Just Say No -Timeless Advice from Bob Newhart


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Some months ago I wrote a guest post on Lee Ann Brady’s blog called Trust is the Killer App. 

It is no great revelation to understand that no matter what business you are in, your success will depend on your ability to build trust and above all to develop trustworthiness.  In that post I described the Trust Equation:  T=C+R+I/S, where T stands for trustworthiness, C for credibility, R for reliability, I for intimacy and most importantly, S stands for self-orientation.

This is a topic I discuss thoroughly in my new book, The Art of Case Presentation...because trust is so germane to case presentation.

By far, the key to building trust is to increase the numerator and diminish the denominator…in other words to lower the degree to which you are self-focused.

But how do you do that?  My last post implied that you just do it (I hate when I get self-righteous), because it’s more difficult than you might imagine.  In fact it’s the essence of good leadership and falls under the categories of knowing oneself, self-awareness, self-management, empathy and social skills.  It requires the uncanny ability of executive attention, or focusing to the degree of shutting off your emotional brain. 

Most of the time we operate from our emotional brains…it’s the default.  When we don’t pay attention our minds wander.  When our minds wander—they wander to the self…increasing self-orientation and raising that denominator.

The key to reducing that number is to practice attention training…I’ll get to how in a second.

Dan Goleman, in his new book Focus, says, “Stopping on cue is the holy grail of cognitive control.”  By that he means that once we realize we have been emotionally hijacked we need to stop and correct.  In other words become more mindful.

After years and years of practicing dentistry, and fighting off my own demons (like an over-awareness of myself), I agree with Goleman that attention training and mindfulness is the key.  But it takes practice.  In my book I write about practicing the soft skills, but mindfulness practice can go a long way in helping you to develop the trustworthiness you will need to become an effective presenter.

What kind of practice?

Meditation, (Goleman suggests twenty minutes per session at least four times per week), and breathing exercises.

For me…I do meditate and I do hot yoga.  Both of these have done wonders for me physically but I can also tell you that the focus needed for both, slows the mind down…so I can become more aware…and just stop it when I am thinking of myself too much.

Simple? Yes. But not easy.

Or…just take the advice that Bob Newhart gives to his patient in the classic comedy skit that you can click on above.

Enjoy the video — it’s hilarious…and there’s a lot of wisdom and business sense in here too.












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Occlusal Splint as a Tool of Persuasion


Many dentists are under the impression that presentation is a specific, isolated procedure.  In my new book I make


the very important point that presentation is not a system or a’s an approach.  Through over the 200 plus pages of the book I continually make that point.

Recently, a new patient entered my practice.  She found me on the Internet (through a piece of the Art of Presentation known as Cyberbranding, that is discussed in the book).  Her chief complaint was discomfort–sore muscles to be specific).  Her bigger problem was that she had a failing 6 unit upper anterior bridge.

She has a dentist.

Her dentist was in the process of making her a new provisional when she told him of her discomfort.  He told her to get that fixed first…but he never referred her…so she found me…by Googling…TMJ specialist…and my name came up #1.

But it’s here where the real adventure begins.

She has a dentist.  She trusts her dentist.  Her intuition told her to stop and get the TMJ problem solved first.

My job…is to take very specific information that I will gather up in a comprehensive examination, and find a way to explain it to her, in a way that makes sense to her.  Along the way  I find many bumps in the road…mostly centered around trust and money.  My first bump is explaining the need for the complete examination.

She said she had radiographs taken recently.  She brought them with her.  Bitewings and a few periapicals revealing the failing terminal abutment of the bridge.

Within a few minutes, by addressing her chief complaint (pain) and relating it to the musculature (by showing her the relationship of muscle contraction and canine guidance…my masseter shuts down while her’s continues to fire), she sees some light.

John Kotter in his book, The Heart of Change, describes the most effective way to persuade people is to use a method he calls See, Believe, Do.  That’s what I did…showed her.  She then believed me and she did the exam.

It’s that quick.  But I still didn’t relieve her pain…just her confusion.

The next step is to prescribe splint therapy.  This takes time.  She’s already told the other dentist to halt the provisional until she gets comfortable.

I know the splint will work.  I’ve made a few in my time.  The more difficult part of this case is to change her thinking…change her beliefs about dentistry…see, believe, do.

The splint will do that.  No pictures of beautiful cosmetic dentistry of how she will look.  No convincing her of how good my work is or that I am an artist.  No photography.

So by showing her the care she was looking for by attending to her chief complaint, and by by providing her with a solution that will actually relieve the pain she can then go forward and address her bigger long term issue...because I exhibited care and competence…the two components of TRUST.

And the splint is the major behavioral tool of change.

There are many lessons here:

1. A confused mind always says no.  That’s why she sought a second opinion.

2.Make the art of explanation a priority.

3. Understand occlusion as a key to opening the door to your more technical skills.

4.  Slow down…build trust.  With people, as Covey says, fast is slow and slow is fast.

These are the lessons I learned through the years at the Pankey Institute, the Dawson Academy and Spear Institute.  Tough lessons with huge payoffs.

The future of dentistry belongs to those who get it…for the others who want to know the next generation of bonding agents or what is the benefit of platform switching….Google it.













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Selling S***t No One Wants to Buy



Dachshund puppies

In my forty years of practicing dentistry I never had the opportunity to tell a patient, “It’s a boy!”

“You need a root canal,” aren’t the words that most people want to hear.  There’s a reason why comedians have picked on dentists for years.  If I hear the root canal metaphor one more time it won’t be too soon.

Persuading people to get their teeth fixed is a bit more difficult than selling cars or puppies.  I know…I sell puppies.  People come looking and they always leave a deposit.  I wish my front desk had it so easy.

There’s a reason sales professionals created something called the “puppy dog close.”

The closest thing we have to a puppy dog close is the trial smile, or cosmetic mock up.  But we can’t tell the patient to take it home for the weekend like a beautiful puppy.  A photo will have to do.

I can discuss needs vs. wants till the cows come home but the problem, as I see it, it’s what Avram King expressed years ago when he said you want your patients to be paying with “happy dollars.”

I really think this was the reason why the cosmetic dentistry revolution started.  Dentists realize that complete dentistry is a tough sell, what with all the objections, so they grabbed onto the most obvious visible benefit.

But esthetics shouldn’t be the driving force behind dentistry.  Hiding beyond the idea that everyone wants a beautiful smile (well, not everyone), is that everyone wants to keep their teeth (yes, everyone).

Strangely, not everyone likes dogs, but even still puppies are quite persuasive.  It’s a 55 billion dollar per year industry.

So how do dentists fulfill their obligation to help people keep their teeth?  Yes, I do believe it’s an obligation and if you are a dentist reading this, and you have other thoughts, I would like to hear from you.

It starts with leadership.   It really is about becoming the change you want to see in the world.  That is why I wrote my new book The Art of Case teach dentists there is no way of closing someone on keeping their teeth.  No gimmicks, no manipulative tricks.  Case presentation, persuasion, and leadership are all one.  An approach to practice and life.

Persuading patients to lose weight, stop smoking or get their teeth fixed will never be as easy as persuading them to take one of those dachshunds home…but that’s part of our job.  If we can do that- then  just like Sinatra said about New York—“if you can make it there, you can make it anywhere.”

For a short time I will be offering the Art of Case Presentation at a 25% discount by clicking on the ADL Newsletter sign up button.








The Real Key to Influence



There are many books dentists can read to get better at presentation.  Most of the books can be found in the Sales and Marketing section of your local bookstore.  It seems that over the years I have read most of them.  Add to those the numerous books on philosophy and psychology and I could write my own book.  Hmm…I already have.

But in all seriousness, one book that was recommended to me years ago by Dr. Peter Dawson was S.P.I.N. Selling by Neil Rackham.

Great book…lots of practical information, but like so many books it falls short on specific advice for my day to day experiences with patients.

Let me give you an example.

S.P.I.N. is a process or series of questions that guides your patient interview.  It starts with Situation questions, Problem questions, Implication questions and finally Need payoff questions.

Essentially it is a guide to uncover the patient’s real problems and for you to fit that problem with your solution (payoff).

The real crux of Rackham’s system comes with finding the right implications.  In other words—what’s the real meaning behind the problem?

This is what most sales trainers call the WIIFM part of the presentation…the benefit.  And this is what they used to call in the Bronx…what separates the men from the boys.

The very best have a way of drilling down to uncover the real problems and their emotional implications.  Most of us have heard the sales saying, “People buy on emotion and justify on logic.”

Well the very best understand that and always think in terms of implications.

For example, I had a patient who resisted getting her front tooth fixed until her husband refused to go out in public with her anymore.  Fix the tooth for health reasons?  For functional reasons?  For comfort and appearance?

No way.

But when the idea of not being accepted came up…she was in my office in a New York minute (second reference to the Big Apple).

Yes sitting high up on Maslow’s Hierarchy of Needs is that need to belong.

It is their own particular circumstances and their own story that we need to explore in order to find what moves them.  That is why I advocate a complete examination that focuses on knowing our patients.

As a coach I hear stories like these all the time…specific incidents where the dentist says: “What do you say when they don’t see the problem, or when they tell you this objection or that.”

I tell them there are no words…just a mindset which includes lots of empathy and thinking about emotional implications.

Think in terms of implications — be preventive, so your patients don’t leave with regrets—“I could have had a V-8.”

 In the comments below—leave some specific situations where thinking in the language of emotional implication has helped you or created frustration.

In my next blog post I will give you an example of “selling ideas” rather than dentistry that just might improve your relationship with your laboratory.

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I Saved His Teeth —No Drill




Ralph had a dilemma.  He was in severe pain and had lots of dental fear and “no money.”  But he wanted to save his teeth.  I guess that’s more like a tri-lemma or a quad-lemma.  According to the dictionary, a lemma is a premise or a theory.  Ralph had three or four premises working against each other.  Anyway, he was not happy when I first met him.

Have you met many Ralph’s in your practice?  I guess so.  One thing about these issues – pain always wins.  Pain beats fear, pain beats money and pain beats time.

This is a moment of truth…not for the patient, but for the dentist.  Let me explain.

Most dentists, when a new patient arrives, look at the patient’s mouth and see a final result.  Their vision of a beautiful smile overcomes them and they start presenting dentistry, either in a positive or negative way.  But the dentist who is concerned with real change, and making a real difference will step inside the shoes of the patient and see the world from their point of view.

Ralph has been unemployed for three years.  His financial picture looks bleak.  Through further conversation we come to find out that Ralph said he had “no money” and he was jobless…but he has a home and a wife who works.  This doesn’t make him Rockefeller but he still wants to keep his teeth.

So what does Ralph really need?

If you said a plan, you are right.  Ralph needs a long-term plan.  A long term treatment plan that will take into account his financial circumstances.

This may sound obvious, but I don’t think it is common practice.  Creating plans and having in depth discussions are not what many dentists enjoy doing.  They like to fix teeth.

Yet…the real “art” of dentistry lies in the ability of the professional to effect real change.  That’s what artists do—they create—they create change.

Too many dentists think the art of dentistry lies in their veneers or their bonding.  I disagree.  Dentists call themselves artists…yes, even patients refer to them as artists, when most dentistry isn’t art at all.

When I ask dentists how they can be more creative in their practices, I mostly get blank stares.

Today, I used the Art of Examination and the Art of Case Presentation to help Ralph make a decision.  A first step.  That is not what he woke up thinking this morning…and I made those changes…created that change without picking up my drill.







5 Deadly Sins of Case Presentation

Avoid These 5

Avoid These 5



Becoming a great presenter is a requirement for leadership.  Avoiding the 5 deadly sins of presentation is one step in the right direction toward becoming a leader.

I find that dentists commit these sins on a routine basis, and in this age of mega-information it behooves dentists to get their point across as fast and effectively as possible.

                        1. No Clear Objective.  Many dentists just present from the hip without thinking about what action they want the patient to take.  It’s a good idea to write down exactly what you want the patient to do as a result of your presentation.  This will serve two purposes…you will know if you are successful and it will keep you focused during the presentation.


                      2. The Presentation is Too Long.  Case presentations or any presentation shouldn’t take longer than 20 minutes.  It’s way too much information for anyone to digest.  When you are focused on the action you want the patient to take, then you will present only what is necessary for them to make a decision.  If you see their eyes glazing over…you have lost them.


                      3. No Benefit.  People will accept treatment when they understand the benefits.  Usually those benefits are emotional.  Don’t present the features of the work you are going to do…just tell them WIIFM (What’s in it for them).


                      4. Too Detailed.  It took a long time for you to get through dental school.  Now it’s time to condense that education into a succinct understandable presentation…not a lecture.  Albert Einstein said, “If you can’t explain it simply, you don’t understand it well enough.”


                      5. No Clear Flow.  Find a way to organize your presentation…the best way is to use story as your structure.  My new book The Art of Case Presentation explains how to structure presentations with story.


Prepare your next presentation avoiding these mistakes and observe how much better you do…remember the objective.






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Can You Use a Relationship Drug?




I don’t mind talking about dentistry…anywhere, anytime.  So, when a friend approached me in the gym and asked how business was, I told him, “It’s been slow.”  He then felt compelled to tell me, “Well, if you guys would lower your fees, you’d get more business,” as I stared at the gap in his smile that he never fixed.

Funny how people reduce complex problems down to a simple cause.  Most people can’t live with the idea of unsolved complex problems.  The answer to getting more business into a dental practice is not to simply lower fees.

But I love to talk dentistry, so I told him a story.

I asked him to imagine a dental experiment in which a dentist did the exact same procedure on ten different patients.  Let’s say it was a simple single surface filling on a lower molar.  He was following me because he was familiar with the terms filling and molar.  I didn’t want to confuse him, and I didn’t know how much dentistry he knew.

The procedure, I told him, required an injection, some drilling and then putting in the filling.  He nodded.  Then I asked him, “Do you think the procedure would be exactly the same for each patient?”

He gave me an understanding look…he was a master of the obvious.  He said, “No, each patient was different.”

“Yes, some would move, some would cry, some would scream, some would salivate too much…the variables are endless…and those ten scenarios only included the patients who made it for their appointed time,” I said.

Once again, full comprehension.

So I asked, should the fee be different for each one?

Now he looked baffled…actually upset, stymied, dumbfounded.  No answer.

I felt sorry for him, because my intention is to educate not aggravate, so I proposed a different solution:

“What if the dentist added a drug to the Novocaine that filled each patient with a high level of trust…love almost.  A strong feeling of attachment was created by this drug.”

He laughed and said, “Sure…can’t ever happen.”

“What if I told you that the drug already exists…and actually we humans can create our own.”

I had his attention.

“It’s called oxytocin.  It’s a hormone and a neurotransmitter (was pushing it with this word) that women secrete during childbirth.  I even use it as a dog breeder to help the girls give birth and start lactation.  It’s been called the hormone of love.”

He was wondering where I was going with this, so he said, “Why don’t you guys use it?”

“Because it’s not available here in the U.S.  The Swiss have a version that’s inhalable.  But we really don’t need it.  Recent research shows that if a person feels that they are around someone or something that expresses love, trust or the desire to bond, then their levels of oxytocin increase.  In other words we can manufacturer it ourselves.”

“So what good does that do us,” he said.

“Well, if there wasn’t all of this distrust in our culture, if there wasn’t so much self-interest going on, if people , including dentists didn’t worry so much about getting theirs, well, that would be a solution.”

“When pigs fly, ” he said.

Not really, if each of us takes the responsibility to really care about the other…things will change.  If not, capitalism in health care will need more and more regulation.  Or we can just lower our fees.

 By the way this conversation was a presentation of sorts…can you see why?




When a Dentist Gets Writers Block

overcoming writer's block - crumpled paper on ...

Overcoming writer’s block – crumpled paper on wooden floor – crushed paper


Do dentists see themselves as creatives?  I don’t mean mean dentists who write or paint…but rather in their everyday practice of dentistry.  It is my belief that people bring creativity to their job…and dentists are no exception.

In many ways dentists are like writers.  Let me explain.

Years ago, before I created my examination process, I would gather up all of the information from the clinical examination:  the radiographs, the models and the charts.  These days I have added study models and photographs.  Either way, I would sit down at my desk, get a cup of coffee, close the door and get ready to create my plan.  Sometimes I gave thanks that there wasn’t much to do…a simple case.  Other times, especially when the amount of material I collected seemed overwhelming and confusing,  I would sip my coffee and look blankly at the viewbox.  I would pick up the models, and many times nothing came to me.

It was the same feeling I would get when I get writer’s block.  Brainfog.

There are many ways to cure writer’s block, like going out for a walk and coming back later, but when you’re facing a deadline you have to produce something.  When a reporter gets writer’s block he just writes a bad article.  When a dentist gets writer’s block he creates a bad treatment plan.

Writers use outlines and other techniques like freewriting to create ideas.  Mind maps work well too.

One thing I always rely on is a guide.  When I sit down to write, I always put three words on top of the page: Topic, Angle and Purpose.  Those three words keep me focused.

I am a big believer in using guides.  When I create a presentation…I always use guides.

When I treatment plan I also use guides.  My treatment planning guide always sits out on my desk while creating treatment plans.  It has become a habit, regardless of the simplicity or complexity of the case.  For me it was about avoiding the brainfog of writer’s block.  And guess what?  My treatment plans make more sense.

I became more confident in my treatment planning process…because I actually had a coherent thought process.

This may sound obvious to many dentists, but what I have found out is that most dentists don’t work with a process.  They don’t have an examination process, a treatment planning process or a case presentation process.  Many operate by the seat of their pants.

It’s funny but some writers actually like writing by the seat of their pants, without guides or outlines.  It works well for them.  It works because they have erasers on their pencils…they can revise.

Dentists don’t get second chances.  Your Treatment plans are your gift to your patients…your creativity.

If you would like a free copy of my guide, become a subscriber to the ADL Newsletter.  As a bonus I will be sending out the many ways I use it to put my treatment plans together.  For those familiar with the Art of the Examination this is new information that I never wrote about in that book.

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What Does Dentistry Have in Common With Baseball Part II



In my last post on this blog I made the comparison of creating discipline in hitting a baseball with examining and communicating with patients.  Soon afterward  dentist-friend wrote me that the analogy can include staff as well.

I agreed.

I reminded him of another post I wrote concerning our definition of placing people above or below the line, and how we have a tendency to judge things as either this way or that way. 

I don’t know about you but dentistry has certainly changed over the past forty years, and our approach must change with the times.  There certainly was a time when my “boundaries” were a lot tighter than they are today.  To use a baseball analogy again, I see a lot more curve balls and cutters these days.

 Anyone can hit a fastball.

When it comes to patients my philosophy is to meet people where they are.

Of course, that doesn’t mean I have to bend my rules and change my policies to accommodate them…I just have to have more patience and more discipline.

I meet so many dentists who use phrases like “oh, that patient has no value for what I’m trying to do, maybe this isn’t the practice for them.”

Nice thought to discuss over a Miller Lite, but in this economy, where patients really need deep communication I like the approach to give them more of a chance.

I am seeing four patients at the present time that are in their late twenties, very poor dentition and personal circumstances that almost prohibit complete dentistry.  All have accepted care…and I am confident that when things get better, I will have played a big role in their lives.

The role of a mentor, a teacher. 

Taking time to understand them and build trust is the key.  I have written blog posts about motivating rather than educating…I want to quote myself, and hopefully you will quote me as well:  “You don’t have to know how The Force works, you just have to trust it.”

Patients, staff members who don’t trust the “force” have no place in a relationship with me.  I am quite sensitive to that…it never seems to work out in the long run.

Too many dentists are too quick to pull the trigger and tell a patient that this isn’t the practice for them.  Maybe it’s not.  Certainly, I have behaviors (boundaries) I won’t tolerate, we all know what those are.

So many of these patients are looking for someone who will work with them.  When our focus becomes one of growing people, we will grow along with them.

The guy down the street can’t do it any better than you.  Or any cheaper.




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What Does Dentistry Have in Common With Baseball? Part I

Cover of "Moneyball: The Art of Winning a...



I am a baseball fan, and I love using sports as a metaphor for life.

A few years ago Michael Lewis wrote a great book that was turned into a popular film, called Moneyball.  The book was about the Oakland A’s general manager, Billy Beane and his plight to assemble a competitive baseball team in a league where the big market teams had huge financial advantages (did I say the Yankees?).

Beane realized that there were certain skills that ballplayers possessed that actually lead to more runs, and those skills didn’t necessarily belong to the high priced stars of the game.  In other words he looked for specific skills rather than star power.

One of those skills was having discipline at the plate.  And one player that exemplified this was Scott Hatteburg, a relatively unsung player who developed and practiced skills to become a more disciplined hitter.  (Note to my Phillies—stop swinging at the first pitch).

Hatteburg developed 5 rules:

  1. Develop the ability to hit almost anything.

  2. Create the ability to know what pitches he could “do something with,” or p[itches he could look for.

  3. The ability to look for those pitches.

  4. The ability to spot and avoid those pitches he knew he couldn’t do anything with.

  5. Repeat all of the above.

What does all of this have to do with dentistry and presentation?  Take out the word pitch and replace it with patient.

For those who are familiar with the life of L.D. Pankey, you know how much emphasis he placed on the four skill areas of examination, diagnosis, treatment planning and communication (presentation).

In 1932 he left his thriving dental practice to take a three month program at Northwestern in Chicago to study these four disciplines.

These are the time honored skills that make dentists effective and successful.  These four skills enable the dentist to understand the game at a deeper level.

Don’t be swayed by the big stars who place their beautiful photos on Facebook…the best dentists are the quietly confident ones who understand the subtle aspects of dentistry.  Learn to “read and react” to your patients…these are skills that can be learned, developed and practiced.

I once took an implant course with a dentist who wanted to use my book, The Art of the Examination, as a reference.  During the program he explained that he didn’t think it was a good idea because it wasn’t what he was teaching (how to place implants).

I accepted his premise, but I disagreed…it’s worthless to know how to do something if you don’t know why, who, where, and when.  Is that what is being taught in dental school and CE programs today?  The disconnected “how.”  That’s not art.

In Part Two of this post I will explain some of the benefits of knowing why, when, who and where…Billy Beane saw those advantages when his team became more competitive.





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