Achieving a great practice has much to do with choices and decisions. This forms the foundation of gaining case acceptance from our patients.

However, it is not only about giving choices but also making sure that those choices are understood, and hence more favourable decisions can be made. Correct choices can only be made if the patient has a comprehensive understanding of the choices that are available to them. People rarely buy into things they don’t understand.

So it often helps to look at what aspects of your practice are inhibiting your delivery of those choices? Or, more importantly, which aspects of your practice provide a negative impact on the patient’s decision as to whether to go ahead with you or not? This is often about the patient’s perception of your practice competence rather than the treatment choices available.

Perception Affecting Choices

Patients do not understand the very foreign medical language of dentistry. They cannot decipher between a highly-skilled clinician and a basic one based on this language. They do not realise what a tremendous clinical preparation looks like or what a fantastic occlusion looks like. A full mouth rehabilitation sounds like a horrendous hospital operation where they are wired up for months!

The only things patients are able to comprehend with some certainty are the messages that they receive from their sensory systems. These include the things that they see, hear, touch, feel and smell. They often make assumptions about how good we are as clinicians based on these things, and things such as our communication skills and how we receive our patients prior to receiving the treatment. Also, the case acceptance often depends on their level of trust and value built by all these individual factors.

Your patient’s perception ultimately affects their choice of the options available, including the possibility of doing nothing at all.

This means that it becomes vital to have a process in place that can make it easier for patients to understand the benefits of the dentistry we can provide them. There also needs to be a well thought out process of assessment that takes all the things a patient assesses us by into consideration.


There are three essential aspects that comprise the communication process:

  1. The Pre-Clinical Experience.

    Here using good communication skills to build rapport and really understand the patient can help your team to connect with the patient. Also, the pre-clinical experience determines the initial perception the patient creates in their mind. And is hence influenced by the entire team, including receptionists, treatment coordinators, nurses and dentists. This is a trust and value builder.

Note: Every stage in the assessment process is important. However, if I were to give an arbitrary percentage to the impact a particular stage has on gaining case acceptances, in my opinion this step will have 55% relevance from the entire assessment process.

  1. The Clinical Examination.

    Your evaluation must be two-way communication. A thorough clinical examination in a way that involves the patient can be very useful. One method is called co-discovery. Essentially, discover the problems together. It is also a trust-builder and exemplifies your take on dentistry.

This step has 35% relevance in the entire assessment process.

  1. Post-Clinical Presentation.

    If you have understood the patient and his or her needs really well and you have involved them in your diagnosis, then this step is a simple formality of putting things together. Patients by now should understand fully what is available to them and the consequences of their decisions.

This step has 10% relevance in the entire assessment process.


Guiding the patient through this 3-step journey of co-discovery will help them to discover the answers to their requirements for themselves. If you are able to meet their needs and wants in a way that is in tune with how they perceive you, then you are more likely to get the case acceptance.

communication skills

The patient journey, however, can only be productive if the communication skills of your team are clear and compelling. If the actual values of your treatment plans are matched or exceeded by the perceived value of the patient, then they should be happy to accept your treatment recommendations.

Having a process established in your practice for patient assessments also makes it easier for the team to follow and care for their patients. It forms a system that can be structured in a stepwise fashion to help coordinate the entire team. This includes a well-organized and smooth flowing practice as far as the patient is concerned.

Case acceptances can only be achieved by considering patient perception, especially by understanding the decision-making process from both sides of the dental chair!


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