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The Interview


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Lesson #5: CORE Lesson #5 – Health vs Disease

About This Lesson

Instructions coming soon..


Action Items

  1. Make sure you have slides or pictures of disease and health. Let the patient know that the role of the exam is to determine where they are at on the spectrum of health vs disease.
  2. Study the Disease Cycle and the corresponding documents around it with the psychology behind why this is so powerful.
  3. Understand the role of Primary, Secondary, Tertiary Prevention (basically, Prevent, Protect Renew). The simple structure of goal setting is laid out with these terms. This will be further reinforced with the Risk Assessment Pyramid. Two basic tools to establish goal setting.
  4. Just like the 3 universal wants, practice, drill and rehearse this over and over. Can use this for existing patients as well!

Full Video Transcript / MP3

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What is up everybody and I want to welcome you back and brace yourself. This is going to be probably the most intense video in the entire series because there's so much to cover on this one particular concept that I just want to make it very, very clear. There's three very important elements of health versus disease, which is what we're going to cover as we talk about this interview process. So we are now onto tenet number five and there's three things that I want you to pay close attention to when we're talking about the difference between health and disease.

The first is we want our patient to understand the difference between what healthy mouths look like and disease mouths look like before we ever see their mouth. This is the part that almost every dentist miss. Listen we don't want to prejudge our patients. We don't want them to think that now that we saw that there's something wrong with them, quote unquote, something wrong with them, that we're going to go ahead and try to explain to them what health actually looks like. I want that done at the very beginning of the process. So I actually say at the end of my origin story, and I'm talking about crafting my practice differently. It's the first thing that we want to look at is what healthy teeth actually look like. What does a healthy system look like? Because, in nature, if we can replicate what health looks like and help you move on that path, you're going to be in a lot better shape for the rest of your life. Just like you'd have a blueprint for a house, we want a blueprint for your mouth so that we know ultimately healthy systems have some basic characteristics.

I have pictures of health and I have pictures of disease. So that's the first tenet, right? So that is the most important thing we do. Then what we want to do is actually take them through a process of looking at a disease cycle and a wellness cycle as a patient. What's the difference between the two? And so there's supplemental resources in this program that you're going to find like health and disease and some things that you can give to your patient to help them think a little bit different between what I consider a disease cycle and a wellness cycle.

I have to give credit to Dr T J Bolt of Omaha, Nebraska for this. He was the first person to my knowledge that took all the information that he learned and put it into a very simple to use diagram to explain to patients. Now I've modified that a little bit, made it my own, but the basic elements of that, that disease cycle and wellness cycle were from Dr T J Bolt, so I have to give him credit on that.

So we now have pictures of health, pictures of disease. Then we have disease cycle and wellness cycle, and then what I want to do then is to give them a choice as to where they want to move. Do they want to move towards wellness and health or do they want to continue to do the status quo of what they've traditionally done in the dental office? So those are the three basic tenets and what I want to do is just break down this process.

Now I encourage you, as you go through this, there is a manual in Dental Sales Secrets that explains this in depth. I encourage you to go through that because this and the three truths are some of the most important things you can do during your interview process to set the stage for later on. If you're doing comprehensive care and you're not doing it from the elements that I'm describing here, you're going to lose, right? Unless it's implants, like I said, implants are totally different game because they're already down the hill or whatever. But this, I'm talking about like all on fours and things like that. If you're doing traditional dentistry at a higher level and you're trying to move patients towards complete wellness care, you have to do it this way. And kind of a supplemental bonus fourth thing that you really want to do is help them understand the three major diseases. And that is on that wellness cycle and disease cycle. It's at the very, very top. I have a PowerPoint slide talking about this during the new patient process. It wasn't one of the core tenets, but it's very important.

I said, listen, there's really three major diseases. And again, I got this kind of from Dr Bolt as well. He's brilliant. If you don't know who he is, you have to go reach out to him. He's really, really good. And I know he's seen this program. So Dr Bolt, if you are listening to this, thank you so much for everything you've done for me. You're truly an incredible doctor and anybody who's trying to ascribe to this model should be following him and really listening to what he has to say because he's mastered this better than almost anybody that I know. And he's been a personal mentor for me so I can't thank him enough.

As you're going through this, there's basically three main diseases that we see patients have in the dental practice.

One is tooth decay, the second is gum and and gum disease. That's what I tell patients. They don't really know what periodontal disease is. But gum disease and then the third is a bad bite or what we call occlusal disease. And other than trauma, those are really the three major diseases we see and the first two, tooth decay and gum disease are diseases of choice. You can choose not to have them if you don't want to. We know what causes those and we can help prevent those. The third one, occlusal disease, you really can't brush away. This is exactly what I tell my patients. You can't brush away so we can identify it. We know what can cause occlusal disease as well. We will be able to help you in that capacity, but that's something that you're going to need our help. The first two, really honestly, we're going to give you the tools that you need so that you never have to worry about tooth decay and gum disease again. The third one you're going to need our help with if you actually have it.

That's how I laid those three major diseases out. So we've done three things. We have pictures of health and pictures of disease now in the process, we start with that. We don't have their pictures yet and what I'm doing is telling them, all we're going to do during this exam process is actually see where you're at on the spectrum. Do you have a really healthy mouth or do you have a diseased mouth based on these pictures? Okay. Right. Once you do that, you go through and give them a choice. Now we give all of our patients a choice here. We can choose to go in a more wellness oriented direction where you take control. You don't rely on your insurance company. You're going to kind of dictate where we go and you're always moving towards eliminating those three diseases.

Or you can spin around in what we call the disease cycle where you just kind of react to things that happen to you. You never look at causes of disease, and as a result, you'll end up losing more teeth. You'll end up having more disease. It's more insurance dependent, but we give you a choice and honestly in our practice, we don't care which direction you go. We just need to know, we need to let you know that you have a choice as to how you want your health to proceed in the future, right? I want you to keep it simple. I don't want you to go in depth on the cycles to where patients get lost in that process, but you can give them something. I already printed the cycles off and I give those to the patients. "I really want you to go through this and think about what it is that I'm talking about today and if you have a spouse or family member that you want to go over this, this diagram kind of helps explain what our orientation is and we really give you choices here. We want you to know what your choices are and then you can make the best decision based on on the information that I'm giving you."

What I'm trying to do is create an identity crisis for them. I want them to know that they have a choice. They can be proactive or reactive and they both have consequences. Now, 9 times out of 10, they're going to want to move towards a wellness cycle, so I want them to get a verbal commitment. "Out of these two choices, which makes the most amount of sense for you, Mrs. Jones?" Nine out of 10 people will say, "I want to move in a wellness direction." If you have one that says, "I'm happy with the disease cycle", you don't have to kick them out of the practice, but know they will never be a great patient for you. Anybody who says, "I want more disease" is probably not going to be a good patient for you.

Right? And I know this creates an identity crisis even for the dentist when I tell them, they'll be like, "Well, if they don't have disease, but how am I going to help them?" Listen, there's so much work that can be done for patients that are beyond tooth decay and gum disease that you have to understand you're not going to run out of work. In fact, you will be more busy than you know what to do with. So you want to get them a verbal commitment that they want to move towards this wellness cycle because you're going to be able to check in with them through the process when they go, "Oh, I don't know, my insurance doesn't cover this." and "Mrs. Jones, I just want you to know that I don't have a problem with any choices that you have, but I have to give you the best possible alternative because you did tell me that you wanted to move towards wellness, and this is part of the process, right?"

You see how that creates a problem for them. They've just verbally committed to this wellness cycle. They want to get healthier and if they rely on their insurance again, you can not necessarily call them out, but kind of call them out and say, "Well this is what you told me you wanted. Is this still what you want or is this something where you actually are a little bit more dependent on relying on a third party to tell you how healthy you can be." You can do that in a tactful way. You don't want to attack them because they will leave your practice, but you want to do it in a way that allows them to make these choices.

Okay, so there's a lot of information on here. There's a lot of supplemental videos and I want you to go through the manuals and I want you to come on the Q and A's because you have to understand this process and it's hard in a 10 minute video to explain exactly all the nuances to this, but just understand the basic tenets.

If you have pictures of health, pictures of disease, right, the three major diseases and then show them a disease cycle and a wellness cycle and give them the choice and say all we're doing during our exam process is seeing where you're at on this continuum and perspective. And I'm going to talk about that in the next video. I think it's when we talk about health risk assessments and working our way up this pyramid that will kind of allow you to see more in detail what I'm talking about, but understand the basic premise of what we're trying to accomplish here. Health, disease, three major diseases, diseases of choice versus diseases of non choice and then the wellness cycle and the disease cycle and give them a choice, have them verbally tell you where they want to move. And then from that point, now you're moving towards the next part of the process during the interview.

So the action steps, really for this, keep it really, really simple. Make sure you have pictures of health and disease or slides. I have slides that I laminated and I can write on them and I can show them stuff, right? I want the patient to know that the role of the exam is to determine where they're at on the spectrum of health versus disease. I want you to study the disease cycle and the corresponding documents around it with the psychology because of the psychology behind this is so powerful, right? You can understand the role of primary, secondary, and tertiary prevention. If you go to that wellness cycle, what you'll see is there's a prevent, protect, renew. Now, when I talk about master plans, you look in my office manual, I have a master plan. I learned this concept from the Schuster Center. There's some very specific things that I do in a master plan. If you think about it, patients really understand this, so I want you to use prevent, protect, renew.

"When we're going through this process, Mrs. Jones, what we're trying to do is three basic things. We're trying to prevent any new disease from occurring. That's the most important thing we do. Okay. Then if you do have disease from the past or currently, we're going to protect you from having that disease get worse and then once we prevented and protected, guess what? We can actually start building the mouth and building your system back to that optimal state so you can keep your teeth for the rest of your life with no issues. It's simply not enough to keep your teeth or some teeth for the rest of your life. If you can't chew with them and you can't function with them, you can't smile with them. Right? Patients are living longer. My patients are 60, 70 years old. I have this discussion all the time. I want you to think about where are you going to be at when you're 90, 95, right?"

I asked them that specific question. Where do you want to be 25 years with your dental health? Because we can just treat stuff, in three months, six months, one year later you're fine, but what about 10 years, 15 years, 20 years? I want them future focused on where they want to go. Okay. And I don't really talk about that that much, but it is important. And the reason I don't talk about it as much as because I used to have, I learned that dentists would ask that question, where do you want to be 20, 25 years from now? Patients don't really know and it's way too early in the process and so the the dentist will get confused by asking that question. The patients don't really know. They never thought about that before and it kind of goes south. So think of prevent, protect, renew, and then plant that seed because you're going to talk a lot about this in the actual review of finding stage. That's when we're getting them really future focused on where they want to be 10 to 20, 30 years from now, right? All we're doing right now is planting the seeds, prevent, protect, renew.

And the simple structure of this goal setting is laid out with these things in mind. Always simple goals first. Interview is all about the things that we've laid out. You're planting seeds here, okay? When you use the risk assessment pyramid with this prevent, protect, renew method, you have two very powerful tools for goal setting, right? And just like the three universal wants, I actually noticed there's four action steps, but there's only three numbers. There's two twos. So if you're paying attention to this, I'm sorry. Number three is number four, and just like the three universal wants, you want to practice, drill and rehearse this over and over and over. Videotape everything and start to ask yourself, am I going through this? Am I going through this? Am I going through this? Am I going through this? You have to master this interview process before anything else, right? This is the most important thing you do. I've said that about 28 times. I'll say it again. Most important thing you can do is master this interview.

So we're done with this video and I want to thank you so much for tuning in. I really do encourage you to watch this video at least three or four times because there's so much compacted into this that right now, there's some supplemental videos on it. There'll probably be more in the future. As you know, this program is always changing, modifying, and growing as more students give me feedback. So I encourage you to come back to this over and over and over because it's one of the most important things you can understand.