One Step to Overcoming Approval Addiction

Today on the show, we are delighted to have Shelly VanEpps, and our topic is One Step to Overcoming Approval Addiction. Shelly is currently a treatment coordinator and one of All-Star Dental Academies’ Mastery Coaches. By working on the business with her clients, she focuses on how the team can provide the ultimate patient experience – an All-Star patient experience.

She has worked in the same dental practice for 22 years and has faced many challenges, such as having enough team members or the wrong team. Still, through it all, she’s worked in every position within the practice, from administrative tasks to assisting the doctor’s chair side. Her passion is treatment coordinating and connecting with patients. She was inspired by her own coach to become a coach herself and help others feel confident in what they’re doing, and this leads to today’s topic of the confidence factor. Please stay tuned!

Key Highlights

  • [00:58] Who is Shelly VanEpps?
  • [02:07] What is approval addiction?
  • [04:06] Why many doctors and team members suffer from approval addiction
  • [04:58] Easy ways to overcome approval addiction
  • [05:03] #1: Have a positive self-talk
  • [06:48] #2: A permission statement
  • [08:42] An example of a permission statement
  • [15:32] Difference between embodied to permission statement versus not practicing
  • [19:02] Investing in your employees through coaching

Notable Quotes

  • [05:01] Positive self-talk is key to overcoming approval addiction. Lack of confidence in presenting information may lead to mistrust from the patient.
  • [10:18] People prefer buying over being sold to. It’s important to remember that when a patient says yes, they are choosing, and often, providers make the mistake of jumping straight into the next step without any conversation.
  • [14:25] A permission statement is a great communication skill that I wish everybody had because it makes such a big difference in how you interact with everybody.
  • [18:21] Often, the simplest things are the best, but to achieve simplicity, one must have the right mindset and prerequisites, which require work.
  • [19:18] If you invest in your employees, and they appreciate that, take it to heart, and use the skills, it comes back to you. It pays for itself.


About Alex Nottingham JD MBA

Alex is the CEO and Founder of All-Star Dental Academy®. He has authored the dental practice game-changer book “Dental Practice Excellence” and co-wrote a bestselling book with Brian Tracy. Alex has shared the stage with Michael Gerber (the author of “The E–Myth Revisited”), and lectures nationally and internationally to prestigious dental organizations. 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 Masters of Business Administration (MBA) from Florida International University.

Podcast Transcript

Alex Nottingham:

Hi everyone. I’m Alex Nottingham, CEO of All-Star Dental Academy and welcome to Dental All-Stars. Our guest is Shelley VanEpps and our topic is One Step to Overcoming Approval Addiction. Shelley has been in the dental industry for over 21 years and is currently a treatment coordinator. And one of All-Star Dental Academy’s Mastery Coaches working on the business with her clients.

One of her focuses is on how the team can focus on providing an ultimate patient experience, an all-star patient experience. Please welcome Shelley.

Shelly VanEpps:

Hello. Thank you so much for having me.

Alex Nottingham:

I just added editing your bio on the fly.

Shelly VanEpps:

There you go.

Alex Nottingham:

Tell us a little bit about you.

Shelly VanEpps:

Sure. So I’ve been in a practice, same practice for going on 22 years. And throughout that, I’ve found and gone through a lot of different challenges, as many other practices – do we have enough team, we have too many team, we have not the right team, all of those different things. But throughout that, I was able to find myself in each position within the practice.

So from administrative, scheduling, insurance, all of that over to assisting the doctor chair side, doing treatment coordinating, which is kind of my passion. It’s where I really thrive and I love to connect with patients. So I found myself wanting to coach when I had a coach myself, and she was very inspirational. And I looked I was listening to her one day and I thought, that’s what I want to do.

I want to be able to take what I’m doing and expound upon that and help other people to feel this confident with what they’re doing. So it kind of leads into today’s topic. A little bit of the confidence factor. But yeah, it’s been a great ride and I’m excited to be here today.

Alex Nottingham:

What is approval addiction?

Shelly VanEpps:

Well, approval addiction is the need or desire to hear “Yes.” And so many of us are afraid of potentially being turned down or told no. And so we start to become fearful or avoid different conversations. And it’s very powerful and something that a lot of dentists and team members have that fear of. “I don’t want to tell this patient what’s going on because they’re going to tell me no, they’re going to turn me down.”

They’re going to explain why this isn’t necessary and it makes them vulnerable of having to tell somebody everything. So that’s ultimately what approval addiction is.

Alex Nottingham:

And it reminds me of like even with broken appointments or trying to make sure that we’re scheduling properly, we don’t want that or this, you know, I can get it. You don’t want the patient to not like you. And so we’ll let them off. We don’t want to upset them. So it’s getting the “yes”, but also getting the approval from the patient that they’re happy with you.

And if you’re doing anything to the contrary, that’s the concern.

Shelly VanEpps:

Correct. Absolutely. It’s one of those things where patients come in and they start off their conversation with, “No offense, but I hate the dentist.” I mean, talk about a negative conversation and feeling like, well, let me just get back on my high horse and come on out. I mean, you’re already being told that you’re not liked.

And so then you’re going to go in there and talk to this patient about X, Y, Z, or the patient is starting off the conversation in the phone in a negative light. So you have to be able to turn that around and overcome that approval addiction of feeling like they don’t like me, they don’t like what I have to say.

I’m going to have to defend my responses and it’s uncomfortable. So, yeah, ultimately everybody experiences it from the phones all the way through to the doctor and in the checkout at the very end of the appointment.

Alex Nottingham:

Well, speaking of that, why do you think that so many doctors and team members suffer from this approval addiction?

Shelly VanEpps:

Yeah, I mean, starting right there with the “No offense, I don’t like you,” or “No offense, but I don’t want to be here.” I mean, that’s uncomfortable. And then you’re telling somebody something about their health that maybe they didn’t want to hear. And you know that that’s ultimately what’s coming. It’s pretty rare. I shouldn’t say rare, but there are a handful of patients who come in healthy.

But for the most part, we find something of concern. And you are the bearer of bad news and you know, that’s what they’re there for. And we have to remind ourselves of that. They’re coming to see us as a professional, as a health care professional. And ultimately, if we see something that’s bothering that, we see that will bother them or could bother them.

We have to bring that to their attention, whether we want to or not or whether they want to hear it or not.

Alex Nottingham:

What is an easy way to overcome approval addiction?

Shelly VanEpps:

Well, I say it’s a one-step thing, but actually it’s a two-step thing. You have to start within yourself. You have to have positive self-talk. If you go into a conversation already assuming that this patient is going to say no, they’re going to see that. They’re going to feel that it’s not in the words that you’re saying, it’s in the tone in your body language.

If you go in not confident with the information that you have to present, they’re going to feel that and they’re going to think that something is going on, that you’re being shady or not truthful. So, yes, they have to start with your self-talk and confidence and knowing they’re here to see me because they want to know what’s going on.

And I’m here as this professional and it’s my duty to share this information.

Alex Nottingham:

It takes a lot of work. I mean, mindset work. And it’s not an overnight thing, right? I mean, that’s where it’s nice to learn some tactics. We’re going to talk about some, but it’s an ongoing process of improving yourself and being able to then apply that every day.

Shelly VanEpps:

So I have to walk into the room with a “ten” on your forehead ready to have a conversation, positive atmosphere, positive attitude, ready to go.

Alex Nottingham:

And it starts with, Did you sleep well? Did you eat well? So you’re saying that almost it could be a second step or we’ll even call it a prerequisite if you’re going to do this next tactic that you have to be in the right state of mind. And you’re growing, you have to be congruent. And this is the other thing, too, for those that are listening.

I have brilliant people on these podcasts, such as Shelley, and we’re going to continue to share with you great things. But don’t you can’t use these things to manipulate people. You have to be clean.

You have to be sincere.

And if you’re looking to take a shortcut, then this isn’t the podcast for you. All right. Go ahead, Shelley. So what is this? What do we do?

Shelly VanEpps:

So the second step is going to be a permission statement. Okay, this seems silly. It seems like a lot of team members say, well, that feels really uncomfortable. Why would I ask a question where it’s obvious they’re here for me to take a look in their mouth. Why would I ask them if it’s okay for me to take a look in their mouth?

It’s a simple question, and it’s to get a “Yes.” It’s to start a conversation off with yes. So, you know, if you’re able to start off in that positive interaction and they’re telling you, yes, it’s okay for you to tell me what’s going on in my mouth all of a sudden for yourself. You feel confident, obligated to share the information with them.

I use this all the way across the patient experience. There’s always questions. You’re always asking questions. That’s just part of the investigation with a patient, that’s non stop, right? That’s always something we’re doing. But this particular question is to shift and allow yourself to do something where you’re about to be uncomfortable with what’s going to happen. But this gives you a little bit of peace about that conversation of saying, no, this is what they want.

This is why they’re here. And on the on the phones, Heather does a great job with the great call process. And one of those questions is, you know, in order to better serve you, is it okay if I ask some more questions? What patient says no to that? Very rarely, unless they’re on a time constraint. But that’s going to help us to be able to better serve them.

So that, yes, that you’re getting is allowing you to ask those questions. Otherwise, if you just randomly started spewing off questions, those patients are going to be like, what is going on? This person is asking me these random, weird questions. We have a purpose. We want to be able to provide that to them. In asking that simple question and hearing yes allows us to go through that process.

Alex Nottingham:

What’s an example of a permission statement?

Shelly VanEpps:

So, starting with the phone, that one that we just talked about.

Alex Nottingham:

You’re using the Transition Statement?

Shelly VanEpps:

Transition statement is a permission, you’re getting that “yes.” From the hygienist, you know, is it okay with you if we go ahead and take a look around? How simple is that? It’s not complicated. It doesn’t have to be an awkward, uncomfortable conversation or question. A lot of people get hung up. I don’t know what to say, like just talk to the person.

It’s just that you want to use in this particular situation. You want to use a close ended question versus an open ended question. You want there to be the potential of one or two answers, yes or no. And if they say no, that’s a that’s okay, because now you’re going to find out why you’re going to dig deeper and you’re going to ask more questions.

If a patient tells, you know, I don’t want you to lay the chair back and take a look at my mouth. Why are you here? What’s going on? Is there anxiety? What how can I better serve you and you start a different type of question or a different series of questions, I should say. So you’re heading that appointment in a different direction because they clearly aren’t prepared or ready for you to look around it.

Alex Nottingham:

It also feels for the patient empowering. It sounds that if you ask them, you’re humbling yourself, you know? May I take a look at your mouth like, Oh, that’s so nice of you to ask, first of all. And second, yes, I would like that. So now I’m feeling empowered when we get to just this idea of case presentation at the end of the case presentation, which we’re talking about the kind of the beginning steps, but it’s all part of setting it up is the adage that people like to buy, not be sold to.

So if they’re yes, if they’re saying yes, they’re choosing. That’s very important because sometimes the problem is, as a provider, whatever we might do, coach, hygienist, dentist, team member is we just go right into it. Let’s you know, we’re going to schedule you your go. Right. And I’ve been saying things go right into their mouth. It’s like it…

Shelly VanEpps:

Becomes abrasive, it’s aggressive.

Alex Nottingham:

It does. And we don’t see that. And these are the sorts skills we have to be very mindful of. And these little maybe trivial things we think about can have an enormous impact on whether somebody accepts treatment. And sometimes it may make total sense to them, but they don’t feel right. We make decisions on how we feel and then we justify them with logic.

So what you’re doing is you’re getting them to feel good. You’re setting the situation up for case acceptance and that’s what you’re a pro at.

Shelly VanEpps:

Absolutely, yes. So this like I said, this permission statement is all the way through the patient experience, all the way to the point of if you’re not the treatment coordinator who’s going to be presenting the treatment to this patient, going over the financials and everything, you ask this patient permission to share with the next person what all you’ve already talked about in what they’ve decided to do about it.

So if you’re the doctor, “Is it okay with you if I share with Shelly everything that we’ve talked about today so that she can go ahead and get these appointments reserved for you?” The patient says yes. The treatment coordinator already knows everything that’s going on at that point, and they can take it from there and make sure that those appointments are scheduled.

If there’s a concern about cost, “Would you like to know about the different financing that we have?” Yes, great. You can go ahead and have that conversation. Otherwise, if you just jump in and say “This is a lot of money, do you want to know our fees?” And so I get in the habit of doing the permission statement. I can almost not even role play of not doing it.

But you know, if you just have a treatment plan and you say, “Yeah, it’s going to be a lot of money here, how do you want to pay for that?” Or you assume they’re not going to be able to pay for it. If you ask the question would you like to know about our different financing or “A lot of our patients are interested in our financing options, is that something that you would like to know more about?”

They may say, Nope, I’ll write a check.” Great. Or they may say,” I’m not going to get approved.” Well, you’d be surprised. And then you can have the conversation.

Alex Nottingham:

Yeah, that’s an interesting point you made, because we often assume who can accept treatment or who can do that. And that’s a big mistake because it’s very interesting. It’s like the ones that all this person’s going to do this case and they don’t. And then the ones I can’t believe this person did the case. You never want to assume.

And I think that this creates a process to protect you from yourself and set up the patient for optimal treatment and an optimal experience. So just to clarify, you mentioned the doctor as well. We’ll use a credit mission statement. So everybody putting permission statements.

Shelly VanEpps:

Everybody. And, you know, it doesn’t only apply to the patients, it applies to your team, too. If you see somebody who’s doing something incorrectly, I’ll put that in quotation marks incorrectly because they’re outside of your systems. What better way than to go up to them and say, “Hey, is it okay if I talk to you about the way that you’re doing that?”

Or can I ask you a question about the way you’re doing this or that? Like, say, they’re scheduling and incorrectly they’re not following your blocks. Can I ask you why you put this person in the spot? It’s not aggressive. It’s not hey, you put this in the wrong spot in making somebody go in the back room and cry.

It’s opening that and having a conversation with them so that you can better understand where they’re coming from. And that goes all the way across the team, from team member to team member, from doctor to team member. I mean, it’s just a great, great communication skill that I wish everybody had because it makes such a big difference in the way that you interact with everybody.

Alex Nottingham:

And I assume that the patients respond well to this.

Shelly VanEpps:

Absolutely, absolutely. They appreciate it. I can’t tell you how much I hear. Thank you for asking. Yes, I’m comfortable with this or just the yeses that I hear. I can’t tell you. It’s very rare to hear a “no.” But when you do, it’s okay. It’s okay because you know that that means that they’re still interested and they need more.

They need something more from us that we haven’t provided yet. And you have to step back. You don’t just say, oh, you’re not okay with me setting the chair down. Okay, well, I’ll see you later. And they leave. You don’t leave that appointment that way. You have to dig.

Alex Nottingham:

You learned this process many years ago because it sounds so embodied in what you do. Did you see a difference between when you weren’t doing it and then once you shifted to it? And what did you notice?

Shelly VanEpps:

Oh, my gosh, Alex, this is difficult because it’s been embodied for so long that I can’t even remember when I didn’t do it. But I can see and I observe team members doing it or not doing it, and I can see the difference in the patient experience. And so, for myself, it’s become a life changer all the way across the board.

And definitely with my patient interactions it’s made a huge difference. But being able to help team members to develop that and just remind them, hey, permission, and some of them get so nervous about it. It’s just a question. That’s all it is. It’s to help you. It’s to help the patient. And if you can just ask one question that gives you a yes, your conversation is going to be so much more impactful and actually benefit both of you, because ultimately they’re there to find out what’s going on.

You don’t go to a neurologist, have a scan done and expect them to not tell you if you have a brain tumor. You want to know people come into our office if they have a cavity, if they have an abscess, they want to know. They don’t want to know about just one of them.

They want to know about anything that’s going on. Because ultimately, I hear over and over patients come in. Every time I would go to my dentist, they’d tell me about something else that’s going on. So frustrating. It’s like they’re just looking for something. Really, it’s a matter that the doctor probably had some approval addiction going on and didn’t want to let the patient know about everything.

So they chose one area that was the worst. We’ll just focus here and I’m just going to let them know this and then I’ll kind of let them know the next thing, next time they come in so that I don’t have to overwhelm the patient. And that actually causes frustration because they feel like every time you’re finding something new, when in reality it was all there the whole time, and we just held on to that approval addiction and didn’t want to overwhelm the patient, which ultimately was us not wanting to hear no or be told, there’s no way I have that many cavities.

Alex Nottingham:

I typically ask at the end of a podcast, the one thing that you can put into practice tomorrow that had the have a great impact on your business and it seems like you already answered that question. I mean, this is really simple. I was like looking at the title and I’m like, I’m like the one step to overcome approval addiction.

I’m like, that’s kind of over simplistic. And I’m like, as you explain it, like, that’s the one thing. So there you go.

Shelly VanEpps:

Get it. Really, truly.

Alex Nottingham:

Use your permission statement.

Shelly VanEpps:

It really is. Sound simple?

Alex Nottingham:

Well, often the simplest things are the best things. You have to have, often, to do simplicity, you have to have the right mindset. The prerequisites are really going to be the work. This is just remembering to do this, but continue to work on yourself, continue to learn. And it’s not just grabbing information. It’s being coached.

It’s working on yourself. The fastest way to success is mentorship, being mentored and coached. You’ve now made a part of your life mission to help others as well grow. And that’s what it is all about.

Shelly VanEpps:

100%. I couldn’t thank my doctor enough for investing in me in that way because I on my own, I probably wouldn’t have had the opportunity to have some of the coaching that I’ve received. And so for him to put that investment in me, if you have an office manager or somebody that you foresee being with your practice or even somebody who’s not your top employee right now, if you invest in them a little bit and they appreciate that and they take it to heart and they use the skills it comes back to you, it pays for itself, right?

The coaching pays for itself when they take that and run with it. I mean, implementing one simple question, your case presentation, your case acceptance goes through the roof and there are so many other little things that you can implement that would make a big difference for you. So that’s self-funding.

Alex Nottingham:

Yeah, well, that’s what I spoke about in the last podcast that I did is I talked about self-funding that we believe we do this at All-Star, but we believe any coaching should self-fund every 90 days. You should be looking at it and saying, look, wow and your it’s not difficult to do that. We focus on that with our KPI coaching process, key performance indicators.

Well, Shelly, thank you so much for being on our podcast and I look forward to having you many, more times. You’re so brilliant.

Shelly VanEpps:

All right.

Alex Nottingham:

Please remember to subscribe on YouTube and follow us on Apple Podcasts and Spotify. And until next time, go out there and be an All-Star.

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