Chris (00:01.231)
Hey everyone, welcome back to the No BS Dental Growth podcast. I’m your host, Chris Pistorius. And today we’re going to talk about the stuff that actually drives production inside of a practice. So kind of like what your team says, how your systems run and really why patients say yes, or they disappear on you. We’ve all had that happen. I know. But so my guest today is Eric Vickery. He’s got a business admin background. spent over a decade managing dental practices.
And since 2001, he’s coached more than 250 offices across the country. He’s a true expert in case acceptance, verbal skills, personality profiling, and he’s obsessed with stopping cancellations, handling objections, and asking patients for referrals and reviews, which I’m always harping about, by the way. And he also knows how to structure financial arrangements and third-party financing so you’re not chained to insurance, which everybody wants to know more about.
So this one’s gonna be super tactical and very actionable. So let’s jump in with Eric. Eric, how are you?
Eric Vickery (01:05.129)
I’m great Chris. Thanks for having me. I love your podcast and so I’m very excited to be on.
Chris (01:09.156)
Awesome.
Yeah, well, I know this is a hot topic for a lot of a lot of our folks out there. You know, when we talk about case acceptance, what do you think is the number one reason why I’m just going to jump right to it? No BS, right? So what do you think is the number one reason people say no to treatment?
Eric Vickery (01:27.31)
Mm-hmm.
Eric Vickery (01:32.13)
I don’t think they understand what’s going on. I don’t think they understand what’s gonna happen if they don’t get it taken care of. I’ll tell you just a quick story. My mom called me up and she just said, hey, I let you know that that two’s not bothering me anymore, so I canceled my crown appointment. So, you know, I spent about, I don’t know, four and a half minutes on the phone with her and she goes, okay, I’ll call them back and reschedule it. And I said, you know, and given my card, you know, people, the number, two things.
Dental offices don’t wanna be salespeople. They don’t wanna be known as pressure, which I totally agree with. They don’t wanna be known as pressure salespeople. Okay, fine. Then number two, why is the most common phrase heard in dental office, you need a crown? Because that’s pressure sales. And people only hear crown and they think money. And in their mind as a non-dental human being, they go, well, a crown is, that’s when I have pain. They’ll call the office, I’m sure you listen to the new patient calls. Yeah, how much is a crown? And they haven’t been in this in four years.
They’re having sensitivity, they’re having a problem, they don’t understand. They don’t call up and say, you know, I’d to schedule a D0150 comprehensive examination, please. I’m having pain in number three. I haven’t been to the dentist before. They don’t know what to say. They say that and we perceive it to be, this is a shopper or they’re just price shopping for crowns and people are so money conscious. No, they don’t understand what they don’t understand. We have to do a better job at helping people process this. So we work from a sales perspective where we do no pressure sales at All-Star.
And our case acceptance mastery starts with foundation principle number one in sales is this, people don’t buy a solution to a problem they don’t perceive to have.
Chris (03:07.959)
Mm. Yeah.
Eric Vickery (03:09.304)
So helping people understand what’s going on and what’s gonna happen if they don’t do it. That’s what we wanna do. So we have rules and we have verbal skill systems that are applied to help dissolve that problem, to make sure that doesn’t happen.
Chris (03:22.597)
Yeah, I, you know, I think, I think you hit a lot of very strong topics there and it’s, know, it’s not just case acceptance. It’s even like with front desk reception, like just, you know, talking to patients, you know, who are, know, how, how you brought up there, they’re really trained nowadays to say, Hey, how much is something? Cause like you said, they don’t know what the hell to really ask for specifically. The only thing that they really know is, is price. And, know, they’re trying to compare everything to a monetary unit.
So what can front desk people, case acceptance experts, what can they do to change that language a little bit and improve these numbers?
Eric Vickery (04:03.832)
So All-Star Dental Academy was founded by Alex and Heather Nottingham on phone skills, the great call process, greeting, rapport, engage, ask for the appointment, take the information. So what typically happens is when a patient calls in and the admin person has not been trained, the person asking the questions is the one that’s in control of the direction of the conversation. So you answer the phone and I go, how much is, do you take? Or something really intelligent like, are you taking new patients? You know, no, we’re going out of business.
They just don’t know what to ask. And so if you are just an answering service and you’re just answering questions and there’s dead silence, okay, well thanks, bye. You have to know how to get control of the conversation a very nice way by being the one who answers the question. And a simple coaching hack is, oh Chris, I’d be happy to help you out with that. Again, my name is Eric, who are the pleasures, I said I didn’t know your name. Oh, I’d be happy to help you out with that. Again, my name is Eric, who are the pleasures of speaking with.
Chris, wonderful. When was the last time we saw you in our practice? you’ve never been? Well, welcome to practice. Thank you so much for choosing us. Tell me what’s going on right now. What are you experiencing? How long has it been? Just ask questions and you build rapport with them by being interested, not interesting. Instead of the answering service and being transactional, you want to shift to being relational. So when you shift to being relational, you have a shot.
People call up and say, do you take Medicare or something? They think, my gosh, this phone call. No, we don’t take Medicare. I’m so tired of hearing this. Well, that person just doesn’t know what to ask. You have to engage first. Yeah.
Chris (05:25.029)
Yeah, that’s great.
Chris (05:33.613)
Exactly. Yeah. It becomes less transactional when you actually, you can develop a pour in under a minute, right? And it’s just by asking the right kind of questions. And you’re absolutely right. get, you know, on our marketing stuff, I mean, we get some feedback sometimes, especially in newer.
Eric Vickery (05:42.295)
Yes.
Eric Vickery (05:52.632)
Yeah.
Eric Vickery (05:57.666)
Yeah. Yep.
Eric Vickery (06:16.472)
So you’re, yep.
Eric Vickery (06:24.536)
It still says record on my end.
Chris (08:34.805)
All right, sorry, man. I’m not sure what I got going on here. I’ve got it. really? That’s interesting.
Eric Vickery (08:38.478)
You sound a lot better this time.
Mm Yeah. A lot clearer.
Chris (08:45.637)
Okay, I’m not sure what’s happening here. I think we’re good. Is it still show recording? Okay, all right, let’s
Eric Vickery (08:50.19)
It says recording on my end. Yeah, studio is still up and live and going. might be your connection might be maybe over buffering or something. Yep.
Chris (08:57.061)
I’ve got a hardwired Ethernet connection. I don’t. I’ve never had this error come up before. Let’s just keep going and we’ll figure it out. So let’s see. So we were talking about case acceptance and what can people do quickly. Yeah, phone skill stuff you want to finish your last thought there and then we’ll just keep going. Alright.
Eric Vickery (09:03.798)
Yeah, let’s see how it turns out.
Eric Vickery (09:10.168)
Phone skills, yeah. Yep, sure. Yeah, so for what we see is this, look, a patient who’s looking for a high quality dentist wants somebody in their mind they can trust. And trust is gonna only be developed in someone who has relationship. And relationship has to have this flavor of credibility. So what that means is you could be a level 10 clinician, but if you’re a level five communicating team,
The patient’s perception is, your credibility is way down here’s a five and you can’t even get into building trust. can’t even, doesn’t even feel like I could build a relationship with you. And the phone call is transactional. So the phone call is a great way to really get case acceptance moving in the right direction. Like we always talk about the first impression. Now we know it’s the website, the referral source and all those things, but it’s an extension of that. And they’re not scheduling if the phone skills aren’t just locked in and really, really good.
We love our process for training bone skills and it definitely influences how the patient shows up with expectation.
Eric Vickery (10:27.054)
Yeah, yeah. So all of the above, the All-Star Dental Academy is an online training platform that you can access anytime you want, 24-7. I recommend, look, repetition is the, what, mastery of skill or something like mother of skill. I that’s what the saying is. And it’s just 20 minutes a week reviewing, how do I do phone skills? There’s scheduling, there’s stopping cancellations in there. There’s even a dental MBA. mean, there’s Alex and Heather have done an incredible job.
you know, filling out all of the training opportunities. And then my coaching division, we have 13 coaches working with clients all over the country and we’re working like this virtually with them. And then I’m leading a seminar live. were just in Fort Lauderdale. We have an event in May in Fort Lauderdale where we’re doing a live training in person you come to, or you do virtual training with your coach once or twice a month with the team on how to work through things.
You know, we like our teams to listen to their recordings. I would tell any administrative person, listen to two things every month, two calls, a really, really good one that you know you crushed, that you did really good, and one where you just didn’t get the person to schedule. What’s the difference? What’s the difference? But if you can’t figure that out, put it in the hands of a coach, put that in the hands of a team member, and just figure out what do I need to do differently here? And it’s funny, when we go through that great call process, the A, ask for the appointment.
Oftentimes, we want to do one of two things, make the patient say no, or answer a nice open-ended question so they don’t feel pressured like this. So Chris, how? How would you feel about going ahead and getting your first visit scheduled here in our office? Even if you know it’s probably a no, I want to make them say no to me. Even if you know that. Or you could say, feels like Chris, it makes sense to go ahead and get your first visit scheduled here in office. Am I right? And you have to say no to me to do that. But
I would love for you to give me as much language as possible so I know where you are so I can converse with you on that. I’m having a conversation with you. It’s not transactional. I can’t emphasize that enough. And they should feel like when they walk in, you’re the person I talked to on the phone. You were so nice. I’m so glad I got to meet you. I’m nervous coming to the dental office. You make me feel like a little bit less nervous, you know? And that’s how it should be. And it should be effective and we should be getting people scheduled.
Eric Vickery (12:47.982)
at a much higher rate than what’s the national average. Like, was it 22 % or 33 % of calls are converted or something? It’s really, really, really low.
Eric Vickery (13:02.082)
Yeah. Shat. Yep. Yeah.
Eric Vickery (13:16.3)
Yeah, yeah.
Eric Vickery (13:29.708)
Yeah, I would imagine they’re calling five offices, let’s say four five offices. There’s your 25 % conversion rate, one out of four. They’re gonna schedule one of them. Well, who are they scheduling with? They’re scheduling with, first of all, the one that answers the phone that doesn’t put them on hold right away, or they’re not at lunch or what have you. Number two, they’re scheduling with someone that makes them feel really good while they’re on the phone with
Yeah, so have engagement. Yeah.
Eric Vickery (14:10.446)
Yeah.
Eric Vickery (14:25.1)
Yeah.
Eric Vickery (14:36.482)
We have a verbal skill we use, Heather Nottingham teaches so well on our online platform called Share the Sizzle. And what people are looking for is, did I call the right place? Are you able to really help me with what specifically I’m looking for? And when you just simply go, yeah, we could do that. That’s not really instilling confidence in your competence. I wanna really know. So when I say, know, Chris, the fact that you’re looking for somebody who does implants and can really do it well,
Our doctor’s been doing that for over 10 years. You’re talking about hundreds, if not thousands of procedures of happy patients. know what, check out, I can email you link to our Google reviews where you can see what people have said. You can go to our website and look at our reviews. People are specifically talking about how we helped them with tooth replacement and did it in a way that made them actually enjoy going to the dentist. We’d love to help you just like that. How? How would you feel about going ahead and getting your first visit scheduled? That’s what we’re looking for in that verbal skill. And you’re going,
Yeah, that’s where I want to go. I want to be impressed with your language. You’re telling me what it’s going to be like. Well, you’re telling me either by saying nothing, you’re telling me it’s not going to be that great, or you’re telling me it’s going to be awesome. You’re setting the bar and raise your verbal skill to a level 10. Now all of a sudden your verbal skills and your clinical training or I attend, it needs to all match. yeah, and then once we get them in, then we go through the exam in a way that is
focused on getting them to understand the conditions. You can’t just show a picture and go, that’s fractured, you need a crown. That does not work anymore. You’ve got to explain what’s happening with really, really good verbal skills, know, word pictures, analogies, describing what’s happening and what’s gonna happen if they don’t do things. And you don’t do it in a way that scares them. You don’t say, you should do this. You know, that word should, we should be careful how we say that word.
And you don’t want to tell anybody that you want to use questions. You want to say, know, Chris, has this tooth started to hurt you yet? Have you ever had a toothache before? Do you know anybody who lost a tooth from like a vertical fracture? Have you ever heard of this before? Okay. You know, you have to have these questions because by using questions, you’re implying here’s what’s coming when you don’t take care of this. Instead of my mom saying, yeah, it’s not bothering me. Well, it’s not going to, that’s, that’s, that’s not cutting it anymore. Yeah.
Eric Vickery (17:03.512)
So on the, I think it’s the perception. It’s you’re self diagnosing going, well, it’s not hurting. I have a saying, I say no pain, no problem, no pay. And we have to help them understand that pain is not a dictator of whether there’s a problem or not. Early stages of cancer do not hurt. So pain is not an indicator. That’s not what we’re looking for in dentistry. We’re looking for…
getting the patient to see it with their own eyes, hear it with their ears in a way that is simple for them to understand so that they’re asking you for a solution. Or we have a verbal skill called the case presentation formula. We follow a formula to help them understand what’s, you know, here’s what’s happening now, here’s what’s gonna happen if you don’t do anything. How concerned are you with that? And just seeing if they’re in. If they believe there’s a problem, then you have the right to proceed. Great, let’s talk about a plan.
And then after the plan, you say, how do you feel about this plan? So there’s the how word again is so powerful in really finding out, am I about to schedule a future no show appointment or is somebody really in on this? And I feel comfortable moving forward. Cause when you go, know, Chris, do you see a good reason why you wouldn’t want to go ahead and get this crown schedule today? And you go, I don’t even know if you know what you’re supposed to say to that. It’s like a double negative. So, and you go, exactly the pressure and all of that. they go, yeah.
Exactly. Yeah, yeah. These leather seats, these leather crowns. So they go, yeah, yeah, put me down for something. And as soon as you hear that, you’re going, man, I don’t know if they’re in. Or they go, well, how much is it? They’re looking for an excuse. Instead of somebody saying, I didn’t realize it was so bad. What do I need to do to take care of it? Great. Here’s your solution. How do you feel about this solution? Have conversation with them. So it’s on the phone.
It’s chair side with the doctor and then the transfer back out to the front, whether it’s a patient coordinator or someone who’s gonna go over financial options, the treatment plan and scheduling, that language is all used throughout that entire process. So the rule we use is called 95-5, 95 % of your communication versus five. 95 is focused on condition and consequences and only 5 % of your words are focused on treatment. Treatment does not.
Eric Vickery (19:23.692)
have to be what you talk about. We wanna talk about crowns and bridges and implants and veneers and root planings and periodontal this and all of that sounds like money. Instead, when I bring the patient out front, I say, know, Betty, Chris and Dr. Smith both really want to get the infection in his gums taken care of, right, Chris? And now I’m not telling you what you need to do.
I’m using the word want instead of need. And you can honestly say, I want to do that because of the conversation we had out back. And now a person upfront is not getting a dump off. They’re not getting to, all right, Betty, Chris just needs four quads of scaling root planning. All right, all set. Have a good day. If you have any questions, let me know. I mean, that empowers nobody. Again, now we’re back to level five or lower communication. And now we’re wondering why are we getting people who cancel appointments? And I could go on and on about stopping cancellations, but lots of verbal skills there too. Yeah.
Eric Vickery (20:32.995)
Mm-hmm.
Eric Vickery (20:55.534)
Okay, so when someone says I need to think about it, my first instinct is thinking, okay, where did I lose them? That’s a temperature check. When I say, Chris, how do you feel about moving forward with this plan? You go, well, I need to think about it. I’m happy to help you think about this process. No pressure from us. We never want you to feel pressured. So that you have, make sure you have all of the information and everything you want to think about so you make a great, healthy decision. What sort of information can I provide you?
on your decision, is it cost? Is it, do I really need this? Is it value? Help me understand. And so I’m eliminating, well, what’s the objection? Is it a money? Is it lack of urgency? What is it? And then you go, yeah, I’m just not sure I need it. Boom, now I can go back into realizing I didn’t have impact when I did the 95-5 rule and I test the buy-in and I ask you how concerned are you with this? So now if I did all that really well and then I present it you go, I really need to think about this, it’s probably gonna be money.
It’s probably like, do you, then you probably say, well, it’s just the money part. go, listen, I totally get it. Figuring out how to make it affordable and fit in your budget, that’s why we have magicians who do this. They know how to figure out how do I make this as easy to move forward with as possible to make the payments as easy as possible? Is that something that you’re looking for? And if it’s not, you’ll tell me it’s something, you’re like, I would just never spend $5,000 on my teeth or whatever. Okay, well, we’ve got payments out.
that will make this really easy for you. And I’ll put an asterisk on this. We don’t recommend 12 months and beyond financial arrangements unless we’re talking about the whole mouth. Very rarely are we saying, let’s do single tooth dentistry for 12 months, no interest. Because when are they doing tooth number two in 13 months? That’s not helping anyone. That’s not helping anyone. Yeah, our goal is how do we get this patient as healthy as possible, as quick as possible by removing the friction points.
And what are the friction points? I don’t know, I don’t understand, and I can’t afford it. I don’t see value or urgency because it’s not bothering me, or I can’t afford it. But we can make it affordable for people. We can absolutely do that. Think about an orthodontist. They’ve been doing this forever. They’ve been doing this forever in ortho. Why are we having a problem in general dentistry? We don’t have to have this problem. We have people who aren’t willing to get out of financial arrangement worksheet because they don’t want to pay the seven and a half points on the cost of the treatment.
Eric Vickery (23:14.702)
because they’re locked in on a horrible insurance PPO plan and their fees are already staked. Well, as you read in my bio, let’s talk about that. Let’s go insurance free and that’s a loaded comment. We believe in out of network participation where the check still comes to you and we help offices all the time get to the place where like, my gosh, I actually have the financial freedom to offer things to my patients to make it so that they can make payments and I don’t feel like I’m paying people to come see me.
So I think the average PPO rates 42 % write-off rate and we’re worried about a 7 % cost of a business cost of making things affordable. So we’ve got it backwards sometimes we got to fix that.
Eric Vickery (24:00.47)
Yeah. Yeah, you dig deeper. Yeah, you dig deeper. So our formula for that is simply to engage. We acknowledge and we engage. We say, I hear it. I hear you. I get it. I acknowledge, I engage, and then I ask questions. So I acknowledge it. I say, I hear what you’re saying. I would feel, you know, I’d want to talk to my wife and think about it too. Let me ask you this. Is it this or is it that? And then I usually will give them two potential objections that I think it might be.
I don’t think money is as big of an objection as people think. I think it’s a smoke screen. I think it’s lack of urgency is the number one objection. And that is because we’re not doing things like the 95-5 rule. We find that when our clients use our system from great phone call all the way through case presentation formula, the objections go away. Other than life conditions, I want to, but I can’t. That’s different. Yeah.
Eric Vickery (24:57.006)
Yeah.
Eric Vickery (25:04.056)
do it. Yeah. Yeah.
Eric Vickery (25:26.52)
Mm-hmm.
Eric Vickery (25:34.668)
Yeah. The first thing I find is people have it. They have to have the right mindset. If you’re going to be a financial coordinator, you have to the right mindset. First of all, you can’t have this approval addiction. You can’t have fear of rejection. The second thing is you also can’t be a bully. You can’t be this really, really direct person and tell them what they need to do again. So you got to find that middle ground where I say, you know, Chris, I’m so glad that you and Dr. Smith have made a decision to take care of things.
I love the plan that you guys are talking about. I think things are going to look amazing. My job is now, do I make this as easy for you as possible on the financial side? And so what I’d like to do is go over all the options we have to make this affordable for you. And you can choose whichever option you think works best for you. And then I literally have three to four options on prepay savings, extended payments, and may have a half down, half as you go type in office sort of situation. one of those options is going to work for
a vast majority of your patients. It’s the person who’s, you know, I’m on a fixed budget. I haven’t met anybody who’s not on a fixed budget, but I’m on a fixed budget is what they say. I can only afford so much per month. Well, let’s figure out a payment plan where I do. Why would you pay tooth by tooth by tooth for the next five years and end up with root canals and lost teeth? Instead, why don’t we do it all right now the next five months and you can still pay for it for five years? The small amount of interest you’re going to pay on the loan is a lot cheaper than
root canals and extractions and implants. So let’s do it right now and let’s do that. And you just have to have the right knowledge. You have the right perspective of that as a financial coordinator to go, is how everybody buys everything that’s worth it. People who want things that are valuable, we make payments on them. Very, very, very few people go pay cash for their 50 to $100,000 car now. That’s pretty rare. Yeah.
Eric Vickery (27:29.582)
you
Eric Vickery (27:55.27)
Yeah. Yeah. Yeah. I’ll tell you a story. So we taught this, had a team use the verbal skills of asking questions, digging deeper, building relationship. And I’m not talking about a 30 minute new patient phone call. Nobody has time for that. You know, just as long as it needs to take. And this elderly lady, I was probably in her seventies, right in our wheelhouse for what we want to do for whether it’s all on four or full mouth dentistry.
And she said, she called up and said, do you take Medicare? Now, before our training, the team member would have just said, no, I’m sorry. We don’t work with them. Phone call over. Very, very unfortunate. It happens a lot. But with our training, she was able to thank her for calling, get her name, talk about, you know, when was the last time you, you know, we’re in an office, new patient, welcome to practice. And who may we thank for referring you? And at that moment, when they got to that place of asking questions and the greeting.
She said, my three best friends that I live with at the retirement community, I’ll come see you. Well, she knew all three of them pay cash when they come in. So again, this is the perfect example of somebody who just didn’t know what to say when she called in. She just knew what she knew, okay? So they were able to engage into a conversation and go, we’ll take care of you the same way we take care of all of our patients who have Medicare. We have a membership plan.
They pay $48 a month for all their preventive services and it creates savings for you when you see the doctor. It’s amazing. How? How does that sound to you? And then ask some questions, know, explain, ask questions. So the system works. Now, if somebody goes, I can only go to an in-network dentist. I refuse. Well, okay, well, we fixed $5 haircuts. I’m not picking anybody who’s in network. We have a lot of clients who are network, I’m teasing. But like, you know, a Medicaid practice for an adult,
Nobody’s explained to them how that works. So I tell, this is my verbal skill for that, Chris. I go, Chris, you know, it sounds to me like you’ve been calling around asking people this question. Am I right? And they go, yeah, you’re like the 12th person I’ve called. Okay, has anyone taken the time to explain to you why it’s called Medicaid and not denikade? No. Okay, think about it for a second. You’re an adult and you have Medicaid. The only thing they’re in cover is like you’re in emergency room and you’re having an extreme toothache and they’re gonna give you pills.
Eric Vickery (30:17.678)
That’s it. Maybe there’s a way that they paid it covered extracted tooth, but you’re trying to save your teeth, right? Okay, so here’s what we do with all of our patients who have Medicaid that come see us. That’s a key verbal skill. We have a lot of patients who have that in that same situation come see us. We offer a membership plan. It’s only $48 a month and you have access to all of our preventive services. There’s no cost in addition to that when you come in for your hygiene visits. And then when you have dentistry that you want to do with a doctor,
We’re upfront about how to make that affordable with payment plans and options that we have. How does that sound to you? And get them talking and just see where they’re at. Now, that might not be what this patient wants to hear and then they go call around four more places and guess what they’re gonna hear? No, no, no, no, no. And they’re gonna remember me. Call me back. I’ll get their number. I’ll call them back in a week. So there’s a system for all of it. It’s not a silver bullet. I would be doing a lot better if I had silver bullets, but.
There’s no perfect solution, but we can improve our batting average with really good verbal skills.
Eric Vickery (31:23.596)
Yep. Yep. Yep. Yep.
Eric Vickery (31:38.018)
We love talking to people about what their best options. We don’t think we’re the only coaching company. We know we’re not the only coaching company. So we’re happy to just listen and see what the best options are. So I would email Heather at allstardentalacademy.com. She’s our co-founder. She’ll love to just meet with you and talk with you about what’s going on and figure out what your best options are. You can look at allstardentalacademy.com and see all the things we offer.
You could come to one of our events. I’m doing case acceptance mastery for the AGD at their base, their home office in Chicago and in March, or you can come to Fort Lauderdale with us in May, where we do our annual event and we focus on case acceptance and, and two days of growth. It’s, it’s a lot of fun. So any of those will work. Yeah.
Eric Vickery (32:55.714)
Heather at AllStarDentalAcademy.com
