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The Part of the New Patient Experience the Doctor Does Not Normally See Average Verses Peak Performance Model Many orthodontists are going through their daily routine and getting average results. We have to focus more and work harder to create a “Peak Performance” practice. Why settle for average case acceptance when excellent is totally possible. Let’s look at what “average” looks like: The doctor’s closing statement: “She is ready to start at any time. When you are ready, we are ready. It should take about 20 – 24 months to complete the treatment. It is a pretty routine case. Do you have any questions? Great then, I will turn you over to Heather. She will take care of you from here. It was nice meeting you.” Then the doctor exits. Heather, the Treatment Coordinator, then goes through the demo materials, brushing, bonding, separators, may use a program such as Aquarium, and may use informational materials. Mom and the kids are getting tired. The little ones are restless and Mom is starting to look at her cell phone. She’s thinking, “I need to know the cost and can I afford it?” Heather gets out a calculator and starts computing the options on the payment plan sheet. This can take several minutes. Mom sits and anxiously waits. She then presents Mom a fee of $5,200. Mom thinks, “Wow.” “If you want clear brackets on the uppers it’s an extra $300. When you have four broken brackets, there is a $25 fee per bracket. Your insurance does not cover orthodontics. We require 25% down ($1,300) and 20 monthly payments of $195. For clear braces, add $300 to your down payment or $1,600.” She offers 3-5% discount for payment in full ($260 for 5%). Mom says, “I have to go home and talk to my husband.” She’s thinking, “I don’t have $1,300 to pay down.” The TC says, “OK, I will call you in a few weeks to see what you have decided.” She gives Mom a copy of the handwritten payment option sheet. Heather gets up and leaves the room to copy the form. She brings a copy back to Mom. This is all that her husband will see when they sit down to discuss the doctor’s recommendation. In a few weeks Heather has a non-patient day. She picks up her pending files and calls mom. She leaves a message on the home phone during the day. She does not hear back from Mom. There is no further follow up other than, maybe, one additional voicemail message or email. There is no tracking system in place for Heather to calculate or report the case acceptance percentage, production presented verses production accepted. This type of scenario does not lend itself to anything other than a very average case acceptance of approximately 45 – 55% or less. The following is the Peak Performance Practice Model that Renders 60 – 80% Case Acceptance: The doctor makes a confident and definitive statement to the patient and the mother. The patient photos and x-rays are shown during the presentation. The doctor stays focused on their number one concern and addresses that first. He/she rarely offers multiple options. “Mrs. Jones, I feel confident we can correct Kelly’s crowding which was your number one concern. Kelly, I want you and Mom to know that you would definitely benefit from orthodontic treatment at this time. Mom, if we get Kelly started now we can actually take advantage of her growth. Kelly, you will be in treatment about 18 – 20 months. I feel confident you are going to have a beautiful result. Heather will discuss the next step to get you started. So nice meeting you both. Mrs. Jones, we are going to take great care of Kelly.” The doctor exits the consultation room. This entire doctor time took 7-15 minutes. Heather, the Treatment Coordinator, confirms if they have any other questions about the treatment plan. Typically they say, “No.” Then, she asks, “Kelly, are you excited about getting braces?” “Have you thought about if you would prefer to have the metal braces or the clear ones Kelly?” Mom asks, “Does one cost more than the other?” Heather responds, “No they are exactly the same fee. They are both excellent options. Whichever way Kelly want to go is fine with us. Our goal is for her to be very happy with her braces.” “Ok, let’s go over your payment options Mrs. Jones. (If the siblings are there and they seem restless you can offer for them to go to the game room.) Heather has already calculated the fee options and tells Mom, “Your total orthodontic investment is $5,280. This includes all orthodontic treatment and procedures. Everything that is done will be included in this comprehensive fee. It also includes one full set of retainers and one year of follow up treatment. If you would like to pay in full we do offer a 5% ($264) courtesy discount. You can use a credit card or pay by check or cash. Your second option would be our no interest in-office financing. Your insurance is estimated to pay $1,500 which leaves us a balance of $3,780. Here are several options available to you for no interest in-office financing. Select One: Initial Payment Balance 20 Monthly Payments $250 $3,530 $179 $500 $3,280 $164 $600 $3,180 $159 $700 $3,080 $154 $800 $2,980 $149 $900 $2,880 $144 For this option, the monthly payments are set up on an auto draft monthly. All you need to do is select one. If you come up with a different plan, we can discuss that also. The initial payment is due the day the braces go on and your monthly payments would begin the $1,000 $2,780 $139 following month. Which one of these down payments would work best for your budget?” Mom says, “The $500 down and $164 per month would work for me.” “Great! We can actually get Kelly started today as a convenience to you or we can make you our next available appointment, next Wednesday at 9 a.m., to get started. Which would work best for you?” Mom either takes the same day start option or schedules. It is important for the Treatment Coordinator to definitely know their next available start dates and work with mom to get the patient scheduled. Moms love feeling like they have some control of the payment arrangements. If they ask questions about foods to eat, it is important to say, “Well, Kelly, what is one of your favorite foods?” Typically they will say hamburgers or pizza. “The good news is you can still eat all the pizza and hamburgers you want with your braces. All you have to do with pizza is just stay away from the hard crust because it may break a bracket off. Kelly, we recommend that a few days before you get your braces on you go grocery shopping with Mom and get all your favorite soft foods like ice cream and macaroni and cheese and spaghetti. You will want to eat some softer food for the first couple of days after getting your braces. Our talented team of assistants will give Kelly all the instructions she needs to take care of her braces including brushing and flossing.” Kelly and her mom leave with a beautiful walk out package. A letter outlining the treatment plan, the payment option sheet, Kelly’s pictures, and a brochure listing the benefits of what sets your office apart are all included. This impressive package will be presented to Dad that evening at home. It is very important to understand the fees and the price point that is going to work for your target market and in your area. This will change according to your demographics and median family income. If you are starting 80%+ of your patients then you are definitely in your target market range. Heather sends Kelly a “Thank You” note after the visit. The mother says, “I need to talk to my husband before we schedule an appointment.” The Treatment Coordinator says, “Ok, sure. Here is my card just give me a call anytime you or your husband have questions. I’ll call you in a couple of weeks to touch base with you. The Treatment Coordinator may follow up with a letter or survey. The file is put into a stack of pendings. In a couple of weeks, the Treatment Coordinator would go back to the stack and start calling the pending patients between 11 am – 2 pm. Quite often, they call the home phone and get voicemail. They write LM (left message) in the chart. Zero, one or two attempts are made. No analysis is done of the pending patient system. The doctor notices when it impacts the practice income. By that time, thousands of potential production for the practice has been lost. I find it is quite common to find 40 – 50% of potential starts sitting in a pending status. Tracking the results of the exams is critical to top performance. This should be done daily, weekly and monthly. Focus on what works for the patient and the responsible party. That’s what creates positive reviews that motivate them to tell their friends. “Raffles and games may be fun…but word of mouth is still your best source of referrals.”