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Building Relationships of Low Fear and High Trust.
Dr. Dick Barnes has often said, “People do business with people they like and trust.” In terms of dentistry, building relationships of low fear and high trust are important across many levels: doctor-to-patient, doctor-to-team member, team member-to-patient, etc.

Patient relationships that are built on trust are important because in the absence of fear, patients will trust the doctor and proceed with treatment. When a dentist has a high level of trust toward his or her team members, those team members can project confidence to patients.

Most successful dentists learn that projecting trust and eliminating fear are skills that they can develop and master. Once these valuable skills are mastered, dentists can train their team members to do the same.

Several years of working in the dental industry has taught me a number of behaviors that can foster relationships of high trust. These behaviors usually begin with the dentist. However, many dentists experience common fears that can hold them back from developing high-trust behavior patterns. If left unchecked, fears can develop into habits that are especially challenging to break.

Fear-Based Behaviors
The first step to overcoming fears is to identify them. Dentists should identify any internal fears they have so that they can be mitigated. After visiting dental practices around the country, I’ve noticed three common fears:

1. Fear that comprehensive treatment is too difficult.
Comprehensive dentistry can be intimidating for doctors on many levels. Sometimes a dentist’s fear is that he or she doesn’t have the skills needed for implant dentistry, full arch reconstructions, or other treatments that may be necessary for comprehensive treatment.

If you honestly evaluate your skills and feel you need more training before presenting comprehensive dentistry, think about taking that step. At the very least, dentists have little to lose by taking continuing education (CE) and determining whether implant dentistry or full arch dentistry are procedures that will benefit their patients and bring their practice to a new level.

Taking CE can be helpful in overcoming a fear of large-case dentistry. The Dr. Dick Barnes Group offers many CE courses to help dentists become better and more productive. Building your skills helps refine the quality of your dentistry. And when you and your team members believe in your dentistry and can offer more types of treatment, you will have more referrals and keep more revenue in house. Therefore, keep learning and be confident in the quality of your dentistry.

It’s a mistake to dismiss comprehensive treatment as too difficult without investigating whether or not it’s something for you. Don’t simply assume that comprehensive dentistry is something that patients in your area don’t want or need. Delivering quality dentistry and adding to your skill set enhances your reputation as the best dentist in town.

2. Fear of presenting comprehensive dentistry.
Even dentists who have refined and advanced skills can miss out on opportunities to help their patients if they don’t present comprehensive dentistry to every patient. Every patient deserves the opportunity to get the best care possible, but it’s extremely common for dentists and team members to pre-judge patients and the likelihood that they will accept the optimal level of care.

To change this behavior, dentists first need to acknowledge the problem. Think about the process in your practice when you visit with patients. Do you pre-judge patients or do you present the same high-quality level of dentistry regardless of your perception of a patient’s ability to pay?

If dentists only present treatment that they think the patient will accept, it can result in “patchwork” dentistry (only presenting dentistry for one or two treatments to avoid financially or emotionally overwhelming the patient) or “watching” (waiting for a problem area to get worse before recommending treatment)—neither of which are in the best interest of a patient’s health or functionality.

Dentists have a moral and ethical responsibility to let their patients know what they recommend after a thorough and comprehensive examination; it is the patient’s choice to move forward or not.

During the years that I worked in a dental practice, I saw many patients who were frustrated because they came to our office after receiving patchwork dentistry somewhere else. Countless times, I heard patients say that they wished they had been told about a problem and its potential consequences before it worsened, when they possibly could have saved a tooth or two (or more), saved money, and understood the overall diagnosis.

Think about how you approach case presentations in your practice. Do you present comprehensive dentistry or only what you think the patient will accept? If it’s the latter, start changing that behavior and presenting comprehensively. You’ll likely be surprised at how many patients appreciate learning about the bigger picture.

After presenting comprehensive treatment successfully, a third fear sometimes needs to be addressed—the fear of the patient’s potential response.

3. Fear of rejection.
To successfully treat comprehensively, dentists sometimes need to overcome a fear of rejection. A simple way to do this is just to remember that a patient’s condition is never the dentist’s fault. If a patient cannot immediately move forward with comprehensive treatment, it is not necessarily an outright rejection.

An initial rejection can mean that the patient isn’t quite ready to say “yes.” But with patience, a “yes” may be forthcoming. If a case presentation is not accepted, it’s usually because of a patient’s unique circumstances—and you never know when someone’s circumstances may change.

To retain patients in your practice (and keep the possibility of case acceptance at a later date), make patients feel welcome regardless of their reason not to move forward.

I recently met with a dentist who felt uncomfortable presenting a comprehensive treatment plan for a particular patient. He worried the patient would reject treatment because he had bought his practice from a dentist who did not present comprehensive dentistry. The dentist worried that patients would have “sticker shock” over the treatment fee.

In this example, the dentist should have asked, “How would this treatment benefit the patient? Is it the function, overall health, absence of pain, ability to smile confidently, or all of the above?”

Instead of focusing on the dentistry’s benefits, he prepared himself for rejection. He had attended the private Total Team Training (TTT) and received some verbal skills, but he was still nervous to present the case. When the diagnosis appointment approached, he focused on the benefits for the patient and he presented the treatment comprehensively. To his great surprise, he successfully closed on treatment.

It’s important for all dentists to switch their focus from a negative perspective to a positive one. Remember that you can change your patients’ lives through dentistry—but they have to be given the chance to say “yes.”

After that experience, the dentist said, “Even though I had doubts, I did what was best for the patient and presented ideal dentistry. When I changed my focus from worrying about rejection to focusing on providing the best possible care for the patient, my whole perspective changed.”

Don’t take rejection personally, and always keep the patient’s well being in mind. Continue to stay positive regardless of the outcome and move forward—and just as it happened for this dentist, the results may surprise you.

High-Trust Behaviors
Once you’ve identified your fears and how to overcome them, you can work on building high levels of trust with your patients and team members. A great way to develop trust is to define and cultivate an organized structure for managing your team and your practice.

After you’ve defined how your practice will be organized and you’ve set expectations, it’s important to communicate that structure to your team members. With a well-defined structure in place, all the team members in a dental practice can be on the same page.

The Dr. Dick Barnes structure offers a system for organization and emphasizes developing good relationships with patients. When patients consistently have a good relationship with their dentist, they trust them and their dental practices.

During the TTT seminars, we offer many tips for building a solid foundation for your practice. Here are three of my favorite suggestions for establishing a high-trust environment.

1. Listen to your patients.
Establishing good relationships with patients can begin with something as simple as listening to your patients. When patients make an initial call to the dental practice, they sometimes communicate a lot of information. For example, they often tell you if they are in pain, if they have dental fears, and how long it has been since their last visit to a dental office.

Patients don’t like to repeat themselves from the phone call to the doctor examination. With a good structure in place, everyone knows the flow of information for the patient. Information should be communicated to other team members in a well-defined way, so that patients feel heard and validated.

When dental practices have a system in place that communicates and documents the patients’ needs in a consistent way, there is no need to repeatedly ask them the same questions. If your practice asks patients the same questions over and over, they probably think you are not listening to them and that they are not a priority.

2. Be consistent.
It can be frustrating when patients hear one message from one team member and something different from another. The words used in your dental practice matter! Mixed messages are very confusing and can lead to mistrust, and patients who are confused do not buy treatment.

Team members should learn and practice what to say to patients—how to talk about an objection before it becomes one, how to greet new patients on the telephone, and how to give patients consistent messages.

In the Winter 2015 issue of Aesthetic Dentistry, Tawana Coleman writes about five messages that are critical to deliver to patients. These five messages help dental practices establish good relationships with their patients. In the article, Tawana discusses the actual words to use when delivering the messages.

The messages include what to say about referrals, insurance questions, financial resources, sterilization practices, and concerns about pain. These five messages address issues that are common in every dental practice. Keeping messages consistent throughout the practice ensures that patients will receive the same response regardless of the team member they ask.

3. Have integrity.
If a dentist or team member says they are going to do something, they should follow through and do it! Being responsible and being true to your word is a great way to build trust with patients.

For example, if a team member offers to research a patient’s insurance to see what the insurance will cover, the team member should do it thoroughly and document all necessary information in order to retrieve that information later on.

Similarly, if a dentist says that he or she is going to offer a patient a treatment at no charge, it’s important to communicate that information to team members so they know to follow through with that promise. Patients will develop trust with you and your team members.

When you build relationships with patients, your patients will refer other patients to you. This is a direct reflection of taking the time to think about the structure of your practice and the messages that dentists and their team members communicate to each and every patient.

In such an environment, the patients’ fears are all addressed before they become a problem or a hindrance to treatment. With these proactive strategies in place, “breaking up is hard to do!” Your patients will be loyal to your practice because they like you and trust you.

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Trish Jorgensen has been working in the dental industry for more than 35 years. In July 2017, she succeeded Tawana Coleman as a Practice Development Coach for the Total Team Training seminars with the Dr. Dick Barnes Group. She can be reached at


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