This was what I once told a client, a dentist who is very experienced at initial consultations for referred, high-value treatment plans who always concluded said consult with a request for the patient to book their first appointment.
Any experienced sales psychologist will know that this request was what is known as an “assumptive close” – self-evidently making the assumption that the patient is so pleased with the proposition and the value, that proceeding to the treatment is a foregone conclusion.
The purists and the precious will argue that there has to be a demonstration of informed consent – and I can confirm that, following the consult, the patient does receive the usual magnum opus in writing.
PREVIOUSLY, the proportion of such initial consults that became delivered treatments was 70% – yes, 7 out of 10 new patient consults proceeded through to the delivery of the treatment.
The dentist is a brilliant clinician, a good communicator, a gentleman and rather charming – so what happens next?
His diary fills up.
The practice experiences record year on year growth.
He is a single-handed principal, helped by a first-class hygienist.
The practice branding, customer service and environment are “right up there” on the Barrow scale of excellence.
The waiting list starts to get longer.
Currently the first space in the diary is in 3 months’ time.
So what does the principal do?
He decides to “help” the situation – by ending the request to book the first treatment appointment.
The rationale is that he is calming down the pressure on the diary.
Avoiding a moment of disappointment in the patient journey.
After all, who wants to whip the patient into a frenzy of expectation about their new, confident smile – and then burst the bubble by explaining that there will be a 3-month delay before treatment commences?
Or for that matter, have the patient complaining to their own dentist that the nice man is too busy to see them?
Good strategy?
Nope.
Why do I know?
The principal’s wife and business manager explained that over 50 treatment plans are “out there” and that in many cases she feels that the practice have lost control of the relationship.
At the end of the first consult, our principal is sending them off with the promise of a treatment plan in the post – that they can digest, raise any questions – and then make up their minds as to whether they wish to proceed further.
Previously delighted patients are now difficult to get hold of, “thinking about it” and delaying or refusing treatment.
The conversion rate is dropping from 70% to….
Have a guess?
20%.
That, my friends, is a disaster in the making.
Is it because our dentist is losing his touch?
Clinically – no.
As a salesman – yes.
He is letting them wander off back into a world in which:
a spouse says “no” to the bare price, without having enjoyed the practice experience
a friend or relative points out that the “same” treatment is available “cheaper” elsewhere
a knock ’em dead offer has been made by some other firm, travel agency, car showroom, furniture retailer, pension broker – and that offer was CLOSED by the sales people involved.
So unless our dentist gets his closing skills “mojo back” – he is going to find his diary starting the get gappy around August and September – and it will take at least three months for him to get back on track – by which time six months turnover will have gone “down the swannee”.
Solution?
Start asking patients to book their appointments again – now!
And alter the patient journey to manage the expectations of the referring dentist and the patient – long before the first consultation.
Disney figured this out years ago.
Visitors to the theme park became frustrated by the queues for the most popular rides – and so they examined what was going on in the customers mind.
The frustration wasn’t the length of the delay – it was the uncertainty.
Initially, the idea was to build signage that indicated the probable waiting time – later, technology allowed them to issue tickets declaring “come back at 1.00 pm and your ride will be ready. 
All of a sudden – tension has gone.
The supermarket deli counter invented the numbered ticket.
Even the Department of Transport started erecting somewhat disconcerting signage along the lines of “road-works until January 2011 – sorry for the delay” (which always has me imagining a six-month queue and cannibalism).
So our dentist needs to make sure that his prices remain reassuringly expensive and that his appointment book stays full for months ahead.
The real skill is turn that perceived disadvantage into an advantage.
To explain the delay early on in the patient journey and to explain the benefit of waiting – maybe even sugaring the pill by guaranteeing to hold prices or some such.
“Before we start the consultation can I explain to you that, due to the popularity of our work, should you decide to proceed to treatment, we would be looking in 3 months’ time as a start date – would that be a problem for you?”
If the answer is a genuine “yes” then you may able to defer some other activity to accommodate.
I believe in most cases the answer will be “no problem” as long as the end of the treatment coincides with any transitional life event that has prompted the initial enquiry.
It just needs thinking through.
But the whole episode took me on a deja vu journey back to my 80’s financial services days. Listening to failing sales people telling me about all the cases they had “on the go” and yet which never seemed to materialise.
You have to close the sale.
*This blog is a reworked article that was posted in the April 13 2009 Confidence Club ezine