Case Acceptances Starts with the Phones

Eric Vickery and Alex Nottingham JD MBA discuss how success starts with the first interaction – phone skills are vital for case acceptance as this interaction builds trust and rapport which impacts long-term patient relations.


About Eric Vickery

Eric holds a degree in business administration and brings a strong business and systems approach to his consulting. His initiation into the field of dentistry was in the area of office management. He managed dental practices for over ten years and has been consulting over 250 offices nationwide since 2001.

About Alex Nottingham JD MBA

Alex is the CEO and Founder of All-Star Dental Academy®. He is a former Tony Robbins top coach and consultant, having worked with companies upwards of $100 million. His passion is to help others create personal wealth and make a positive impact on the people around them. Alex received his Juris Doctor (JD) and Master of Business Administration (MBA) from Florida International University.

Episode Transcript

Transcript performed by A.I. Please excuse the typos.


Welcome to Dental All-Stars. I’m Alex Nottingham, founder and CEO of All-Star Dental Academy. And with me is Eric Vickery, the president of coaching of All-Star Dental Academy. And we’re talking about the phone call as the first step to case acceptance. Please welcome Eric Vickery. Alex, thanks for having me again. Love our conversations about this kind of stuff. So fun. I love them too. Phones, case acceptance. It’s interesting.



sometimes they’re in their own silos. So we’re known for phone skills. We’re known for case acceptance. But we often talk about them as like separate things. Are they separate? Or is there a relationship? And why are you saying that it starts with the phone? Yeah, it probably goes beyond the phone call, like the referral source, the marketing, you know, you’re communicating something about who you are as a dentist and everything you’re not doing.



Really, the results of your dentistry are great. They’re confirmation of who you say you are. What I mean by that is your physical plant looks a certain way. It says something about who you are as a dentist. The car you drive says something about who you are as a dentist. The, your website, the way it looks, I’m gonna go look there. What are people saying about your referral sources? All of those things are adding up to case acceptance, and I’ll clear in on this concept.



But the person answering the phone is a mirror of you and your skill set. The person answering the phone is building the rapport to get you a place of trust. So they’re willing to allow you to do dentistry on them. So I think this is best told by a story. We had a client in Ohio who sent me a recording of his new admin team member of a new patient phone call and he just said, we need training.



He said we, he wasn’t blaming her or anything like that. There was no criticism, she’s new. And it was a 45 second new patient phone call. Now this office focused in on implant-supported dentures of some sort. And you can imagine a 45 second new patient phone call probably doesn’t go very long. So I looked at it, 45 seconds, I pushed play and listened to it really quickly. He’s like, I can listen to this right now. And great job answering the phone. Thank you for calling. This is Eric, doctor’s office, how may I help you?



And the person on the other end said, oh, hi, my name is so-and-so, I was looking at your website and I see you guys do those implants that are permanent. I don’t think she knew what to call them. And she said, with implants. I have 20-year-old dentures that don’t fit at all. They’re moving all around, I’m so sick and tired of them. I have Blue Cross Blue Shield and I’m wondering where do I go from here? And our poor team member said, oh, I’m so sorry, we don’t work with them. Okay, thanks, bye. And that was the end of the phone call. Now nationally,



our marketing partners will tell us 22% conversion rate on new patient phone calls. Only 22% of new patient phone calls are being converted. Now that includes calls during lunch, that includes calls after hours, all of that. However, if we have them on the phone, our goal when that phone rings is to figure out how can I help this person? Now all that phone call did was create friction and barrier for that person to come in and work with us. And what in the world, that’s probably a



I don’t know, I’ll estimate low, $40,000 case that we just basically ended on the phone. Probably $40,000. The annual maximum of that insurance plan was probably $1,500. I bet that doctor would have went to the bank and got cash and counted out 15 large bills and said, I’ll cover your insurance maximum. We’ll get your dentistry done for you. Your insurance plays no role in that type of case. Why are we so worried about that? We have a tendency for some reason on the phone to think about all the ways this person



can’t come into the practice and we create friction and we funnel it down and then they’re not a patient here. They weren’t a good fit. You don’t really know. Now, there are some pretty obvious, not gonna be a fit, I get that. But most of the time, our conversion rate is 80% or higher on new patient phone calls. For referred patients, it should be nearly 100%. Where it starts to dip is when people aren’t referred to us website, they drove by, saw the building, that sort of thing. Social media.



So converting the new patient phone call, yes, but get it out of the silo of, it’s just about converting the new patient. That’s not just what we’re talking about here. It’s how you get the new patient scheduled. When you’re in a position to first get your frame of mind into, okay, every call is a blessing. Every call is a good thing. Every time that phone rings, I joke all the time and I say, you ever, you ever, I felt like that team member was in the middle of something and the phone rang and she went, oh.



Like this is an interruption, almost like her alarm clock was waking her up in the morning and disrupting her sleep. That’s how I took the way she answered that phone call. And again, no fault of her own, there’s just training that has to happen there. And a simple, I’d be happy to help you out with that. Let’s dig in and let’s have a conversation about this, is a very subtle and simple tool that you can use on the phone to get that conversation to continue on to give yourself a chance at scheduling that person while…



you are building so much rapport and trust, case acceptance is already starting. Case acceptance is beginning the moment I start to build rapport with them and trust, get to know them, ask the right questions, and figure out how we’re gonna take care of them. Now let’s assume they’re in the 80%, they’re the right fit, we wanna schedule them.



you’re gonna be getting research, you’re gonna be documenting things on the great call sheet that makes sense for everyone to know. And I’ll typically ask the clinical team, I’ll say, what is the most important thing that you wanna know as a clinical team member about this patient before they come in, therefore, what questions should you ask? And they’ll say things like, chief complaint, oh, get their name, how did they hear about us, what sort of insurance do they have, ask all these questions. And then the reframing of our mind,



And then I ask a second question, I say, let’s shift it. What is the goal of every new patient phone call? And immediately the mind goes, well, let’s get them scheduled. Well, that becomes the question that we’re trying to get to. Based upon all the questions you’re giving me, get their name, their phone number, their marketing source, how they heard about us, who can we thank for the referral, how long has been in the dentist, their chief complaint, you’re asking all these questions. But ultimately you’re doing that to build rapport with them to get to a place where it makes sense to say,



How do you feel about going ahead and getting your first visit scheduled in our office? That’s what we’re trying to lead to. And when that person says, that sounds really good to that question, you have peace of mind knowing as the scheduler, this person’s actually gonna show up for their appointment. You’re not pressuring them, you’re not convincing them, you’re not quickly going, come on in, we’ll get you in tomorrow at two. And just trying to get off the phone as quick as possible.



So because of that, I’ll ask the team, I’ll say, well, how long should a new patient phone call take then? And they think for a moment, think for a moment, they say, oh, however long it takes for that person. How do I build rapport with different people? With you, your personality style, I could build rapport really quickly with you. If you were the patient, it’d be much quicker. If one of our master coaches, Cheyenne, was on the phone, I would go slower, I would take longer to probably build trust with her on the phone.



And I would do that purposefully, but I’m reading that person’s tone. Are you saying that Cheyenne is slow? I’ll have to center this podcast right here, this clip. You listening Cheyenne? I get it a lot quicker than you. He has to go slower. Oh man, oh gosh. A little inside. I had to bluster chops a little bit on that one. Yeah, yeah. The personality is the part that you’re picking up on. And you’re not even seeing that person because you’re on the phone with them. But your case acceptance is in effect. The process has begun.



And so my ability to not bore your style with all the details, but yet give Cheyenne all the details she wants to feel safe and comfortable moving forward is going to vary. Your phone call is going to be quicker than Cheyenne’s. It’s not going to be three minutes, but your phone call might be seven minutes by the time you get everything done. What you’re speaking to is personality profiles. In the All-Star Mastery series that you lead, and we have three levels of case acceptance. We can put a link later. That’s really important.



you talk about disc as one of your top personality profiles, I almost look at it like the first level, well, first level is as you were talking about, and Shelley, I can put a link as well, we did a podcast with her about called Don’t Answer the Phone, meaning how so many offices just look at it as a nuisance. So right there, it was kind of a nuisance. How do I get out of this call and back to collecting insurance, back to doing admin? It’s not making us money.



What’s making, right? How do I get off the phone and fill all the cancellations I’m having right now, the openings? They’re not gonna do that either. I don’t wanna do anything, I just wanna, the phones is a distraction from who’s in front of me, all that, the first step is a priority that this is, like you said, a blessing every phone call, and I’m gonna be present and I’m gonna care. And then there’s the training that goes along with it, right, because the second part is we have to then train, so it’s a priority, we have to train them on these skills.



We teach the great call process at All-Star. You were referring to rapport. And then the advanced step, which is mastery, is can you do all that while understanding who you are and who they are? Emotional intelligence, EQ, where you can adapt to who you are. That’s the advanced, so we call it mastery, because you gotta get the first two first. It’s important, it’s a priority. I train, that’s what our All-Star training program does. And then third is now we have to add coaching and disc to it to make it.



really alive. So because we see this is very important. Let me put this out here. I always got to remind this because I talk about this in our webinars, the cost of not converting a phone call. The average, and this is before inflation, the ADA, I haven’t seen the new numbers, but the average first year value of patient is $642. The average office will



But let’s say they just not convert one per day. There’s one you just said. That was $40,000 case. But let’s just say that was only $640. $642. We do 16 working days a month times the 642. You’re at $10,000 a month. Missed opportunity. That’s $120,000 a year. If that’s a lifetime value of a patient of 10 years, that’s $1.2 million of lifetime revenue gone.



And then let’s play some, let’s play it lastly. If you invested that $1 million in the S&P 500 in 20 years, it’s $5 million. So you just lost $5 million by not valuing this as important to phone, which I just told you why it’s important. And second, not training your team. Go ahead. That’s right. Well, we do this same conversion with an endodontist and the numbers are staggering. I did this with an endo practice.



because they gave me their numbers on how many calls they were not converting. It was 80,000 a month is what that number converted to because the root canal, you know, the price is pretty straightforward. The price of a patient is pretty straightforward. So the numbers go up from 642. That is very conservative. You know, the one crown, you know, more than that. And I’m talking about one missed opportunity of working day with a busy office. And so it’s important we know these numbers because we’re saying, oh, it’s so nice to train, but



Until we quantify, that’s what I love about all-star coaching is one of the key tenants of the two calls a month, it’s all we do. One of them is KPIs. We got to know what the numbers are saying. We can talk all we want, but if we don’t see the pain quantitatively, what it’s costing us and how we can improve it. We were talking about this in our last call that we did and our coaching calls, we keep repeating it over and over again. We are about, at our coaching program, self-funding two things.



Affordable, sustainable coaching that is self-funds and pays for itself. Oh, I like that. We should write that down. Affordable, sustainable coaching that pays for itself. Because our clients stay with us. You had one that you celebrated 20 years. They don’t leave because coaching pays for itself and not just that it pays for itself. That’s a big one. The other part is if you do too much work, too many calls, we’re busy. You can’t stick to that. Even if it was making you a ton more money.



Even if it is self-funding, you have to go work. You want to live your life. You want the minimum dose that can give you the maximum benefit. That’s the point of coaching. It’s all these little, as we train these maneuvers, you’re saying, how do we improve case acceptance? All these things we talked about, phone skills, making it as important, coaching, mastery training, the events that you do, you start turning these dials little by little, they improve. That’s right.



So, and think about it this way, people who don’t go to the gym for a year, then they go work out for two weeks, they’re so sore they can’t move, and they don’t see the immediate results they want, and they quit. It’s about just a very even keel workout constantly. So to go back to that phone call and to say, all right, this is case acceptance, when what doesn’t happen, often times, if you think about we’re creating a perception, your clinical skills are a 10, but your communication skills are a five, your patient perceives your clinical skills as a five.



It’s very simple. So we’re trying to move that phone skill up to a 10. And here’s what happens. Oftentimes, early on, training admin team members doing the great call sheet, doing the great call sheet, and then nobody clinically is paying attention to what they’re doing. And they’re like, well, why would I bother doing this anymore? And then it goes away. And then we lose it. So that information has to be then passed on to the clinical team at the morning huddle. And what happens is that next clinical team member that connects with that patient that was on the phone with me,



is going to pick up right where I left off. We are never going to say, so Alex, what brings you in today as a clinical team member when you meet that new patient? That is a complete deflator. You’re now starting back to ground zero because that patient’s thinking, well, I just told that person on the phone everything they need to know about me and I filled out all that paperwork you wanted. How come you don’t know what brings me in today? Maybe it’s not so conscious, maybe it’s more subconscious, but it creates an antitrust and you’re losing credibility. So when you do the great call process and you follow through,



that person should grab that patient and say, hi Alex, I see you talked to Eric on the phone. He told me that one, two, three, four little things that you guys talked about on the phone. And now all of a sudden credibility increases and I’m now communicating to my patient Alex that my dentist is phenomenal. My communication skills just went up and now the patient perceives those communication skills help him perceive that those clinical skills are a 10.



This credibility formula is confidence in your competence. Credibility equals confidence in your competence. So everything you do, website, referral sources, physical plant, phone skills, communication skills, from front to back, communication skills. From morning huddle, passing the baton, even if it’s not in person, it’s a written transfer. That patient now perceives, these people really know what they’re doing. That dentist must be phenomenal. And now you’re building rapport and to trust and to confidence in your competence.



And now, case acceptance is going up. They’re more likely to listen to what you have to say because they believe you really know what you’re doing. That’s what we’re shooting for. That’s what the phone call does to improve case acceptance. Awesome. So I wanna give some links. You can go to alls backslash webinar and that will take you to a webinar where I talked about the phone, cost of the phone, and so on. That was great primer free training.



Also, if you go to alls and click events, you can see some information about the events. We’ll put the link to our Mastery Program coming up. And I believe the link is alls I believe that will forward to the ticket tailor to get information about, we now have early bird availability for our case acceptance program, total case acceptance or Mastery Level 1. Learn more about that. That’s where, as I mentioned.



You can take your case acceptance, and we do phone skills through the entire process, but we’re doing multiple tiers. We’re adding that layer of personality and emotional intelligence and doing this and role playing to get that right. So when you go through Mastery, you’re really a pro at that entire process. And then as Eric said, when you’re done with Mastery, no, you’re still role playing, you’re coaching, you’re doing the online training. This is something that I think most importantly for those that are listening,



To be successful in business and a leader is to constantly can I, which is an acronym from Tony Robbins, continuous and never ending improvement. You are always improving. You are always training. Little by little, as Eric said, is a huge improvement, a huge difference. Even listening to this podcast is a way to get that little jolt as we go along. So continuously train. I did a podcast.



It’s coming out soon in a few weeks. It’ll be on the, so Eric’s on Mondays, I’m on Fridays. Wednesdays is our hangout bunch of guests and we have our president on. And I’m gonna come out with in a few weeks, one on consistency over intensity. James Clear, Atomic Habits. It’s more important that you’re consistent. That’s the measure of success than intensity. So we can go, I’m gonna just do one event, that’s it. Or I’m gonna just trade really hard for one month, then stop. Or when is this, you mentioned before, when is training done?



never done. It’s consistency over intensity. The tortoise versus the hare. That’s success. Eric, thank you so much for being on the call on seeing how phone skills lead the first step, one of the first steps towards case acceptance. Remember to follow us on Apple Podcasts, Spotify, YouTube, and get the episodes as they are released. Share with your friends. Until next time, go out there.



And be – an All-Star.

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