Lesson #4: CORE Lesson #4 -Invitation to the Possibilities Appointment

About This Lesson

Instructions coming soon..


Action Items

  1. Make sure your flow chart is created to accommodate an invitation to the possibilities appointment.
  2. Practice ways to transition into Possibilities appointment Invitation.
  3. Make sure you have some printout etc. you can give patient as they leave so they can stay engaged in the process!

Full Video Transcript / MP3

Expand View

Hello. Welcome back, everybody. This is Dr. Steve Schluentz. We are going to talk about The Guided Discovery Process in a little bit more detail. This is going to be tenet number four, which is all about the invitation to the possibilities appointment. So basically at this point, we have started up the Pyramid of Wellness. We used visuals for engagement. We set simple goals first, larger goals later. This is when you actually give them an invitation to the possibilities appointment. There is an art to this because when I first started there was always this awkward pause. I'd get done with the exam and they go, "Okay, what's next?" And I'm like, "Oh, you're going to come back for another appointment." And they go, "Really? Why would I come back for another appointment?" You have to craft this in a way that it makes sense for them to want to come back for another appointment, okay?

You have to remember that your patients are not used to any of this. And so the way that I do this now, we're going to talk a little bit about this, how to actually craft this so that it's in the patient's best interest to come back. And there's different ways to do this and I don't want you to feel like there's one approach because the reality is, depending on the situation, I've had patients go to the prophy stage next, or work with the hygienist to get them kind of cleaned up before we even give them an opportunity to come to the possibilities appointments. That's why I encourage you, if you're struggling with this part of it, how do I get them to come back for a review at level, I encourage you to hop on the Q&A calls. I encourage you to reach out to me because every situation is going to be a little bit different. But, if you say, "Hey, I'm really struggling with this," that's what I'm here for, okay?

My kind of criteria for this is if the patient is at a medium or high risk for any of the risk pyramid, they're invited to a possibilities appointment. Now, if it's perio, and we can start with perio, they might need a full mouth debridement, they might need something just originally to get them to a baseline before we do this appointment. And sometimes, the possibilities appointment isn't actually required at first. Remember shorter-term goals, if there's so much to take care of that we really just have to start someplace, you don't necessarily have to do this right away, you just have to remember at some point you're going to have to have a discussion with the patient.

So what I always tell patients is after this appointment, if I know they're at a medium to high risk for any of these multiple categories or even one category, I always just sit down with the patient and say, "Okay, so next we really have a couple of different options and you're going to let me know what works best for you. There's always a tendency for us to want to jump into treatment right away and taking care of things. And while that's important, it actually pales in comparison to you understanding what is currently going on, and how we can work on a plan together so that over the next one year, five years, ten years, you have the least amount of disease possible, you have the least amount of dentistry possible, and you spend the least amount of money possible. And the easiest way for me to do that really, honestly is to have you come back and we just spend 30 minutes time together just looking over everything that we covered today, and then setting some type of roadmap and plan on the future so that you're working with me in eliminating this disease. Does that make sense to you?" And they say, "Yes." Yes, or no, or whatever they're going to say. They're usually going to say, "Yes, that makes sense."

And say, "Okay, great. Now, what I recommend we do is have you come back for another appointment and we're just going to review everything. And at that point we have a plan going forward." And they're going to say, "Oh, that makes sense." Or, "No, really, I just want a cleaning." Now here's the point. If they can get the prophy at that next appointment, this is where I've deviated a little bit from what I was told. I'd say, "You know what? Okay, let's go ahead and get you the prophy first, and then after that prophy appointment, you're going to come back with me and we're going to talk about those things. So it's just one visit, but you're getting two things done. Does that make more sense to you?" And they go, "Okay, yeah, that makes more sense."

Now, here's the point that we talked about at the previous video that you're going to have to do something. If they want the prophy first, you still want them setting the goal before that prophy appointment. Something simple they can measure and then the hygienist can check in on that. And when they leave you talk to your hygienist, "This is the goal they set. Make sure they're held accountable to that goal." And then they can have the prophy and then they can do the review. Ideally, though, it goes review and then a prophy, or review and then whatever is the first step on the plan. Typically, it's cleaning them up from a perio standpoint, which involves them seeing a hygienist at some point. So, I'd like the review first, and then we go ahead and start the perio work, and that first rung of the Wellness Pyramid, or wherever they're at that they need to work on first. Right?

But I like to give them a choice about the Disease Wellness Cycle and understand like, "Listen, you don't have to come back for the possibilities appointment. We've gotten everything." If they say, "I just really want a cleaning and I don't really want to set goals with you. I don't really care," don't push it because at this point if you've spent an hour and 20 minutes with them and they're not interested in learning more about the process and what's possible for them, they probably are not going to be our ideal patients and you're going to be wasting your time anyway. At some point, if they then are in your process and they say, "You know what? I really want to kind of take a step back and talk about some of these things," then you can go ahead and almost start the process all over again. I just want you to be aware of that. Most patients, given this choice in this way, they will go ahead and make these appointments the way you want them to make the appointments.

Here is the key though. You have to project this with confidence and you have to give them a choice and you have to help them understand why spending 30 extra minutes with you is going to help them save hours, and hours, and hours of you on the backend of not having to come in all the time to get treatment done for disease that's left unchecked. You have to get them to understand that, right? And you have to give them this confidence in this charisma that you feel very confident in whatever decision they make. It's not going to affect you.

Too many dentists struggle with this because they don't practice, drill, and rehearse. They're not confident when they talk about it. They just kind of go, "Okay, well the next appointment's going to be, we're going to sit down longer and talk about some things." Now I'm going to tell you, if I gave you that option as a patient, you'd go, "I don't want to do that. That sounds terrible." There has to be a benefit and a motive for why you're going to do what you're going to do.

Listen, if we spend 30 minutes creating a plan together, here's what I find for most of my patients. It takes a little bit more work up-front, but it saves you a lot of time on the backend because we're both on the same page. We're working on stuff together. Does that sound right for you? Right? It's pivotal, guys. It's absolutely pivotal.

So here's number four, this is point number four. So you've done all that. You want to leave them with something to read and think about between appointments. They should have some understanding of where they're at on the Risk Assessment Pyramid at that first appointment. Do not leave them completely in the dark and say, go back to that risk assessment pyramid and say, "Where do you think you're at so far on this spectrum, based on what we saw today at the guided discovery process? During this exam, where do you think you fall in this spectrum?" And you'll be amazed at how accurate they actually are. If you've done it right at the interview and showed them what each one of those things looked like, and then you went through this process and you showed them visuals, they usually can pinpoint exactly where they're at in the Risk Assessment Pyramid, so they know if they're in good shape or bad shape. So that's key.

And leave them with something to read or think about. Give them a book. I've given patients books. I think it's The 22 Irrefutable Laws of Wellness. Find a good book that's health and wellness-focused, that you can give them, that they can read. Now, they might not read it. Or a brochure about what you do. I have a TMJ brochure about what I do and it talks more about health and disease than anything. I want them thinking differently, so got to give them stuff to engage them at a different level than what their dentist have done in the past. So make sure you're giving them something to think about between appointments, not treatment recommendations, not a treatment plan, something to get them thinking about wealth. Or thinking about wealth, I don't think you're going to be getting them to think about wealth. Getting them to think about health, wellness, different stuff to trigger different parts of their brain and show and differentiate yourself just as a dentist overall, "Wow, this is unique. I've never had this done before." This process makes sense to patients if done in the right way. I'm telling you it's absolutely essential.

So the action steps in this video is make sure your flow chart is created to accommodate an invitation to the possibilities appointment. If you're a busy dentist, the first thing you say, "I don't have time for this. I don't have time to work stuff up. I don't have time to talk to patients." You don't have time not to. You have to do this and you have to take it slow, and you might not do it for every patient, especially when you're starting, but those patients that are health and wellness-focused, you have to have this process in place, and then practice ways to transition into the possibilities appointment invitation.

Listen, there's an art to that and you have to be confident, and you have to project that confidence when you're talking about this appointment. Because if you don't, the patient says, "I don't really want to do that." That's because you haven't created enough value for that possibilities appointment. You have to create enough value to make them want to come see you, right? That's your job. That's not their job. That's your job. So don't blame it. Don't scapegoat the patient and say, "They just don't care." No, you didn't create enough value. They should want to do that. Right? And then make sure you have some printout, something you can give them so they can stay engaged in the process as they leave your office, so they're thinking about you. Something simple, but you have to do it. And it's got to be your own. You've got to craft something. So, hopefully, you got value out of this one. I'll see at the next video.