Motivating Your Patients To Pre-Pay

Many doctors get concerned when I start talking about motivating patients.  Sometimes I run into a doctor who is afraid that some of this is manipulation.  Please know that I am not talking about convincing people to have a procedure they do not need or necessarily want.  I am talking about motivating the patient to do what is best for him or her and making it easy to do.  One little phenomenon that many of us “normal” folks are unaware of is this:  People buy what they want, not necessarily what they need.

I once had a friend I’ll call Sandra.  We were in our twenties and just started making good money.  We were both married to husbands who also were just starting to make good money.  Sandra had a desire for a nice dining room suite.  She wanted to have her family over for Thanksgiving to show them that she and Ron were doing well and making good money.  So I went antique shopping with her several weekends and she finally found exactly what she wanted.  She wrote a check on the spot and I was very happy for her.  About two weeks later I get a call from a crying Sandra asking to borrow $500.  “Fine,” I said, “sure, of course, but are you okay what is going on?”  “They are getting ready to tow Ron’s car away.”  “What?!”  “I haven’t been able to make the payments on it in 5 months so they are trying to repossess it but the guy says that if I give him $500 he can leave the car and I can pay the rest later.”  I drove over to her house and rescued her in this one situation not really knowing what else to do.  When I questioned her further, I found out that she had made neither car payment over the last five months.  When I questioned how she was able to write the check for $2500 she responded, with a large sheepish grin on her face, “How do you think?”  She had been not paying certain bills in order to save enough money to buy something she did not need immediately or at all for that matter.  She bought what she wanted.  I never saw my $500 and that was the end of that friendship.  Some people have a sense of financial responsibility but, unfortunately, some do not.  Your job is to keep people like Sandra from ruining your love for dentistry or taking jobs away from your team.  You must stay in business, or you’re not helping anyone.  (If you’re interested in my personal story on how I know this, click here and scroll down one screen.)

Easy Does It

Does that make sense?  Is that okay?  These are my two favorite questions to ask because patients want everything to make sense and be okay.  They also want to be agreeable. To be in your practice to begin with, they must want to do something.  Act on their initial motivation – why are they here in the first place?  What do they want?  What will they say, “Yes,” to?

Then make it easy for them to say yes.  Provide the treatment they want at a price they can live with.  Notice I didn’t say, “Give them treatment they need at a price they can afford.”  People buy what they want – not what they need.  They can never afford what they need – especially dentistry – but they always manage to find the money for the things they want.  Have you ever purchased a higher priced car than what you intended simply because you could “live with” the monthly payments?

So listen to what they want, tell them what they need, then motivate them with lots of options to pay – in advance.  We were shocked in our practice at how much more compliant and motivated our patients became after we implemented the pre-payment system.  But if you stop to think about it, it makes sense.  They have invested something so they really want it to work.  Instead of spending $5,000 over the course of several appointments, they have committed to it all up front.  They show up for their appointments without reminder calls, they use their appliances, they keep their follow-up and re-care appointments.  When you can’t motivate them clinically, you can most assuredly motivate them financially.  And, of course, some simply aren’t ready to be motivated – when the student is ready, the teacher will appear.

Overcoming Objections

“Why in the world would anyone pay for anything in advance if they didn’t have to?” is a question I’m often asked.  “To save money,” is my reply.  Most people think of this system from the opposite direction.  They think that we arm wrestle patients to the floor and make them pay for their treatment in advance.  That simply is not true, and think about it, if that were the case, do you really think we would have patients?

I came to the realization shortly after stepping into BJ’s practice that you can’t make anyone do anything.  You have to motivate that person to do what you want them to and sometimes, especially in dentistry, that means motivating them to do what is best for them.  How do you do that?  Give them a huge reason to want to pay you up front and here is the real secret – make it easy.  In fact, you can take that little gem and apply it to any area of your life.  If you are having trouble motivating yourself or your children or a team member to do something, make it easy for them to do and see if you don’t get a much better response.

One time while presenting payment options to a very nice little old lady who needed about $4,000 in treatment, I was interrupted very early on.  She said, “You mean, all I have to do is pay you today and you’ll take off 10%?”  “Yes,” I said. She swung her purse up and onto the counter so fast papers flew off my desk.  She got out her checkbook, and as she started to write the check, she looked at me and said, “Are you sure?”  I just chuckled a little and said, “Yes, Mrs. Jones.  I’m sure.  But if I’m wrong, I’ll pay the other 10 percent.  I have some pull with the doctor so I think it will be okay.”  (For anyone who is unfamiliar with my background – I am married to that dentist!)

So here is what I would say to the person as I was scheduling him or her:

“Mrs. Jones, the cost of your next appointment is $900.  If you pay for that today with cash, check, or credit card I can take off 10 percent as a bookkeeping courtesy.  We also have payment plans available if that is of interest to you.  Which do you prefer?”

Notice that I did not offer the option of waiting until her next appointment to see what she wanted to do then.  I gave her two options, letting her know that payment plans are available. Easy. Simple. Remember, a confused mind always says no.

Now, a lot of Dentists, right after they start using a company like CareCredit will want to save the 5 percent they pay CareCredit and just offer their regular old payment options and only discuss CareCredit if the patient asks if they can make payments.  The problem with that is, what if the patient is too embarrassed to say they can’t afford the treatment and, since you didn’t mention payment plans assumes that is not an option?  This patient will often walk away without scheduling and imply that they will call back once they’ve made their decision then go somewhere else and have the tooth extracted – or go somewhere else where they’ve been told over the phone that they can make payments!  Or they schedule thinking they will be able to come up with the money somehow and when they don’t, they cancel stating something came up at work, etc.

The best method of presenting payment options is with the form I discussed yesterday that everyone in the office can use and be consistent.  List all of your payment options including all of the options from your outside financing firms.  A form like this makes it easy for you to remember what to say, how to offer options, what all of the options are and how the financing works.  It is also great for new employees.  The best part is, the patient understands it better because instead of just telling them, they can see it in black and white and they’ve been asked to sign it – making it “official.”  When you are first turning things around in a practice, it is also a signal to returning patients that there is a new system in place and they need to sit up and take notice.

The reason for two separate forms is that I don’t offer a 10% discount anymore to everyone.  Typically, I only offer the discount to patients who accept a multi-appointment treatment plan and are paying with their own funds.  I can afford to give 10% for cash, check, credit card because that is alternatively what I will pay Care Credit if they choose the 12 Months No Interest option.  Also, my fees are adjusted to include that 10% as overhead.  In other words, if you feel the 10% is too much – raise your fees. (I feel another blog post coming on.)

So I have one form that discusses the pre-payment discount, the other does not.  You can download both versions, free of charge, by clicking here.

What do you say when a returning patient asks why you’ve changed your policies?

“Mrs. Jones, it was either this, or raise my fees.”  Trust me – that always shuts them up.  Another good answer to use when they are really pushing to want to make payments to the Dentist is, “Mrs. Jones, I found out a couple of months ago that by extending credit to people I was violating Truth-in-Lending laws.  I’m just a simple Dentist.  I can’t afford to do all this stuff like the banks do – so I’ve found this solution to try to satisfy everyone.  Can you work with me on this?”  I always try to stay in control of a conversation by ending with a question.  But that’s another blog!

Keep It Short

By using a form, you will have eliminated the need to explain any change in policy in the first place.  But for the persistent patient, sometimes you do have to be blunt.  “Can’t I just pay you a little each month?”

“No.”

Seriously.  I’ve used that.  It works.  The first guy I used it on whipped out his checkbook and wrote a check in full (less the 10% discount.)  By the way, while I am thinking about it, a lot of people have tried giving only a 5% discount, and this whole thing failed.  For whatever reason, it takes 10% to get their attention.  If 10% bothers you, raise your fees.  Fee increases are really not that big of a deal – especially 5%.  And there’s another blog – I think this one is long enough.

Thanks for reading my web log.  I hope you have been enlightened.  I’d love to hear from you.  What do you think?  Could you motivate your patients to pay in advance?  What methods have you found that work?  Are you afraid to give pre-payment a try and, if so, why?

Posted under Dental Practice Management