A Better Way To Make The Case For Treatment

17 years ago I gave my first professional dental lecture. Yep, someone actually hired me to come and present to their study club in Bend, Oregon. The topic was “Clinical Photography” and I had a blast. I guess it went well because other groups started calling and it took off from there.

As much as I enjoyed presenting on the topic, I felt like I was leaving the attendees short of the goal. While I could teach them the “how” of photography, they would often follow up with an email (yes, there was internet back then wise guys) asking what they should do with the images and how should they present care. I found myself attending every case presentation lecture I could find, speaking with every consultant I knew and reading every book I could buy on the subject. I ultimately came up with the idea of “Digital Co-Diagnosis” and while it was a small twist on traditional digital case presentation, it ultimately proved so successful that in 2007 Dental Economics asked me to write a three part series about it.

There’s an old saying: “You cannot sell someone a solution to a problem they don’t have.” In orthodontics and dentistry, patients often come to us because they’ve been told they have an issue but they neither accept it or recognize it. That makes it very hard to get them to understand the need for treatment. That’s where digital co-diagnosis can make all the difference in case acceptance.

The concept is simple: Instead of telling or showing the patient what they need by pointing out problems on dental images, we allow the patient to tell us. Yes, you read that right. When patients hear themselves telling you about a problem, it makes it more real to them. So, while it sounds minimal, there is actually a massive difference between a patient hearing “You need orthodontics” and them saying “I need orthodontics“.

While waiting for a flight about a decade ago, a nurse asked me about what my lecture topic was. I explained the ideas of digital co-diagnosis and she told me that it was a form of motivational interviewing, which has now become the norm in the medical field. Who knew?

The cornerstone of the process is exceptional photography and practiced verbs skills. Fight the urge to tell them what the problems are and instead, simply show them the problem and ask them as simple question about it. While it sounds inane, I promise you that the effects are powerful.

Instead of showing them crowded incisors, ask them (while circling the crowded incisors with your mouse):”What do you see when you look here?” They’ll obviously respond, “Crooked teeth?” to which you will respond “Yes, exactly.

Keep asking questions until you’ve painted a picture to the “jury” that there is, in fact, a problem. Then ask “Are you as concerned about these issues as I am?” When they inevitably answer “yes” ask them “Would you mind if I discussed some solutions with you?” and then you’re off to the races.  If you do it right, the whole process will feel a little like a trial scene out of My Cousin Vinny. 

The whole process should take about 2-3 minutes and while it sounds simple, it actually takes practice to get good at it. But, if you are diligent and role play with you team for a while before using it, you’ll watch your case acceptance go through the ceiling.

I wish that there was some sort of miracle phrase that got every patient to say “yes” to treatment, but the reality is that when you follow the steps of digital co-diagnosis, your case acceptance rate will go up and more importantly, your patients will understand their treatment options far better.

All the best,

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