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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One Way to Motivate Patients





In a recent post I explained that one of the most important roles for a dentist is to be a motivator.  Motivation is a leadership skill that too many dentists confuse with education.  Sure education is important, but I know a lot of smart people who never get off the couch.  This blog is committed to making you a better presenter so I want to remind everyone to never lose sight of constantly and consistently motivating patients to “be better.”

Now that could mean a lot…I can write a book about that (actually I am completing that book right now—The Art of Case Presentation).  “We are always presenting,” and “Doctor, you are the message” are two of the topics I cover in the book.

The mouth you see in this blog post belongs to a new patient I saw last week.  What do you think he needs more than anything?  Like the smoker and the overweight person…he needs some motivation.  Obviously he knows the score…he just needs some really good emotional reasons to get moving.  And that is our job.  Or you could argue that our job is just to inform him or that our job is to just make it go away.

The problem with those last two job descriptions is that we tend to “educate” and inform by implying the word, should.  I know a lot of dentists who should all over their patients...I like the term, musterbate (they must do it, or else something bad will happen).  Did you ever should on a smoker?  How far did you get?

So I sat with my patient during our preclinical meeting and asked some questions.  Mostly the questions concerned the obvious orthodontic condition.  I asked the thirty five year old if he ever considered straightening his teeth…he said he was okay with the way they looked, so he saw no need.  I followed up that question with, “Can you think of any other reasons why braces would help you?”

He looked befuddled.  I gave him time to answer but he really had no clue.  So I told him (I educated him about periodontal disease and function and even the oral-systemic connection), but he appeared unmoved…interested, but unmoved.

Then I asked him about his parents.  How were their teeth?  He said his dad still had his teeth but his mom had lots of problems with her teeth.  I asked if she wore dentures, but he didn’t remember because she died early.  “From what,” I asked.

“Heart attack,” he said.  But he said it with emotion, and as if something clicked,  I saw the emotional gap closing.

That is the goal of presentation…to close the emotional gap.

I write about this a lot in my new book, but I wanted to share this story with you because it clearly illustrates the distinction between motivation vs. education.

Dentistry doesn’t do the public any great favors by overemphasizing cosmetics…we can actually devalue dentistry by focusing on things that are superficial for many people.

Science tells us that when we give examples of other people, our brains don’t get the connection.  The gap stays open because our brains see the other as a stranger.  Our job is to get so close that the patient actually visualizes what will happen to him in the future.  Difficult to do?  Yes, but we can do it with morphing software which will eventually be available, but we can also do it with surrogates like our parents.

When we close the emotional gap we also swing the cost-benefit ratio way in favor of the benefit side.

Leadership skills and presentation skills are what will make the most successful and effective dentists of the future…I have always contended that and that is why I have devoted this blog and to those ends.



The One Skill That Leads to Success





I continually get into arguments with dentists and lab technicians about our role with patients and with other dentists.  There just seems to be so much complaining clients who just don’t do what we want or expect them to do.

Last week, on two separate occasions I was discussing this issue with a dentist and a technician.  I asked them what they did when they faced this very frustrating situation.

Both replied in exactly the same way (which, by the way, I have heard over and over again, whenever the subject arises).  They both said, “I educate them.”

As if this education process somehow leads to more compliance.  Well, it usually doesn’t.  But it does absolve the dentists and technician because at least they feel they did the proper thing…the right thing…the moral and correct thing.

It just doesn’t work.  And that is more frustrating.

I suggested to both, like I always do, that instead of trying to educate their clients it might be good idea to motivate them.  The technician said it was just semantics.

Well, it’s not…there is a big distinction between education and motivation, and a good motivator can save a lot of time and be much more effective.

The late Thomas Leonard, founder of Coach University, was very emphatic about making distinctions of words.  You might say it was the basis of his coaching style.

Making the distinction between educating your patients and motivating them will change the way you approach all of your patients.  When you take on the role of motivator, it will not make your job easier…just different.  You will notice that there is an art to motivating people…moving them from what is to what could be.

The business of dentistry is all about changing people, not unlike gyms and diet centers.

Sure, some education is necessary, but to truly be effective we need to motivate.  Do I have to mention flossing?

Motivating patients is an “art.”  That is why I named my books The Art of Examination and The Art of Case Presentation.  If we don’t get our clients to act when they must…we have failed them.  Tough job, yes, and probably the one role we have that we haven’t been trained to do, and the one role when mastered can lead to more success than any other.



What’s a Dentist For ?

Glossodynia-Burning Tongue

Glossodynia-Burning Tongue




Jvonny has no stomach.  Whatever he eats goes straight to his small intestine.  Jvonny has been a patient in my practice for over twelve years.  I never knew him when digestion was a simple process.  Cancer took his stomach many years ago.  He is an ideal patient who does whatever it takes to keep his teeth.  He hasn’t lost a tooth under my watch.  He’s a good guy and he’s a Giant fan too.

Four months ago he came in complaining of burning tongue.  I referred him back to his physician for a workup.  This week he came in for his cleaning appointment, and he reported that his mouth was on fire.  He also reported that he was losing his sense of taste.  But at times there was relief.  I asked what his physicians had found.  He said that they were treating him for pernicious anemia.  That made sense to me because absorption of Vitamin B12 takes place in the stomach.  He was self-administering the B12.  But his problem was getting worse.

I went to the Internet.  I discussed the need for a nutritionist, someone who could find the right dosage of B12 and folic acid.

Jvonny was grateful.  He said that no other doctor had spent this amount of time with him…how my staff and I showed true concern.  We all felt good…but that’s what we do.  That’s what dentists are for.

Dentistry through the years has gone through many changes.  Remember Doc Holliday? or Painless Parker?  The profession worked hard through the years to clean itself up…to get honor and respect from the public.
With the help of the ADA, dental education and the various specialty boards dentistry became a highly revered and noble profession.

But something is changing.  In many circles dentists are looked upon as tooth mechanics or cosmeticians rather than doctors.  many of our services have been reduced to commodities.  Procedures with codes that are disconnected from the human beings like Jvonny that come to us for advice.

At it’s heart dentistry is an arm of the medical profession and should be treated that way.  Health care is about treating people right.  It’s about sitting down with our patients and helping them solve their issues besides just filling or whitening their teeth.

Every dentist MUST find the dignity in the work.  Please leave your comments below — if you have any insight into Jvonny’s burning mouth syndrome…I would appreciate the input.

If you have ever felt that you have lost the dignity that you thought came with the profession…please let us know.






The Real Reason Dental Patients Accept Your Treatment




1980 Popular Book by Roy Garns

If you are in private practice and you present treatment to your patients for a fee there is only one reason why they complete the transaction.  The fee you assign for your service is the value you place on the service.  How do you determine your fees?  How do you calculate the price of your dentistry? 

The final transaction will occur because each party, the dentist and the patient assigns a value to the service.  And that value is higher than what either party either party provides.

The value that is assigned is usually based on the anticipated future value of the service.  It’s kind of like buying a stock.  You pay a price based upon your future return of value.

For the dentist the value comes is monetary.  But for the patient the future value is always emotional.  That is the reason people accept our dentistry.  Those emotional reasons include the return on investment for self-esteem, self-preservation or any number of things your patient wants.

So what does this mean?

Your role is to close the emotional gap.  To understand what your patients want at an emotional level.

One of L.D. Pankey’s favorite books was The Magic Power of Emotional Appeal by Roy Garns.  This hard to find book is still a classic.

Understanding patient’s motivations, whether keeping their teeth, getting out of pain, or looking their best for social or business reasons is the key to acceptance.


So think of your examinations and presentations as an exchange of values.


Dental Case Presentation-Practice Makes Perfect


Don’t try this at home–it takes Practice





As I mentioned in a prior post, I do Bikram Yoga.  Not just any Yoga mind you, but Bikram Yoga.

For the uninitiated Bikram Yoga is carried out in a room heated to 105F  degrees and 40% humidity.  There are various reasons for the heat including, protection of the muscles for deeper stretching, thinning of the blood to clear the circulatory system and to increase the heart rate for a better cardiovascular workout.

Every class is the same.  We spend ninety minutes performing twenty six postures and two breathing exercises.  There are no advanced classes…all classes are for beginners, hence we get to practice forever.
Generally, sixty three year old males don’t bend very well.  I was never able to touch my toes.  It can be very intimidating doing Yoga with twenty-something year old women who can bend themselves into pretzels, but I heard about the medical benefits of Yoga and I wanted that.  So I practice Yoga.
One of my teachers, Leo, gets very philosophical in his lively repartee.

One morning as I tried to do a backward bend called Supta Virasana or the fixed firm pose, I felt as if my back would snap.

Leo said something that really helped.  He said you will do this pose over a thousand times and during those thousand attempts it will be 99% effort and 1% technique. 

Then he said, one day, after so much practice it will reverse…1% effort and 99% technique.
Many months later I was doing the fixed firm when I went back as far as I could, and without pain, I fell right into the posture, just as Leo promised.

All practice is like that.  I remember placing my first implant, doing my first filling in dental school, giving my first injection.  The real question is why we have so much trouble practicing the soft skills of presentation. 

Communication skills, interviewing skills, trust-building and storytelling are all skills that can be learned when we apply consistent effort.  The mythology of every culture tells stories of people who worked hard to master knowledge and skills. 

Science has shown the law of 10,000 hours that has been written about by Malcolm Gladwell in his popular book The Outliers.

Dentistry is a practice like any other.  Through time there is no skill we cannot master.  Most dentists understand this for the technical but give up way too soon with the behavioral.

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Become a Better Presenter in 2013



First of all, happy New Year – and here’s wishing all of you a very healthy and prosperous 2013.

I love this time of year because I get to set new goals.  I love setting goals.  Some years are better than others…but this year I am determined to really make some changes.

It is all about change isn’t it?

One thing I always tell people is that I am never inspirationally satisfied.  I grew tired of the same old production/collection goals that so many of us get hung up on.

This year’s goals will be “growth” goals.  Become a better….photographer…writer…blogger, and yes, a better presenter.

Becoming a better presenter tests my leadership skills, because all presentation is leadership.  All presentation is about moving people in a positive direction.  By the way, becoming a better presenter will take  care of those production and collection goals that the consultants tell us to concentrate on.

If I heard it once I heard it a thousand times…a dentist commits to produce “x” dollars per month, and when you ask him how…he doesn’t know.


Becoming a better presenter will get you closer to those monetary goals that seem so elusive.

Here is a process to create and accomplish this year’s goals.

Step 1– Identify the change you need to make to become a better presenter.  What specifically is stopping you from getting to “yes.”

Step 2– Write is down and keep it close so that you are aware…everyday…of what you want to change.  Don’t work on more than 4 goals at a time.  Two is preferable.

Step 3– Create monitors and track your progress.  Write in a journal or use some of the great apps that are available.  I use a great one called Habits Pro.  Those of you trying to lose weight or exercise more try MyNetDiary.

Step 4– Commit to the goal.  No I mean really commit through daily actions not just reading the goals and wishing.  Make a game plan, do the work.

Step 5– Get support and feedback.  Use staff members to keep you accountable.  Don’t beat yourself up.  Read books and apply the lessons.  Get a presentation or leadership coach.

Step 6– Control your environment.  Don’t multitask.  Focus on the presentation process and have faith in it.

Step 7 – Reward your successes and study them.  What did you do right…do it again and again.

Step 8 -Persist and persevere until presentation success becomes a habit.


There is nothing that you cannot do if you put your mind to it.  Presentation skills are learnable.





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