There once was a farmer who entrusted the job of keeping his fields clear of all the hungry birds and animals to his young daughters. The farm sat on the edge of a large forest, and just before the harvest, the animals would fill their bellies, cutting into the family’s profits.

 

The girls worked relentlessly at inventing ways to keep the birds and animals from the field.  But as the years passed, the girls found themselves longing for the day that the birds would fly overhead, the squirrels would roam the front yard, and the deer could be seen at the tree line.

 

So, on one glorious spring day, the girls walked out into the pasture with outstretched arms to welcome the animals back to the farm. Day after day, they went out among their father’s crops and waited.

 

But the animals never came; they were terrified of the new scarecrows they saw wandering the fields. 

 

Isn’t it interesting that while the outstretched arms of the young girls were meant to welcome the creatures, they actually scared the animals away? In dentistry, sometimes our intentions of communicating value to our patients can, in fact, have the opposite effect. As dentists, we need to be conscious of the way we approach our patients so that we aren’t scaring them off. By asking the million-dollar “future-focused questions,” we can better understand the patients’ dentistry goals and tailor our language to effectively avoid what we in the industry call the “scarecrow effect.”

 

As a functionally-trained dentist with The Dawson Center and The Pankey Institute, I am proud of our comprehensive approach to dentistry. Through verbal communication and marketing, I let patients know about the thoroughness of our examination, our understanding of the TM Joint and bite, and the other principles of occlusion that set us apart. We instruct our teams to be sure our new patients understand and appreciate this because these are the “value-driven” services of our practice. While this approach may be effective with some patients, it could very well have the “scarecrow effect” on others.

 

How do you know if you’re dealing with a patient who is driven by esthetics versus functionality? How can you consistently align conversations with what the patient wants while maintaining the integrity of the practice? The answer to these questions lies in the quality of the “future-focused questions” that you ask the new patient upon meeting them.

 

It is important for us to understand that comprehensive care in the minds of our patients includes cosmetic/esthetic principles. They expect us to be experts at designing smiles, fixing bite problems, choosing materials, and eliminating disease. With that said, simply ask patients how they want their teeth to be at the end of treatment. These “future-focused questions” will make you aware of the patients’ primary issues. The orchestration goes like this:

 

8:00 a.m.: The patient, Mrs. Jones, arrives. She is welcomed and given a tour of the office. The mood is light and friendly, and the treatment coordinator will ask permission to take some digital photographs (full face, smile, upper occlusal, and lower occlusal).

 

8:25 a.m.: The doctor arrives, welcomes Mrs. Jones to the practice and, after a little small talk, picks up the photos and inspects them with the patient. The doctor will then ask the key question:

 

 

At this point, the dental team just listens. Esthetically-driven people will be talking about color, size, shape, contour, and tooth position; functionally-driven people will be talking about longevity, avoiding pain, and bite issues. By finding out what drives a patient, a doctor can find out two critical things:

 

1.   A doctor can determine which patients want elective cosmetic dentistry. This is significant because it is a completely patient-driven phenomenon. Many patients with unattractive smiles have no interest in cosmetic/esthetic dentistry, while others with relatively nice smiles may have an interest in making a change. Never try to sell people on elective dentistry; let them tell you if that it is something they want.

 

2.   By listening to what the patient wants, you can accurately arrange your words at the consultation appointment so that your presentation is aligned with the patient’s dentistry goals.

 

It is important to realize that knowing what the patient wants does not change the values of the practice. Traditional functional practices are disturbed by the patient who has elective cosmetic desires, but we should be celebrating this! If we have patients who answer the future-focused questions with only esthetic goals, we need to follow with questions such as, ”I think it is wonderful you want a new smile, but how long do you want these restorations to last?”

 

This value-driven question gives the team the opportunity to discuss the practice’s functional expertise. You will find you now have someone who is ready to listen; esthetically-driven patients have strong functional desires as well. This process of asking the right questions and truly listening to the patients’ answers allows the dental team to develop comprehensive plans that not only follow the values of the practice but also remain in line with what the patient wants. The net results are increased case acceptance and happier patients.

 

In my professional experience, I have stumbled upon road blocks that arose from forgetting to ask those all-important future-focused questions. I encountered a long-time patient from the practice I purchased who only seemed to show up when one of her old amalgams was broken. She had nearly every tooth in her mouth patched and re-patched. Whenever she showed up, I told her that I needed to do a comprehensive exam, a full-mouth series of X-rays, and mounted diagnostic models so I could thoroughly study her situation. My staff assured her that I had had extra training and performed the most thorough examination in our area. She would always ask me to patch her up, promising that we would get to the examination next time.

 

Months went by, and I lost track of her. Then, at a church Christmas party, I ran into her. I was shocked to be staring at 28 beautiful crowns. While I was devastated, I decided to learn something, so I approached her. I complimented her on her smile, and then I asked her why she didn’t give me the chance to do the work. She looked both embarrassed and shocked when she told me, “Dr. Cranham, you are such a good patcher; I didn’t know you did this kind of dentistry.”

 

I learned so much from this story. In fact, it was a turning point in my career. Not only did we not have any evidence that we did beautiful dentistry, but my verbal skills were not attuned to what this patient was looking for. Telling her about the thoroughness of our examination only told her about us. Instead, we should have been listening to what she wanted to accomplish. We would have understood that she had wanted beautiful teeth her entire life. If we had listened to her goals, we would have done the dentistry and avoided a rather traumatic event.

 

We have found great success in the utilization of future-focused questions to connect with our patients. This practice has given us the opportunity to customize our treatment plans and case presentations to be in sync with what our patients want to achieve through dentistry. By doing this consistently, we can show them that dentistry isn't something to be scared of.

 

Be careful of the hidden messages you send. Sometimes, the outstretching of our arms to show patients who we are, in fact, drives them away. The new patient process is not about us; it’s about the patients. Asking those million-dollar, future-focused questions gives your patients the opportunity to tell you who they are, what they want, and what their expectations are. This will put you and your patient on the same page as you design a comprehensive plan that will fulfill not only the patient’s needs, but fulfill their desires as well.

 

Like the farmer’s daughters, we too will become lonely without frequent visitors to the farm. But if we remember to approach our patients in ways that speak to their goals and desires by asking future-focused questions, we can create wonderful relationships, practice functional dentistry, and achieve our patients’ dental goals while avoiding the dreaded “scarecrow effect.”