Dental Practice Heroes

The #1 Case Acceptance Bottleneck Dentists Ignore

• Episode 623

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Are you ignoring a crucial part of your practice? In this episode, we’re talking about the front desk. It’s one of the most overlooked areas in dentistry, yet can also make or break case acceptance and production. Tune in to learn how to train your front desk to talk money, close treatment, and follow up the right way!

Topics discussed:

  • Why training is crucial for front desk
  • Do you need a treatment coordinator?
  • Key factors to closing treatment
  • Follow-up systems that boost case acceptance treatment
  • How to coach your team and set them up for success

This episode was produced by Podcast Boutique https://www.podcastboutique.com


Title Options:

  1. The #1 Case Acceptance Bottleneck Dentists Ignore
  2. You’re Losing Cases at the Front Desk — Here’s How to Fix It
  3. Stop Ignoring the Front Desk (It’s Costing You Thousands)
  4. How to Train Your Front Desk So Patients Say Yes
  5. The Front Desk Training Every Dentist Skips (And Pays For)

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SPEAKER_01:

Have you ever had this happen? The patient says yes to treatment in the back. Everything's lined up. They are so on board. And then they get to the front desk and suddenly they disappear. They don't schedule. They need to think about it. They're going to call you back. They have to check their schedule. And deep down in your heart, you know exactly what that means. You will never see them again. You've lost them. And it's frustrating because clinically you did everything right. But here's the truth this is not a patient problem. It is a training problem. You see, most dental offices, maybe yours too, have never truly trained the front desk on how to confidently present treatment, how to handle money conversations, or even follow up effectively. We train our hygienists, we train our assistants, we train our associate doctors, but the team that's responsible for that final yes, for some reason, we leave them to figure it out all on their own. In today's episode, we are going to change that. We're talking about the most overlooked area in every practice. It is your front desk and how you can turn that team from order takers into confident proactive treatment coordinators who know how to help the patient say yes. Now you are listening to the Dental Practice Chairs podcast where we teach dentists how to step back from the chair, empower their team, and build a practice that gives them their life back. So if you've ever wondered why your case acceptance isn't where it should be or why patients keep slipping through the cracks at the front, this episode is going to give you the clarity and the tactics to fix it. Let's get into it. I am joined here with the DPH coaches, two the smartest dudes in the dental industry, redefining what it means to be a dentist in 2025. Dr. Steve Markowitz and Dr. Henry Ernst, both large practice owners, big teams, lots of experience. And today we're going to talk about a very neglected part of all owners' offices, and that is the front desk, is we don't ever provide training to the front desk. And I would, you know, I shouldn't say ever or never. I guess we do sometimes. There is a lot of opportunity in almost nearly every office that I work in. And we always think about, okay, yeah, that's phone skills, right? You know we've got to teach them how to answer the phone. But we never actually focus on what happens when we pass a patient off to the front and they go over some financials and they get the patient to say yes or no. And that is a skill. And we train on it, how to talk to patients, but we rarely train our front desk on it. So I'm going to pass to you, Henry. What is like, do you have a treatment coordinator at your office? What is that a position at your office? Or like what kind of things are you doing to set your team up for success as far as closing treatment from the front end?

SPEAKER_00:

So we have a democracy here. We don't have one person that's designated as the treatment plan coordinator. And I think some of that comes with just the long hours we have and not everybody's here the same day. So we have a treatment planner position that every day somebody slotted into that. But we provide pretty basic training for everybody. And I've mentioned it before is on previous podcasts. We have something called a Dentistry for Dummies program, where I have it's probably about an hour-long presentation that even if you worked at Walmart for five years and you came here with no knowledge, after watching that video, you'll have a basic knowledge of most basic dental procedures and how to talk in basic language to patients. Because I think that's the problem, is people talk up to patients. They talk with all this specific dental terminology. You know, when we talk about a crowd, we talk about it's like a ring around a barrel, holds it together, you know, that kind of thing. So we train all of the staff to have the dentistry for dummies program that we have, and it's really simple. They watch, once you do it once it's done, they watch a video, there's a little test. We even do an oral exam where we kind of just role play and stuff like that. So everybody knows that. When the people that are in the treatment planning role that day is, they're very proactive. So our dentists should always provide a comprehensive treatment plan, whole enchilada as we call it, and the basic one. And if they don't get that, they should be proactive to tell the dentist, hey, I didn't get a backup treatment plan. They want to get people to say yes. And so we all know that if you provide a humongous treatment plan, it's harder to get to say yes sometimes with finances. They're very proactive. And then the important part is the follow-up. So how we talk to them, how we train them to talk to people in basic language and have a personality, right? Don't just be very where you're just talking about the numbers and nothing else. Let's get to know people. And then the follow-up afterwards. They're part of that job and that role, no matter who's doing it. We have a little Google sheet that they know. I need to follow up on people two days later. I need to follow up on people two weeks later and one month later. And it's a really simple confidence call. Hey, Paul, I was just calling you from our Pleasant Plains Dental, and you know, I just wanted to see if you had any questions about your treatment so we can get you scheduled. Right? So there's a lot of everybody has to understand the roles and what their job is in our practice. I'm interested to see how you guys do it.

SPEAKER_01:

Well, I almost disagree. I don't think they want the patient to say yes. I would say I feel like most people that work at the front desk don't care if the patient says yes or no. And I think that's are they incentivized? Well, that's the thing, is I think if we incentivize them, but I think I think that's what we're up against. I find that is the hardest part for the training with my front desk is helping them relate the fact that when patients say yes, they get healthier and that they play a part in that. I think most front desk people feel like if I present the treatment and I show them what they owe and what their payments are, and I say, Hey, you know, did you want to schedule that today? And they say no, I'll call you. They're like, Cool, I did my job. I did a great job. I did what I was supposed to do.

SPEAKER_00:

Yeah.

SPEAKER_01:

And my goal with my team is to push that a little further. Is like you are the person that is supposed to figure out how to make this work in the patient's life. It is not just here it is, do you want it? No, fine. Going to you, Steve. Steve was shaking his head violently.

SPEAKER_02:

Sorry. Yeah, I'm I want to keep my head on my my neck. It's important to me. While you were talking, Paul, the reason why we have treatment coordinators is because they feel like they own that schedule.

SPEAKER_01:

That's the thing, is I want to say I also do not have a treatment coordinator. I'm very much like Henry, but Steve, your model is different.

SPEAKER_02:

I'm gonna sell you on why you need a treatment coordinator.

SPEAKER_01:

I think I'm with you.

SPEAKER_02:

We just someone got a new position of a their period treatment coordinator. So they're responsible for the periodonist schedule in one of the offices. She just started two weeks ago. And I got this message from the manager in that office that said, Is it okay if she goes? It's a Sunday. I got this message from the new treatment coordinator. She wants to go in and prepare for the week, make sure she's all set. She asked not to clock in. Is that okay? And I was like, absolutely not. That is the coolest thing I've ever heard. She owns that schedule. That's her definition of whether or not she's successful in her job. She wants to make sure that she can do the best job possible. When we have given ownership of any place in the office, but especially in those TrueBook coordinator roles, they own it. They get so excited to see it win. They want the patient's schedule. When someone falls out, they take it personally. Like, why would someone fall out of my schedule? Let me go fill it. I'm gonna see how fast I can fill it. And it is one of the coolest things that I see in our organization of how much the business team cares when they know what they're responsible for.

SPEAKER_01:

Well, I think it's awesome to point out is that I totally agree with you. And this is something I have talked to my team about for years, and that they do not want to have like dedicated treatment coordinators. And I disagree with them, and it's been a battle that I've wanted to fight and I haven't fought all the time, but I'm in the same situation as you, Henry. It's a little bit difficult because we're open solo, we're 7 a.m. to 13 hours. That's exactly what I was gonna say. So that's what makes it so hard.

SPEAKER_00:

Yeah. Our practice has 60 clinical hours. So, yeah, Steve, you're raising your hand. I get it. Um, so our practice has 60 clinical hours, so we run into this issue with different things. And it's like, how do you do it? You tell me.

SPEAKER_02:

Okay, my hand's going up again. Yeah. Just because the person isn't there doesn't mean that they're not fully responsible for it. And meaning that, yes, if one of the doctors is only there two days a week, does that mean that you're not responsible for the what happens to your patients the other five, three days of the week? You may have someone else helping you out. If one of my temporaries comes off, I'm not there. Someone's gonna help me, but it's still my responsibility to make sure that patient gets cared for. Same rules apply, and that's true influence. If we can influence people when we're when we're not there, that's even stronger leadership than when when in our presence.

SPEAKER_00:

So just giving a different perspective. So for us, whenever somebody is, we have the spirit of competition. So we have goals and everybody has their stats that we put up like every month. Who's got the most percentage of people saying yes? Who has the most money that they've got people to say yes to? So when somebody comes through the system, they're responsible for it. Even though they're not there like you're talking about, it's kind of a a little bit of a different way to get the same thing. So we get the spirit of competition. That's why they're very proactive. And they've done that to me sometimes, right? Hey Doc, you didn't give me the backup treatment plan. Because they want people to say yes. Nobody wants to be the person that's put up on the on the KPI board that says, Oh, you're the lowest. Nobody ever wants to be the lowest. How do you track this? How do you do this? That's a great question. So that's why I delegate. So we've got systems in place that we've had for years that they do, and I see the numbers where like people have percentages and they're reported every month and they're up there and stuff like that. And I'm like, okay, good job, so and so. And sometimes it's not a financial reward, but sometimes it's like, hey, you know what? So and so had the highest percentage. Let's give them here's a gift certificate go to Ruth Chris or something like that.

SPEAKER_01:

Well, I think the challenge is, and I'm I'm with you, Henry, is I feel like with larger teams, it's hard to give somebody a responsibility or have them really take it. There's so much opportunity in a larger office that's split shifted for somebody to kind of fly under the radar and not finish a task and pass it on to somebody else. I'm thinking about a client that I'm working with right now, large office, four or five doctors, but every doctor has their own team, has their own treatment coordinator, their own front desk person. And while this works very well in some regards, as far as like keeping someone's schedule fill, when that doctor is not there and their team is not there, they're now nobody is covering for anyone else. No one's saying, Oh, well, I'll help this patient. It's almost like there's a lot of not my problem there as well. So there's like the dark side of that system as well. So I don't necessarily know what's right, but I'm with you, Steve. I feel like somebody has to be the responsibility of the schedule and somebody has to truly close treatment. And often when we have everybody doing it, we're putting people in situations that are not, you know, gravitating towards ease of talking with money. They don't like it. It's not energy rich for them, and they're not going to be very good at it. But yet, I'll tell you, this is how we do it at my office. And I don't agree that it's the best way to do it. You have specialists in your office, right? We do. Yeah. And they they do have their dedicated treatment coordinators. I would say that. They actually do. Yeah.

SPEAKER_02:

Cool. And that works great, right? Right. Because if that person, if that person came in and their schedule wasn't full, that specialist would be BS.

SPEAKER_01:

That's what spawned us having dedicated people. Okay. Because that's what happened.

SPEAKER_02:

I'm just gonna extrapolate this a little bit. What if you had general dentists that were that vocal and wanted their schedule a certain way? What would happen?

SPEAKER_01:

Yeah.

SPEAKER_02:

What would happen?

SPEAKER_01:

I feel like we're having a breakthrough right now.

SPEAKER_02:

I think we might be. That's the same thing that happened to me. Our specialists were put on these pedestals, and if their schedule fell apart, it would be like three people at once, which is all cry like, oh no, the specialist's schedule is gonna fall apart. We need to call blah blah blah blah blah. And I'm like, guys, that's 10% of our revenue. We got five other dentists who are would love that level of attention.

SPEAKER_01:

Yeah.

SPEAKER_02:

So that's exactly what happened to me is we didn't have treatment coordinators. I saw how beneficial it was. I saw how people cared so much. And then we just extrapolated that to help to make sure everyone had that that level of support.

SPEAKER_01:

Yeah, I love that idea. And you're really my wheels are spinning right now. And I'm thinking about how could I schedule this so one each doctor has their own dedicated person.

SPEAKER_02:

It doesn't work in a single doctor office. I can all get behind that a hundred percent. Why not? But when there's multiple doctors and who's doing what and why?

SPEAKER_00:

Why doesn't it work in a single doctor office? I would think it'd be easier to do it in a single doctor office. Um it's simple. Yeah, that's what I was thinking as well.

SPEAKER_02:

Because everyone's the treatment coordinator. Like there's not enough differencing. Yeah.

SPEAKER_01:

Yes, because in a single doc, I'm thinking like two, three front desk people. I had a solid presentation team because I could pour into all those people. Like I have 12 or maybe 11 people on my front end team, and it's hard to train all those people. It's hard to keep track of it. Do you know how to do the front desk job? No. I know how to verify insurance vaguely, but no, not as not as well as I know you learned it before. Yeah.

SPEAKER_02:

No, I actually don't. And that was the conversation I was just having this morning was I can train a doctor, I can train a hygienist, I can train an assistant. I actually can't train the front desk. I don't know how to do their job. So I think part of what when we started this conversation about not training the front desk enough is we don't know what to do. True.

SPEAKER_00:

Yeah, that makes it hard. Well, if we kind of poke holes here, if in our practice, where we've got, like we were talking about before, 60 hours and stuff like that. My mentality has always been these last maybe five, six years, as this practice has grown so much, is to always have the backup, the bullpan, not dependent on one person so much. So my biggest concern is I'm putting all a little bit of eggs in one basket. Whereas I've got a bunch of competent people that are doing the same job together. And if one happens to leave or something happened, I'm still good. Doesn't affect me one bit.

SPEAKER_02:

If you don't have the culture that if one person leaves, then the thing falls apart, then I could see that. But if that treatment coordinator for your specialists isn't there, there are people that are able to fill in the gaps enough to support that person because that's the culture you've created in your office. And if that person were to leave, we've had the treatment coordinators leave, then it's an open position and people will apply, and then we'll give them the training and the tools to be able to be successful in that role.

SPEAKER_01:

Follow-up for this, Steve. Let's give tactical. Most people are not operating in larger offices with multiple associates, but so where does this fall into like the smaller office, two to four front desk people? How does someone use what we're talking about to make their team better?

SPEAKER_02:

I think what Henry said was creating ownership mentalities, and I love that. How do we empower our front desk, our business team, treatment coordinators, whatever you want to call them? How do we empower them enough to take ownership over the schedule? And if something were to fall out of my schedule, I know that there are people that'll be more upset than me. And that is what I want to create. So that as soon as something happens to that schedule, there's someone who's gonna be calling patients, filling it, and making sure that they understand what that needs to get done.

SPEAKER_00:

How about you, Henry? Yeah, so if we're taking this to the most dentist practice owners that have the five ops, you know, keep it simple, right? Start up, you don't have to have a fancy spreadsheet. Make a freaking folder, right? Anyone that leaves your office that does not say yes to a treatment plan, what's their name? What was the treatment plan? What was the date? And then follow-up. Like, when did I follow up? I can't tell you how many offices. It drives me nuts when I work with people and say there is no follow-up. They just leave and that's it. Screw it. Yeah. There's so much opportunity there. Sometimes people, it's amazing when I hear some of these calls sometimes, or sometimes they call it's the simplest, stupidest question that they didn't have answered. And just that leads to boom, let me get those crowns done tomorrow. So just do it simple. Train up some, make sure that your team understands how to just talk basic language to be role play. Make a lunch one day and just have role play. Talk about talking about a crown. How do you talk to a patient? Because don't just talk in this dentrix language, you know, blah, blah, blah code, build up, blah, blah, blah. Bullshit. Talk to them like a person and keep it simple. You don't have to be a large conglomerate office to do these simple things to make your practice better. Yeah, true.

SPEAKER_01:

And the thing that I'm thinking of as well is that I love my treatment coordinators and my people presenting treatment to ask the patient, you know, I went through a lot, tell me what questions you have. I want them to be able to fish for objections and to push through those, to find out what's keeping the patient from booking. Now, if the doctor didn't sell it in the back, if the doctor didn't make the patient feel like they need it, no amount of treatment coordination is going to do it there. But we should have it there. And they should be able to take it over the finish line by asking, what's keeping you from scheduling this treatment? And I think that takes special people. There are people on my team that will do that very well. And I know there are people on my team that probably should not be presenting treatment. And I think I might take a different approach after having this conversation.

SPEAKER_00:

And it's important, I think, also to show that you're a person too. I love the fact that I have an implant. I tell every single patient that I treat a plant, but I've got one myself. I love the fact that we always have a ton of team members in Invisalign, so they show, okay, look, I got it right now. So you're kind of having that we're all together in this kind of thing. We're people too that need dentistry.

SPEAKER_02:

If you decide to move forward with a treatment coordinator or having someone who's going to be responsible for a case presentation, as the doctor, go and have lots of conversations with them. Follow up. Learn how you can be presenting better and make their jobs easier. If, like Paul said, if you're as the doctor, if you're not doing a job creating value in urgency, it doesn't matter how good good of a treatment coordinator you have. It needs to start with you.

SPEAKER_01:

Absolutely. All right. Well, if you're thinking about taking your office to a next level and scalable practice that gives you more time off, please set up a strategy call with me and we could talk about what your biggest bottleneck is and come up with an action plan to get you to the next level. Check that out strategy call for free at dentalpracticeheroes.com. Thank you so much for listening today, and we'll talk to you next time.

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Dr. Paul Etchison

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