Framing It: Different Ways to Present Treatment Plans to Patients

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When you present your restorative treatment plan to patients, you only have a 34% chance of patients accepting it, per findings by Jarvis Analytics, a data analysis platform by Henry Schein One.1 However, leveraging the Framing Effect may boost your percentage rating.

Per the American Psychological Association (APA), the Framing Effect means the way you present the information affects how people respond. In other words, by defining the context of the treatment you present to a patient, you also influence how patients receive that information.2

For example, the statistic by Jarvis Analytics is 34% of people accept treatment plans. That also means that 66% do not. But while this might just be a single statistic, there are a plethora of ways to share this metric. For example:

• Clinicians only have a 34% chance patients will accept their treatment plan
• Only 1/3 of patients accept restorative treatment plans
• Two-thirds of patients will reject your restorative treatment plans
• Clinicians will present their restorative treatment plans to patients, and two-thirds of patients, 66 percent, will reject them

These versions are an example of Reframing. Presenting the information from a different angle can alter the perception of the problem.2 If you read each of these out loud, it is easier to see the way a statistic is presented changes how it sounds, and even how it makes you feel.

The Framing Effect Influences Many Buying Decisions

The Framing Effect is a standard tool in many decision-making scenarios. In general, we choose the more positive presentation.

For example, financial advisors might use it to talk to you about your portfolio. They might say, "Diversification has a 70 percent chance of positive growth," or "Diversification has a 30 percent chance of losing money." Even though these are the same information, how the financial advisor states it could change how confident you feel about diversifying your investments.3

In addition to the Framing Effect, there are two other cognitive biases at work in this scenario. One is our fear of loss, which behavioral science calls Loss Aversion. Loss Aversion refers to the concept that many of us hate losing more than we enjoy gaining. Put another way, we try harder to keep what we have than we do to get what we want.4 Loss Aversion is why we favor the financial proposition that doesn't discuss the potential for loss.3

The other psychological principle influencing our reaction to the information is that we like the idea of more significant numbers over smaller numbers when discussing things like gains or savings. Not surprisingly, we think the 70 percent chance of making more money sounds pretty good. Suppose we were talking about savings. Which sounds better: "Get 70 percent off regular prices!" or "Pay only 30% of the sticker price!"? They are the same thing, but we like the idea of the larger-sounding savings.3

Therefore, when presenting your treatment options, consider how you can offer the treatment plan to benefit from patients' cognitive biases as humans.

Financial Framing Is Crucial in the Patient Experience

Craig Haynor, Founder and CEO of FeatherPay, a dental payments and billing platform, says framing the financial conversation starts by understanding the patient's financial situation. These conversations help the clinician or treatment coordinator better understand the patient's decision-making regarding going forward with treatment.

For example, if the reluctance to move forward is because the out-of-pocket expense associated with treatment feels like an unexpected expense at this point in their life. The conversation could be about how the practice can facilitate payment optionality moving forward. Haynor says services such as FeatherPay enable flexibility on the practice's part regarding how to make the cost of care more affordable for patients.

"Some examples of using FeatherPay include allowing the practice to access multiple payment methods in one simple transaction. The most common use case we see in this type of scenario is the patient has some amount on his FSA or HSA card and the rest on the credit or debit card. That's two transactions that happen seamlessly on our platform," Haynor explains. "We connect practices to the many different pockets of liquidity that all patients have, and we make it easy to stitch them together if necessary."

Another common scenario that could follow this conversation is positioning the payment as a custom payment plan where the practice handles in-house financing by charging an agreed-upon amount to the patient's credit card or bank account on a recurring basis until the balance is fully paid off. Services such as FeatherPay automate recurring payments over time for the practice, Haynor says, describing the service as a "set it and forget it" payment system.

"We allow a treatment coordinator to say, 'We know this is an unexpected expense. Insurance is only going to carry us so far. But don't worry, we have ways to help you think through the affordability side, and we're very flexible on how we get you into the chair for the care you deserve,'" Haynor says.

Haynor founded FeatherPay to provide a payment platform that supported these conversations and provided an empathetic means to close care. Moreover, the present economic situation has put consumers in a position where traditional financing is more challenging and expensive.

"It's more important than ever for dental practices, especially those that are fee-for-service, to have ways to finance patients in-house," Haynor says, adding that third-party financing companies and in-house options are available in the FeatherPay platform. "Over the last 12 months, we have seen a significant increase in the adoption of our in-house payment plans. While traditional payment financing approvals are down, the demand for patient care remains constant. Practices are taking measures into their own hands to maintain and grow revenues."

When working with a financing service such as FeatherPay where patients have access to mobile payments, the decision process can change dynamically. A simple text message and link allow patients to use their phone to make payments, and because this can be done from anywhere, the patient can continue to consider the options while still in the practice and after they go home. Having the option to consider payment and weigh options away from the presence of the treatment coordinator removes some of the friction from this moment in the patient experience, Haynor says.

"Our technology offers a flexible payment solution that patients can use at their leisure, whether in the chair or later on. This not only streamlines the process but also eases payment-related anxiety, ultimately boosting patient satisfaction,” Haynor says.

Haynor also thinks these types of conversations should happen sooner rather than later. For example, if the patient is in for a cleaning and you know they need a root canal, having their insurance and out-of-pocket costs estimated beforehand is helpful. Then, you can present your payment optionality and flexibility early in the patient journey.

How you present this news affects how patients perceive it. Haynor suggests using language surrounding that conversation that includes phrases like:

“We've already done some quick math with your insurance.”

“Some of the treatment is covered, and some is not. But don't worry. We have flexibility that can help ease the out-of-pocket component of care.”

"That's a simple way to say there's going to be some out-of-pocket," Haynor says. "Just be sure also to say, 'When it comes to out-of-pocket expense, there are several ways that we can help you.'"

Applying the Framing Effect in Your Operatory

On the medical side, researchers published in the Journal of General Internal Medicine that how clinicians present treatment effects to patients makes a difference in treatment decisions. The researchers suggest that when a clinician describes treatment effects, communicating these effects in more than one way can help patients have a balanced view of the options and make informed decisions.5

Using this cognitive bias to communicate your restorative treatment plan has a few practical applications in the operatory. The Ness Labs learning community has a few suggestions for strategies that include:

• Be aware of the current frame. When presenting your treatment plans, how are you currently framing them? Do they emphasize the favorable outcome or the negative? Once you know the current frame, you can make a deliberate change to match the circumstances and the patient's personality in your treatment center.
• Practice reframing. Reading about the Framing Effect is one thing. It's another to use it in real life. Like everything, practice makes perfect. Try reversing your current frame and see how it changes the message. For example, if the treatment plan has a 90 percent success rate, practice both presentations as the 90 percent success rate or the 10 percent failure rate. Once you get the feel for the change, it's easier to recognize and manage deliberately.
• Consider the potential frames for all treatment options. When you practice framing, don't forget to practice it with the other treatment options, too. Some of these options might have substantial gains, while others prevent more losses or buy the patient time to determine what to do long-term. Each of these benefits has the potential for influence using Framing Effects, so be sure to consider how you are presenting each of them to communicate that.6

In addition, you can frame your presentation to speak to the patient’s personality type.

Simplifeye, a communication management platform recently acquired by Vyne Dental, suggests framing to communicate to each type in terms they value.7

For example, a "Type-A" patient appreciates efficiency and direct communication. So, presenting your treatment plan without flowery language and modifiers is a more practical tack. With a "Friendly, Outgoing" patient, you might want to take the opposite approach, using the presentation to show the patient they have your attention and empathy. "Quiet or Shy" patients need reassurance and a gentle tone to help them move forward. "Detail-Oriented" patients value expertise and competency and want as much information as you can give them. In these cases, answer their questions and provide the information they need to feel comfortable with treatment.7

In addition, focusing on the benefits of fixing teeth rather than the need to restore teeth. If you frame your message to present how moving forward with your treatment plan will improve how they feel when they smile or see themselves in a video meeting or how treatment might mean they can eat their favorite foods again, you might have more success getting into that 34% of patients who say yes.7

At 34%, treatment acceptance rates across the industry have an opportunity for improvement. How you present information, AKA Framing, affects what patients do with that information. Reframing the treatment plan from your usual delivery might make a difference. Moreover, ensuring you have flexible financing options like in-house financing and frictionless payments also reframe the financial conversation, which can help move patients forward with care. Haynor thinks that this will not only be good for patients but also for dentists.

“Practices are just trying to deliver care to patients that need it. It’s deeply concerning to think that financial limitations could prevent patients from receiving essential treatments,” Haynor says. “There are viable solutions to make care more accessible for patients, while also minimizing financial risk for practices.”

References

1. 3 Important Tips to Increase the Case Acceptance Rate (2021). Available at: https://www.jarvisanalytics.com/blog/how-to-improve-the-case-acceptance-rate-of-your-dental-group/ (Accessed: 1 September 2023).
2. APA Dictionary of Psychology. Available at: https://dictionary.apa.org/framing (Accessed: 1 September 2023).
3. Framing Effect: What It Is and Examples (2023). Available at: https://www.investopedia.com/framing-effect-7371439 (Accessed: 1 September 2023).
4. What Is Loss Aversion? (2018). Available at: https://www.psychologytoday.com/us/blog/science-choice/201803/what-is-loss-aversion (Accessed: 1 September 2023).
5. Moxey, A., O'Connell, D., McGettigan, P. et al. Describing treatment effects to patients. J GEN INTERN MED 18, 948–959 (2003). https://doi.org/10.1046/j.1525-1497.2003.20928.x
6. Cunff, A. (2021) Framing effect: how the way information is framed impacts our decisions, Ness Labs. Available at: https://nesslabs.com/framing-effect (Accessed: 1 September 2023).
7. 7 Effective Ways to Increase Dental Case Acceptance - Simplifeye (2023). Available at: https://simplifeye.co/increase-dental-case-acceptance (Accessed: 1 September 2023).