Chris (00:12.11)
Hey everyone, welcome back to the No BS Dental Growth Podcast. I’m Chris Pistorius and today we’re gonna get into a topic that quietly kills practice growth more than almost anything else out there. That’s called case acceptance. Most dentists think they have a new patient problem, but in reality, a lot of them have a case acceptance problem that’s hiding in plain sight. Patients show up, they nod along,
They say they understand, they smile politely, they walk out, and then nothing happens. No scheduling, no follow-up. Hopefully that’s not the case. Just ghosted by someone who definitely needs treatment. So today we’re going to talk about why this happens and how to fix it fast. And I’m not talking about sales tactics or pressure. I’m talking about communication, trust, systems, and psychology. The things that actually move the needle.
in case acceptance. Let’s jump in. First things first, let’s bust a few myths. Dentists love to assume patients say no because treatment is too expensive. Yes, cost matters, but cost isn’t the number one reason patients decline treatment. Another myth is that insurance is everything. Patients care about insurance, sure, but the truth is the bigger issue is understanding. If they don’t understand the problem,
doesn’t matter what insurance covers. Another big myth, if I explain the treatment well enough myself, they’ll accept it. No, case acceptance is a team sport, not a solo act. If the team isn’t aligned, case acceptance breaks later in the process. And my favorite myth, our case acceptance is great. Most practices don’t even track case acceptance, at least not accurately.
So most of the time, that confidence is based on vibes, not data. Let’s talk about the real reasons patients don’t accept treatment. And these might sting a little, but it’s the No BS Dental Growth podcast. So here we go. Reason one, confusion. Patients rarely say, don’t understand. They just smile and nod. If a patient can’t go home and explain the problem to their spouse or partner in simple human language,
Chris (02:39.586)
They are not accepting treatment. They don’t want to look stupid. So they say nothing. Reason two, fear and anxiety. This is one of the biggest ones. Fear of pain, fear of cost, fear of being sold to dental PTSD is real. Sometimes they’ve had a bad experience somewhere else. Sometimes they’re afraid of the unknown. If you don’t address fear, you’ll never fix case acceptance. Reason three, lack of trust. This is huge.
If the relationship isn’t built before you diagnosed, acceptance tanks. Patients decide whether they trust you in the first two or three minutes. If the doctor walks in, barely makes eye contact, talks fast and goes into, me show you your cavities, you’ve already lost the case before the explanation even starts. Reason four, too many choices. This happens a lot. Dentists love to give options.
We could do this or this or maybe this or a combined this and that approach. That’s great clinically, but from a patient’s brain perspective, it’s paralyzing. More options equal fewer decisions. Reason five, bad handoffs. And this one kills case acceptance more than almost anything else. The patient hears one thing from the doctor, then walks to the front and hears something totally different, either in tone or urgency or clarity.
the baton gets kind of dropped and in that moment the case is dead. Reason six, zero follow-up. 90 % of dental practices never follow up on unscheduled treatment. Let me say that again, 90%. You’d be shocked how many multi-thousand dollar cases just float into outer space because no one had a system to follow up properly. All right, now let’s get into the good stuff. How to actually increase case acceptance in a real
practice or I’m sorry in a real practical practice environment. Monday morning kind of way. I break it into five pillars. The first pillar is building trust before you diagnose. This is so simple but so overlooked. People don’t buy dentistry. They buy the dentist. They buy the relationship. Small talk matters. Eye contact matters. Sitting at eye level matters. Learning something about their life matters. It’s not fluff.
Chris (05:05.972)
It’s trust and without trust, nothing else works. This doesn’t mean wasting time or being fake. It means slow, just slowing down for 60 seconds and making the patient feel like a human, not a number on today’s Pillar number two is using simple visual explanations. No jargon, no just confusing nonsense. Patients don’t understand that.
You have to show the problem visually with photos, scans, diagrams, whatever you have. Show them what’s happening. Show them what it’s causing. Show them what happens if nothing is done. That’s a biggie. The key here is consequences. When a patient understands the consequence of doing nothing, case acceptance skyrockets. When they don’t understand consequences, everything feels optional.
Now, pillar number three is the clinical to treatment coordinator handoff. This is a biggie. The most commonplace case acceptance dies is really the moment the dentist finishes explaining treatment and then leaves the room. The energy drops, the urgency drops, the patient gets confused again. They suddenly have questions they didn’t ask when the dentist was in the room. A strong handoff sounds like, hey, Sarah, this is Amanda, our treatment coordinator.
She’s gonna go over the plan with you, answer questions, and help you schedule the next steps. What we talked about today is important because if we wait too long, you may end up needing a bigger procedure. Amanda will help guide you all the way through. That’s it, transfer trust, transfer urgency, transfer clarity. Now, pillar number four is making money easier. This is where the dental industry still feels stuck in the Stone Age sometimes. You have to make paying easier.
financing options, clear estimates, a calm explanation of cost, no pressure, no guilt, and definitely no, I’m sorry, it’s expensive energy from the team. If you act uncomfortable talking about money, the patient will feel uncomfortable accepting treatment. Phasing treatment can also work wonders here. Breaking things into steps lowers the emotional and financial barrier. It moves people forward instead of leaving them overwhelmed.
Chris (07:25.484)
Now, pillar number five is follow up. And this might be the biggest difference maker of them all. Most practices never follow up on diagnosed but unscheduled treatment. And that’s just wild to me. If a practice diagnosed $100,000 in treatment this month and only 50,000 got scheduled, that doesn’t mean the other 50,000 disappeared. It means there’s a $50,000 sitting out there waiting for someone to follow up. It’s opportunity.
There needs to be a system, a list, a workflow, a plan, something that ensures no opportunity slips through the cracks. A quick check-in call, a text message, a simple, hey, just wanted to see if you had any questions about the treatment we discussed. All of that adds up. And by the way, this is exactly the type of thing AI powered follow-up systems are built for. No pressure to mention Smart Follow by name, but this is definitely where it shines.
Let’s also talk briefly about the team’s role in all this because case acceptance is absolutely a whole team sport. Hygienists plant the seeds. They educate. They identify, especially early issues. They reinforce urgency in a way that feels natural. Assistants are often closer to the patient emotionally than the dentist is. They’re the ones who can say, you’re making a good choice fixing this now, or you’re going to feel so much better after this is taken care of.
Treatment coordinators are the closers. They bring clarity, patience, and financial guidance. They answer the weird questions patients don’t want to ask the dentist. And the front desk supports the decision with empathy, scheduling flexibility, and clear financial explanation. When the whole team plays their role consistently, case acceptance becomes predictable instead of chaotic. So before we wrap, let’s talk about measuring case acceptance the right way.
This is huge. Most practices calculate it wrong. Case acceptance is not how many people said yes, it’s how many procedures get completed. It’s not we feel like we do pretty well. The correct way to measure case acceptance is dollars presented versus dollars scheduled. Not dollars completed, dollars scheduled. If you present $50,000 in treatment and schedule 30,000, your case acceptance is 60%. That’s your real number.
Chris (09:49.57)
You should track this by provider, track it by treatment type, track it for new patients versus existing, track it for big cases separately from small ones. Just tracking case acceptance for 90 days, 90 days straight, will open the eyes of any doctor. You’ll start to see exactly where things break down and exactly where improvement needs to happen. All right, let’s wrap this up. Case acceptance is not about selling dentistry
It’s about helping patients understand what they need, why they need it, and what happens if they don’t do anything. When you build trust, simplify communication, tighten handoffs, make money easy, and follow up consistently, case acceptance becomes a predictable engine instead of a constant struggle. Pick one pillar from today’s episode and implement it this week. Just one. You’ll see a difference fast.
Now, if you want to help in creating real growth systems, one that not only brings in new patients, but helps convert them and keep them, reach out to me anytime. No pressure, no BS. So thanks for listening. I’m Chris Pistorius and I’ll see you in the next episode.
