What to Do When the Answer is “No”

What is the best way to handle situations when patients say “no” to treatment at your practice?

To address this, we should first consider some practical points regarding how people who visit your practice actually arrive at “no”. Here are four key points to remember:

• Most people know at the end of the consultation whether they want to move forward or not. An exception  is the ‘shopper ‘who has not yet completed their other practice visits.

• Patients will almost never say “no” in a consultation. Instead, “no” will be presented as “I need to think this over” or “I need to talk to my spouse.” These responses don’t always mean “no”, of course, but these are common ways of communicating that message.

• Most people who cannot say “yes” at the consult, but do plan to start treatment, will say so if asked.  In other words, if the TC asks, “are you planning to move forward with treatment?”,  if  the patient say anything other than “yes” to that question, it usually means “no”.

• Post-visit, the easiest way for patients to say “no” is to not return the TCs phone calls or emails. The most common  reason that patients do this is because they have chosen to go to another practice, and do not want to explain their decision and/or give you the bad news.

So….”no” is a simple word that, in case acceptance, is rarely actually heard. Recognize that there are going to be some cases in which patients are going to decide not to get treatment with you; it happens.

When it does, here are some ways in which you can salvage a win, and perhaps save the case:

• In the consultation, if you get the feeling that the visitor isn’t happy or on-board with what has been presented, ask this question: “What concerns do you have at this point?” This politely assumes that there is a problem. If they share their concerns with you – and many times, they will – you will have the opportunity to address the concern and save the case. (Note: do not say “do you have any concerns?” as this is a yes/no question, and the easy answer is “no”).

• Always get an email address for communicating after the visit. Most people prefer email to telephone follow-up, especially when delivering bad news. You are much more likely to get a response, albeit a negative one, via email than a telephone call. At least you get a definitive “no”, so that you can  move on.

• When you are given “no” post-decision on the telephone, use the moment to gather some good intelligence. “If you don’t mind my asking, what were your reasons for your decision ?

• If they went to a competitor, ask, “what were the factors that led you to choose the other practice?” And take notes. This information alone can turn a lost case into a “win” for your practice.

• If they say “their fee was lower”, respond with “if the fee were not an issue, would our practice have been your first choice?”

Finally, if the answer is “yes”, ask, “While we cannot lower our fees, would you reconsider if we offered you a financing arrangement similar to the other practice?” (Keep in mind that most people are more concerned about the budgetary impact of monthly payments than the difference in fees). If they say “yes”, ask them to come in for a second look, and be prepared to work with them on the payment plan arrangements.

One practice that I currently work with came up with a creative way to win with “no”. They designed with my input a quick, 3-question email survey sent to lost cases with different responses below each question;  the “no” patient can simply check appropriate boxes and send this brief survey back to the practice, which  takes only  a few moments to complete.

The TC can then follow up with patients who are deemed salvageable, and in every instance, the practice will gather valuable ongoing intelligence on lost cases and the reasons for them.

To my TC readers: It is important for you to distinguish between what you can control, and what you cannot. Recognize that, despite your best efforts, you are going to lose a good case from time to time. The only relevant question to ask yourself here is, “what could I have done differently?” If you know my process and identify an issue that needs fixing, fix it. If, upon review, the answer is “I would do nothing differently” , accept it and move on. You will get “yes” most of the time; and that alone makes the occasional “no” a misdemeanor, not a felony.

In case you are wondering: the most common correctable reason for lost cases is not identifying, and  properly handling, “shopper” patients during the initial consultation.