Ethical Sales & Communication
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“Ethical Sales & Communication”
Dr. Richard Madow With special guest – Ashley Latter
EDITED TRANSCRIPT
Welcome to the Madow Brothers audio series with Rich and Dave Madow.
Rich: Hi, this is Dr. Richard Madow, and our guest today is Ashley Latter. Ashley is coming to us from Manchester, England, across the Atlantic Sea. How are you doing today, Ashley?
Ashley: I am very well, thank you. Really good, Rich. It’s good to be here.
Rich: I am excited to have you here. I mean, it’s not that often we have international guests on the audio series, except for maybe Canada if you want to count that as international here in the US. We are kind of the same country these days. So it’s great to have you here. I found out about you by the recommendation of somebody who runs a huge dental seminar in the UK and they said that you have been one of their best speakers and guests over the years. So, hey, I sent out some feelers and here we are having you on the audio series. So thanks for taking the time out of your busy day to do this.
Ashley: You are very welcome.
Rich: So, Ashley, you are very well known in the UK and parts of Europe, but maybe not quite as much in the US if at all. So I will give you a little introduction, so people will know a little bit more about you. Eighteen years ago, you started a program called the Two Day Ethical Sales & Communication Programme, and it was just chock-full of attendees. You had two dentists that actually took part in it 18 years ago. But since then, it’s grown quite a bit. Close to 10,000 people including dentistry coordinators, specialists, orthodontists, team members, etc. They have taken part in your program all across the world, so it’s very well-known. You might even say legendary in the UK. You have gotten all kinds of honors from the dental world, etc., etc. You have delivered the program all over Europe, Canada, and actually five times in the US. Hopefully, we will get you back in the US to do your program.
Ashley: Love to, love to.
Rich: It would be fun. You are also an author. You have written three books. You are probably best known for the one called “Don’t Wait for the Tooth Fairy.” What is that all about – “Don’t Wait for the Tooth Fairy”?
Ashley: Yeah, I was out with some dentists one day and I told them I was writing this book, and we just brainstormed this title and they just came up with it – “Don’t Wait for the Tooth Fairy: How to Communicate Effectively and Create the Perfect Patient Journey.” So basically, the book is really my two-day course in the book. We came up with “Don’t Wait for the Tooth Fairy” because dentists have a – I’m generalizing – not all dentists are like this, but dentists have a habit of procrastinating in getting things done and taking action, and sometimes, maybe a little bit slow. So the idea of the title is don’t wait for the tooth fairy, because the tooth fairy never comes. So that was the title behind the book, really, and people love it – it’s a great title.
Rich: I agree. Dentists do like to procrastinate. We can generalize. It’s fine! I was thinking about procrastinating but just never got around to it. So last year you got a high honor. You were voted number 12 in the Top 50 Most Important People in UK Dentistry. You were invited to present at the Royal Dutch Dental Conference in Holland, which was opened by the king of Holland, and you were the only outside speaker to do that. So, wow! You have done 24,000 hours of business coaching. You really excel at all kinds of things, especially getting dentists and their teams to communicate with their patients and saying yes to all kinds of treatment plans. So, wow! I cannot wait to have you tell all of our listeners about all this great stuff and how they can incorporate this into their practices. Just a little personal, in case you are wondering what this guy Ashley Latter is like. He is constantly travelling the world. But when he is home, his home is Manchester, England. He has a beautiful wife, whose name I can’t pronounce, Graziella?
Ashley: It’s Graziella. Everyone calls her Grace. She is half Italian, Sicilian. Everyone calls her Grace for short.
Rich: Graziella, I like that. Two daughters. You exercise a lot – box, hill- walk, do a little reading, and since you are in Manchester, England, not only are you heavily into the music scene – I don’t know how many Americans know how important Manchester, England, is to music. But it’s quite important. I am just thinking off the top of my head. Graham Nash and the Hollies, Oasis, the list is huge, I’m blanking. But maybe you can help with that.
Ashley: Well, there is New Order, Joy Division, Stone Roses, James, the Doves, ___, T. Rex, and there’s the group that we were talking about last week on the phone, Elbow are massive now in the UK.
Rich: Elbow, great band. Not very well-known in the U.S. I am a big Elbow fan. So US listeners that want to explore some new music might want to listen to Elbow. And of course, since you are from Manchester, you are a football fan, or soccer as we call it. I know that in Manchester you have to be either United or City, right?
Ashley: Yeah, there’s no in-between.
Rich: It’s like a war over there. Which are you?
Ashley: I am a Man United fan. Forty-year season ticket holder.
Rich: Wow! It’s a lot of football games.
Ashley: It’s a lot of games.
Rich: All right, hey, now that everybody knows you; you sound like a really interesting and cool person. So I am glad we got to do the introductions. We can get going with our interview now. We are still in the workday now in the US, but it’s after-hours in the UK. So you are probably sitting there on a chair with your feet propped up, drinking a dry martini or something along those lines, I’m not sure.
Ashley: It’s a Budweiser actually.
Rich: A Budweiser? You’ve got to be kidding!
Ashley: A cold one.
Rich: All right, good, good. Got a little US spirit going. That’s fantastic! So let’s go way back to 18 years ago when you started this program – your two-day Ethical Sales & Communication Programme, which has been really a big, big hit in the UK. So why did you decide to call it that? What do you mean by “ethical sales and communication skills”?
Ashley: A great question. Well, basically how it came about was we have these... I was at the ___ working for an organization which you are probably familiar with, called Dale Carnegie. I was a Dale Carnegie instructor and salesperson here in the northwest of England. I was delivering a two-day sales course and I got a list of the delegates beforehand and right at the bottom of the list was two dentists. So we had some radio salespeople, car salespeople, engineers...about 11 or 12 different industries, and I could not believe why two dentists would be taking this course with me. So I got to find out they were staying in the hotel the night before, so I went to meet them for a drink and I asked them to tell me about dentistry, and why they are in this course. And it was interesting what they told me. They were dentists that could place implants, they could place crowns, veneers – they had been in all the cosmetic courses. But what they were not particularly good at was communicating what they could do for the patient. They openly admitted that they would talk very technical, they would waffle, and use long words that would put the patient off, and give the patient a treatment plan, and tell them to go home and think about it. They were not particularly good at discussing fees, so they would reduce the price of treatments in half. So say, if the treatment was one thousand pounds or dollars, by the time it came out of their mouth, a hundred went missing, and they were doing this several times during the day. So I was a bit shocked really. Anyway, these two dentists took part in the course with me, and on the second day, about 6:00, we sat down and I asked is everything ok? So they sort of smirked and smiled at me. I said I would give a you a ring in a few weeks to see how things are progressing. A few weeks later I am lying on the couch at home, started thinking how those two dentists got on. I gave them a call from my lounge in my house, and I’m pretty pleased I did really, because I couldn’t get them both off the phone. They were telling me how much their treatment plan acceptance had increased, more patients were saying yes. They were not reducing the fees anymore; in fact both of them had told me they put the fees up. But the one thing they both told me was for the first time ever with delivering the dentistry that we looked to do what our patients want, and they are kicking themselves for not having this type of course when they left university. So I kept in touch with them over several weeks and the results were getting better, getting better, and getting better. And, one day Neil Sampson, who is still one of my best friends now, we still socialize, him and his wife, our wives. He said, I spoke to a lot of dentists. Would you be interested in a sales course just for dentists? And I just said I would love to. Would you come back and help me? So, both Neil and Barry, who were the first two dentists, they came back and helped me deliver this course. They gave all the examples, and about six months later we had 26 dentists in a room and I delivered my first other course. But we tried to think of a name, what we could call it, because if you mentioned the word “sales” to dentists 18 years ago, they would run a mile. In fact, probably half the population would still run them out today in the UK. So we came up with this word “ethical,” and this is not, like, a hard sales course. It’s not about pushing products or treatment plans to patients that they don’t want. It’s about what they want and how they benefit, so we came up with this word “ethical,” and we put the word “sales” very small, and it stuck with us ever since. People like it. The program is not about selling dentistry to patients that they don’t need. It’s really about doing four things really, really well. They are: building really strong relationships with your patients; asking questions to find out what they really want and what they need; to create opportunities and providing solutions to patients in a language they understand, in a language that excites the patient. The last part is what we call commitment: when we tell the client, here is your problem; here is the solution; which one is best for you; how does this sound? So it really is about ethically selling what you do to the patient in a relationship way, so that the patients turn around and say, yes, this is exactly what I am looking for, this is exactly what I want. That’s why we came up with the word “ethical” and dentists love it. They contact me often and say the reason we are doing your course is because we like the word “ethical,” so it sort of stuck with us and we never changed it.
Rich: Yeah, it’s funny. I like how you said you put the word “ethical” really large and the word “sales” really small. I am picturing a marquee on the theater where the big star is ethical and tiny little second character is sales. Let’s face it, dentists are in sales, but the word seems to have a bad connotation or a bad reputation. Do you agree?
Ashley: It is! I’ll tell you a little story and I use it sometimes when I am delivering a presentation. You know, the story of the bunny rabbit and the snake that bump into each other in the forest. The bunny rabbit says to the snake, “Who are you?” and the snake says, “I am blind. I can’t see.” So the snake says to the bunny rabbit, “Well, who are you?” And the bunny rabbit says, “I am blind. I can’t see either. So why don’t we touch each other? When we leave here, we will know exactly what we are.” So the snake starts touching the bunny rabbit, and the snake says, “Wow! you are all furry, you’ve got a bushy tail, a long tail, real bushy, with big ears; you are a bunny rabbit.” So the bunny rabbit starts touching the snake and says, “Wow, you are all beady, you got beady eyes and slippery, you got sharp fangs. I know what you are. You are a salesperson.” I think sales always had a bad reputation, probably not so much in the US.
Rich: In the US, that joke would end with: I know what you are; you are a lawyer.
Ashley: Yeah, that’s right. That’s why I think that if you, when I speak at conferences, I say to dentists, “How many people are in sales?” Even today in the UK, only half of them would put their hands up. Well, ok, would you agree then that every single day you are communicating ideas to all the people, whether they be patients, whether it be your staff? Whether they take the ideas up or not will all depend on how well you communicate or sell your ideas. Then I gave examples, and in five minutes, everyone is putting their hands up. So you are right; every dentist is in sales. In fact, everyone in the practice is in sales: from the girl or the receptionist that answers the telephone, right through to the nurse, the hygienist, and the practice manager. Everyone is in sales and it only needs one person who has a bad attitude, who does not get it. I call them a sales prevention officer. Then the baton gets dropped and all the good work that the dentist, the treatment coordinator’s done in the surgery can get lost at the desk. So everyone in the dental practice is in sales. Everyone is selling an idea to each other and every human being. In fact, if you think about how many minutes or hours the dentist is actually in communication with the patient, I suspect it’s probably close to half the day. Yet it is a skill really that very few dentists spend their time developing. It is crucial to their success.
Rich: So true. I love the term “sales prevention officer.” If I steal that, I will give you full credit.
Ashley: Thank you.
Rich: I think you said something really interesting, and I hope that dentists who are listening to this will also listen to this interview with their entire team. You mentioned this really quickly, but it is so true that the sales and communication is up to every single person that works in the practice, and if there is one weak link, then the whole thing falls apart. It’s funny, right before this interview, Chris, our engineer, was talking about how if you could have the greatest speakers and the best amplifier in the world and you play some crappy low-res MP3 through it, it’s going to sound horrible. It is the same way in the dental practice.
Ashley: I was speaking to a specialist last week, an implant specialist. The guy is 44 years of age. He just had his first child. If you went to his office, he’s got more certificates in that office. I have never seen so many. He’s got that many awards and everything else, and yet, when I speak to him on a one-to-one basis, the guy is skint; he does not have any money. It’s a realization that, although he is a brilliant dentist... by the way, he has lots of opportunities, but because he cannot communicate his ideas to the patients or sell it in a way that the client is buying into it, that he is not fulfilling his potential and is not doing the treatment that he spent hours and hours learning and developing. Yet you could have a dentist down the road who is half qualified than my client, but he is really good at communicating, selling, and marketing his practice, then he could do twice as well. Three, four, or five times more income than my client. It is the realization from many conversations we had that he really came to that conclusion. That’s why now he starts to do some work, starts to work with me. So it’s crucial; it really is crucial. You could have all the qualifications in the world, but if you can’t get across in a way that excites the client to take aboard your idea, then you will never fulfill or deliver the dentistry that you hope to do.
Rich: No question about it! I don’t know if the stereotype is the same in the UK as it is here in the US. I’m guessing, before you taught that Dale Carnegie course, many, many years ago, did you think that dentists just went in their offices and people threw money at them all day, and their biggest dilemma was what kind of German sports car to buy? Isn’t that what people think?
Ashley: I think that anyone growing up, you saw anyone in the professional world, whether a lawyer or a dentist, doctor, you automatically thought these people were successful and had lots of money, and the realization as you got older that it’s actually not true. That there are other skills that are equally just as important and that, unfortunately, most professionals do not spend their time on. I have a got a neighbor who is a lawyer actually. He is a great lawyer; he is poor at communicating and poor at marketing. It was a couple weeks ago we went for a really long walk, and I was helping him out and stuff like that. He just realized, he says, “You know, I am 48 and never worked at these skills, and you are right.” Again, a great lawyer, fantastic education, has got all the qualifiers, but yet, still has not fulfilled his potential.
Rich: I also love how you call lawyers “solicitors” in the UK. It’s just a great term. Has a different connation in the US. My wife is an attorney; she is a lawyer so I call her a solicitor every now and then.
Ashley: A realization of what soliciting is in the USA.
Rich: So, it seems like we have talked about a bunch of things so far. It seems like a common theme has been communication by the dentist and the team. So why don’t we take a few minutes and talk about some of the mistakes that dentists and team members make in their communication skills, and these mistakes can be extremely costly.
Ashley: Yeah, I am going to generalize here, if that’s ok, Rich. Rich: Of course!
Ashley: Like you said today, at the start of the talk, and I want to give people tremendous value in this hour we have got together. I want to give people really good concepts and ideas that they can use. I am an idealistic person. Like you said, I deliver my ethical sales communication course every single week, and I visit practices every week. So I deliver in-house, and I watch dentists, and I see what goes on, and there are a few common mistakes that I see. Here is just a few of them in no particular order. One of the big mistakes I found with dentists is that they don’t listen well. They listen to respond rather than listening attentively or to understand. So I can often hear a dentist ask a couple of questions and they jump in again quickly with solutions. Rather than keep asking questions. When I say listening to respond, what I mean by this is, as I am listening to my patient, I’m thinking, what I am going to say back. As soon as there is a space, I am going to fill it quickly. So if you are listening to respond rather than listening to understand, you cannot do both at the same time. You cannot think what you are going to say in response and listen. So as soon as you start thinking about what you are going to say, you stop listening. That’s a common mistake I found with dentists. Another common mistake is that they make assumptions about what the patient can or cannot afford. Often by the way the person dresses, or the posts, zip code as you call it, and what is their patient’s occupation. By doing that, they are not offering all the solutions to the patients. So I often speak to dentists; I was with some dentists yesterday. We are doing a year-long course, so I think we were at session/day three yesterday. I got everyone to stand up and give a report, and half of them reported that they have managed to secure big treatment plans from the patients who in the past they did not think they could afford it and made an assumption about the patient. Some of these were many thousands and thousands of dollars. Another mistake dentists make is that they provide the solution without truly, fully understanding what the patients’ wants and needs are. So if we have time today, I can help you with some questions that your dentists or doctors could ask that could help and make sure that they don’t make these mistakes again. So selling too quickly is a big mistake. Another mistake dentists make is that they talk too technical when they are presenting the solutions to patients. What I find is a lot of dentists go on technical courses and they write notes, and they come back and then they start explaining to the patient all the technical jargon, and what happens is the patient stands there or sits in the chair and nods in agreement. As soon as the doctor leaves the room, they ask the nurse what the hell was just being said or can you explain it in English. So they talk and as soon as you start talking too technical or using your own jargon, like scale and polish and that type of language, you lose the patient. Another big communication mistake I find, and it’s a difficult one to get across in just one minute because we could probably spend a good hour on this alone, is that they are very poor at gaining commitment from the patient. So often, mostly in the UK than in the USA, probably slightly better in the USA at this. Dentists would typically give a patient a treatment plan and say, “Well, here is my treatment plan” or “Here is my solution, so what you need to do is go away and think about it.” Now, when that happens, inevitably, that’s what happens. Patients would leave the practice and think about it. So there are probably five or six common communication mistakes I find dentists make on a regular basis that do cost them many, many thousands of dollars’ worth of lost opportunity.
Rich: I so agree. I love this list. I have talked about many things on this list before. It is so funny about talking too technical. I feel that sometimes we can say this over and over and over again and dentists don’t understand this because, to them, MOD composite is normal language. I remember Dave and I were doing an in- office consult, and everyone is on their best behavior when you are doing an in-office consult. This dentist was showing the radiograph to a patient and he looked all proud and he was saying, “As you can see, there is a translucency at the apex of the root.” Just as you said, the patient is going, “Oh, ok, ok, ok.” They had no idea what he was talking about! Ashley: Yeah.
Rich: I would say if a sixth-grader can understand it, then a PhD can understand it as well.
Ashley: Yeah.
Rich: Or maybe the PhD can’t.
Ashley: Couple of things here. I had a dentist, and he is a very, very good friend of mine now. He is called Steven, and, in fact, Steven actually helps me twice a year to deliver my courses. He came on my program, must have been about eight years ago. He came on my course three years later after being heavily recommended by several people. He came on the course; he brought his whole team down, and I remember at the end of the second day, it was about 6:00, he was shaking his head. I said to Steven, “You don’t look very happy; is everything ok?” He says, “I can’t believe it. I have been on all these technical courses all my life and I thought that the more I speak technical to the patient, the more they would believe me. The more they would think that I am an expert at what I do and take up my treatment. But I realize it’s probably actually the opposite. I am probably not only boring the patient but making it complicated as well.” That is a great lesson, and the realization is that when you talk too technical, you put the patient off. So I often use this phrase when you are communicating with your patients: Think of them as being stupid. What I mean is communicating with them as if they are stupid. If you do that, you won’t use half the language that you use. For example, as you just said, an implant, if I speak to a dentist and I ask them, “What is an implant?” they will tell me that an implant is a titanium screw that gets surgically screwed in your jawbone under anesthetics. But who wants one of those? Communicate in a way that the patient understands. Explain to them in plain English that excites them. An implant is the nearest thing to a natural looking tooth. It’s fixed and it doesn’t move. The benefit is, it won’t move like a denture. What it really means is you can go out and chew a steak, eat an apple without ever worrying about your tooth falling out. Is that the solution you are looking for? Now you got the patient excited and they understand what it is.
Rich: You know, I just want to take one pause for a second. Because I love that definition of an implant because you did not really define it as much as tell the benefits, which was so good because that’s what people really want to know. Again, you could have said it’s titanium and it gets inserted in the jawbone, blah blah blah blah. You said it’s the most modern way to replace a missing tooth so you can smile and enjoy apples and steak. That’s a great definition.
Ashley: It is. It’s the client, and the problem is I can’t chew a steak; I can’t eat an apple. All they want to know is: When I finish this and I got this, can I do that? Because at the moment, I can’t. So you have to tell them you can. I do accept that further down the line you have to explain it, you have to do informed consent, and you have to go in a bit more detail. But let’s get them on the bus first. Let’s get them excited about what we can do for the client, and once they are excited, once they know they can chew an apple or chew steak, they are on board, and then we can do the informed consent part. Get them excited first; that’s what I am saying.
Rich: I totally agree. What do you mean by that sometimes the solution is provided too quickly or the dentist tends to sells too quickly?
Ashley: I’ll give you an example, best example; I can give you hundreds of examples. But one of my favorite ones – I am delivering an in- house program for two dental practices together. They have two practices. So the clients ask me would I observe some consultations. So I said, yeah, no problem. So I got down there about 2:00 the day before, and I observed 10 consultations, and in 10 consultations, eight opportunities were missed. Now, this is my favorite one. A client walks in, late 20s, she sits down, and the dentist, my client is Indian, she has only been in the UK for about five to seven years, so her English is not great. You have to get close to her to fully understand what she is saying. She is speaking to the patient; she is building rapport with the patient with the face mask on. So all you can see is half of her nose and her eyes. She asks the patient the question, “Is there anything at all I can help you with?” In fair play to her, it mustn’t have been easy with me watching her, so this is what happened: The 28- year-old patient – she is a lady, by the way. She has jeans on and a sweatshirt. It’s her day off work – she opens up and says, “Well, I notice that you do invisible braces. I noticed that in the reception, and I have been thinking about it for a while now and I would love my teeth straightened. Because, when I was a kid, I had them straightened but I never kept the retainers on, but I got this new job now and I think it’s important to have a really nice smile. Now depending on the cost, I would like to have my teeth straightened.” Now, the dentist heard the word “cost.” So what happens next? You just probably couldn’t make this up, but this is exactly what happened. She went into a payment plan. She went into how many monthly installments that the patient could take it over. What no-percent interest was, she went into 36-months, 48- months payment. She became an independent financial advisor right in front of the patient. She puts the patient right back in the chair. She puts the back up. She says, “You need a filling and when you go back to the desk, ask Gloria if she will give you a leaflet on the Invisalign teeth straightener.” Perfect example. Patient walks in with a problem; she walks out with a problem and a leaflet. What happened there was, because she heard the word “cost,” she made an assumption – that’s exactly how she is basing the decision. She never asked any questions at all about the treatment. Nothing at all about the treatment. About what she wanted, how she wanted it, what she was looking for, what her goals were, nothing at all. Presenting the solution without fully understanding what the patient’s wants and needs are. Another example: The following week I was with a special implant practitioner, and I watched another consultation. This is a 48- year-old lady, divorced, very attractive. Just recently got divorced. She pulls out a denture. I mean, I was shocked when she did it, and she says, “I absolutely hate this; I want to replace this. I’m getting a divorce; I’m going out.” She opened up. She is one of those patients that wears her heart on her sleeve. And the next minute, the dentist is telling her about the up-to-date denture. Well, she does not want a denture. She just told him she did not want a denture, but he was not listening. He did not ask enough questions to find out what she really, really wanted. So that’s what I mean, and what I find is that dentists don’t ask questions; they listen to respond rather than listening to understand. So they ask a couple of quick questions, and assuming they heard something, they go into solution mode too quickly. Then they present too quickly without really, truly understanding the client’s problems. Does that make sense?
Rich: It does. I am just curious if you have any exercise or tips on how somebody can listen to understand as opposed to listening to respond?
Ashley: Rich, we could spend three hours on this alone. I use an analogy. If your doctors just wrote this down, they would get tremendous value from this one hour, and it’s called “Prescription before diagnosis is malpractice.” In other words, imagine going to a doctor and you sit down and the doctor says (or GP) and he says “What can I do for you?” and you tell him, “I’ve got a really bad headache.” Within a minute he is writing a prescription and telling you how many you should take a day. Well, that’s what a lot of dentists do; they present too quickly. We practice in my courses, and the reasons why we are so successful is we do a lot of practice and we role play a lot, and I give lots of examples. But the best way to practice your listening is just to listen. I know it sounds crazy, but when you are really, really, really tired and you go home, sit down with your partner and ask them how their day was? Really become genuinely interested; that’s the key word. Genuine interest. When you are really tired and you don’t want to have a discussion, have that discussion. Find out about your partner’s day. Find out what they did and what they accomplished for that day. Sit down and talk with your six-year-old. Everyone complains about kids not communicating these days. We just decide that they are not. So sit down with them, have a chat with them, and find out what their day was like and what they like, what they achieved. What they did not like. It’s a matter of practicing it, and the more you practice, the better you become at it.
Rich: So true. I have heard the phrase many times that you should be interested, not interesting. I am just curious, you are not a dentist, yet your insight into dentistry, especially the communication skills, is unbelievable. How did you learn all this stuff? How did you acquire all this knowledge as somebody who 18 years ago would have never considered training dentists?
Ashley: You know what it is? It’s spending time with dentists. I spend more time with dentists than I do with my own wife and kids. You see, the best thing I ever did was to make those two phone calls to those two dentists 18 years ago. If I did not make those two phone calls, I may have never gotten into that industry. So I still do that every day. I’m not saying every day, because some days I don’t get the chance. But I would say on a weekly basis, I would speak to eight to 10 dentists who have taken my courses. One way or another, I get around to it. Most of the time it could be in the car when I am driving, and the questions I am asking is: John, you have taken the course; how is it going? What are you doing? What’s working well? And they give you the material for your next program. I know it sounds daft, but they told you what they did, what works, what they tried. The more questions you ask, the more you learn. The more you can tell other dentists about them. The best thing about it, Rich, is that you have new material for your manual next time and the book.
Rich: So true. Ashley: It’s brilliant. They give you it all. These dentists are clever guys. They use my material and in a very innovative way. They use it in ways that I don’t even think of myself. Then they come back and they share it, so I have new material to share with everyone else.
Rich: Only because you are using your own skills of listening to learn and not listening to respond.
Ashley: Correct.
Rich: So you have just given a bunch of really cool tips. I would call them maybe Monday morning ideas of things people can really change the next time they set foot in the office. Do you have any other key skills?
Ashley: This is why it’s great when dentists bring their nurses on the course with me, because the nurses go through the same program as the doctor. What I say to the doctor, look, you are here with your nurse. What you do is make two or three times in the day, and what you need is five or 10 minutes, and let the nurse coach you. Let her tell you what you did well, what you need to change, what you need to tweak. They spend more time with you than your own family. They can help in a big way as well. Had a great story from a dentist called Peter. He is based in Edinburgh and he told me the story. About three months after my course, he was going through a treatment plan with a patient and everything was going fine, and then he just turned round and said, “Here is your treatment plan, Mrs. Jones. You need to take it home with you and think about it.” And the nurse pops up; she says, Dr. Bookins, shall I take Mrs. Jones to the desk to make that next appointment?” and Mrs. Jones says, “That’s fantastic! Thank you very much.” It’s great that they were together in the same room and they did the same course. Because he was slipping and she was able to bring the case back. Back to the conclusion again if that makes sense.
Rich: Teamwork for sure. So, Ashley, you do this kind of famous two- day program and, obviously, in our interview today, you cannot give the entire two-day program. But you do have what you call eight steps that you cover in your program. The eight key steps. So why don’t you tell everybody what the eight key steps are, or maybe we can talk about each one just a little bit.
Ashley: Sure, ok. Here are the eight steps. The first one is what I call preparation. Preparation is absolutely everything the dentist or the whole team needs to do before the patients come through the door. So, for example, let’s say a new patient is coming through the door. Then maybe the receptionist at the desk will have a meeting with the dentist and say, “Your next patient here is Mr. Smith. He is a teacher, blah blah blah. Here’s how he heard about us. Now here’s his problem.” Now the dentist has got all this information. Now he/she can get ready for the appointment. If there are any before-and-after books that I need. Any testimonial videos, books, etc. Everything is ready now before the patient walks through the door, and that’s what I mean by preparation.
So after preparation, you have what I call building rapport. Building rapport is when you spend time with the patient. Just getting to know him as a person. Building that trust to start off with. The patient may be slightly nervous as they walk through the door. Maybe nervous about going to the dentist. What we do here now is really spend time building quality rapport with your client to build that trust, and to build that relationship. Become genuinely interested in them. Now the best thing obviously, if you have gotten some background information from the receptionist, that should help you in building really good rapport.
Once you build rapport, then you go into what I call the question techniques. We go for four sets of question that we go for in depth. But what you are doing here is you are finding out more information about your client’s problem. You are finding out what the situation is now. What the goal, what the vision is of the patient. What stopped them from doing this before. You are finding out more information about the problem, and you are finding out what it would mean to the patient if you could solve that problem. So you are becoming genuinely interested in the patient.
Once you have done that, you can summarize back to the client what they told you. So there are your first three steps.
Obviously, then you do the examination. For the fourth step is when you go back and say ok, here is your problem. Here is the best solution or the best solutions for you, and you are presenting your solution in a language that excites the patient. That’s basically benefits that we have discussed at the start of the program today. But the patients are interested in the benefits of the solution and not interested in the features. But they are interested in how their problems can be solved and what impact, difference, it can make on a day-to-day basis. Once you have done that, you can provide any evidence to support your case to help you. You can include before-and-after pictures, videos, testimonials, and demonstrations of the models or anything at all to support your solution.
Once you have done that, you ask the patient what they think, and then you can start discussing the fee. The fee is really important in how you present it, creating value in the person’s mind. But occasionally, you will get what I call price objections. Price objections or any sort of objections are now a barrier to the sale. We need to overcome this objection because if you don’t, the treatment plan can’t be concluded. So you need to overcome those objections. A big mistake dentists make is they tend sometimes to become defensive, and you have to do it and show empathy. Become the client’s concern.
Once you have done that, you can go to the commitment stage. When you turn around to that page and say – well, you know this is your problem; here is the solution. Mrs. Patient, what do you think? Is this the sort of thing you are looking for? How does it sound? And hope that the patient comes back and says this is exactly what I want.
Then you have conclusion to the treatment plan. That may be over two appointments or three appointments. Sometimes it is not done over one. Once you have done that, you have delivered the treatment and are following up with the patient to make sure they are happy, and you are giving them exactly what they are looking for. You continue the relationship, and it’s a great time to ask for referrals and a testimonial letter from them. So that’s your eight steps.
Rich: Wow! I can see why that takes two days.
Ashley: Yes, 18 hours and five minutes.
Rich: It’s funny, but I can see why it takes two days. You really go into everything. I will just ask you a few pointed questions about some of the stuff. Let’s talk about fees for a second. It’s so funny, when I first started practicing, I referred to this young orthodontist, and then I met with him for lunch a week later. I said, hey, (can’t remember the patient’s name of course, it was many years ago) what happened to so-and-so? She is a great patient and she really wanted to get orthodontics for her kids. He said: I made a big mistake. When she first came in, she asked me how much it was going to cost and I said, whatever, it was $4,000. After that fee was mentioned, she did not hear anything I said. I could see her the whole time sitting there thinking $4,000, $4,000. I learned a lesson from his mistake very early on in my career. It is tough to discuss fees. I think dentists don’t even like to recognize that, and it is something we need to know, and something we need to have the skills to do. So what are some of the mistakes you see being made, and maybe some suggestions on fee discussions?
Ashley: Well, it’s interesting. That’s why I wrote the book, “You Are Worth It: How to Communicate Your Fees and Achieve the Income Your Services Deserve.” I don’t think I have ever met a dentist or doctor even in the US that has not found this part challenging. Gee whiz, we could spend literally the whole hour on this. But the biggest mistake dentists make is that they think price is the issue. They really do. And, it is only an issue. An exercise I do on the course is to write down three purchases that you recently made in the last week. It could be anything from a concert ticket, a blouse, a skirt, and I list even a coffee from Starbucks this morning. When you purchased those three items or services, was price the issue or an issue? Very rarely do you ever get more than two stroke three where price was the number one most important factor. Even when we have the nurses in the room, price is very rarely the issue. The problem you have is that with most dentists, they think that price is the issue instead of an issue. So a big mistake dentists make is they tend to do two things: they try to reduce the fee, thinking if I make it a bit cheaper, they are more likely to buy. Another mistake they make is to reduce the price of treatment in their head. So let’s say a crown, maybe $950, and I have seen this even in America, by the time it comes out of their mouth, it is $850. Well, where has that $100 gone? Well, they thought that if I make it a bit cheaper, the client will be more likely to buy. Well, what’s crazy is this: the only people that know that a discount is being given is the doctor and the nurse, and the nurse is shaking her head again. But the patient does not know a discount is being given because the doctor did not tell them, because the reduction is taking place in their head and not verbally. What they need to recognize is that price is not an issue anyway. All the purchases we make, price is very rarely the issue; it’s an issue, not the issue. So if I could give one piece of advice to a dentist or doctor or any team member, is stop thinking that price is the issue. It is an issue, but is very rarely is the issue. I think sometimes that dentists get so fixated with this and it influences what they charge. Another thing that dentists will do is they will ring around ten local dentists in their area and find out what the highest is, what the cheapest is and set their fees, and set their fees somewhere in the middle. So all they are doing is becoming the average of everyone else. Stop thinking that price is the issue. It is an issue but it very rarely is the issue.
Rich: I thought that was a crazy, but I’m sure a very common example when you said the dentist gives a discount in their head and then just spouts out the lower fee and the patient does not even know they are getting a discount. Do you ever recommend discounting and letting the patient know that you are discounting the fee? Or do you think that shouldn’t even be something that happens?
Ashley: Look, just charge what your fees are. I have dentists, doctors in my course, and by the way, this happens in the US as well, not only in the UK. I have delivered five two-day programs in the last 12 months all over the USA. So US doctors do this as well. But if you are doing this two, three times a day, and you are working five days a week. That is fifteen times a week times by, you guys work more hours than we, a longer week. So if you work in a forty-five hour week a year, if you add it all up, it’s really $700- $800 times a year you are discounting your prices to patients who do not know a discount is being given. But if you add it all up, $100 here, a $100 there – it’s big money – $60-$80,000 a year of discounts you have given to patients who do not know a discount is being given. So it is crazy behavior. By the way, if you do that for 10 years, can you imagine the figures you are talking about – $800,000 of discounts? So, do I think discounts, avoid it like the plague. Now, occasionally, depending on culture. I have just delivered a program in India where haggling is part of daily life. What I said to the Indian doctors, no, just stand up for your fees, but give them something of benefit to them that maybe it does not cost you a lot of money or cost you anything at all. For example, free toothpaste or maybe some TePe’s or whatever the case may be. But let the patient know what they do cost normally. So you want to try and avoid discounting like the plague really. Once you start, it’s like a cancer; it’s hard to stop.
Rich: I agree. Those figures you gave, when you start adding them up and multiplying over the years, wow! It’s a lot to give away.
Ashley: Well, it’s your pension, isn’t it?
Rich: Absolutely!
Ashley: I will say to dentists when you are coming out ET or coming out of university, look, come to my course now. If you leave it 10 years, it will probably cost you a million pounds. Because you will be discounting and you will be making all these mistakes. Come on the course now and you will do all the right things right from day one.
Rich: So true. Do you think your clients in the UK tend to be the higher fee type dentists? Maybe more cosmetic-oriented? What are your clients like? Are they all over the map? They tend to be...
Ashley: They are all over the map, Rich. I could deliver a program here in my office, here in Manchester Training Centre. We can have 30 dentists, we could have 10 cosmetic implant dentists, and we could have three or four specialists, we could have some private dentists, and then we could also have what we call National Health Service dentists. Now we are getting a lot of National Health Service dentists now. These are dentists who have previously delivered National Health Service dentistry, in other words had been paid by the government. But with all the cutbacks and austerity now, what’s happening in here is that it’s been cut back, it’s been cut back every year. So a lot a dentists are now seeing their income decreased. So they come to my course now to learn how to sell private options to normally patients who come in on a National Health Service basis. The last 12 months we have seen a significant jump in that area, and, you know, hopefully, long may it continue, ’cause there are still thousands and thousands of dentists out there who have been doing National Health Service, who have not yet taken my program. So, hopefully, we should be busy for the next few years.
Rich: Now, I may be wrong, but for some reason, I was under the impression – I formed this impression many years ago – that in the UK you were either a National Health dentist or a private dentist, but can you see both?
Ashley: Yeah.
Rich: So is that you cannot see both types of patients?
Ashley: Yes it is, it is, but what’s happening now is, a lot of dentists who have been delivering National Health Service dentistry, some, a lot are leaving. So, I should know, but I don’t know, but I think it’s about maybe, about 45% to mid-probably close on 50% of dentistry now is delivered privately in the UK, and I think it’s growing all the time. But what’s happening is that we are still having a lot of National Health Service dentists who don’t want to go on to become private, but still believe in the National Health Service, but recognize that their patients will buy private if they are offered it, so they don’t want to leave completely, but they want to grow their private work at the same time of delivering National Health Service dentistry. Does that make sense?
Rich: It does. It’s just kind of a...
Ashley: You’re not putting all your eggs in one basket, basically.
Rich: Can a patient take advantage, can they get their preventive services, cleanings, X-rays, check-ups, exams through National Health, and then opt for cosmetic dentistry where they pay out of pocket?
Ashley: Yeah, yeah. A lot of dentists are now getting those results. The patients have to pay something. I’m not quite sure what the figures are. I go privately, so I’m not quite sure. But if they come in for a check-up and they get a cleaning, I think it may be something like $40 or $45. But anything else on top of that they have to pay for.
Rich: Got it. Interesting, I would love to learn more about the UK dental system one day.
Ashley: Yeah.
Rich: I know that the dentist in Mayfair is not taking the National Health, I know that.
Ashley: No, I mean, in London, I would imagine it’s probably, maybe 60% will be private. I live in the north of England, so the National Health Service up here, we still have, I would say the National Health Service dentistry is still bigger than the private one in the north of England, were I live, here.
Rich: Is Manchester considered a bit more working class than London?
Ashley: Years ago, if you consider what Manchester was about, we were the first city. This was where the Industrial Revolution started. So if you came here 70, 80 years ago, everyone worked in manufacturing. We were the leading cotton, you know, railway trains; everything was built here. A lot of things were built here in Manchester. I think what has happen over the past, like most big cities, manufacturing decreased. We have become more of a service city – tourism. So we are very much a more cosmopolitan city compared to what we were, like, 20 years ago. I think in 1996, what happened is we had an IRA bomb here, and it actually blew up the worst part of Manchester. We had a shopping centre in Manchester which was just awful, that the IRA blew it up. So actually they did us a big favor, and what happened after that was just that billions are being spent on the city center. If you come now in the city center, Manchester now is really a world- class cosmopolitan city. It has a fantastic city center with great modern architecture, against old architecture. So all the old factories are now apartments, and lots of modern buildings here as well. Billions have been spent on the city center so it’s a great place to visit, although it just rains a lot; that’s the only problem in Manchester.
Rich: Sounds great. I have been to the UK many, many times, but never to Manchester, so I have to put that on my list.
Ashley: Well, I think we are the, possibly I think there is London 1, Edinburgh 2, I think we are number 3 now. And I think it’s probably, a lot is down to soccer. People come down here for the soccer week to watch the football here, and the music as well. That type of thing. But the concerts we have here...... So, I think we are maybe about the third most visited city in the UK now, I think, after London and Edinburgh.
Rich: Sounds good. Good to know. Hey, our time is almost up, which I think, I get the feeling we could speak for hours and hours and hours and have a great time and talk about some stuff to really help dentists and team members here in the US. But you have given a bunch of great information. Some of the things we will call key skills, or Monday morning ideas. Do you have a top key skill that you suggest, that if you’re going to learn anything or change anything, this is so crucially important?
Ashley: Yeah, Dale Carnegie wrote that book in 1936 called “How to Win Friends and Influence People,” and it’s still probably more relevant today than when it was first written. If you become genuinely interested in your patients, they will become genuinely interested in what you have to offer. Your patients don’t care what you know until you first demonstrate that you care. So if it’s one key skill, and that is to every single consultation with your patients, just spend some time building rapport. Getting to know the person, and ask some really, really good questions about their teeth, and you’d be surprised at what you’ll discover, and your patients will start, not all of them, but some of your patients will give you a shopping list of things that they want. And, you have to remember, people’s circumstances are changing all the time. My hairdresser, she comes to visit my office every four weeks. A year ago she had a crooked tooth, never bothered her, but she had a split in her relationship with her boyfriend, and now six months down the line, she is wearing braces. So if you were to ask the questions a year ago, she was happy with her teeth. Ask the same questions six months later, you get a different answer. So there is just thousands and thousands of dollars’ worth of opportunity sitting there with your patients now, and all I would say is just spend some time just listening, asking questions, finding out what they are looking for, and you’d be pleasantly surprised at some things your patients will tell you. You create more opportunities to deliver the dentistry that you love to do, and most importantly, what your patients want as well, so that would be the key skill.
Rich: That’s a great one, great way to close our interview; it’s fantastic. I think it’s also one of those things that is a lifelong project; that no matter how good we think we are, how much we pay attention to it, we can always improve and get better and get better and get better, and, you know, that kind of skill or lifestyle makes your life better too, doesn’t it? Ashley: Well, it makes it more interesting, doesn’t it?
Rich: Absolutely.
Ashley: That’s the key. It just makes your day more interesting.
Rich: No question about it.
Ashley: Than just going in, drilling and filling the whole day, you know.
Rich: I agree. So, Ashley, thanks again. I’m so glad that we were able to get in touch with one another. I can’t remember who told me about you, but I thank him or her if you are listening. I wish I could remember who it was. Would love to get you to our TBSE seminar in Las Vegas one of these days. I think you’d be a humongous hit there.
Ashley: Yeah, I’d love to. I have delivered five of my courses in the last 12, 18 months or so, and have been great courses been delivered, and the people there are being affected by what we have talked about, and what we have delivered, so yeah, I would love to come over.
Rich: That’s great. Now, in the meantime, I would imagine many of our listeners want to find out more about what you are doing. How they can maybe take your program, get some of your publications, sign up for whatever you’ve got going information- wise, how would people find you?
Ashley: Ok, ok. So my website is very easy. It’s ashleylatter.com, so that’s spelled A s h l e y. I think it’s a girl name in America. Latter is L-A- T-T-E-R. We do an email newsletter that goes out once a week full of tips and strategies, so you can sign up for that. There is a section called Learning Zone, which is full of videos and loads of free information as well. If you have enjoyed this interview, there’s tons more stuff there. We have got a shop where you can buy some of my books, CDs, and DVDs. So if any of you guys buy any of my stuff there, we will personally find the books and get them over to them as well. So if you just go to my website, ashleylatter.com, there is tons of stuff for your listeners.
Rich: Fantastic, and do you have your courses, your programs listed as well?
Ashley: They are all there. We are, in 2016 as well, all over the UK. We got one in India, one in Holland, two in Australia, and as yet we haven’t brought anything down for the US. Although I’m talking to some people to see if we can make that happen, so hopefully we’ll come.
Rich: But in the meantime, you have just listed some great places to visit, and as we cannot officially give tax advice, but I think, as everybody knows, if you take a nice trip and have a great dental course intertwined with it, there can be some tax advantages in the US, so nod, nod, wink, wink.
Ashley: Yeah, absolutely. If you come in May, this is normally the best time to visit Manchester. Normally the best month we have here, and so you’ll be here in the spring, in the summer, so if any of you guys come over to us here, we will look after them; we will give them a good time in Manchester.
Rich: How about football season? When does Manchester United play Manchester City? That must be a crazy day.
Ashley: Oh, dear me, I got a feeling, I think it’s about March time. I think it’s March, I think. Rich: Probably a tough ticket?
Ashley: It’s a tough gig. You can’t get in for love or money. It’s a tough ticket, you can’t get one really. I mean, I get them for here, I’ll watch the game. We will get, like, a 3,000 allocation, and, like, 30,000 people are trying to apply for the tickets. It’s virtually impossible to get.
Rich: Wow, but if you can, what a fun day.
Ashley: I have been to a few in the past, in the time I have been to several at City’s ground. They are crazy occasions, really are.
Rich: Sounds like it. Well, Ashley, thanks so much again for....
Ashley: You are very welcome.
Rich: ....taking your time. I know your schedule is really busy, so all of our listeners appreciate it very much. I’ll just review one more time. You can visit Ashley, find out all this great stuff and get some good free information too, at ashleylatter.com. So once again, thanks to all of our listeners. This is Dr. Richard Madow with Ashley Latter. We thank you for listening. I think it was a fantastic program today. I hope you felt the same way, Ashley.
Ashley: Good, thank you.
For more information on this interview, be sure to visit Madow.com. While you are there, check out the Madow Brothers seminar schedule as well as the many different ways that Rich and Dave can help you in your practice. Be sure to become a fan of the Madow Group on Facebook and follow Madow Group on Twitter. Remember, you are not alone anymore.