One-on-One An Interview with Dr. Paul Homoly Simply Beautiful A ...

But I understand Kevin has two boys in college and is remodeling his house. Now, when I present care to Kevin, I
want to present the fit issue along with the treatment plan. I’m going to say something like this: “Kevin, first of all,
I understand that you have two boys in college right now, that you’re really proud of that, you’re spending a lot of
time visiting them. I also know that you’re remodeling your home and I just remodeled a part of mine, and I know
all about that process. I want you to know that we can help you with your care. What I’m not sure is how that fits
into your life right now. Do we do your care right now or later? Or a little bit at a time?” You see, what I’m doing
here is I’m not allowing that patient’s fit issues to get in the way emotionally with me. What I’m doing is almost
subordinating my treatment plan to what this patient has going on in their life. What that does for me is increase my
Crossover Zone because I’m telling this patient when you’re ready, we’ll be here—it’s very authentic and it’s based
on my understanding of that patient’s fit issue.
MD: Interesting. I can also picture a scenario where a young dentist right out of school might have a pretty low Crossover
Zone, like $1,500, whereas a 60-year-old patient who owns his own business might actually have a higher Crossover Zone,
where anything under $4,000 they just kind of sneeze at.
PH: Well, I think you’re correct there, Mike. I think patients have Crossover Zones. We all kind of have an idea or
intrinsic value of what we’re willing to pay for something. We’re getting estimates right now on painting the inside
of the house. And you know, I looked at the house—there are four bedrooms, a big rec room, a porch, kitchen and
a dining room—and I’m thinking, “What is it going to take to paint this place?” It seems like it should be about
$5,000 or $6,000 to paint the whole place. So I walk in with an expectation rattling around in my head. I have a
Crossover Zone related to cars. I don’t want to spend more than $60,000 on a car, I just don’t put the value there.
I’d rather put it in the boat…you know what I’m saying?
MD: That’s different in the sense that you know what the car is going to cost before you get to the lot. I mean you don’t know
it to the exact penny, but when you have somebody over to get an estimate on painting and you’re thinking it’s going to be
$4,000 or $5,000 and they throw out a number like $12,000, there’s an opportunity for you to be stunned, right?
PH: Right. Sure. You know, the Crossover Zone is largely caused, but not completely caused, by the dentist who
typically doesn’t know how to respond when the patient says, “No, I can’t afford it,” or “Gosh, I had no idea it would
be that expensive.” I mean, would there be a Crossover Zone, Mike, if we knew the patient would say yes?
MD: No, not at all! If we knew the patient would say yes, we’d probably have to double the number of dentists because
everybody would be doing the ideal treatment and only be able to see about a third of patients currently in their practice.
PH: Sure. So, if there’s no Crossover Zone, if we knew the patient would say yes, then it’s not about the money. It’s
about the patient’s negative reaction to the money… you see that? If we know the patient is going to say yes, that
is if you quote $10,000 dollars and they say “Yippee! When can we start?” there is no Crossover Zone. But what if
you had fear of the patient screaming when you say $10,000, demanding to know, “What makes it so expensive?”
The dentist doesn’t have the answer to that question, which is what creates a lot of anxiety and results in a low
Crossover Zone. So, it’s more so about the dentist’s feeling than it is about the patient’s feeling.
MD: Absolutely, and it’s about the dentist’s confrontational tolerance and not wanting to be rejected. It really almost goes
back to the dentist’s reason for becoming a dentist—so that he or she didn’t have to go into sales.
PH: (laughter) Right, right! So the whole issue of advocacy—that is, understanding the patient’s life circumstances
and then asking the patient whether the treatment plan fits the life circumstances now or later or a little bit over
time—really helps ease the anxiety of the Crossover Zone. A way to decrease the Crossover Zone is just continue
to pursue excellence. It’s the whole blind pursuit of saying, “Listen, I’m going to give you the best treatment plan.
Whether you’re my brother or my mother or my wife, this is what I would do. And this is the very best, and we use
the best this, and we have the best lab…” It’s that head-in-the-sand way that will continuously drive the Crossover
Zone down, because treatment planning and offering care in the absence of knowing the patient’s fit is always an
invitation for stress on you and your patients.
Interview with Dr. Paul Homoly29