In previous articles, we have explored patient engagement and orthodontic marketing with the aim of getting the patient to attend at your practice to learn more about their options for starting orthodontic treatment. In this article, we will explore the patient engagement activities that need to be considered during the consultation.

First impressions count

From the moment the patient approaches your practice for the first time, they are forming impressions about the likely experience of undertaking treatment with you. If you know from your day list that a new patient is scheduled, make sure you have everything prepared such as medical history forms so that they are made to feel welcome. Consider the experience from the patient’s perspective and undertake a walk-through taking in as much detail as possible. If your website talks about attention to detail and a comfortable, relaxing waiting area, make sure everything the patient experiences reflects this. 

Take time to ensure they are welcomed to the practice and try to appreciate just how apprehensive they may be; it isn’t easy opening up about insecurities they may have held for a long time and some patients may require more support than others. If your practice has a Treatment Coordinator, this will be an ideal opportunity for a friendly, relaxed conversation in preparation for the consultation and time should be built into the process for this to take place.

The consultation

During his presentation at the British Orthodontic Conference in London in 2018, Prof Jonathan Sandler described a consultation as a meeting of two experts, the clinician and the patient. There is a great deal of merit in reflecting on this statement and questioning whether the process you use, and may have used for many years, respects the expertise of the patient in selecting a choice of treatment most suited to the outcomes they are hoping to achieve.

Through exposure to advertising, their research, and what they would have learned from your website and conversation with your team, patients will usually have a reasonably good idea about what their options are and some of the merits of one or more orthodontic solutions. During the consultation, you need to explore the patient’s understanding of the concerns they are presenting with, the types of treatments they would be willing to consider and the outcomes they wish to achieve. 

Let’s break these down and explore them further. A consultation will very often start with the patient describing what it is about their teeth that bothers them. This might include crowding, irregular spacing, or a poor bite. Usually, the consultation quickly moves on at this point to a clinical examination but it is always worth exploring this first part in more detail to gain a better understanding of the impact their teeth are having on them. Questions such as ‘what is it about your smile that you do not like’ followed up by ‘how does this make you feel’ or ‘what impact does this have on you’ can lead to a greater awareness of patient motivations and using this information later in the consultation can help you to move closer to a commitment to start treatment. From a patient’s perspective, it also shows you have a genuine interest in them as a person which is one of the key areas when considering improving patient engagement.

When asking about their thoughts about different brace types, remember the patient would have already undertaken some research or been exposed to marketing which is likely to have helped them to reach a decision about the treatment of choice. To help you guide them towards the best option, you will need to gain an insight into their understanding of the merits of their preferred system. If a patient states they are looking for aligners (or more likely will simply name one system), you could explore what it is about aligners that appeals to them and if they mention they are looking for something which is quite discreet, this will enable you to later explore alternatives such as clear labial braces or lingual braces, both of which meet their criteria.

Using typodonts is a great way to highlight the merits of each brace type but there is something even better than this and that is having a member of the team in treatment and letting them show off their brace and talk about their experience. Patients welcome the opportunity to talk to someone else in treatment and often the quality of advice received is considered more authentic and influential in their decision making than that received from the clinician.  

The final area to explore is the desired outcomes from treatment. Using the information you gained earlier about their motivations for treatment, you should explore what the patient is looking to achieve and how they are hoping to feel once their treatment is complete. Whilst there is much debate about how orthodontics impacts other social factors, most patients would want to feel more confident about their smile and for it to have a positive impact on their work or personal life. 

Gaining commitment

After completing the clinical examination and assessment of the patient’s suitability for treatment, the conversation can now resume where you can provide advice as to all the options available to achieve the outcome the patient had previously highlighted. It is important that you refer back to the earlier discussion as this will make it easier for the patient to understand the relevance of the options and how it relates to their motivation to seek treatment.

Once you have confirmed the various ways the patient can achieve their desired outcome, you can discuss the merits of each system and where possible, make sure you refer back to what they told you earlier about their preferred choice. This is where typodonts are useful as it enables to you visually move the pieces in and out of the conversation until the patient is left with the best option (or combination of options) to achieve their desired outcomes.

At this stage, you are looking to gain commitment for whatever the next stage is. This may be a records appointment if the patient is ready to start treatment, another appointment with a treatment coordinator if they require time to chat through the decision with members of their family or a follow-up conversation if they are still undecided about proceeding. Whatever the outcome, it is important that there is agreement on the next step, do not leave it to ‘we will hear from you’ as inevitably, the patient will lose motivation and not come back.

One question frequently asked is whether a consultation should be free or whether a fee should be applied? There is no one answer. There is a direct cost to provide a consultation and it is reasonable to expect the practice to recover costs where possible. Charging a fee can be a barrier to some patients and may encourage them to seek a free appointment elsewhere but if they are price sensitive at this point, are they likely to commit to a course of expensive orthodontic treatment? Some options to consider might include a free consultation with a Treatment Coordinator and a paid consultation with the Specialist or a fee that is refundable upon starting treatment. The decision will likely be based on what nearby competitors are doing and how much value you can build into the consultation process.

The importance of the consultation cannot be overlooked, it is the start of the personal relationship with the patient and an opportunity to showcase everything that is great about your practice. Monitor your conversion rate and reflect on what you can improve upon in the future to make this most effective.

This article was first published in the Sep/Oct 2019 edition of Orthodontic Practice.