#35 – Gains Commitments from clients for improved health

Don’t be a chat and polish hygienist!

This will be very difficult for you. In fact, this will be the most difficult step for you professionally in this first level.

Commitments reward you 3% of the fee for the procedure for motivating clients to improve their level of health. Most hygienists (and hygiene schools) teach hygienists to become friendly tooth cleaners. Nice people, good cleaners, but our clients deserve more than this. Your task is to become a trusted counselor. This requires you to:
1. Learn about the medical/dental history of the clients
2. Learn about them as people, what their interests, wants, needs are
3. What dental problems they are having
4. Learn how to present your ideas on improving their health in a way that motivates them to improve

Commitments aren’t meant to make you a tricky salesman. None of the dentists are interested in doing unnecessary dentistry to generate more money. You cannot “sell” dentistry just to gain commitment bonuses.

As an example, when a molar loses one cusp, a filling will usually work very well. If more than 1 cusp is lost, then a crown is the restoration of choice. Is your own mouth as healthy and attractive as it could be? It’s hypocritical to counsel your clients to have the best dental health if you don’t!

Use your hygiene documentation effectively. Don’t make extensive notes on the treatment sheet. You won’t go back to read them 6 months later. Make your notes in the right hand column in pencil so you can update them as situations change.

If you have a broken appointment, use this time to call these clients to see if they would like to schedule the treatment that you thought they wanted. Record this conversation on the treatment sheet.

Hints on Commitments
1. Ask questions; don’t tell clients what they need.
2. When clients make statements about improving their level of dental health, follow up
with more clarifying questions.
3.Lower mirror and discuss what you are seeing during your cleaning.
4. Example questions
a. What concerns do you have about ___________?
b. Why do you say that?
c. How important is _____________ to you?
5. You should check your charts 1 day in advance and write down the commitments you plan to discuss on a printed schedule.
6. You can see if a client has insurance by clicking into the family file. You can see if that insurance plan has paid for the treatment you are recommending by clicking on the Payment table button in the insurance window. This might be nice information for the client to know as they are deciding on having this treatment done. Write this down on your copy of the schedule.
7. Our philosophy is that money doesn’t have to stop someone from having dentistry they want. If you present treatment to your patient and he says, “I cannot afford it” then you can say “If we found a way to work out the financial side for you, would you want this treatment?” Your job is to make sure they understand why this treatment is important for them. Then, you should have a higher level secretary check them out so that they can discuss financial arrangement options. You will want to be prepared for this conversation if a patient asks you. Try to get an idea what works best for them because you present them to a secretary. So you can help lead the financial arrangement conversation in the right direction. Just so you are aware, our options include:
a. Pay in full to receive
i. 5% discount with cash or check
ii. 3% discount with credit card
b. 6 months same as cash with CareCredit
c. Pay ½ to schedule and ½ day of appointment
d. Set a pay as you go account, (example: pay $100/month, when ½ is paid on account, the client can schedule 1st appointment.
e. Asking the secretary to send a PTE will give the patient an exact amount that will be correct. (Some patients prefer to do this first.)

8. Your job is to present the urgency of the situation – why should your patient have this treatment completed now?
9. Part of learning how to succeed with the commitment system is tracking your success. Daily in the huddle, while the meeting begins, get the commitment sheet and copy the names from your treatment sheet onto the commitment sheet. When its your turn, you will report the names of the clients you plan to discuss commitments with. Then the next day, you will report which of those clients scheduled. This is your best way to measure how you are doing. As you write down client names in your notebook, you can use this for self-coaching. Did you discuss the warranty? Did you offer for the client to meet with a treatment coordinator to discuss finances? What seemed to work well, what did not?
10. Make your intraoral camera your best friend
11. The hygiene sheet is your second best friend

Don’t forget to stress our 3-year limited warranty. This will help our clients feel more comfortable in accepting more expensive treatment and help us to protect this dentistry through regular cleanings.

In Level 1, you should be able to achieve about $300 in improved dental health each day you are with clients. This doesn’t seem like much, but you will be surprised how difficult it can be.

These commitments are an excellent measure of how effective you are at establishing a professional relationship with clients. Here are some suggestions:

The Tracking System
1. Hygienists: When you motivate a client to accept treatment – be sure to let your dentist know. You do not receive credit if:
a. The dentist has already developed the commitment at an earlier appointment.
b. Another hygienist had gained the commitment in the last 30 days.
c. You do not tell the dentist that the client has chosen the treatment and the dentist creates the commitment. When the dentist is performing his exam, say “Dr. Case, Mrs. Nesbitt has decided to have that bridge constructed to replace her lower molar if you think that would help her occlusion.”
d. The patient will be returning for a comprehensive exam where the dentist constructs a full tx plan.
e. The patient is unsure of tx. If they want to think about it. You can document it in your notebook and follow-up with them. If you can schedule the patient after the appt. you can then take your notebook & patient chart to doc for a signature.

Once you have the commitment, write it down in your notebook. As the dentist finishes the exam have him/her initial your entry.

2. Hygienists: When you motivate a client to accept a specific treatment – enter a note in Dentrix for that patient:
a. Click on client’s family file
b. Click on recall box
c. A list will come up – click on commitment
d. Type your commitment in the box
e. Exit out
f. You can run a report whenever you want to see the commitment names for you to follow up on.

3. When you motivate clients to improve their dental health, write this information in your spiral notebook.
1. Date
2. Treatment client accepted
3. As your dentist exits your operatory, have this commitment initialed to confirm.

Also, in your notebook, print the date, client name, accepted treatment, and client phone number. When you have a hole in your schedule check clients who have had their committed treatment accomplished. Check off all completed commitments in your notebook and also note the clients that have not been in.

See the sheet on the next page. Buy a 3×5 card file and index cards for each month. If a client doesn’t schedule, put one of these slips in your file to remind you to call.

4. On a monthly basis, give the office manager a list of patients who you have commitments and they completed treatment. This must be given to her by the 5th of each month. If I find a commitment, I will delete the computer note and calculate 3% of the fee for this procedure as a bonus for you. Be sure to give me a copy of your commitment notebook page so I can compare your computer and notebook entries.  Each month you will receive a bonus equal to this amount.

To be successful with the commitment system, you must call and talk with your clients that do not schedule the treatment you have recommended. To prioritize these calls, you can use this tracking page to see how much open time you have in a week and how effectively you use your open time.

Week of Monday_______________ – Friday________________

# of units open _____ _____

Projects accomplished off of the weekly Management Meeting Project List: (do not include your regular tasks such as checking charts, C&S, etc.)


Commitment goal achieved for 1 month


Signature / Date