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Do you find that your treatment presentations always seem to end with the patient saying, “Let me think about it”? You’ve completed the exam, explained the options, and given them the best possible way forward. Yet they still seem uncertain about the next step to take.
The problem may not be your plan or your fees. And it’s certainly not the patient themselves.
A gap between your exam and your presentation may be the very thing keeping your patients from trusting your recommendation.
Most dentists treat the exam and the presentation as two very different events. The exam is seen as the time to capture data. The presentation is their opportunity to persuade based on the gathered facts.
Even the patient’s experience is separated – one chair during the exam, another when the diagnosis and treatment are explained.
It may be this bifurcated structure that does the most damage to your case acceptance rate. In a recent Dawson Academy webinar, practice management consultant Larry Guzzardo walked through a model that dismantles this split. It’s the most useful reframe on case acceptance in a long time:
By the time you get to the presentation, the patient should already be ready to say yes. Because the presentation isn’t really a presentation. It’s a review.
When the exam and presentation are consistently separated, the presentation goes from a chance to offer hope to a patient to a sales moment with a paying customer.
It’s not always the dentist’s fault – it’s just how most modern humans are wired today! The patient walks in knowing that you’re likely going to ask them for money, and their guard immediately goes up. That guard then translates every recommendation as an upsell.
In short, many practices have created a moment designed to make the patient feel “sold to”, and are surprised when they react as if they’re being sold to.
Modern patients won’t accept decisions that are made without their input. Depending on the situation, they may have already Googled their symptoms, read reviews of the treatment and your practice online, and created a plan themselves long before they schedule an appointment.
When they do come in, they desire a collaborative experience – and they are unlikely to feel that a 15-minute consultation after a 45-minute exam equates to “collaboration”.
Guzzardo explains his method – and the fascinating outcomes it provides – in his webinar. The method starts with a simple premise: every step of the exam is an exchange.
You explain what you’re doing (and why you’re doing it) as you’re doing it. You bring the patient into the exam process, asking them what they think of what they’re seeing as you explain each step.
This collaborative process changes everything downstream. By the end of a properly conducted exam, you already know:
Why the patient is in your office (not just what they wrote on the intake form)
Which conditions in their mouth threaten those things they really care about
How they’re feeling about their current conditions
What direction they may be inclined to go when treatment gets complicated
This offers much in the way of practical and actionable data. Best of all, the patient feels empowered as they’ve informed you of their lived experience and expectations.
By the time you return for the “presentation”, you’re connecting dots the patient has already helped draw – and avoiding the awkward treatment-as-a-pitch experience.
Every patient is unique, and how they will (or won’t) react to a collaborative exam/presentation experience will vary. But Guzzardo offers a formula for the average patient visit that’s worth implementing:
Why + Conditions + Implications + Test Buy-in = Commitment
First, you must understand why the patient is there. But this requires more than an intake form or notes from a scheduling call. You must identify the true reason they chose to take the step to sit down in the chair, and any fears or preconceived notions they may have brought with them.
Then you must identify the conditions that might conflict with that why – and help them see the potential implications of leaving those conditions untreated. (Guzzardo points out that many patients need this help, as they often see dentistry as static when it’s actually progressive in nature.)
You can then test the temperature with a low-pressure question: “Tell me how concerned you are with what we found today during the exam.” This is the moment where commitment becomes the natural next step.
Guzzardo speaks of a specific signal that he listens for, one that shows a patient has arrived at a moment of collaborative connection: “Doc, what do you think I should do?”
This reveals that the patient is no longer feeling “sold” on a treatment, but recruiting you into their decision.
In the webinar, Guzzardo tells a story that illustrates just how powerful this shift in visit structure can be. When many dentists want to show the long-term risk of wear, they’ll often show patients images of individuals much older with far more severe damage.
But this “wake-up call” rarely works, especially when a young patient interprets your warning as “I’ve got plenty of time to deal with this down the road!”
Instead, Guzzardo encourages a change: show them the wear on someone who is only a few years older than the patient. Someone with the same lifestyle and in the same age bracket. Suddenly, that wear is a much more relevant concern with risks playing out right now.
The change? You’ve stepped into the patient’s timeline and connected the actual conditions with their why.
You turned the exam and presentation process into a collaborative experience that puts the patient in the driver’s seat of their own treatment – empowered with your dental expertise and compassionate recommendations.
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Concerns or complaints about a CE provider may be directed to the provider or to the Commission for Continuing Education Provider Recognition at ADA.org/CERP.
