The #1 Case Acceptance Bottleneck Dentists Ignore

Episode Transcript
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SPEAKER_01 (00:56):
Have you ever had this happen?
The patient says yes totreatment in the back.
Everything's lined up.
They are so on board.
And then they get to the frontdesk and suddenly they
disappear.
They don't schedule.
They need to think about it.
They're going to call you back.
They have to check theirschedule.
And deep down in your heart, youknow exactly what that means.

(01:16):
You will never see them again.
You've lost them.
And it's frustrating becauseclinically you did everything
right.
But here's the truth this is nota patient problem.
It is a training problem.
You see, most dental offices,maybe yours too, have never
truly trained the front desk onhow to confidently present
treatment, how to handle moneyconversations, or even follow up

(01:39):
effectively.
We train our hygienists, wetrain our assistants, we train
our associate doctors, but theteam that's responsible for that
final yes, for some reason, weleave them to figure it out all
on their own.
In today's episode, we are goingto change that.
We're talking about the mostoverlooked area in every
practice.
It is your front desk and howyou can turn that team from

(02:01):
order takers into confidentproactive treatment coordinators
who know how to help the patientsay yes.
Now you are listening to theDental Practice Chairs podcast
where we teach dentists how tostep back from the chair,
empower their team, and build apractice that gives them their
life back.
So if you've ever wondered whyyour case acceptance isn't where
it should be or why patientskeep slipping through the cracks

(02:22):
at the front, this episode isgoing to give you the clarity
and the tactics to fix it.
Let's get into it.
I am joined here with the DPHcoaches, two the smartest dudes
in the dental industry,redefining what it means to be a
dentist in 2025.
Dr.
Steve Markowitz and Dr.

(02:44):
Henry Ernst, both large practiceowners, big teams, lots of
experience.
And today we're going to talkabout a very neglected part of
all owners' offices, and that isthe front desk, is we don't ever
provide training to the frontdesk.
And I would, you know, Ishouldn't say ever or never.
I guess we do sometimes.
There is a lot of opportunity inalmost nearly every office that

(03:06):
I work in.
And we always think about, okay,yeah, that's phone skills,
right?
You know we've got to teach themhow to answer the phone.
But we never actually focus onwhat happens when we pass a
patient off to the front andthey go over some financials and
they get the patient to say yesor no.
And that is a skill.
And we train on it, how to talkto patients, but we rarely train

(03:27):
our front desk on it.
So I'm going to pass to you,Henry.
What is like, do you have atreatment coordinator at your
office?
What is that a position at youroffice?
Or like what kind of things areyou doing to set your team up
for success as far as closingtreatment from the front end?

SPEAKER_00 (03:40):
So we have a democracy here.
We don't have one person that'sdesignated as the treatment plan
coordinator.
And I think some of that comeswith just the long hours we have
and not everybody's here thesame day.
So we have a treatment plannerposition that every day somebody
slotted into that.
But we provide pretty basictraining for everybody.

(04:00):
And I've mentioned it before ison previous podcasts.
We have something called aDentistry for Dummies program,
where I have it's probably aboutan hour-long presentation that
even if you worked at Walmartfor five years and you came here
with no knowledge, afterwatching that video, you'll have
a basic knowledge of most basicdental procedures and how to
talk in basic language topatients.

(04:22):
Because I think that's theproblem, is people talk up to
patients.
They talk with all this specificdental terminology.
You know, when we talk about acrowd, we talk about it's like a
ring around a barrel, holds ittogether, you know, that kind of
thing.
So we train all of the staff tohave the dentistry for dummies
program that we have, and it'sreally simple.
They watch, once you do it onceit's done, they watch a video,

(04:43):
there's a little test.
We even do an oral exam where wekind of just role play and stuff
like that.
So everybody knows that.
When the people that are in thetreatment planning role that day
is, they're very proactive.
So our dentists should alwaysprovide a comprehensive
treatment plan, whole enchiladaas we call it, and the basic
one.
And if they don't get that, theyshould be proactive to tell the

(05:04):
dentist, hey, I didn't get abackup treatment plan.
They want to get people to sayyes.
And so we all know that if youprovide a humongous treatment
plan, it's harder to get to sayyes sometimes with finances.
They're very proactive.
And then the important part isthe follow-up.
So how we talk to them, how wetrain them to talk to people in
basic language and have apersonality, right?

(05:25):
Don't just be very where you'rejust talking about the numbers
and nothing else.
Let's get to know people.
And then the follow-upafterwards.
They're part of that job andthat role, no matter who's doing
it.
We have a little Google sheetthat they know.
I need to follow up on peopletwo days later.
I need to follow up on peopletwo weeks later and one month
later.
And it's a really simpleconfidence call.

(05:46):
Hey, Paul, I was just callingyou from our Pleasant Plains
Dental, and you know, I justwanted to see if you had any
questions about your treatmentso we can get you scheduled.
Right?
So there's a lot of everybodyhas to understand the roles and
what their job is in ourpractice.
I'm interested to see how youguys do it.

SPEAKER_01 (06:03):
Well, I almost disagree.
I don't think they want thepatient to say yes.
I would say I feel like mostpeople that work at the front
desk don't care if the patientsays yes or no.
And I think that's are theyincentivized?
Well, that's the thing, is Ithink if we incentivize them,
but I think I think that's whatwe're up against.
I find that is the hardest partfor the training with my front
desk is helping them relate thefact that when patients say yes,

(06:24):
they get healthier and that theyplay a part in that.
I think most front desk peoplefeel like if I present the
treatment and I show them whatthey owe and what their payments
are, and I say, Hey, you know,did you want to schedule that
today?
And they say no, I'll call you.
They're like, Cool, I did myjob.
I did a great job.
I did what I was supposed to do.

SPEAKER_00 (06:41):
Yeah.

SPEAKER_01 (06:41):
And my goal with my team is to push that a little
further.
Is like you are the person thatis supposed to figure out how to
make this work in the patient'slife.
It is not just here it is, doyou want it?
No, fine.
Going to you, Steve.
Steve was shaking his headviolently.

SPEAKER_02 (06:55):
Sorry.
Yeah, I'm I want to keep my headon my my neck.
It's important to me.
While you were talking, Paul,the reason why we have treatment
coordinators is because theyfeel like they own that
schedule.

SPEAKER_01 (07:06):
That's the thing, is I want to say I also do not have
a treatment coordinator.
I'm very much like Henry, butSteve, your model is different.

SPEAKER_02 (07:11):
I'm gonna sell you on why you need a treatment
coordinator.

SPEAKER_01 (07:14):
I think I'm with you.

SPEAKER_02 (07:15):
We just someone got a new position of a their period
treatment coordinator.
So they're responsible for theperiodonist schedule in one of
the offices.
She just started two weeks ago.
And I got this message from themanager in that office that
said, Is it okay if she goes?
It's a Sunday.
I got this message from the newtreatment coordinator.
She wants to go in and preparefor the week, make sure she's

(07:37):
all set.
She asked not to clock in.
Is that okay?
And I was like, absolutely not.
That is the coolest thing I'veever heard.
She owns that schedule.
That's her definition of whetheror not she's successful in her
job.
She wants to make sure that shecan do the best job possible.
When we have given ownership ofany place in the office, but

(07:58):
especially in those TrueBookcoordinator roles, they own it.
They get so excited to see itwin.
They want the patient'sschedule.
When someone falls out, theytake it personally.
Like, why would someone fall outof my schedule?
Let me go fill it.
I'm gonna see how fast I canfill it.
And it is one of the coolestthings that I see in our
organization of how much thebusiness team cares when they

(08:20):
know what they're responsiblefor.

SPEAKER_01 (08:22):
Well, I think it's awesome to point out is that I
totally agree with you.
And this is something I havetalked to my team about for
years, and that they do not wantto have like dedicated treatment
coordinators.
And I disagree with them, andit's been a battle that I've
wanted to fight and I haven'tfought all the time, but I'm in
the same situation as you,Henry.
It's a little bit difficultbecause we're open solo, we're 7

(08:43):
a.m.
to 13 hours.
That's exactly what I was gonnasay.
So that's what makes it so hard.

SPEAKER_00 (08:48):
Yeah.
Our practice has 60 clinicalhours.
So, yeah, Steve, you're raisingyour hand.
I get it.
Um, so our practice has 60clinical hours, so we run into
this issue with differentthings.
And it's like, how do you do it?
You tell me.

SPEAKER_02 (09:01):
Okay, my hand's going up again.
Yeah.
Just because the person isn'tthere doesn't mean that they're
not fully responsible for it.
And meaning that, yes, if one ofthe doctors is only there two
days a week, does that mean thatyou're not responsible for the
what happens to your patientsthe other five, three days of
the week?
You may have someone elsehelping you out.

(09:21):
If one of my temporaries comesoff, I'm not there.
Someone's gonna help me, butit's still my responsibility to
make sure that patient getscared for.
Same rules apply, and that'strue influence.
If we can influence people whenwe're when we're not there,
that's even stronger leadershipthan when when in our presence.

SPEAKER_00 (09:38):
So just giving a different perspective.
So for us, whenever somebody is,we have the spirit of
competition.
So we have goals and everybodyhas their stats that we put up
like every month.
Who's got the most percentage ofpeople saying yes?
Who has the most money thatthey've got people to say yes
to?
So when somebody comes throughthe system, they're responsible
for it.

(09:58):
Even though they're not therelike you're talking about, it's
kind of a a little bit of adifferent way to get the same
thing.
So we get the spirit ofcompetition.
That's why they're veryproactive.
And they've done that to mesometimes, right?
Hey Doc, you didn't give me thebackup treatment plan.
Because they want people to sayyes.
Nobody wants to be the personthat's put up on the on the KPI
board that says, Oh, you're thelowest.

(10:19):
Nobody ever wants to be thelowest.
How do you track this?
How do you do this?
That's a great question.
So that's why I delegate.
So we've got systems in placethat we've had for years that
they do, and I see the numberswhere like people have
percentages and they're reportedevery month and they're up there
and stuff like that.
And I'm like, okay, good job, soand so.
And sometimes it's not afinancial reward, but sometimes

(10:39):
it's like, hey, you know what?
So and so had the highestpercentage.
Let's give them here's a giftcertificate go to Ruth Chris or
something like that.

SPEAKER_01 (10:46):
Well, I think the challenge is, and I'm I'm with
you, Henry, is I feel like withlarger teams, it's hard to give
somebody a responsibility orhave them really take it.
There's so much opportunity in alarger office that's split
shifted for somebody to kind offly under the radar and not
finish a task and pass it on tosomebody else.
I'm thinking about a client thatI'm working with right now,

(11:07):
large office, four or fivedoctors, but every doctor has
their own team, has their owntreatment coordinator, their own
front desk person.
And while this works very wellin some regards, as far as like
keeping someone's schedule fill,when that doctor is not there
and their team is not there,they're now nobody is covering
for anyone else.
No one's saying, Oh, well, I'llhelp this patient.

(11:28):
It's almost like there's a lotof not my problem there as well.
So there's like the dark side ofthat system as well.
So I don't necessarily knowwhat's right, but I'm with you,
Steve.
I feel like somebody has to bethe responsibility of the
schedule and somebody has totruly close treatment.
And often when we have everybodydoing it, we're putting people
in situations that are not, youknow, gravitating towards ease

(11:50):
of talking with money.
They don't like it.
It's not energy rich for them,and they're not going to be very
good at it.
But yet, I'll tell you, this ishow we do it at my office.
And I don't agree that it's thebest way to do it.
You have specialists in youroffice, right?
We do.
Yeah.
And they they do have theirdedicated treatment
coordinators.
I would say that.
They actually do.
Yeah.

SPEAKER_02 (12:06):
Cool.
And that works great, right?
Right.
Because if that person, if thatperson came in and their
schedule wasn't full, thatspecialist would be BS.

SPEAKER_01 (12:15):
That's what spawned us having dedicated people.
Okay.
Because that's what happened.

SPEAKER_02 (12:19):
I'm just gonna extrapolate this a little bit.
What if you had general dentiststhat were that vocal and wanted
their schedule a certain way?
What would happen?

SPEAKER_01 (12:29):
Yeah.

SPEAKER_02 (12:30):
What would happen?

SPEAKER_01 (12:31):
I feel like we're having a breakthrough right now.

SPEAKER_02 (12:32):
I think we might be.
That's the same thing thathappened to me.
Our specialists were put onthese pedestals, and if their
schedule fell apart, it would belike three people at once, which
is all cry like, oh no, thespecialist's schedule is gonna
fall apart.
We need to call blah blah blahblah blah.
And I'm like, guys, that's 10%of our revenue.
We got five other dentists whoare would love that level of

(12:54):
attention.

SPEAKER_01 (12:54):
Yeah.

SPEAKER_02 (12:55):
So that's exactly what happened to me is we didn't
have treatment coordinators.
I saw how beneficial it was.
I saw how people cared so much.
And then we just extrapolatedthat to help to make sure
everyone had that that level ofsupport.

SPEAKER_01 (13:09):
Yeah, I love that idea.
And you're really my wheels arespinning right now.
And I'm thinking about how couldI schedule this so one each
doctor has their own dedicatedperson.

SPEAKER_02 (13:18):
It doesn't work in a single doctor office.
I can all get behind that ahundred percent.
Why not?
But when there's multipledoctors and who's doing what and
why?

SPEAKER_00 (13:26):
Why doesn't it work in a single doctor office?
I would think it'd be easier todo it in a single doctor office.
Um it's simple.
Yeah, that's what I was thinkingas well.

SPEAKER_02 (13:33):
Because everyone's the treatment coordinator.
Like there's not enoughdifferencing.
Yeah.

SPEAKER_01 (13:39):
Yes, because in a single doc, I'm thinking like
two, three front desk people.
I had a solid presentation teambecause I could pour into all
those people.
Like I have 12 or maybe 11people on my front end team, and
it's hard to train all thosepeople.
It's hard to keep track of it.
Do you know how to do the frontdesk job?
No.
I know how to verify insurancevaguely, but no, not as not as

(14:00):
well as I know you learned itbefore.
Yeah.

SPEAKER_02 (14:02):
No, I actually don't.
And that was the conversation Iwas just having this morning was
I can train a doctor, I cantrain a hygienist, I can train
an assistant.
I actually can't train the frontdesk.
I don't know how to do theirjob.
So I think part of what when westarted this conversation about
not training the front deskenough is we don't know what to
do.
True.

SPEAKER_00 (14:20):
Yeah, that makes it hard.
Well, if we kind of poke holeshere, if in our practice, where
we've got, like we were talkingabout before, 60 hours and stuff
like that.
My mentality has always beenthese last maybe five, six
years, as this practice hasgrown so much, is to always have
the backup, the bullpan, notdependent on one person so much.
So my biggest concern is I'mputting all a little bit of eggs

(14:41):
in one basket.
Whereas I've got a bunch ofcompetent people that are doing
the same job together.
And if one happens to leave orsomething happened, I'm still
good.
Doesn't affect me one bit.

SPEAKER_02 (14:51):
If you don't have the culture that if one person
leaves, then the thing fallsapart, then I could see that.
But if that treatmentcoordinator for your specialists
isn't there, there are peoplethat are able to fill in the
gaps enough to support thatperson because that's the
culture you've created in youroffice.
And if that person were toleave, we've had the treatment

(15:13):
coordinators leave, then it's anopen position and people will
apply, and then we'll give themthe training and the tools to be
able to be successful in thatrole.

SPEAKER_01 (15:22):
Follow-up for this, Steve.
Let's give tactical.
Most people are not operating inlarger offices with multiple
associates, but so where doesthis fall into like the smaller
office, two to four front deskpeople?
How does someone use what we'retalking about to make their team
better?

SPEAKER_02 (15:39):
I think what Henry said was creating ownership
mentalities, and I love that.
How do we empower our frontdesk, our business team,
treatment coordinators, whateveryou want to call them?
How do we empower them enough totake ownership over the
schedule?
And if something were to fallout of my schedule, I know that
there are people that'll be moreupset than me.

(16:01):
And that is what I want tocreate.
So that as soon as somethinghappens to that schedule,
there's someone who's gonna becalling patients, filling it,
and making sure that theyunderstand what that needs to
get done.

SPEAKER_00 (16:13):
How about you, Henry?
Yeah, so if we're taking this tothe most dentist practice owners
that have the five ops, youknow, keep it simple, right?
Start up, you don't have to havea fancy spreadsheet.
Make a freaking folder, right?
Anyone that leaves your officethat does not say yes to a
treatment plan, what's theirname?
What was the treatment plan?
What was the date?
And then follow-up.
Like, when did I follow up?

(16:35):
I can't tell you how manyoffices.
It drives me nuts when I workwith people and say there is no
follow-up.
They just leave and that's it.
Screw it.
Yeah.
There's so much opportunitythere.
Sometimes people, it's amazingwhen I hear some of these calls
sometimes, or sometimes theycall it's the simplest,
stupidest question that theydidn't have answered.
And just that leads to boom, letme get those crowns done

(16:55):
tomorrow.
So just do it simple.
Train up some, make sure thatyour team understands how to
just talk basic language to berole play.
Make a lunch one day and justhave role play.
Talk about talking about acrown.
How do you talk to a patient?
Because don't just talk in thisdentrix language, you know,
blah, blah, blah code, build up,blah, blah, blah.
Bullshit.

(17:16):
Talk to them like a person andkeep it simple.
You don't have to be a largeconglomerate office to do these
simple things to make yourpractice better.
Yeah, true.

SPEAKER_01 (17:23):
And the thing that I'm thinking of as well is that
I love my treatment coordinatorsand my people presenting
treatment to ask the patient,you know, I went through a lot,
tell me what questions you have.
I want them to be able to fishfor objections and to push
through those, to find outwhat's keeping the patient from
booking.
Now, if the doctor didn't sellit in the back, if the doctor

(17:44):
didn't make the patient feellike they need it, no amount of
treatment coordination is goingto do it there.
But we should have it there.
And they should be able to takeit over the finish line by
asking, what's keeping you fromscheduling this treatment?
And I think that takes specialpeople.
There are people on my team thatwill do that very well.
And I know there are people onmy team that probably should not
be presenting treatment.
And I think I might take adifferent approach after having

(18:04):
this conversation.

SPEAKER_00 (18:05):
And it's important, I think, also to show that
you're a person too.
I love the fact that I have animplant.
I tell every single patient thatI treat a plant, but I've got
one myself.
I love the fact that we alwayshave a ton of team members in
Invisalign, so they show, okay,look, I got it right now.
So you're kind of having thatwe're all together in this kind
of thing.
We're people too that needdentistry.

SPEAKER_02 (18:24):
If you decide to move forward with a treatment
coordinator or having someonewho's going to be responsible
for a case presentation, as thedoctor, go and have lots of
conversations with them.
Follow up.
Learn how you can be presentingbetter and make their jobs
easier.
If, like Paul said, if you're asthe doctor, if you're not doing
a job creating value in urgency,it doesn't matter how good good

(18:45):
of a treatment coordinator youhave.
It needs to start with you.

SPEAKER_01 (18:48):
Absolutely.
All right.
Well, if you're thinking abouttaking your office to a next
level and scalable practice thatgives you more time off, please
set up a strategy call with meand we could talk about what
your biggest bottleneck is andcome up with an action plan to
get you to the next level.
Check that out strategy call forfree at
dentalpracticeheroes.com.
Thank you so much for listeningtoday, and we'll talk to you
next time.

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