The dynamics of a busy dental practice often entail communicating with patients “on the fly.”

They come in, we diagnose their clinical conditions, talk about potential solutions, and choose a determined treatment route. But that does not mean we do not encounter some resistance during the process. In this article, I want to introduce practical ways to deal with that resistance and drive informed decision-making; specifically by addressing the stages of the patient's “buyer’s journey” and by using a technique I have dubbed the “Bottega Argument,” which is based on an actual patient interaction I had.

Talking to patient's about their treatment plan can be complicated.
Figure 1: Talking to patient's about their treatment plan can be complicated.

As I have discussed in a Spear online course, the treatment planning process is analogous to the so-called “buyer’s journey,” a commonly known marketing term that outlines the linear path leading to a purchase of a good or service. However, it should be underscored that the stages need to be artfully crafted and articulated.

In other words, we may be effective in walking a patient through “the journey” but still may fail to convey “the Why.” Why is it in their best interest to proceed with treatment with us?

We may have structured, scripted talking points to help a patient understand the implications of a given process or treatment, but often we require a more customized narrative to drive the conversation in a compelling way.


A Dental Patient's Buyer's Journey

In our practice, we recently saw a woman who has been a patient for years and with whom we had previously discussed the structurally compromised/hopeless condition of a mandibular first molar that required extraction followed by implant placement.

We presented the treatment plan and the fees, and she told us she would think about it and get back to us. A week later, she came back, contending that she had given this treatment option some thought and decided to have the implant placed somewhere else but made it clear that she would want to have the implant crown made in our office.

She argued that she did some “research” (shopping around) and found a dental office that would place the implant for a fraction of the price we had quoted her. Nonetheless, she made it clear that she genuinely appreciated the quality of the restorative work we had done for her in the past, so she wanted us to make the crown for that implant.

We could take this remark in multiple ways, but the reality is that in today's economy, we should be sensitive to the reality that not all patients may be financially ready to embark on dental therapy. This means they will often need to choose between doing the dentistry or spending money on something else.

In all fairness, we all do the same. We constantly choose between spending money on some things over others based on personal priorities.

The challenge we often encounter when talking with patients is capturing their full attention for them to grasp the implications of any given therapy. For instance, educating them on some critical aspects involving surgical placement of an implant, such as hard and soft tissue management and 4-dimensional positioning, not to mention the importance of implant selection. While all of this seems straightforward and obvious to us, it may be completely foreign and, to an extent, irrelevant to patients particularly when they are concerned about their finances and have other significant priorities.

This is why it often becomes crucial to customize our narrative based on what we hear, what we see, and what we feel may be the points that truly drive the discussion home.

So, there I was, mentally debating how to articulate a compelling argument for our patient who wants to have the implant placed elsewhere, when I noticed something. It was the expensive handbag she had placed on the countertop of the operatory.


The Bottega Argument

Full disclosure here, I know very little about handbags. But it just so happened that I had recently been “educated “about that specific brand—the Bottega Veneta, known for its iconic “intrecciato” design, which is a special technique for weaving leather strips together and has grown to be an essential motif of this brand. It is one of those things that once you see it, you cannot unsee it. And, that specific model is worth close to $5000.

Of course, it is none of my business why she had this luxury item and is so concerned about the cost of a dental implant, particularly one intended to go in a “part of my mouth that is not noticeable.” All I knew at this point was that this iconic handbag was about to become my “communication assistant,” and it was time for me to get creative for a couple of minutes.

So, I said to her, “You know I could not help noticing your beautiful “Bottega handbag.” They are so cool, aren’t they? They come in such amazing colors, like that lime green, and of course their “intrecciato” design is so unique.” Then I paused, and I could see that she was intrigued to see where I was going with this.

I said, “I’m no expert, and to my “uneducated eye” it would be impossible to tell if this is an original or one of those clones. In the garment industry, clones are often undistinguishable, and the price difference is so big that there is no wonder there is such a big market for them. On the other hand, I am sure an original piece could be easily identifiable for a savvier connoisseur.”

Of course, I did not pause to judge or to inquire if it was a fake bag. It was time to apply the example to her dental implant buying decision.

“You know,” I said, “just as in the handbag world, there is a huge replica market with dental implants. There are tons of different systems that are significantly less expensive. In our office, however, we exclusively utilize the premier brand of implants. This is a foreign body that will be surgically installed in the bone of our patients, so we need to have scientific evidence that the material it is made of, the implant design, and configuration are all proven to work.”

I continued by adding more to consider, saying, “And with implants, there is also the question of how precisely they are surgically placed, so for us to be able to fabricate a crown that looks and functions seamlessly on top, the implant underneath needs to be positioned in a very specific site. To achieve this kind of precision, our team generates a computer-based surgical guide that allows us to place the implant exactly where it is intended to be, and by doing so we can minimize complications in the future.

At that point, the patient looked at me and said: “Okay Doc, now you are making me a bit nervous. I did not realize there was so much detail behind one screw for a missing tooth. I get it now. I think I would rather have the whole treatment done here.”


Driving Informed Decision-Making

The lesson here is that educating patients is an art form. Not all patients are willing or capable of understanding all the intricacies and implications behind the proposed treatment, which is precisely one reason they rely on us. And that means we need to take the time to let the patient understand what is in store for them when choosing a given treatment. Moreover, that is often why we need to customize the narrative to drive a more informed decision-making process—one that is intended to reduce anxiety, build engagement and trust and, only then, increase case acceptance.

Remember, it all comes down to opening our eyes, ears, and heart and connecting with the patient at an emotional level when it is our time to talk.

I hope you find this “Bottega Argument” useful when helping your patient's “Buyer’s Journey” and you are encouraged to use examples like this when helping to drive your patient's decision process.


Ricardo Mitrani, D.D.S., M.S.D., is a member of Spear Resident Faculty.