something wrong by being there, not that she feels like that, but you don’t always know what they’re feeling, guys, and it’s tough with the mask, too. It’s really tough to read the situation.
Dr. Brittingham: Not to the point where they have to come out but there’s, you’ve lost enough that makes it hard to kind of piece things.
Patient: Right? Yeah. I just feel like with my age, I’m too old for braces. I don’t want to fuck with braces. I just feel like to me, they’re not worth saving because of just how they look. I’m, I’m tired of just being unhappy with it.
Dr. Brittingham: Okay. Well, we can help you, but it’s going to be a pretty, um, pretty big step for you.
Patient: And expensive.
Dr. Brittingham: And one we can’t necessarily go backward on, once we start down that process. So again, just making sure you really thought that through. We can put our implants in now. Let me just give you a little food for thought. I think you know, a fixed arch is something you’re going to like more than what you’re choosing to do. These are more expensive, but the way we’re going to put our implants in…
Bart: So now we’re going to the fixed arch thing? Um, if we ask the questions, hey, how important is aesthetics, use scale one to 10, she said 10. How important is the functioning scale, one to 10, she said 10. How important maintenance is? Is it- do you want something high-maintenance or low maintenance? She says, low maintenance. Okay, scale one to 10, 10. It becomes really easy to segue into talking about full arch fix because she came in, her budget for both arches is 25, so she’s like, right in the ballpark of snap-ins, and she’s asking specifically about snap-ins. Um, so, what if she said, thus far to make us believe that a fix is going to be a better option? Now the doctor knows that most people are a lot more happy with the fix, right? Dr. Brittingham knows that just from the experience of doing this, so he’s trying to do everything that’s right for the patient.
But remember, this is psychology. This is how it’s going to be perceived. Right and wrong, it’s important. But what’s really important is how they’re perceiving it because we can be doing the right thing and it can be perceived, um it can be perceived differently in a lot of, in a lot of instances, right? So if she tells me ten, ten, ten, it’s really important, it’s the most important thing. And I say, listen, based on what you tell me, what’s most important? Doing something aesthetically, it’s going to be that’s going to look the most natural and the most beautiful. You want something that’s going to feel like natural teeth and be as stable as possible so that you can eat, you retain maximum function, right? And you want something that’s going to be low maintenance. Now I have something that’s gonna give you all three of those things, but to give you all three of those things, on a level of a ten in each area, you’re not looking at a snap-in anymore. You’re looking at something that’s more fixed. Let me show you because I think this is going to give you everything that you’ve told me that you wanted, this is going to better represent those things.
Always anchor it back on it was their idea. Not my idea. If it’s my idea, all these things are my idea, it’s going to feel like we’re selling. That’s just the way that it’s going to feel because we’re bringing something up unprompted at that point. And the whole purpose of selling it in the manner that I’m teaching you guys to sell in is that it doesn’t feel like they’re being sold.
They don’t feel like they’re being presented with anything, they just feel like they told us where they are, they explained and articulated where they want to be. And we are determining if they’re a candidate, and if they are, which option is going to best get them from point A to point Z, right? And that’s all we’re doing. So everything is uhm, everything is very, very natural. That’s why I always make sure if we’re going to offer something, ask them and try to get their answer first, so that it, so that it makes sense.
You’ll have it at times, guys, where you’ll ask these questions and you go “Function?” “Um, you know, I don’t know. I don’t have a whole lot of function right now. Any function is going to be way better. So, I don’t know, say like a three”. You know, “What a- what about aesthetics?” “Well, I don’t know. Any aesthetics are going to be better than what I have right now. I look like crap. So I don’t know, a three?” “What about maintenance?” “Yeah, I don’t care. I don’t give a shit. I don’t take care of my teeth anyways, so I don’t know. High, low, whatever.”
Sometimes, people that don’t have any value for their teeth, they can kind of give you those answers as well. And nine times out of ten when they give you answers like that, it’s gonna be a really, really tough sell to put them in for a large fix. Because nine times out of ten, they look at even the regular denture as better than where they are. And since they haven’t had any value for the teeth at this point, they’re not going to want to spend the money most of the time. So people with no value for their teeth, we have to do a really, really good job at helping build the value, and then, creating the emotion, getting them to picture themselves with the teeth so they’re emotionally invested in it, and then they get excited about paying the money. It’s really, really important.
Dr. Brittingham: Replacement things. There’d be ones that if you ever wanted to upgrade to something like that, down the road, you could. We’re just going to break your expenses up a little bit, get the teeth out, get you the smile you want, and the over dentures, but the fixed arches is more, probably, what you’re going to be the happiest with, not just cause it’s more expensive- because it can be the most like your teeth because those don’t come out, those are what are called the fixed prosthesis.
They’re more streamlined. They don’t have nearly as many, you know, have no movement, and it’s going to be the most like your teeth because we can make our bridge, you know, only as big as we need to get it fitting right. It doesn’t need all this extra acrylic and stuff for retention. So, this is more expensive than what you’re asking for, for sure, but again, at your age, I think, especially on that lower one, something like this you may really appreciate because it’s not going to have any movement at all, and it doesn’t come in and out of your mouth, like for social situations and stuff.
Patient: But do they actually, like, have the screws in there like that or?
Dr. Brittingham: Say that again?
Patient: Are like, are, is it somehow it would actually look when it’s all said and done? The screws…
Bart: Guys, I had a question come in real quick, but I just want to address it because it’s relevant right now. It said…
Meeting member 2: What if the right thing to do is a full mouth re-construction and that’s going to be…
Bart: Yeah. What if the right thing to do is save the teeth into a full mouth reconstruction, and that’s going to be about 25k versus doing, you know, an all-on-four at 25k. What do you do? And um, the patient has a right to choose what it is that they want.
We have to make sure it’s informed consent, right? It’s informed consent on our part to know that they have options, but that’s exactly why I would ask the patient and say hey listen, right? It’s not the patient’s job to guide us in what to do. It’s the patient’s job to describe the clinical outcome that they’re trying to achieve, that’s their job. Their job is not to say, this is how you should, this is how- this is the treatment that you should provide me to give me that result. Sometimes they will say that and that’s okay, but that’s not their job.
Their job is to tell me what result. And then I’m going to tell them what are the most efficient ways and the best ways to achieve that result for the patient, and sometimes they can achieve the results by extracting all the teeth and doing an all-on-four. And they can also achieve the result by doing more of a full mouth reconstruction, um or a complex restorative type of a case.
Either way, that’s exactly why’d I ask the question- if I could achieve the clinical outcome that you’re looking for. If I could do that while maintaining some of your healthy teeth, is that something that you would be interested in? I mean, and the teeth will be as beautiful as they will be with an all-on-four. If all things are equal, I can get you the same look, would you be open to saving… would you be open to keeping some of your natural teeth? Right?
If yes, and then you can give them– then you can start to talk to them um, about some of the pros and cons and ask them more questions to see- to see what the best treatment would be. Um but it’s difficult- I have a difficult time telling a patient, “Hey do this. Don’t do that or you’re wrong here. You’re wrong there.” At the end of the day, we have to let them make their- make the decisions in terms of what it is that they want.
They just have to understand that- what the consequences are and that we can, hey, there’s a lot of instances where we can get that outcome without extracting all these teeth, right? In my opinion, if you, if you can keep your natural teeth for as long as you can, and we can turn this hygiene, hygiene problem around to stop the progression of losing teeth, you still have your front teeth. There are things that we can do to make them look a lot better. And there’re things we can do with implants. We can give them a function in the back. [inaudible] Does that make sense guys? So- and that’s a conversation that the doctors can have. Always just anchor on what type of clinical outcome they’re going for. Um and uh, if we stick with that, you’re going to be in really good shape there.
Patient: Still in there?
Dr. Brittingham: We cover those up, though.
Patient: Oh okay.
Bart: Fast forward.
Dr. Brittingham: More secure, you’re still…
Dr. Brittingham: It’s kind of undulating right now.
Patient: I- just yes, I’d like to change everything.
Dr. Brittingham: We probably would suggest you do this with a little sedation. So…
Patient: Oh, is it possible to just knock me out?
Dr. Brittingham: It is, we just have to work through a nurse anesthetist and bring them in. You have some extra expenses for that.
Patient: That’s fine.
Dr. Brittingham: …[inaudible] we use– we also can do oral sedation, which we do that you know, pretty routinely, two to do these. Oral sedation, you’re not completely out, but…
Patient: Oh no. I-I-I need to be out for all of it, especially the front.
Dr. Brittingham: Okay. So we’re working with some new people right now, and we’re not currently up and running on the IV sedation thing, but it is going to be online pretty quick I think, so. It sounds like [inaudible]
Bart: That can be a deal-breaker for people.
Patient: Okay. [inaudible] okay.
Dr. Brittingham: [inaudible] Which is fine.
Patient: Which I’m not, like, trying to do this tomorrow either. So that’s fine.
Dr. Brittingham: Yeah. No, we’re getting prepared. I think probably within the next month we should have everything where we want it anyway, so I get…
Dr. Brittingham: [inaudible] Which is fine.
Patient: Which I’m not, like, trying to do this tomorrow either. So that’s fine.
Dr. Brittingham: Yeah. No, we’re getting prepared. I think probably within the next month we should have everything where we want it anyway, um so I get some time to get everything organized and figure out what we’re doing.
Dr. Brittingham: Okay?
McKenzie: Yeah, we definitely do like your smile design appointment, though.
Dr. Brittingham: Whenever you’re ready. Nice to meet you. [crosstalk] Alright, I’m going to keep going. If you have questions, come grab me.
Patient: Nice to meet you. Okay.
McKenzie: Alright. So, I’m excited for you. Also that you’re a good candidate.
Bart: Okay, so. Now, as ah- as a treatment coordinator, if I’m standing in the room, what are you guys thinking right now, like what needs to happen? Are you guys worried right now, or what? In terms of this: somebody- somebody kind of chime in, and tell me what would you be thinking you need, that you need to do right off the bat hereafter that second ten where she is right now.
Meeting member 3: I would be very worried. That’s just me. One, because she said she’s not looking to do this right now.
Meeting member 3: That was the key right there, that kind of hinted me, and as the treatment plan coordinator, I would have to try to get her back into trying to make this a main priority to get this started as soon as possible.
Bart: Yeah. And because the conversation was a heavy conversation, right? He really set the expectation, you know. He gave it to her straight, but it’s heavy. You know what I mean? It is. So, the energy’s like, we didn’t create certainty there, right? So, we didn’t create certainty. What we did is we created, we did the opposite, right, of creating certainty. She’s probably second-guessing it right now. Okay? Based on everything that, that was, that he was saying, she’s probably second-guessing it. And then the final whammy is like, the IV sedation that yeah, we can get somebody, but we’re not there yet, so we can’t do it now. That’s like, oh, then you’re like, oh God.
Right now you’re like, hey we got work to do right now. So what you’re thinking is I’ve got to get the emotion back up, I’ve gotta create the urgency again, I’ve got to get her excited. I got to get her excited, I gotta simplify this whole thing, right, to where it’s okay, you know? Because there’s going to be a lot of doubt probably in her mind about, “Hmm, I thought this was like pretty straightforward. I thought this was the right thing to do,” but she may be thinking now that maybe this isn’t the right thing to do and we don’t really have a backup plan here.
Anybody else? Anybody else? [inaudible] I do. Let me see. Hold on one second. I can’t, let’s see. Mm-hmm, mm-hmm. Yep, yep, yep. Mm-hmm. Mm-hmm. Mm-hmm. Mm-hmm. Yeah. Yeah. Yeah. To your point, it is, is it wrong to point out the restorative route, especially in this patient’s case in a sense of putting band-aids on what’s going on, when you can be very well back ten, fifteen years down the road and having to do an overdenture all-on-four eventually, anyways. No, it’s not wrong to point it out. It’s just, we’re giving the patient the option there, you know what I mean? I mean some doctors feel that it’s wrong to not point out the fact that they can achieve the result without extracting the teeth. They feel it’s wrong to extract teeth that would be clinically deemed healthy that are in amount. They feel that’s wrong.
So, as-as long as they understand, “Hey, this is the clinical [inaudible] we’re going for. If I could do that with saving your teeth, is that something you’d be interested in?” Now, there’re pros and cons to both, right? The pro is obviously that you’re going to have similar teeth remaining, some of your natural healthy teeth, but you’re still going to have the same maintenance if you don’t take care of them, you know what I mean? You’re going to continue to lose teeth. If you continue to stand on the same path, you’re going to continue to lose teeth. The good thing is you’ve stopped smoking, you’re doing some things the right way. Um, how important is it to you to retain your natural teeth?
And just to give them that, if they say, “Listen, I don’t want them.” And sometimes, they’ve already done the math and they’re like, “Look, why am I going to spend fifteen-, twenty- twenty-five thousand dollars to get all this done? And then in ten years, I need the implants anyways. Now on I’ll double.” Sometimes they’ve already done it, and that’s kind of why they’re asking for it right now. Um so, no, it’s not right or wrong. It’s not a wrong thing to do, to point it out. I think it’s a good thing to do,
um but we understand- you’ve got to listen to the patient, give them their options, and, and shoot ’em straight without losing all of the energy, and without making them think that they’re doing something wrong. I don’t want them to think, they’re making a bad decision, right? I’m like, well, I’m just, just want to make sure you think it through.
Because how we say it, how that said, says that- I don’t think that’s right, right? And if the doctor doesn’t think it’s right, how are they going to have any confidence in actually doing it, you know what I mean? Uhm, so that’s it. That’s it. That’s a tough one. Um, same[?], let’s see that [inaudible] talk about her treatment.
Yeah, I mean, look. I’ve seen this happen, you know, we’re just getting some, some different comments and different questions here about it about man, you know, I would be a little worried about it, about– sound like almost talking her out of it. Um, and I don’t– the doctor’s not trying to talk her out of it, you know? I think what Dr. Brittingham is doing is just making sure that she knows what she’s getting into. What he doesn’t want to have to happen is somebody come in, that hasn’t asked a lot of questions, hasn’t done a lot of research, ends up getting all their teeth extracted, and then regrets it, right? And then feels like, oh, geez, I went to this place, they extracted all my teeth. I didn’t know that I could have saved them. I didn’t know this. I didn’t know that. I wish I would have never done it. He’s trying to prevent that from happening, which is a good thing. So all of the intentions here is absolutely correct.
Now, from a sales standpoint, right from getting this deal closed, you guys know as well as I do, right? Our ability to close it directly relates on the degree of certainty and excitement that the patient has in regards to what it is we’re getting ready to pitch. So, the second that you sit down, especially when the patient is, well, I’m not looking to do it tomorrow. I know that’s bad. That’s, that’s a bad sign. So, now I have to create some urgency and figure out a way to get the patient excited and get them to open up. Uh, get that, get this patient to open up a little bit. So, I’m going to keep going, I don’t want to run out of time here because there’s a lot of good things that, that happened right here with McKenzie at the [inaudible]
McKenzie: Let’s move all this out of the way… Dr. Brittingham is great so I think you’re gonna really love him. Um so for that upper snap-on denture, lower snap-on denture, the bone grafting, and then the alveoloplasty. We’re looking at twenty thousand four…
Bart: Just one other comment. Um, for the doctors on the call, and the treatment coordinators, if you get in a conversation that gets heavy, like that, um you gotta spend like the last minute or two minutes before you hand it back to the treatment coordinator getting the patient excited and showing that you’re excited.
No matter what is discussed at the end of that second ten, there’s a primary recommendation, right? That’s being made. Alright, this is what we’re going to go with. This is what I would recommend based on everything that you’re saying that you wanted, right? You said if I could give you the same outcome. No, you’re not interested in keeping your teeth because you don’t want to be in a situation where you pay all the money to keep them and then you end up losing them anyway. Totally understand it.
So, what I would recommend given all those things is, this, boom, boom, whatever it is, right? Now, based on your x-ray and everything, everything looks perfect and you’re going to be a perfect candidate. Let me see your smile real quick? Smile for me. Yeah. You know, I think you’re going to look amazing. You have to build them up a little bit. After you break, you break a patie- it’s kind of like the uh build-break-build strategy that you use with people, you build them up and then you kind of set the expectation and then you build them back up, but we want to try to build them up to where that patient feels like you, as the doctor, are excited about whatever it is.
No matter what takes transpires in this conversation, we should leave with an agreement that this treatment is going to best provide you with everything that you’re telling me that you want. And the patient needs to agree that- that’s the case. “Yep. I agree. Okay, cool. Well, given that if you’re going to be a great candidate, the first steps of smile design, I think you’re going to look amazing. Even after the first day, you’re going to look unbelievable. We’re going to take care of you and I’m pretty excited about the treatment. I think you’re getting unbelievable results unbeli– I can’t wait for you to see it. Right?”.
Something, you gotta change the energy level somehow and treatment coordinators, if that doesn’t happen, the energy level doesn’t change, you know what you have to do before you present the price, right? You cannot present a price for something that they don’t want and they’re not excited about. You got to get them back to that point.
McKenzie: A discount of two thousand.
Bart: Woah. Hold on.
Patient: Tomorrow either so that’s fine.
Dr. Brittingham: Yeah no, we’re getting prepared. I think probably within the next month we should have everything where we want it anyway, um so I get us some time to get everything organized and figure out what we’re doing.
Dr. Brittingham: Okay?
McKenzie: Yeah, we’ll definitely do like your smile design appointment, though.
Dr. Brittingham: Whenever you’re ready. Nice to meet you. [crosstalk] Alright, I’m going to keep going. If you have questions, come grab me.
Patient: Nice meeting you. Okay.
McKenzie: Alright! So I’m excited for you. Also that you’re a good candidate. Let’s move all this out of the way… Dr. Brittingham is great. So I think you’re gonna really love him. Um, so for that…
Bart: Okay, Mckenzie right there, you liked it at all, but she didn’t say anything, right? Some say, “So exciting. Awesome. You’re a candidate, how do you feel? Are you excited?” You have to get them talking, right? “How do you feel about Dr. Brittingham?” Yeah, you got, you gotta get her, you gotta get her talking, right? The more she says, the more you’re going to know. You say, “Hey, are you excited? You’re a candidate? That’s awesome. You’re gonna look so good when you get this done!” And she’s like, “Yeah, boy, I gotta tell you. I don’t know.” You know what I mean, that there’s no reason even going through pricing. There’s absolutely no reason to even get into it.
If that’s the kind of response that you get, you know, you’ve got, you’re going to have more work to do. Like in this situation, you got work to do before you get into the price because right now, you don’t know what’s inside of her head. She wasn’t super vocal with the doctor. She wasn’t doing a whole lot of talking there, and the conversation got heavy. So, you need to get her to open up. She’ll say things to you that no way she’s going to say to the doctor. No way.
McKenzie: For upper snap-on denture, lower snap-on denture, bone grafting, and then the alveoloplasty. We’re looking at twenty-eight thousand, four hundred, a discount of two thousand um, from interest. So that’s great. Brings you down to twenty-six four, I know you said your budget was twenty-five. Um, if you paid in full with cash or check, we could knock off the five percent discount that’s paid upfront before treatment starts and that brings you down to twenty-five thousand eighty. I did mention, we have those lending companies too, it takes about five minutes to apply them to do it in-house- if that’s something you’re interested in looking at, too.
McKenzie: Do you have any questions for me?
Patient: Um, no, who do you, well, I guess who do you guys go through?
McKenzie: For the lending? That’s a good question. We have Proceed Finance, think of them as kind of like…
Bart: Alright, you guys noticed her demeanor right now? What are her body language and her tone screaming right now? What’s she saying?
She kind of lost that tone of certainty, right?
Meeting member: Yeah, like she’s uncomfortable now.
Bart: Yep. You can tell there are a million things going on in her head right now, right? When people are uncertain and then they look at the price with, with uncertainty? Now, now it’s like triple the anxiety because now they’re not even sure if it’s the right thing. Even if they want it, they don’t even know if it’s the right thing to do, and it’s a lot of money for them. So then their brain starts going in overtime about “Oh, buddy, hey, hold on here, hold on here. Don’t do this yet. Don’t do this yet. Don’t do this yet,” and she’s conflicted now. We’re at the, in the first ten, she told you, hey, I want this I’ve been doing this twenty-five thousand dollars or less. She said, twenty-five grand like that, but she didn’t hesitate when she was asked about that budget.
But- but watch how her demeanor now has changed. And that’s why it’s so important guys. That’s why I have the treatment coordinator with the patient first, and that’s why the treatment coordinator with the patient, the whole time, right? Because I want you guys to connect with the patient. There’re certain things they’re not going to ask the doctor when the doctor leaves the room, you’ve got to open them back up and make sure before we present it that they say, “I”m super excited”, “It’s awesome”, “I can’t wait, oh my gosh, it’s going to be great” blah, blah, blah like they need to be a ten in terms of certainty, and you want them to be as excited as possible, and then I’m going to present the bundle, right? And then I’m going to close, and it’s going to be an assumptive close and it’s all good. But if they, you can just tell she’s different now.
McKenzie: At Car Loan, they extend their payments to very affordable, low monthly payments. And then we have Care Credit and um The Lending Club. They are zero percent interest rate if you’re approved for that for six to 12 months, so it’s a little higher monthly payment, I’m not sure what you’re comfortable with. You- there’s no penalty for paying either of them off in your, like timeframe, so.
Patient: So, but then this will be [crosstalk]
McKenzie: Those are fake numbers.
Patient: Oh! I was like, my monthly payments are two grand?
McKenzie: Those are fake numbers. [laughs]
Patient: Okay. What, like, what, could you give me an idea as far as what the monthly…
McKenzie: Yeah! We can get pre-approved. It’s…it’s credit inquiry, all you need is your driver’s license, and we can do it right now if you’d like, give you an idea of what to expect.
McKenzie: It won’t affect your credit. It just takes five minutes, so.
Patient: Oh… yeah, I’m just like, making sure internally, this is something I’m actually wanting to do, rather than… it sounded like a great idea at two in the morning. Is this really something I’m going to do?
McKenzie: Well, it sounds like you’ve been thinking about it for a long time.
Patient: About ten years.
Bart: You see, she’s not worried about the financing right now, right? You know what I mean? Her brain, she’s going, “Oh my God. Am I doing the right thing? Am I doing the right thing? Am I doing the right thing?” So this whole thing’s got to be resold, you know what I mean? So this is not going to be done. This, this close is not going to be a ten-minute close, it’s gonna take you at least ten minutes to fifteen minutes just to get her back to the point where she feels confident that she’s making a good decision.
Right now, she doesn’t know if she’s making a good decision. So the money is completely irrelevant. Like, she doesn’t even want to look and see what the payments would be, and these are all actions of- of somebody that doesn’t want what it is that we’re selling anymore. If they want it, they have no problem. “Hey, let’s look at the payments or any payments”, or “No, don’t worry about it, I have cash. I can get a check”, or whatever. Their responses are completely different.
If you feel like, sometimes in the second ten that you’re losing all of the energy guys, it’s not even that bad. It’s not even out of place to jump in if you feel like you need to in certain areas and just build that emotion a little bit, you know what I mean? When certain areas are like, “Hey, look, I had a patient just like that. The first set, the first time you see your smile. I’m telling you, you’re going to love it. You’re going to love it.” And you’re just trying to like, you know what I mean, keep some semblance of- of confidence there with the patient because the conversation just got kind of serious and a little bit heavy. But I mean, she just said she’s like, well, it sounded like a good idea at the time. Now, I’m not sure if this is just even something that I even want anymore. You know what I mean? And when they say that, you have to immediately anchor back on what they’re trying to achieve.
Say, well, listen, there’s no doubt, I mean in terms of what you want, correct me if I’m wrong, what we want is we want to get rid of our problems, right? We wanna get rid of our dental problems. You want to feel good and you want to look good. You have good teeth and you just want to get rid of the pain, the discomfort, and all the problems, right? That- that’s, at the end of the day, that’s what we’re trying to do here. Right? You just like got to start getting a yes out of her. Yes, start getting her back to the point where she was in the first ten.
So this is a situation where you’ve got work. Where I wouldn’t even have pulled out the sheet to close because you can’t close, you know, you’re just it’s never, it’s never going to happen. You’re just going to get further and further and further away from the close and we’re going to lose her. She’s going to go somewhere else. And we’re going to lose her to a second opinion. Somebody’s gonna get, somebody’s gonna get her. Um.
McKenzie: Up to you.
Patient: So [inaudible] because I’m also [inaudible] to buy a car, and this is like, way more than what I’m even spending on the car.
Bart: You see what happens right there? It’s twenty-five grand, basically, it’s the budget that she gave without batting an eye in the first ten and now her brain’s looking at twenty-five grand totally different. Now, her brain’s going, “Well, geez, that’s like a car. I thought it’s less, this that, and the other.” That’s the difference. She came in knowing for certain she wanted uh an implant-supported denture and she wanted it for 25 grand or less with full certainty. Now, she doesn’t know what she wants or what she should do. So, the money, that all of a sudden $25,000 that there’s no certainty as it pertains to that as well. Okay, so, a couple of big takeaways here: I think McKenzie did a really, really good job in the first ten. Did a really good job. We just want to, we want to set the expectation and make sure that we ask questions to the patient. Get that patient to tell you how important function is, aesthetics are, maintenance, get them to verbalize those things. Instead of me telling them, “Hey if you really want a high level of aesthetics, this is what you should do”. No, I want- you to tell me how important aesthetics is and then I’ll, and then I’ll go back to this, right?
When the doctor gets in, just some feedback for the doctor, don’t rush right into that CT. Make eye contact with the patient. I don’t care what the patient says. In the first minute, we just listen and we understand. It could be totally wrong, you might disagree with the whole thing. It doesn’t matter at all. You got to listen. Yeah, I understand. We have to really try not to fall out of rapport and get in a situation where you know, we lose all of the energy and, and not saying you lose trust because I don’t think that, that Dr. Brittingham lost trust, it’s just that she wasn’t expecting that, right? So she got the information she wasn’t expecting to get in a manner that she wasn’t expecting. Um, and we had somebody that was, that had a good budget, twenty-five grand. Knew what she wanted, came in and not, and we didn’t end up, we didn’t end up closing.
So guys, if you ever see this situation happen, you’re the treatment coordinator, you’re in the whole time. You can feel the energy changing, going up and down and you can feel it when they’ve got a weird vibe. When that happens, you go into the third ten and, you know, this ain’t ten minutes. This is not ten minutes. You’ve got some work, and that’s what separates the best treatment coordinators, right, from the average ones, you know?
It’s easy, if the doctor comes in, knocks it out of the park and they’re ready to go, and they end up and they’re super excited when you start, well, yeah, you should close it, but it’s the times where maybe the doctor wasn’t in the best rapport, maybe the doctor didn’t connect the best and the treatment coordinator can still get that patient to a point where they’re super confident in the doctor, uh th- they have a high degree of certainty in terms of the-the treatment and they’re ready to go.
So you can absolutely with this person turn it back around. And this person doesn’t really hide a whole lot. You can read it all over her face what she’s thinking, right? If she’s excited, if she’s worried, if she’s stressed out, that, even with the mask, she’s super easy to read. So, you just know that it’s going to take you a little bit longer. So, you’ve got some work, don’t bother presenting the price in the bundle for somebody that doesn’t want it. If you ask them, “How do you feel?” and it’s not a ten out of ten in terms of certainty, then you got work to do there.
I want to open it up for questions before I let you go. This was kind of a long one, but there was just so much good information and good topics to discuss here as a team um that I didn’t, I didn’t want to rush through it, but I want to give you guys a second and, and open it up for, for questions if you guys have any. Does anybody have any questions?
Bart: What, cat got your tongue or what? Are you good? If there’re no questions, I’ll let you guys go. But there’s a, there’s a lot to- to consume on this one, right? There’s a lot to consume. Just remember, hey, that patient is an adult. They’re entitled to make their own decisions, and it’s not our job to make the decision for them. It’s not our job. Our job is to inform them, “You’re a good candidate for this, this is the clinical outcome we’re going to achieve, and I can achieve this in a number of different ways.” Right? All these ways have pros and cons and yeah, shoot ’em straight, just like that, but people generally don’t want to be told what to do. They want to make up their own minds. That’s what they want, you know? And whether they’re 80` or 20, they want to still make up their own mind.
So we’re going to organize the- the dialogue and patiently the dialogue in a way that, that is more asking questions than telling, right? And more understanding than judging. Not saying any of that stuff happened, I’m just saying how these things can be perceived, you know, you can be perceived that way very, very easily and we don’t want that. Do you know what I mean? We don’t want that.
It’s much, much easier and a much more sophisticated way of influencing is allow the patient to influence themself, and the only way to do that is by asking the right questions, right? I never want to tell a patient, “You’re wrong here, you’re wrong here, you’re wrong here.”
I wanna ask him a question that they will answer, and their own answer’s going to cast doubt in their mind, and then the patient’s going to give me a question now. And now they’re asking me a question. It’s so easy to influence that way, right? But just be cognizant of it. These are things that you only learn by looking back on the call. You only learn that by looking back and going through exercises like this. So um if nobody has any questions, we can go ahead and adjourn if you guys haven’t- does anybody have any questions before I let you go?
Megan Hendrickson: It’s not wrong to like, go full bar on your doctor after they walk out the door, right? [laughter]
Bart: It probably well, look. [crosstalk] Hey, it’s the same thing. No, if I, if I was gonna go full bar on the doctor, right? What I would say is, how do you feel like that went?
Megan: No, because like our office hasn’t- well, no, like so our office hasn’t officially opened but in my previous office, when I was the closer, we had the best brother-sister relationship. And this happened a few times. And I just went right up to him, and I’m like “[inaudible] what the hell did you just do to me?” She just walked out the door. We had a conversation. And then, he really did understand because I’m like, “Hmm, yeah.”
Bart: Well, and look, there’s another approach. There’s another approach that would be even more, that would be even more effective. And it’s the same approach I would take with the patient. I would ask the doctor, “Hey, um, how do you feel like that went with the patient? How do you feel like that went?” Right? “How do you feel like, do you feel like it went well?” I would ask him! He [inaudible], “I don’t know, you know, how do you think it feels like it went?”
Megan: Depending on the relationship you have with your doctor, just use your words, [laughs] I’m just kidding.
Bart: But I like that. Hey, no matter what the principles, they never change no matter who you’re speaking with, right? No matter who. It’s a- it’s a natural reaction, people get defensive, right? When it comes to critiques it’s much easier to critique asking them because usually, people are a little bit harder on themselves than even you are. But it’s different in a question format than…
Megan: Well I only said it that way because it would make him laugh really hard like, what do you mean? [laughs]
Bart: Totally. Totally. But there’s certain, that there’re certain things that you can even get, you can, you can even become more effective and I have it here. Sometimes it’s like, “What the hell was that?” It was, that did not go well, dude, that did not go well. And they’re like, “Oh my gosh, I know. What do you think? What do you think?” Blah blah blah. And then there’re other times where it’s like, “Hey, what did you think?” and get, maybe they’re unaware. I wouldn’t want to see, are they aware that it didn’t go well, and why it, why it didn’t go well? And sometimes they’ll walk through it and they can autocorrect really, really quickly and you have a much lower risk of a conflict arising [laughs] with that.
So it’s all the same. How you guys deal with your team members, how you deal with your kids, your husbands, your wives, your patients. It doesn’t ever change. You know, these things are all the same. If I want to influence somebody, I’m gonna influence in a manner that they feel like it was their idea the whole time, right? And if you want to influence somebody about something, you ask them a question they don’t know the answer to, they’re gonna say, “Well, this, this, this I’m not really sure. What do you think?” Once they ask you the question now, you, now, it, now you can influence, right, without them contradicting you. If you just serve the information up their brain immediately goes to, “Uh what about this. What about this? What about this? What about this?” But I asked the question first, and you obviously don’t know the answer, so you’re asking me now. This is different.
Anyone else have any- any closing comments or questions on it? And don’t be afraid to have a conversation with your doctor. That’s the whole point. They don’t know what’s going on when they’re in it. Just like you guys see things on the video replay that you didn’t know were there when you were doing the consultation yourself, so you make sure in a situation like that, have the conversation with the doctor. Sit down with the doctor and make sure it’s not like a thirty-second thing, you know? Ask the doctor for a quick meeting. Say “Hey, I need ten, fifteen minutes to talk about something,” you know- and then go through it. And then help the doctor, and then if you feel like you need to jump in there at any point in time, jump in. Jump in and build, build it back up, but it’s better, even sometimes you’re just not going to get them after something like that so you don’t have to go through the pricing. You’re just working, working, working to get them back to a point where they feel good about what they’re doing there.
So that was a really good job, McKenzie. I think you did, you did great, you know, in a lot of different directions. McKenzie, What did you, how did you feel about it? Did you get worried during the- the second ten about just the energy level?
McKenzie: Yeah, so Dr. Brittingham and I obviously discussed her CT and kind of, you know, that age was a big factor, seeing how healthy her teeth were. We thought it was– doctor thought it was a very aggressive move and you know, when we could have done Invisalign on her or a few crowns, it might make it better. I will say on behalf of like, our staff, we’ve been very short. One doctor with eight columns. We have three hygiene, three assistants. So, RP’s in and out. We did just recently hire a new doctor so we’ll get better because he’s very personable with patients. So, I think that was just a day we were just short, you know, like we have to be in and out. But yeah, her the whole like, Facebook comment threw me off like, okay, three in the morning, two in the morning on Facebook that was not a good idea, so…
Bart: Well, and look, it’s not, it’s not a time thing. It’s just an understanding thing, right? If– had the dialogue been anchored on the clinical outcome, it would have been completely different. So it’s just framing it. He didn’t say anything wrong. Didn’t say anything wrong. It just wasn’t framed in a manner that’s going to create certainty in her mind about what she’s there to do, right?
Like all we need to anchor on and say is “Hey, I understand. This is the clinical outcome you’re trying to achieve, right? You want to look better, you want to feel better and you want to get rid of all these problems and prevent problems in the future as much as possible, right? Okay, so if I could, if I could achieve that clinical outcome for you, without extracting all the teeth, is that something that you want, that you would be interested in hearing about?” That’s all we have to do. That’s it. That’s it, and she may say no, which is okay, move on, and get, get to the, get to the implants, then, move on, because she’s done. She’s telling you as clear as day, she doesn’t want to do that, she’s over it, she doesn’t want to hear about it, you know? So boom, move on.
But if you ask that question sometimes like, “Well, I didn’t know that that was really possible”. Yeah, I mean there’re things we can do with Invisalign, there’re things we can do with whitening. There are things that you could do with, you know crowns. There’re really sorts of things we can do because these teeth don’t have to come out, right? And we can replace the back ones with implants. There’re other ways to do it. I can get you what you want, two or three different ways, right? Some include extracting all the teeth implants, brand new teeth. Some include trying to save all of your teeth, right? Are you open to that? Do you want to hear about that? And then go into it.
That’s all we have to do right there, you know what I mean? And then if she says no, then we go over the implants, and with full confidence in full excitement that she’s a good candidate, she’s going to love how she looks when she gets done. This thing is going to be easy. The very first appointment she comes in we extract those teeth. Put the new teeth in, and she’s got her new teeth. She’s going to look unbelievable. We just get to it, get to it because she could be closed.
They’re not gonna give you a twenty-five thousand dollar number like that within five minutes of call if they’re not closable. She’s closable. So, it’s not a time thing. Matter of fact, the call was like fifty minutes, you know what I mean? You could do the call in half the time and get it closed. It’s just a question of perception, how we’re framing it. So, it’s just a training thing. That’s it. And that’s, that’s what we’re all here for, is just to get better and better so that you’re on the same page with the patient, you see things happen in real-time and we can be efficient and make sure that the patient is having a great experience, they’re well-informed, they have all their options, but they don’t feel like you’re doing something wrong. Makes sense?
Bart: Okay, cool. Um guys, sorry about going over so long, but it was a really good call. Mckenzie, you did awesome. Keep that up. Any questions that you guys have. Let us know and make sure you get signed up for your power day to come down.
We’ve got one here this Friday, actually, with- with quite a few treatment coordinators. So, get on the schedule. Get your power day. Get to Clearwater. Because that’s where obviously, I have you for a full day, and we can work on a lot of things here. Okay, so I won’t waste any more of your time. You guys go close somebody. Go close some arches, okay?
Meeting member 4: Thanks, Bart!
Bart: Alright. Thanks. Bye. Bye.
Meeting member 5: Thank you, bye.