Patients become programmed by their expectations. They expect that you and the team will be friendly and encouraging. They expect you to be professional and thorough, and they expect that a simple "no" will end the conversation if they don't want to proceed with what you present. Chances are, they have had treatment suggested to them before that they have turned down. You promised to put a watch on it, and that was that. That's the way the routine goes.

It's the same with you. You've raised the same concerns before many times, with many patients, and heard the same variations of "no" in response, so it's easy to just forget it and move on to the next patient. It's easy for you to become programmed by expectations too.

Clearly if there is going to be a breakthrough in how patients view and value your dentistry, it's going to have to involve a shake-up of their expectations. In other words, if you want patients to invest their discretionary income, you and the team have to be ready to invest your discretionary energy.

You obviously can't go to great lengths to break out of the routine with each and every patient. But what if you selected two a day, one in the morning and one in the afternoon? Two patient visits a day where you make a conscious, focused effort to shake up your routine and defy their expectations. Two patients for whom you develop a comprehensive, personalized game plan that makes you really stop and think about what it takes to reach them and makes them see your practice in a whole new light. See two patients each day who are going to experience something extraordinary.

The patients you choose should not be randomly selected; you want to target people who have significant outstanding treatment that you know would make a great difference in their lives if it were completed. Identify these two patients at the morning meeting and have the team work together to gather intelligence, create a profile and develop a strategy that takes into account what you have tried in the past with this patient, what you haven't tried, and what you can do differently.

Here is a profile form you can use to guide your strategy.

It's important that this be a team activity for two reasons. First of all, it's an opportunity to pool knowledge and ideas so that everyone knows what everyone knows. The other reason you need to get the team involved is the simple fact that sometimes the person with the best relationship with the client is not the dentist.

Maybe a patient to focus on is one who has not had significant dental work in some time, but who is disciplined about keeping a regular hygiene schedule. Maybe the strategy should be to book some extra time for that patient's next visit so the hygienist can take the time to present a case for ideal care, to say to the patient, "Before you go, there's something I'd like to talk with you about ... "

This is how real progress happens. It's not about a miracle breakthrough where your entire client base suddenly "gets it." It's about a focused and strategic application of resources and energy where the potential benefits – and the possibility of success – are greatest. It's a smart way for you and the team to build confidence and grow.