{"id":2492,"date":"2016-05-24T06:00:32","date_gmt":"2016-05-24T11:00:32","guid":{"rendered":"http:\/\/allisonwatts.com\/?p=2492"},"modified":"2020-08-28T12:05:21","modified_gmt":"2020-08-28T17:05:21","slug":"ep-49-transforming-patient-process-dr-bob-frazer","status":"publish","type":"post","link":"https:\/\/allisonwatts.com\/ep-49-transforming-patient-process-dr-bob-frazer\/","title":{"rendered":"Ep #49: Transforming Your New Patient Process with Dr. Bob Frazer"},"content":{"rendered":"
This month on Practicing with the Masters<\/em>, I have a special treat for everyone. My guest today not only gave an amazing interview on our call\u00a0but, when the recording cut out, agreed to talk to me again the next day to make sure all of you could hear the rest of his amazing lesson.<\/p>\n Bob Frazer is the founder of RL Frazer & Associates, an innovative thought leader in the world of dentistry. He has been a sought-after speaker and consultant for dentists and their teams for over thirty years. He has presented at over a thousand events and workshops across the world\u00a0and is a member of the National Speakers Association.<\/p>\n In addition to being a world-renown presenter, Bob and his firm offer dentists a range of transformational services, including applied strategic planning, performance coaching, growing emotional intelligence, elevating the new patient experience, and hiring high and growing achievers. He also leads wilderness leadership adventures and a national study club, which is his version of the Inner Circle.<\/p>\n Bob helps dentists around the world realize lives of balance, fulfillment, and significance. He shows them how to make their comprehensive and restorative dental practices not only health-centered and of the highest quality, but also truly remarkable and profitable.<\/p>\n Join us today as Bob helps us to start removing our boundaries to potential by sharing his proven models, principles, and processes that you can start using immediately to build your own perfect future. He also shares his methods of creating the completely unique new patient experience for anyone who walks through your door and into your practice.<\/p>\n <\/a><\/p>\n Welcome to Practicing with the Masters<\/em> for dentists with your host, Dr. Allison Watts. Allison believes that there are four pillars for a successful, fulfilling dental practice: clear leadership, sound business principles, well-developed communication skills, and clinical excellence. Allison enjoys helping dentists and teams excel in all of these areas. Each episode she brings you an inspiring conversation with another leading expert. If you desire to learn and grow and in the process take your practice to the next level, then this is the show for you. Now, here\u2019s your host, Dr. Allison Watts.<\/p>\n Allison:\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Welcome to Practicing with the Masters<\/em> podcast. I\u2019m your host, Allison Watts, and I\u2019m dedicated to bringing you masters in the field of dentistry, leadership, and practice management to help you have a more fulfilling and successful practice and life.<\/p>\n Hi, everybody. Welcome to Practicing with the Masters<\/em>. Thank you so much for being here to listen to Bob Frazer. I just want to let you know that 22 minutes into the original call the recording stopped.<\/p>\n I talked to Bob and he was kind enough to rerecord it with me. We wanted to make sure that you had all the good juicy information and got the value from this call. So I hope you enjoy it. We\u2019ll just start it from the beginning and just know that those of you who were on it, it will be a little different in the second half. Enjoy the call. Take care.<\/p>\n Many of you know Bob very well. We\u2019ve been friends for a long time and he\u2019s a mentor of mine. I\u2019m thrilled to have you on tonight, Bob.<\/p>\n Bob:\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Thank you so much, Allison. Great to be on with you.<\/p>\n Allison:\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Absolutely. Bob Frazer is an innovative thought leader in the world of dentistry. He has been a sought-after speaker and consultant for dentists and their organizations for 30 years. He has presented over 1,000 presentations and workshops across North America and Europe and is a member of the National Speakers Association.<\/p>\n In addition to being a popular presenter, he and his firm offer dentists a range of transformational services including: applied strategic planning, performance coaching, growing emotional intelligence, elevating the new patient experience, hiring high and growing achievers, wilderness leadership adventures, and a national study club which is kind of his version of the He helps dentists realize lives of balance, fulfillment, and significance while he shows them how to make comprehensive and restorative dental practices not only health-centered and highest-quality, truly remarkable, but also profitable. He removes barriers to people\u2019s potential providing proven models, principles and processes from which they can design and build a preferred future.<\/p>\n Bob held a successful private group practice for over 30 years and founded his consulting firm R. L. Frazer & Associates in 1991 in response to mounting interest in his coaching and consulting services. He\u2019s recognized as a foremost authority in applied strategic planning and strategic management in dentistry today. Also I know you\u2019ve done some things outside of dentistry.<\/p>\n Bob:\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 We have. We just signed a contract actually to take the Purple Cow transformation stuff to a large food conglomerate we work with and applied strategic planning. So that will be fun. They play at a little more intense level than we do in dentistry so that\u2019s kind of fun to do.<\/p>\n Allison:\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Interesting. Bob is also a masterful storyteller. He shares with humor and poignancy how to harness the powers of vision, leadership, and emotional intelligence in one\u2019s life and practice. He\u2019s a fellow of the American College of Dentists and the International College of Dentists and has published over 50 articles in dental journals such as Dental Economics<\/em>.<\/p>\n Bob is also newly elected president elect of the AES, which many of you guys know about that and are members of that. I can see who\u2019s on here. That is the American Equilibration Society. And now, is it called something different?<\/p>\n Bob:\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Yeah, AES, we\u2019re going to rebrand it. It\u2019s really AES, myofascial pain dysfunction, occlusion, and comprehensive care because it\u2019s really what it\u2019s about. Our next two programs are going to be very oriented toward comprehensive care with an emphasis on occlusion and myofascial pain. But the whole nine yards of airway and salivary testing and you name it. So I hope everybody on the phone listening will join us. Not the greatest time to come to Chicago, February 21 and 22, but we\u2019d love to have you.<\/p>\n Allison:\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 All right. That\u2019s an invite thing\u2026<\/p>\n Bob:\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 That\u2019s the invite, yeah. Let me know you’re coming and I\u2019ll make you a presidential VIP on the 2018 anyway.<\/p>\n Allison:\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Nice. All right. Bob, again, thank you for being here. If anybody has a question or anything, push *2. I know some of you guys probably read the introduction or the bullet points that I sent out and some of you are doing the Purple Cow, talking about Purple Cow with Bob in his study club. But I want to start by just having you help us understand what you mean by Purple Cow.<\/p>\n Bob:\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Absolutely. I was privileged when I went into this work. In my previous work, I spent a lot of time with the likes of Pete Dawson and Ralph Youdelis and Frank Spear and John Kois and Gerry Kramer, up at Boston in perio-prosthesis.<\/p>\n When I went into this work, I said, I better get in with some of the best people in coaching\/consulting work. So I chose Nido Qubein. Some of you know Nido. He\u2019s a speaker hall of famer. He is president of High Point University and has taken that school to an extraordinary level. He\u2019s still coaching me and he introduced me to Seth Godin a short while back.<\/p>\n Seth is probably the foremost marketing genius maybe in the world. He\u2019s the guy who created Permission Marketing<\/em>. He generated a lot of the concepts that led to blogs and a whole variety of things. In fact, if you go online and you may want to do this, there is a YouTube of Nido Qubein, N-I-D-O Q-U-B-E-I-N, interviewing Seth Godin at High Point University, fascinating interview. It will be well worth you watching.<\/p>\n I have a propriety copy of a talk he gave around the Purple Cow which I used with my national study club and the Purple Cow<\/em> book itself is a very short book. I\u2019m curious, Allison, is there any way to tell how many on the line have actually read Purple Cow<\/em>?<\/p>\n Allison:\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Sure. If you guys have read Purple Cow<\/em>, press *2 and I\u2019ll see your hand go up. One\u2026<\/p>\n Bob:\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 So how many do we have, roughly?<\/p>\n Allison:\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 So far one. I know Ryan has read it.<\/p>\n Bob:\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Ryan has read it. He\u2019s part of the national study club. Well let me talk a little bit about it. In the book, he talks about driving through France. As he\u2019s driving through France, he\u2019s in a beautiful pastoral area and he sees these cows on this beautiful backdrop of green grass and beautiful trees. His family and him and they were, \u201cOh, wow. Look at that. Isn’t that terrific?\u201d<\/p>\n But they drive for two or three more hours and it\u2019s nothing but that. It\u2019s just constantly that. They pretty well begin to ignore it. I will tell you, my belief today, even though dentistry has fractionated into a lot of managed care and those of us that are still in private practice and those of us that are largely, as most of my clients are, non-par in private practice. There\u2019s still among the public, there\u2019s an awful lot of sameness. In other words, if you go in and think about the average dentist, the kind of examination, I know that nobody on this phone call is an average dentist, you wouldn\u2019t be on the call. But it\u2019s pretty much the same thing.<\/p>\n It is a transactional experience. One of the things that Nido taught me earlier is that if you provide transactions for people, exams, veneers, crowns, onlays, CAD\/CAM, grafts, you name it, and you put that on your website as many dentists do, then you’re about a commodity. But if you provide something that is transformational, that is unique in the marketplace, then you have a position in the marketplace which is much less assailable.<\/p>\n So they’re driving through the countryside and he said, \u201cCan you imagine if suddenly after seeing all these cows that we\u2019d begin to almost ignore, we saw a purple cow? We\u2019d pull the car over to the side of the road. We\u2019d get out of the car. We\u2019d go over. We\u2019d take pictures. The kids would run up and want to touch it, etc.\u201d That\u2019s what we have to be in today\u2019s world.<\/p>\n He defines Purple Cow as something that describes something that is phenomenal, counterintuitive, and exciting, and flat-out unbelievable. It\u2019s not a marketing function, this is really key, that you slap onto your product or your service. Purple Cow is inherent. It\u2019s built in and if it\u2019s not there, it\u2019s not there. Period. The essence of Purple Cow is that it must be remarkable. What he means by remarkable is something that people talk about. It\u2019s worth talking about. It\u2019s worth noticing. It\u2019s exceptional. It\u2019s new and it\u2019s interesting.<\/p>\n One of the things, Allison, that you know because you were in coaching for a while, one of the things we do as you adopt this three-phase examination process which I learned from the great Bob Barkley. I don\u2019t know how many of you had the opportunity to delve in. I know Mike Lewis has and maybe many of you, the rest of you on the phone conference will. If you haven’t already, go to Lynn Carlisle\u2019s wonderful website inthespiritofcaring.com because he\u2019s got a wealth of Barkley information on there that you can look at and you can read about.<\/p>\n Barkley was talking about things in 1976 in the area of health-centered and relationship-based dentistry that are as pertinent today as they were in 1976. When you look at what Seth Godin is talking about, there\u2019s a connection because Barkley was talking about creating a patient experience. Not simply an exam, but an experience for that patient that was transformational, that was indeed a Purple Cow.<\/p>\n As I said earlier, when we were working with Allison, what we expected to see after she mastered this three-phase exam and I know that you’re still doing that, Allison, and I know you’re doing it, Ryan. That one third of the new patients at their first visit would go to the desk and ask to appoint somebody else at the end of that appointment for the same kind of examination, whether that be their husband or their friend or neighbor or whatever or they would refer somebody. That\u2019s pretty remarkable to get people going out and talking about that experience in such an enthusiastic way that they’re already referring people to you.<\/p>\n We expect that. That\u2019s one of the cardinal markers we use with our coaching clients to monitor how quickly do people refer after their first visit with you. Godin went on a little bit further. Let me give you a couple more quotes to kind of roll around as I talk about what we pioneered over that 30-year period. I think, Mike, I think you use this process very similar to what Barkley taught.<\/p>\n Godin goes on to say, \u201cA new product or a service offering is nothing more than an idea.\u201d That ideas that are spread are more likely to succeed than those that don\u2019t. So how do you create an idea that spreads? You don\u2019t try to make a product for everybody. That\u2019s the first thing. Because when you make a product or a service for everybody, it\u2019s really for nobody.<\/p>\n He talks about the bell curve. He says where you want to be in today\u2019s world, if you look at dentistry, the great mass of dentists fall on the bell curve. I don\u2019t care whether they’re managed care or they’re in private practice, you want to be at the perimeter of the bell curve because that\u2019s where people will see you and see you as being unique and different. You have to begin that with that first phone call, your website, everything has to speak to that difference that you are.<\/p>\n He says, \u201cWhen everybody\u2019s products and services, when they’re all taken, and in fact the everybody products and services are all taken.\u201d What you want to develop in your practice are \u201csneezers.\u201d Sneezers of your idea virus. I\u2019m going to talk about a number of ideas tonight in the context of that new patient experience. What I\u2019m really going to try to do is to share with you what I’ve labeled some secrets to how you can have this emotional intelligence, relationship-based, health-centered, values-interpreting practice and have an indeed Purple Cow experience in multiple places.<\/p>\n In fact, when we brought the national study club together back in October and they had read this book, we asked everybody to bring at least one Purple Cow from their practice and present it to the group. It was pretty extraordinary. But you\u2019ve got to have, in my opinion, again, these are my truths, everybody knows about truth.<\/p>\n There was a true story back in 1938, a bull elephant escaped from a zoo in St. Louis. Now that wasn\u2019t the real story. The story was that after 24 hours looking for this bull elephant, they couldn\u2019t find him. St. Louis was a pretty big city in 1938. A call comes into the police station the next morning, a little old lady saying, \u201cOfficer, officer, there\u2019s a huge animal in my garden.\u201d To which the policeman said, \u201cOkay, fellas, relax. We\u2019ve found the elephant.\u201d He said, \u201cMa\u2019am, what\u2019s the elephant doing?\u201d She says, \u201cWell, he\u2019s pulling up all my vegetables with his tail.\u201d<\/p>\n The policeman then says, \u201cWell, ma\u2019am, what\u2019s he doing with them after he pulls them up?\u201d She says, \u201cYou wouldn\u2019t believe it if I told you.\u201d So she is seeing what she thinks is the tail of the elephant is the trunk of the elephant. When I talk to you tonight, I\u2019m very passionate about my truths. But realize that my truths may not be yours and that\u2019s okay. And sometimes the opportunity of truth is truth. So take what I\u2019m saying with an appropriate grain of salt.<\/p>\n Lastly, two more quotes from Godin and then I\u2019ll move into what we\u2019ve done and how we\u2019ve pioneered this. I\u2019m going to ask the group a question or two. He says that, \u201cIt seems that we face two choices\u201d and I think this is true in dentistry. \u201cWe can be invisible, anonymous, un-criticized, and safe, or we can take a chance on greatness, uniqueness, and the cow. Because in today\u2019s world, being safe is really risky.\u201d<\/p>\n Lastly, he says that what you want in these people who are the sneezers, these people that are your target market\u2014by the way, another excellent book if you haven’t read it is a book that was written by the Drucker Foundation called The Five Most Important Questions You Will Ever Ask of Your Organization<\/em>. Excellent book. Sharp book. But who is your target market?<\/p>\n Well in this, he\u2019s talking about the target market for those people who created Purple Cow. He talks about something called otaku which is a Japanese word which translates into something that\u2019s more than a hobby but less than an obsession. He says what you want is consumers with otaku who will seek you out and then sneeze on their friends the idea virus that comes out of a well-designed new patient experience.<\/p>\n Then he asks, \u201cAre you obsessed or are you just making a living?\u201d He notes that everybody who works at Patagonia is an outdoor nut. I can tell you that in our practice, we had chosen our team members very carefully and they were very passionate and enthusiastic about what we did.<\/p>\n Lastly, he says, \u201cRemember that your practice can’t be vanilla.\u201d Because in every market, that niche, the vanilla niche, is a boring slot and it\u2019s filled. So I want you to imagine if you’re on this call that I want you to think about the results you want from your new patient experience. I\u2019m going to ask you to tell me what results would you like to get from your new patient experience?<\/p>\n As we think about that, I mean, after they\u2019ve experienced whatever it is you’re doing now, what are the results you’re hoping to have happen for this new patient? Let me take a response or two from the group, or three.<\/p>\n Allison:\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Bob would like to know what are the results you’re looking for from your new patient experience? Oh, there\u2019s a hand. Dr. Susan Maples. I just unmuted you.<\/p>\n Susan:\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Hi, Allison. Hi, Bob.<\/p>\n Bob:\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Hey.<\/p>\n Allison:\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Hi.<\/p>\n Bob:\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Susan could be teaching this.<\/p>\n Susan:\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Oh, yeah right. I want trust. I want kind of an authentic collaboration where I get the patient\u2019s needs really right on my own. I can see what they want. I want a mutual agreement and I want a financial closure and I want booking. Is that too much to ask?<\/p>\n Bob:\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Not at all. Trust, collaboration, mutual agreement, did you say?<\/p>\n Susan:\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Yeah, I want to know that I got it right too. I want a sense that I really kind of hit a home base with the patient.<\/p>\n Bob:\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Then you want them to choose your best advised dentistry. Terrific.<\/p>\n Susan:\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Financial closure is a big one.<\/p>\n Bob:\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Financial closure, yeah. Who else has something that they want that hasn\u2019t been mentioned by Susan?<\/p>\n Allison:\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Dennis, your hand is up also. Hello?<\/p>\n Dennis:\u00a0\u00a0\u00a0\u00a0\u00a0 Hey, how are you? Dennis Abbott. Susan Maples, hello. One of the things that we do is we have that kind of Purple Cow I guess that you were talking about in that we really try to service mainly oncology patients. So one of the things that is important for us is for the patient to really understand the journey that they’re about to undergo because usually we\u2019re going to see these patients right after diagnosis and before they get into treatment.<\/p>\n So a lot of times I\u2019m able to answer questions that they may have left the oncologist still having and especially as it relates to what\u2019s going to be going on in the mouth, especially in our head and neck patients. The one thing that\u2019s important for us is for the patient to feel like that experience has been phenomenal enough to go back and report back to their oncologist and say, \u201cThank you very much for sending me over there\u201d because that\u2019s how we market is marketing to physicians. It\u2019s the financial closure for us because we\u2019re pretty much getting that in that they have to get certain things done in order to get clearance, in order to move forward in their treatment. Yet, that kind of continues to grow our practice and then it makes us feel like they’re welcomed and they’re a part of it.<\/p>\n The other thing that we really try to do is really make sure that the patient understands that we\u2019re there for more than just the dentistry because we\u2019re also kind of an oral medicine practice. Want to make sure that they know and really feel that we\u2019re sincere whenever we say, \u201cWe want you to call us as you’re going through things if you have any problems at all that come up in your mouth.\u201d So having them take that ownership and that stock in \u201cI\u2019ve got somebody on my team now that can really handle these kinds of situations.\u201d<\/p>\n Bob:\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Beautiful. Beautiful. That\u2019s beautifully said, Dennis. Who else has something that they might add that hasn\u2019t yet been said? An awful lot has been said.<\/p>\n Allison:\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 I\u2019ve got Juliana Rowland.<\/p>\n Bob:\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Juliana, okay.<\/p>\n Juliana:\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Hi, Bob.<\/p>\n Bob:\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Hi.<\/p>\n Juliana:\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 I remember you from the Middle Fork a few years ago.<\/p>\n Bob:\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Okay, yeah.<\/p>\n Juliana:\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Yeah, how are you?<\/p>\n Bob:\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 What a wonderful\u2014yeah, I\u2019m getting ready to do it again. I\u2019ve got the Truth North study club is having me come talk to them. That will be fun. I\u2019m doing good. How about you?<\/p>\n Juliana:\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Wonderful.<\/p>\n Bob:\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 What did you think of that we haven’t said yet?<\/p>\n Juliana:\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 I agree with what\u2019s been said and I also would add I want that patient to go, \u201cWow. I’ve never been so listened to. I\u2019ve never had this experience of really sitting and talking and understanding.\u201d I guess that\u2019s what would make your sneezer.<\/p>\n Bob:\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 It would. That\u2019s beautiful, Juliana, thank you. Let me tell you what ours are. They really will echo some of yours. We want them to feel uniquely welcomed and safe. We want them to be oriented and we want to give the patient as much control as we possibly can. We want them to understand and we want to reflect and use empathic listening to listen to both their needs, their wants, and especially the emotions behind those.<\/p>\n One of the things I’ve gotten extremely excited over the last ten years is emotional intelligence because I think people really feel understood. Not when you necessarily repeat the details of what\u2019s going on in their mouth and you\u2019ve heard it really well but when you reflect to them the emotions behind the details of what they\u2019ve told you. I\u2019ll give you an example of that in a little bit.<\/p>\n We also want to begin a collaborative relationship. We want a client to assess their self-image dentally and medically. I\u2019ll show you how we do that. In other words, we don\u2019t start in the treatment room. We start in the consult room in what we call a pre-clinical three-phase exam which we were taught by Barkley. We even do something even weirder and we think it\u2019s very Purple Cow-ish. We do not exam people on the first appointment unless they have an emergency.<\/p>\n We get to know them. We find out who they are. We get our full records and then we exam on the second visit which is generally within seven days, sometimes as many as ten days. We have all of our records in front of us between the models, the photographs, the digital radiographs, etc. If we were using CT scans, we\u2019d have those too. We want to explore both their probable and preferred future because we know if we don\u2019t understand what they perceive as their probable future, they are educably handicapped.<\/p>\n Barkley taught me this way back. He said, \u201cIf you go to the slums and you study slum children. The ones who excel in school are not the masses of the slum children. The mass of slum children don\u2019t excel in school because they’re told that their future is probably pretty bleak. \u201cYou\u2019ll always be working for somebody else. We\u2019ve always been garbage collectors in our family, you probably will be too.\u201d<\/p>\n Patients come to us with a probable future dentally. We need to understand what is that. What do they expect to happen over the next five or ten years. I\u2019ll tell you how Barkley got at that and we\u2019re still using his magical questions around that to get at that. But we want them to also express what they would prefer as to their dental future.<\/p>\n The other thing we do, it\u2019s been interesting when I do my coaching even among well-trained people maybe like might be on this teleconference tonight, they take a short-term perspective with their new client. Meaning they look at what\u2019s wrong now and what might be wrong in the next year or two. We literally tell people that not only are we looking at what\u2019s wrong now and what they want us to do for them and what might be developing, we want to help them develop a plan for the rest of their life. To look down the road the next 10, 15, 20, 25, 30 years. The nice thing about dentistry, it\u2019s highly predictable and we can generally do that.<\/p>\n Lastly, we want to make quality our constant and let time be the variable. Again, Bob said too often what we do is, \u201cWell, Ms. Smith, here\u2019s your three choices: good, better, and best. We must do it now, which will it be?\u201d Well most people have coupons they’re redeeming for their college education of their son or perhaps other coupons for a new home or a remodel or perhaps a special vacation or a trip and they come to us with those already due and payable.<\/p>\n Suddenly we\u2019re telling them all this dentistry that needs to be done. Most of us on the call I think know that with probably six or seven procedures we can take almost anything that is acute and turn it chronic and buy people time so that they’re able to do it in the very best way possible.<\/p>\n The other piece of that though that\u2019s very important is that we have an outstanding pending treatment system. That\u2019s a discussion for a whole other time or it\u2019s on some of the audios that we have available if you’re interested in that.<\/p>\n Again, now that we\u2019ve talked about the results we want, what is the behavior we have to have in order to get those results? Allison, we\u2019re the only two on the call right now because of our technical glitch earlier. What kind of behaviors are we going to need? Give me a couple that you think are necessary in this new patient experience for us to manifest, what kind of behaviors to get the results we want?<\/p>\n Allison:\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 I would say listening.<\/p>\n Bob:\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Outstanding, Allison.<\/p>\n Allison:\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Yeah, outstanding. I was going to say profound listening.<\/p>\n Bob:\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 That\u2019s good. What do we have to listen for?<\/p>\n Allison:\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Listen for, I think what they want.<\/p>\n Bob:\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Yes.<\/p>\n Allison:\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Their fears. Their concerns. Listen for, I do like how you talk about in emotional intelligence, listen for the emotions underneath what they’re saying.<\/p>\n Bob:\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Absolutely. If the patient tells you that they\u2019re still not happy with their smile and they\u2019ve had orthodontics three or four times, let\u2019s say three times, and you get all the details of how they had them when they were early in their teens and then maybe in college and then as a young adult they had another round of treatment, you figure out that they had Crozat earlier and then they had Edgewise, etc. You get all that down on paper, you know, that maybe useful to us technically but it doesn\u2019t really tell the patient they were heard.<\/p>\n What tells the patient they were heard is, \u201cOh my gosh, you\u2019ve had orthodontic treatment for, sounds like over seven or eight years and it hasn\u2019t corrected the problem that you wanted to have corrected. That must have been very frustrating. That must be feeling a certain sense of hopelessness that it could ever be corrected.\u201d That\u2019s when the patient knows that they’re understood. Not when you let them know that you knew they had removable ones and etcetera etcetera etcetera.<\/p>\n One of the most challenging things we have with our docs as I\u2019m doing coaching with them is to listen tight for those emotions so they can respond to the emotions. That makes sense?<\/p>\n Allison:\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Totally.<\/p>\n Bob:\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 What other behaviors will we need? Let me just give you ours. Number one, we want to be warm and welcoming as a guest. When somebody comes to your office and you call them a new patient, they’re really not a new patient. You haven’t done any treatment, they haven\u2019t committed to any treatment yet. So treat them as a friend or a guest.<\/p>\n We want to give them a tour of the office, our health relationship coordinator does that. We know at the morning huddle who is coming in. If they were referred by Allison Watts or Ryan Coulon or Mike Lewis, we\u2019re going to acknowledge that and everybody on the team will know that because in the morning huddle we made sure everybody did. We always give a tour of our office and we take them through the make-ready.<\/p>\n We always says, \u201cNow we\u2019re going to take you through the sterilization make-ready area. We\u2019ll move through there rather quickly because it\u2019s like a busy kitchen.\u201d But we want them to know what we\u2019re doing. We show them that. We show them the turtle pond. We show them private areas of the office they can have if they need to get alone with their telephone or whatever and people greet them as they come through. We want them to be a very special guest to the office. Where did we get that?<\/p>\n I was fortunate to have as a very long-term patient Ann Richards, governor of Texas. While she was governor, she\u2019d come in with a Texas Ranger and we\u2019d often say, \u201cBoy, don\u2019t we roll out the red carpet for Ann. Why don\u2019t we do that for everybody who comes through this practice? Let\u2019s treat them like they’re the governor of Texas.\u201d So I hope everybody is doing that with their patients.<\/p>\n We need to be fully present. What does that mean? We need to be there mentally, emotionally, physically, and spiritually. That\u2019s not easy in the middle of a very busy day, maybe you’re preparing another case. Maybe that margin you’re chasing on the distolingual of tooth number 18 is giving you a fit. But now you\u2019ve got to go meet somebody and you need to center yourself. My team is really good at helping me center myself before I go in there.<\/p>\n They\u2019ll tell me, \u201cBob, would you take a big, deep breath?\u201d This is usually in the reception\u2014not the reception\u2014but in the make-ready area as we\u2019re walking back to the consultation room. The other thing, patients want your undivided attention. So when you go in to meet that new patient, it\u2019s really important that they’re the only thing that matters right now. Put everything else and know that you\u2019ve got a competent team taking care of other things. You want to be uninterrupted in that new patient experience. Another reason why we do it in our consultation room.<\/p>\n That\u2019s what we call the pre-clinical which is Barkley\u2019s three-phase examination. Again, Barkley\u2019s three phases, preclinical, the intake interview. We move from that to the codiagnosis where we\u2019re co-discovering with the patient, a collaborative way talking about choices and which choices they have, including the choice to do nothing. We certainly recognize that that\u2019s a choice and let them know that early during preclinical. As long as it\u2019s an informed choice, they’re aware of the consequence of that choice, we can accept that choice.<\/p>\n You have to take the time to listen with respect, understanding, acceptance, and gratitude. That gratitude one may be the most powerful of all. I mean, all of us should be very grateful that in today\u2019s world with the aggressive advertising that\u2019s going on out there, the patient actually comes to see us out of all the dentists they could have seen.<\/p>\n I was fortunate that\u2014and many on this phone call are probably the same way\u2014I had people that would fly across the country to see me. Or they would come from Houston which is three and a half, four hours away, or San Antonio, or Dallas. A lot of good dentists in Houston. A lot of good dentists in Dallas. So I think we need to be grateful that they’re there.<\/p>\n Be genuinely caring. You see caring all the time in advertisements but you\u2019re genuinely caring because deep in your belief system, you really do care. Interpret value in the context of their wants. You know, the provider of a service always sets the fee but it\u2019s the consumer, the patient, who actually determines the value. But for the kind of dentistry represented by the people on this telephone call, they don\u2019t realize the quality efforts that you go to.<\/p>\n They don\u2019t realize that you look at your dyes under magnification until you mark your margins. That you work with only the best lab. That you’re using probably noble metals if you\u2019re going to use metal. That you go through a series of steps to make sure that it\u2019s as enduring as it can possibly be. But they don\u2019t know that. So we have to be interpreters of value. Everything we do from the very first phone call through the welcome, through the actual preclinical dialog, through the codiagnosis, and then in the consultation when we help them understand exactly what the treatment plan looks like.<\/p>\n Finally, as we deliver our treatment, we need to continue to show people what we\u2019ve done, that extra mile, that Purple Cow, if you will, that\u2019s unique. That they won’t have seen before. Hopefully when that crown goes in and you barely have to touch it, even if touch it at all, because it\u2019s in good occlusion because you took the time to take an accurate bite record, etc.<\/p>\n Be real transparent attentive and helpful in what we do with people. That\u2019s another behavior. Truly educate. Helping people clarify their choices. Educate in the sense of Gibran. Which is a book that I love, The Prophet<\/em>, it\u2019s on my bibliography and third-most widely read book in the world. He talks about the master going down to the sea. As he does, he\u2019s asking all these questions. One of those is about being a teacher. You know the literal definition of the word doctor is teacher.<\/p>\n Well in Gibran, he says that the teacher who is indeed wise does not bid you to enter the house of his wisdom. Rather they lead you to the threshold of your own mind. The teacher who walks in the shadow of the temple among his followers gives first of his lovingness and then of his wisdom. I try to make that my creed and it seems to be very, very helpful. It\u2019s what Carl Rogers said years ago about helping people is unconditional positive regard for a person. Does that make sense, Allison?<\/p>\n Allison:\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Mm-hmm.<\/p>\n Bob:\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 I know you have that in your being. So if all that\u2019s true, and what we did when we were recording everybody is I said the first question about what are my results I want for my new patient are fairly easy to answer. The second question, what behaviors do I need, a little tougher to answer. The most difficult question to ask is \u201cWhat are the beliefs I have to have and my team has to hold in order to sustain the behavior?\u201d<\/p>\n You know, oftentimes consultants will come in, they\u2019ll diagnose you. They\u2019ll prescribe a certain behavior to maybe your front office people or your clinical team or even you as the doctor. You do it for awhile. Then after six, eight weeks, six months at most, you stop doing it. Why\u2019d you stop doing it? You stopped doing it because they never got to your belief system. Your beliefs drive your behavior. Covey talked about this beautifully in his Seven Habits of Highly Effective People<\/em>.<\/p>\n So what are the beliefs we hold? Interesting enough, the first list of results, they’re eight on that list. The second list of behaviors, there\u2019s seven behaviors. On this list of belief, we have 15 beliefs that we hold.<\/p>\n Number one, people have an innate drive toward health. People absolutely, everybody we meet, unless they’re psychologically ill, they want to be healthier. People want our best and most complete care. They just don\u2019t have the same timelines to receive that care. Some people are going to take maybe years to get it done where others may do it in weeks or months.<\/p>\n Both health and illness can be a growth process. Health and illness occur within a larger context, meaning our lives. I think I mentioned to you last night and I\u2019ll mention it again here, that we had a patient once who was named Harvey. Harvey was in middle management at IBM. Frankly, his mouth was kind of like the bottom of a bird cage most of the time you saw him. You wondered whether he actually used the toothbrush or he used the right end of the toothbrush.<\/p>\n Well, Lorraina, my hygienist worked with him and got him cleaning his mouth a little bit better but he never would floss. He would come in and he came in one time, he\u2019d been with us about nine months at the time, and we were seeing him about every three months. By the way, he had a number of areas of carries that I placed IRM in because he wasn\u2019t ready for definitive dentistry. Don\u2019t put definitive dentistry in people\u2019s mouths who aren\u2019t ready to take care of it because it\u2019s going to fail and you\u2019ve hurt them and hurt yourself.<\/p>\n Now we\u2019ve got better materials today than IRM but that\u2019s what we did. Lo and behold, after a few appointments, he came to me and said, \u201cBob, if I hear one more time I’ve got to floss, I\u2019m not going to floss. I\u2019ll come in as often as you want to see me.\u201d So we had him on a monthly recare because he had some early periodontal disease. He came in for about two years that way. Then suddenly one day he comes in and Raina came to me and she said, \u201cYou won’t believe Harvey\u2019s mouth. It\u2019s clean as a pin and he\u2019s flossing.\u201d I said, \u201cAre you kidding?\u201d She said, \u201cNo.\u201d<\/p>\n I went to him and I met with him and I said, \u201cHarvey, what happened?\u201d He said, \u201cI\u2019ve been promoted. I used to manage two people, now I\u2019m managing 25 people. I need to get my mouth cleaned up. I want to get it restored. I want it to look good. I\u2019m going to take care of it.\u201d You understand that our dentistry is to enhance the quality of people\u2019s lives. We have to work with them to figure out where are they in their life and what is it they need to achieve their own life goals? People care more that they’re understood than that they understand is another of our beliefs.<\/p>\n Our most valuable service is diagnosis. Another belief we have is that authenticity, realness if you will, and congruence are fundamental. Interestingly enough when you study loyalty of any customer to a brand, you will find that the number one determiner of brand loyalty, and that would be true of dentist-patient loyalty is authenticity. Is what they say they are, are they actually that?<\/p>\n In other words, are they genuine and authentic? How do you become authentic? Well, you know this very well, Allison. You\u2019ve got to do some inner work yourself. I know you\u2019ve done it. I’ve done it. I\u2019ve been with Bill Woodburn who teaches EI with me. I’ve had counseling there. I’ve done Bradshaw\u2019s healing the inner child because I needed some work around that.<\/p>\n Only way I can be authentic is to know myself. L.D. said that beautifully, \u201cKnow thyself.\u201d That\u2019s how you become authentic. Health is a journey. It\u2019s a process, not a steady state. A team committed to core values is essential. Our practice is founded on values-based decisions by all concerned. If we have a major decision that\u2019s going to affect the lives of our team, we\u2019re going to make it in a joint discussion. I’m not going to make it unilaterally.<\/p>\n We cannot consistently treat our patients better than we can treat each other, especially the doctor and the team. The health of the relationship is another belief. Health of the relationship is more important than the health of the patient.<\/p>\n Then more time in the beginning because we start slow means less time when we go into treatment and into the future, relative to dental care. We had a logo that was a turtle with a delta around it. Every now and then people\u2014we also had turtle pond, people looked out on it. They would ask about the turtles. I’d say, \u201cYou know, we\u2019re a little like these turtles. You remember the story growing up with the turtle and the hare?\u201d<\/p>\n \u201cOh, yeah.\u201d<\/p>\n \u201cWell you remember the turtle started pretty slow didn\u2019t they?\u201d<\/p>\n \u201cYeah.\u201d<\/p>\n \u201cBut who won the race? We intend to do the same thing.\u201d<\/p>\n Lastly, be willing to sign our work. Be competent. I used to tell a patient in preclinical that when I place something in their mouth that I wanted to be willing to sign it and have somebody like David Hildebrand in Dallas, bless his heart, I know he\u2019s had health problems, or Fred Simmons in Houston, two really fine dentists, they would see it and they\u2019d know it was my work.<\/p>\n Lastly, that people gladly pay for what they value and want but reluctantly pay for what they feel they need but don\u2019t want. So again, as we look at those beliefs, remember that beliefs drive behavior. Same way with our patients. So if and when you encounter the patient who wants certain results and they’re not getting them, you have to not only try to modify their behaviors but try to understand their beliefs.<\/p>\n There\u2019s two kinds of doctors. This I learned from Rachel Naomi Remen and many of you know her, she\u2019s a pediatric oncologist that\u2019s written a book called The Human Patient<\/em>. She\u2019s also written Grandfather Taught Me How<\/em>. There is the active caring doctor who treats the patient\u2019s disease. If you come in with moderate periodontitis or mild periodontitis or occlusal disharmony, you’re treated pretty much the same way. They focus on the disease and the patient is very passive.<\/p>\n There\u2019s also the receptive, caring doctor who focuses on the patient\u2019s experience with their disease. That\u2019s what Barkley taught me, that we had to understand what was going on for them emotionally, physically as well, and mentally around whatever it was that was going on in their life dentally and in terms of their oral health.<\/p>\n So in this process we want to focus on wants, not needs. Wants, they equate with words. Needs equate with costs. We rarely use the word need in our practice. There\u2019s only three reasons why people buy and it\u2019s one of the secrets when I teach. I don\u2019t know if everybody knows what they are. They are, number one, they need it. Number two, they want it. Number three, they like the person selling it or the persons selling it.<\/p>\n So it is important, you don\u2019t like people you don\u2019t know. It\u2019s important I think in your office to have pictures of you and your team and perhaps their families. In a relationship-based practice, you’re drawing relationship-motivated people and they love to see relationships in your life. I often noticed more patients standing around looking at some of our pictures of our team and their children and their dogs and my kids and some of my adventures than they were looking at my wonderful plaques and diplomas of this perio-prosthesis course that I took or that one or etc.<\/p>\n As we\u2019re looking at this, I\u2019m reminded of the story of a woman by the name of Loretta. Loretta came to me and we have five levels of entry. Let me talk about that for a moment. The five levels of entry in our practice begin with the same one that I know everybody\u2019s got this one, it\u2019s urgent. It\u2019s an emergency. If they call with an emergency, we ask them how soon can you get here. It may be 10:00 in the morning and they say, \u201cOh, I can’t get there until 3:00 in the afternoon.\u201d They just told it wasn\u2019t as much of an emergency as you might have thought.<\/p>\n But we will tell them that Dr. Frazer or Dr. Bush will get you out of pain. \u201cThey do have regularly scheduled patients so there may be a slight delay when you get here but we don\u2019t want you to be suffering.\u201d Discussion of emergencies are a discussion for a whole other day because whatever you do in emergency care, get the patient out of pain, get in surgically and get out and for heaven\u2019s sakes, don\u2019t try to educate them. They’re not at a point to be educated.<\/p>\n The second level of entry in our practice\u2014by the way, when someone calls, we don\u2019t tell them we have five levels. We listen to them and then we triage them to the level that we think would be most comfortable and feel safest to them. Level two is what is called cursory care. What does that mean? It\u2019s you come in through hygiene, it\u2019s kind of the old standard hygiene appointment with some vertical bite wings, maybe a PA here or there. In the vernacular of John Kois or Frank Spear, it\u2019s a biological exam. We don\u2019t do much else.<\/p>\n We\u2019ll look a little bit at biomechanical or structural integrity but we don\u2019t evaluate esthetics and we don\u2019t evaluate dental facial if you will. And we don\u2019t evaluate very much beyond that in terms of function. That\u2019s in the comprehensive exam. So they come in through hygiene. Now only about eight or nine percent of our patients enter through hygiene.<\/p>\n Some will enter through hygiene because they were referred by really outstanding dentists like Allison Watts or Ryan Coulon or Mike Lewis or Gary Arnold and they\u2019ve been well taken care of. So they come in and they’re in great shape and we don’t have to do much with them. They come in that way and we\u2019ve gotten a good transfer of records.<\/p>\n But most people who come in at level two generally are extremely cautious and they just are wanting to put their foot in the shallow end of the pool. They come in through hygiene and it\u2019s a typical kind of dental exam if you will with the encouragement to move to level three.<\/p>\n What\u2019s level three? Level three we call self-care. That\u2019s a patient who calls, they want their teeth a lifetime. They acknowledge that in their intake interview on the telephone but they have their foot on the brake. There\u2019s something going on. Maybe they’re new to Austin. Maybe they’re a single parent. Maybe their husband is between jobs. We\u2019ve heard that on the phone and it\u2019s wonderful for me to know that this patient comes in with a yellow light, I need to go slow. I need to phase their treatment, etc.<\/p>\n The other is complete dentistry, the person who has their foot on the accelerator. They want to move forward and have the care done as quickly as possible. Lastly is something called Wellness Resource, which by the way, we were doing this back in the late 1970s and the early 1980s. It was a network of other healthcare providers in the area of stress, nutrition, weight loss, stress management, although we had our own biofeedback therapist on staff. We also did some nutritional analysis in house. Admitted, much of that was referred out.<\/p>\n So if you\u2019d come into Wellness Resource, we were going to help you elevate your entire health. As we\u2019re listening to the intake and somebody is telling us they had natural childbirth or that they’re a vegan, etc. She might say, \u201cWe think you might enjoy entering our practice on level five which is called Wellness Resource.\u201d<\/p>\n \u201cGosh, what\u2019s that?\u201d Then they explain it.<\/p>\n The other thing that\u2019s important is when you’re doing an intake interview on the telephone, make sure that the person taking that call is uninterrupted. She\u2019s not trying to check somebody out. So we always slightly overstaffed our front desk or many times they were handed off to the health relationship coordinator, that\u2019s the person in our practice who was the case worker for all new patients. That was her entire job for the most part.<\/p>\n She welcomed them. She read their online surveys that they had completed ahead of time. She highlighted them. She then showed them the tour of the office. Sat down in that preclinical appointment which was about an hour and spent the first 20 minutes with them just getting to know them. Then I would come in and I would be introduced.<\/p>\n Well a woman by the name of Loretta came to our practice and about maybe 45 minutes after she came in and I\u2019m ready to go in, Sandy still hasn\u2019t called me in. So I decided I would knock on the door. I did enter the room. And Sandy said, \u201cOh, Dr. Frazer, we\u2019ve been having an extensive discussion. This is Loretta.\u201d Loretta stood up; not all woman do that. She reached out, grabbed my head rather strongly if you will, strong grip. Looked me right in the eye and said she was glad to see me. Then she sat down.<\/p>\n Sandy proceeded to tell me how she had been referred by a clinic in Tijuana, Mexico and referred because she had eight amalgams that were poisoning her system. Well I didn\u2019t get many patients from Tijuana, Mexico. We were listed in a directory of people, this is in about 1983, 1984 that didn\u2019t use amalgam. It was a little more challenging back then than it is now. But in any case, we didn\u2019t take out serviceable amalgams. We just didn\u2019t use it. We thought there was enough question marks around it and we didn\u2019t also like the thermal expansion of amalgam after people got older and teeth got more brittle and fractures occurred. So we weren\u2019t like giving up a whole lot when we gave up amalgam.<\/p>\n The point I want to make is Loretta found us in a rather strange way. Then I listened to her story and Sandy told me how they ended up in Tijuana because her husband, Loretta\u2019s husband, had had a serious medical problem that was basically GI oriented but it never got better, never got better and they saw something like 24 different physicians in three different states, were not getting any help with it. Finally she heard about this center in Tijuana that did holistic treatment and use chelation therapy. They went down there and lo and behold he got well.<\/p>\n While she was there, they did an exam and they also did not like heavy metals. So they told her she needed to get these replaced and they gave her my name because I was in a directory for people who didn\u2019t use amalgam. I didn\u2019t even put myself there. Don\u2019t know how I got there but I was in that directory.<\/p>\n She also had told Sandy how they almost lost their business during that period of time and that they went through a very, very difficult period. They had little or no family to support them. When I walked in the room and I first met her and she smiled, I noticed her incisors were probably about 5mm long. You know on the telephone that they should be at least 10mm long.<\/p>\n As we sat down and we visited and we talked about a variety of things and got clear on what I thought I was supposed to do as her dentist and what I was going to ask her to do as my patient, that\u2019s what\u2019s called relationship by the way. We don\u2019t have time on this call to go into it in great detail but Barkley always said that we were good at establishing rapport, interpersonal warmth. But not so hot at establishing relationship which meant what are the expectations of me as your dentist getting clear on those? And what are the expectations of you as my patient?<\/p>\n Well we went on and we got the records. This time I took a facebow. Didn\u2019t always do that routinely but with a case like her, I would do it in phase one on every patient but not always at the first visit. We would always take a centric relation bite record and we would trim those in an orthodontic way. That\u2019s something for another talk as well so that we could look at CR but without the articulator. But we took a facebow and we did a number of other things.<\/p>\n She came back for codiagnosis about a week later and the first thing that happens there is she sits down with the HRC and they review the records. They review the photographs. They review the radiographs. She\u2019s just orienting her to the mouth, looking at the models as well. Pointing out areas that look suspicious. You know, our value is determined by the size of the problem we solve.<\/p>\n Think about your best team member. Your best team member is really good at solving problems. That\u2019s why she is your best team member. The same thing applies to a dentist. If a dentist solves only small problems, they’re not worth much. But if they solve large problems, they’re worth a lot more.<\/p>\n By this approach, by going into that codiagnosis, by them looking at their records before you even look at their records, they are beginning to grow the size of the problem in their own mind or the number of problems that they\u2019ve got. So by the time you get there, they’re ready to talk about these things. So we came in and I came into her preclinical a little earlier than normal actually. Sandy had not done as much orientation as she normally would do because I just had the sense that this driver personality wanted to see me.<\/p>\n Came in, Loretta was glad to see me. Sat down. Reviewed what she told me on her preclinical questionnaire. When I came to the part about them almost losing their business and almost losing her husband and going through these 24 physicians, I said, \u201cYou know, that must have been one of the most difficult, challenging and just heart rendering experiences of your life.\u201d<\/p>\n Then this very tough lady spent the next 20 minutes telling me pretty much chapter and verse of everything that happened. I listened. I reflected the feelings, the emotions of fear. The emotions of feeling confused, feeling lost, not knowing where to go. I just listened to her.<\/p>\n Now our exam on a person like that is about an hour and a half. So now Sandy has taken about 10 minutes, I\u2019ve taken 20 minutes, we\u2019re 30 minutes into a very complex exam and we haven’t even looked at anything dental. We looked a little bit at the records. We talked about a few things that we wanted to make sure we looked at. We talked about the wear on the teeth. Then we decided to move out of that consult room back to the chair.<\/p>\n When we go back, we use Frank Spear\u2019s approach of using a dental facial evaluation. We like the patient to be standing up for that. We give them a mirror. As I look at her, I had her smile. I began to talk about Earl Pound and how he studied 200 of the most beautiful smiles in the world and how as I looked at hers, I couldn\u2019t hardly see her teeth. If anything, they were reversed. The curvature did not follow the contour of the lower lip and that if she\u2019d like we could help her smile be more age appropriate or more youthful in appearance.<\/p>\n She said, \u201cGosh, you could do that?\u201d I said, \u201cYes, we could.\u201d We went through the phonetic evaluation noticing that again she was short on her F sound, her S sounds and etc. I began to talk to her about as we were now sitting in the chair talking to her about we would have to go through a period of transitionalization. Oh, I forgot to tell you that during preclinical she said she\u2019d only be here for another month and she wanted to get these amalgams taken care of before they moved out of the country.<\/p>\n Well at that point I told her, \u201cYou know, Loretta, this is going to take more than a month. It may take six to nine months.\u201d You have to go in and do the clinical exam. I\u2019m looking at really good records. I\u2019m dialoging with her. Then she said, \u201cSo you’re going to do one set of crowns and then you’re going to replace them?\u201d I said, \u201cYes, we\u2019re going to make some provisionals that will be our guide to our permanent ones.\u201d<\/p>\n To which she said, \u201cGosh, that\u2019s going to cost more than my automobile.\u201d I said, \u201cWell, what automobile do you have?\u201d She said, \u201cI have a Lincoln Mark IV, a new one,\u201d which was a little surprising to me given that she told me about her economic situation but nonetheless I said, \u201cGosh, well, you know\u2026\u201d Again, this was a few years ago, \u201cYou’re in the ballpark there.\u201d She said, \u201cYou mean $28,000?\u201d I said, \u201cWell, probably close to, in that vicinity. I won’t know until I\u2019ve worked out your complete treatment plan.\u201d<\/p>\n \u201cOh my gosh,\u201d she said. \u201cWell will you take my car in trade?\u201d I said, \u201cYou know, Loretta, I’d love to take it in trade but unfortunately as you know cars depreciate when you drive them off the parking lot. Fine dentistry is like fine jewelry, it does the opposite, it appreciates in value over time.\u201d<\/p>\n \u201cOh, so you won\u2019t take it in a trade?\u201d<\/p>\n \u201cNo, I won’t take it in trade, I\u2019m sorry.\u201d<\/p>\n \u201cI didn\u2019t think you would.\u201d<\/p>\n She leaned back, finished the clinical examination and sat her up. Said, \u201cLet\u2019s get you started with our hygienist next time. At that same appointment, we will have a consultation.\u201d It\u2019s the way we did it. We always decided on the first step in treatment, usually sometimes it was a diagnostic mounting, sometimes it was a hygiene visit. Oftentimes a hygiene visit because we didn\u2019t usually clean their teeth before we examined them. At the same appointment we would do the consultation. She said she was ready to do that then and I would write that up between now and the next time.<\/p>\n As she\u2019s walking out, she tells Sandy, my HRC, \u201cI want to get Joe in here as soon as possible to have this same kind of examination.\u201d I think I said early in our discussion that we would look for at least one third of your patients in that first or second visit that they came in making an appointment for someone else or getting a card to make sure they recommended you to someone else. That would be a cardinal sign that your new patient experience is indeed a Purple Cow. So let me ask you. Allison, you kind of know the answer to this, when did Loretta decide I was going to be her dentist?<\/p>\n Allison:\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Yeah, I think it was definitely when you were listening to her at the preclinical and specifically when you understood the emotions behind her experience with her husband and the health problems and all that she was feeling at that time.<\/p>\n Bob:\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Exactly. Would it surprise you that in most audiences where I tell that story and I ask them where did she decide to be my dentist that the majority of dentists will say, \u201cWhen you did her dental facial and told her that she could have a youthful smile.\u201d<\/p>\n Allison:\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Yeah.<\/p>\n Bob:\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Yeah, that\u2019s not where she decided. That was icing on the cake. She decided that I could trust this guy. He really understands who I am, what I\u2019ve been through, and boy, that\u2019s wonderful. That\u2019s a joyful way to practice. I know that you know that. I\u2019m preaching to the choir.<\/p>\n So let\u2019s bring this all together and bring it to closure because I know we\u2019re running out of time. When you work with patients, you have to be there fully present. You have to listen with your whole self. You have to listen with your head as well as your heart. It\u2019s the heart part that will speak to them the most powerfully. Remember too that patients in order to truly learn meaning that they’re going to manifest new behavior because of what happened with you in that practice, you’re going to climb something that Bob Barkley called the learning ladder.<\/p>\n The learning ladder said we begin at a state of unawareness and we move to a state of awareness. \u201cI didn\u2019t know that if my gums bled when I brushed that meant there was something wrong.\u201d Unfortunately, that\u2019s not enough. The next rung of the ladder, rung three, is they have acknowledged self-interest. Is that important to you? Would you like to correct that? Don\u2019t assume that they would. Find out if they would.<\/p>\n I remember one time asking a young woman who had some pretty moderate periodontal disease if this is something she\u2019d like us to address and she sighed deeply and said, \u201cYou do whatever you need to do. I can’t do anymore.\u201d Which I later learned she had just been filed on for divorce. She had two children. We don\u2019t know what\u2019s going on in people\u2019s lives and sometimes we need to be sensitive to that. So she couldn\u2019t acknowledge self-interest yet. So we need to hold her until she can.<\/p>\n Then there\u2019s an attitude and belief change because some people believe that if you brush your teeth hard enough, they’re going to bleed. I\u2019m using just one simple example. Or that maybe you’re going to lose your teeth anyway. Then there needs to be a commitment by the person that they want to do something. And finally, action. So those are the six rungs of the ladder.<\/p>\n What we mostly do is we go from unawareness to awareness and we go right to commitment and action. Then we create post-purchase dissonance, that patient who says to you, \u201cHey, which chair did I buy anyway?\u201d<\/p>\n Allison:\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Yeah.<\/p>\n Bob:\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 That\u2019s the patient who\u2019s having some sense of post-purchase dissonance if you will. So as I bring this to closure, let me just touch on a couple of really important points in that preclinical which for me is the most powerful of all the appointments.<\/p>\n Make sure you assess their self-image. What\u2019s their probable future? What do they believe is going to happen to them? The easiest way to do that? Ask about mom and dad\u2019s dental health. When they tell you then simply ask, which are you more like? Then if they say they’re like mom who had terrible dental health and lost all her teeth at age 62 as Loretta told me, and Loretta is 58.<\/p>\n \u201cAre you like your mom?\u201d<\/p>\n \u201cI am.\u201d<\/p>\n \u201cWell what would be your rathers?\u201d Find out what their preferred future is.<\/p>\n Then also assess their self-image because if I don\u2019t know what their dental self-image is before I go sticking my hands in their mouth, then I am at great risk. What I mean by that is I simply take a piece of paper, draw a line on it. At one end of the piece of paper, I put a little hash mark and I say, \u201cThis would be the most excellent. I\u2019m going to ask you to rate your dental health. This is not scientific.\u201d<\/p>\n We have this on videotape because we filmed our new patient experience as a training module. It\u2019s available online if you’re interested in it. We had Cliff Katz, a PhD, DDS, psychologist interview the patient after each step of our treatment. Our first preclinical and then codiagnosis and then talk about what was being felt, thought about, but not said. We integrated the two together. Very, very powerful videotape.<\/p>\n During this piece when I asked her, she said to Cliff later, \u201cI thought I was back in grade school and I was giving myself a grade until he told me, \u2018Oh, don\u2019t worry, this is not scientific I just want to know what your opinion is.\u2019\u201d I say there\u2019s a range of excellent. There\u2019s a range of good and draw a hash mark on that line. There\u2019s a range of fair and a range of poor. Then I ask them where are you today in your total dental health?<\/p>\n Why is that so important? That\u2019s so important because if I go into their mouth and they told me they’re good to excellent and I see that they’re fair to poor, I’ve got a very different communication challenge, don\u2019t I? Now the other piece of this that\u2019s terrific is I want them to summarize, I know they\u2019ve told me a lot, this is toward the end of the preclinical dialog and I\u2019m asking this question.<\/p>\n I am going to ask them, \u201cTell me in thumbnail fashion what\u2019s pulling you down. Is there anything you haven’t mentioned that\u2019s pulling you down?\u201d Then I ask them the $64,000 question, \u201cWhen we\u2019re all done, wherever that is, where do you want to be on this scale?\u201d<\/p>\n If somebody tells me I want to be good to excellent or I want to be excellent, maybe I could never be at the top, and I\u2019m going to talk about replacement of a missing tooth, I\u2019m not going to talk about a bridge. I\u2019m going to talk about an implant. That\u2019s the most excellent way to replace that. We might touch on a bridge as a secondary choice but does that make sense, Allison? That we\u2019re trying to figure out where they want to go? Begin with the end in mind?<\/p>\n Allison:\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Yes. Absolutely.<\/p>\n Bob:\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Beautiful. So then during our codiagnosis we use John Kois\u2019 and Frank Spear\u2019s four food groups. We do a dental facial functional evaluation, structural integrity, etc. By the way, we always have them do the same thing for their overall general health, the same scale. What\u2019s interesting, more times than not, they see their overall health better than their dental health with many of our patients.<\/p>\n The other thing, while we\u2019re doing our examination, we will prioritize. That means on a non-full reconstruction case we\u2019re going to let them know that if we find something we\u2019re going to tell them whether it\u2019s a 1 priority, something that should be treated within the next year, maybe even a 1A, within the next six or eight weeks. Or a 2 priority, that could really wait until the second year to be treated. Or it could be a 3 priority, it could wait a little longer if it needed to be.<\/p>\n Obviously if a 1 and a 2 are together or opposing each other, best done together, both from a cost standpoint and a final result standpoint. That really helps patients because then when we finish the codiagnosis, we can let them know since they’re almost always a little overwhelmed by a comprehensive exam, we can let them know how many 1s they had that they need to deal with immediately and maybe how many 2s. Then we\u2019ll write that up between now and their next visit.<\/p>\n As I bring this to closure and there\u2019s so much more to say, it\u2019s really important that we never quote fee unless value is perceived. Now you know with Loretta, she\u2019d already perceived value. She quoted the fee to me by using a comparison. So I was okay giving her a ballpark. I think it ended up being a little bit more than her car. But the point being that normally that doesn\u2019t occur until we come to consultation.<\/p>\n Our consultation is our third visit. It\u2019s associated with our actual first round of treatment which is usually something in hygiene. Could be a splint record, something like that, which we did quote at codiagnosis what the investment would be for that particular piece. By the way, when we quote our fee, we never do it until we know value is perceived. How do you know value is perceived? At that consultation. We ask the patient, \u201cCan you tell us again what Dr. Frazer and you talked about you\u2019d like to have done for yourself?\u201d\u00a0 Yes, we\u2019ve written it all up.<\/p>\n I don\u2019t believe in case presentation unless it\u2019s a case of fine Scotch whisky. Don\u2019t try to sell things to people. Collaboratively develop a treatment plan and let them choose your best and finest care. So never quote fee until value is perceived. We would generally kind of summarize what they told us about, they want to get the bite corrected. They want to get their teeth whiter. They want to get that gum problem corrected. Well here\u2019s our write up.<\/p>\n By the way, it\u2019s never itemized. It\u2019s always by total phase or a total appointment if we have to go down that far. We will itemize for insurance purposes which by the way we don\u2019t call dental insurance \u201cinsurance.\u201d We call it a dental benefit. We say that about five times, the patient will generally ask us, \u201cWhy don\u2019t you call this insurance?\u201d We don\u2019t call it insurance because it\u2019s really not insurance.<\/p>\n So I think I’ve pretty well covered the waterfront, Allison. This may have gone slightly longer than that last one because I added a of couple things I didn\u2019t last night.<\/p>\n Allison:\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 I think it was perfect. I just want you to talk a little bit, I know you mentioned that you have some tapes. I have those and they’re fantastic. So I know you have support materials but I also want you to mention that I know you have a New Patient Experience that I\u2019ve been to multiple times. It\u2019s fantastic and it\u2019s coming up in September.<\/p>\n Bob:\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 It is. While we\u2019re on the subject, the New Patient Experience in September is September 22 and 24 in Austin. I teach that with one of my finest clients, Dr. Don Taylor. Don is doing multiple of these a week. I\u2019m not doing them anymore. So I teach the foundational material but you get to see Don actually do this with a real live patient. Then you’re also given a patient and you’re asked to do this under our coaching. It\u2019s limited to not more than seven doctors and right now we have three offices signed up. So there are four places left open. Again, that\u2019s September 22 through 24 here in Austin.<\/p>\n Who do you bring? You bring the doctor, your key front office telephone person because your telephone triage is huge. Angela Ward on my team, by the way, if you haven’t called and talked to Angela, please do so. She\u2019s one of the finest people on the telephone you\u2019ve ever met.<\/p>\n Part of the session we\u2019re in separate groups and Angela is working with your front relative to telephone triage and interprets value from the very first phone call. You\u2019ll actually see us do preclinical codiagnosis and consultation, including quoting fee, dealing with insurance and all those things. You\u2019ll be asked to do the same thing with our coaching.<\/p>\n The second course we give that we truly love to give, it\u2019s probably the most fun course we offer is November 10 through 12, it\u2019s the applied emotional intelligence course. It is actually titled Inspiration, Empowerment, Wisdom, and Community: Applied Emotional Intelligence. I teach that with Bill Woodburn who is a gifted counselor who before he was a counselor was an actor and it\u2019s a lot of fun. You\u2019ve been to that, right, Allison?<\/p>\n Allison:\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Oh, yeah, many times also. I\u2019m a remedial student.<\/p>\n Bob:\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Yeah, what we expect to happen out of the attendance at the New Patient Experience we would expect your case size to grow by between 50 and 100 percent, either the treatment you’re going to be recommending to people and people will accept.<\/p>\n Then we would expect in the EI course for your leadership ability among your team and your patients and the team members to your patients to grow as well as customer service by at least 75 to 100 percent. I don\u2019t know if you would agree with that, but when you start learning about emotional intelligence, you become very powerful.<\/p>\n Allison:\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Yeah. It\u2019s affected my whole life in a positive way.<\/p>\n Bob:\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Thank you so much. The other thing I have is I have an audio series that I\u2019m very proud of. We have the DVD series of the New Patient Experience and any of your listeners who left us know that they are the\u2014what do you call your series again? It\u2019s the Practicing with the Masters<\/em>?<\/p>\n Allison:\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Practicing with the Masters<\/em>.<\/p>\n Bob:\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Yeah, if they let us know that they’re with Allison Watts or Practicing with the Masters<\/em>, we will extend to them a 20 percent discount on any of these things that they might like to purchase. The Proven Strategies, they come bimonthly or you can buy them as a set. There are six chapters. The fourth chapter is the one that is all about complete care.<\/p>\n If you register for our New Patient before July 1, then you will receive the two-hour audio \u201cChoosing Your Most Comprehensive Care Routine.\u201d That\u2019s part of that Proven Strategies series. If you buy it, we\u2019ll credit that to you. That\u2019s $187 value by itself.<\/p>\n If you sign up for the EI by September 1, then you\u2019ll receive a copy of \u201cThe Dentist on the Couch\u201d which is my interview of Bill Woodburn when he was telling me about those dentists that we\u2019ve worked with that seem to always be stumping their toe and never quite getting over the hump, both in their leadership of their team and with their patients, as well as those that seem to excel. It\u2019s a fascinating discussion. Several of our clients said they listened to that one 3 to 5 times.<\/p>\n So we\u2019d love to have any of your members seek us out. You can look at our website at www.frazeronline.com that\u2019s F-R-A-Z-E-R, Z like zebra. Frazeronline, one word. Or send me an email at Bob@frazeronline.com. If you send me an email, I\u2019ll be glad to send you two things I think you\u2019ll enjoy. One is an article that summarizes everything I talked about that was published a few years ago called \u201cThe Right Time to Quote Fees.\u201d I\u2019ll also send you a beautiful essay called \u201cThe Portrait of a Helper.\u201d So I guess I\u2019m done, for the second time.<\/p>\n Allison:\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Yeah, thank you so much, Bob. I really, really appreciate it. I appreciated it last night and I appreciate it even more today. I\u2019m amazed and impressed and appreciative.<\/p>\n Bob:\u00a0 You\u2019re welcome.<\/p>\n Thanks for listening to Practicing with the Masters<\/em> for dentists, with your host, Dr. Allison Watts. For more about how Allison Watts and Transformational Practices can help you create a successful and fulfilling practice and life, visit transformationalpractices.com<\/a>.<\/p>\n <\/div>\n This month on Practicing with the Masters, I have a special treat for everyone. My guest today not only gave an amazing interview on our call\u00a0but, when the recording cut out, agreed to talk to me again the next day to make sure all of you could hear the rest of his amazing lesson. Bob […]<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_et_pb_use_builder":"","_et_pb_old_content":"","_et_gb_content_width":"","_cloudinary_featured_overwrite":false,"footnotes":""},"categories":[303],"tags":[309,305,304,307],"yoast_head":"\nWhat You’ll Learn From This Episode:<\/h3>\n
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Listen To The Full Interview:<\/h3>\n\n
Featured On The Show:<\/h3>\n
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Full Episode Transcript:<\/h3>\n
Transforming Your New Patient Process with Dr. Bob Frazer<\/h3>\n
\n\u201cInner Circle.\u201d<\/p>\n
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