Who Wants the Whole Pie? 

May 27, 2024 David Rice DDS

By David R. Rice, DDS 

I’m guessing your practice is a whole lot like mine. People can be challenging. Patients are people. Ergo, yes, patients often bring us challenges. With that and 29 years into dentistry, there are a few challenges I’m willing to admit and, like you, work to overcome.  

Our great patients get great dentistry.
Our challenging patients get our best effort.
Our job is to understand who each is, what each wants,
and how we do our best to deliver it. 

As you and I learn the best techniques and technology, we have to understand that many of our patients see the world differently. They see it differently than each other, and they see it differently than we do. At first glance, yes, this is an obstacle. But for those of us willing to spend time focusing on their views, this is a massive opportunity.  

About 20 years ago, the treatment planning and presentation mantra our team developed was: Pizza by the slice or the whole pie? 

 A talented and curious team with character, plus a well-defined process,
always equals complete care and profitable production. 

 Here are the four keys: 

  1. Understanding who of our patients wants complete care—the whole pie right now. 
  1. Knowing who of our patients isn’t ready for the whole pie today and needs us to serve that complete care one prioritized slice at a time. 
  1. Recognizing that some patients love pepperoni, some love veggies, some are all NY and thin crust, some love that Chicago deep dish, and so on. 
  1. Delivering each individual patient’s pizza the way they want it without yielding on our quality. 

All our patients come with a story. Some are ready for a whole pie. They want complete care and they want it now. Other patients are overwhelmed by the whole pie. Right or wrong, some past experience makes their yes to the complete care we know they need challenging. We can push them, or we can appreciate where they are and work with them one slice at a time. 

I’m not proposing we compromise our care. I’m offering us all an opportunity to elevate it. Whether you’re scanning and milling, 3D printing, injection molding, direct bonding, or prepping and temping long-term, the materials and technology we have at our fingertips today afford us an incredible ability to segment care. 

Complete-care case acceptance at 90%+ is a reality when we add great communication skills to the clinical skills we’ve worked so diligently to achieve. Today, I challenge you to assess, calibrate, and elevate your ability to deliver pizza by the slice…or the whole pie. 


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David Rice DDS




A Sturdy Foundation for Relationships

May 7, 2021 Mary Osborne RDH

What would you like to build your relationships upon in your practice? With all the attention that is paid to dental insurance, it sometimes seems as though that becomes the foundation of our relationships with patients. When this is the basis of our relationship, the moment the plan changes, the patient may be looking for another dental office. Do we want to have our relationship based on such a fragile platform?

When I think about what we could have at the foundation and how we could make this happen, several things come to mind.

Compassion as the Basis

Basing a relationship on compassion can begin with the very first phone call. When a new patient calls, compassion can be expressed by something as simple as, “What prompted you to call us today? I hope you are not experiencing any discomfort.” Right out the gate, you are putting out there that you care about their comfort.

For a new or an existing patient, you might to say something like, “I’d like to make sure we schedule enough time to do this very thoroughly…very gently, and that we provide you with the best possible service so you are as comfortable as you can be.”

When you talk with patients about conditions you are seeing in their mouths, you can express concern as simply as saying, “I see a crack in this tooth, and I am concerned that, as it gets larger, you may experience some pain. Have you experienced any pain there?”

Mutual Trust as the Basis

On the very first call, you can begin to base your relationship on mutual trust and respect. You might do this by saying something like, “I’d like to schedule enough time for you to get to know us and for us to get to know you. When we learn what is important to you, we can help you make choices that are in your best interest. We’ll want to know what your previous experiences have been in dentistry because we want to provide you with the best possible experience in this practice.”

During Hygiene appointments, you might say something like this, “As I look in your mouth, it appears to me that over the years, you’ve gone to the dentist regularly and done everything you could to take care of yourself. You’ve chosen to have treatment when it was recommended. I believe that if you have the right information and you have some support in working through the process, we can help you make good choices for yourself in the future.”

If the patient is not in pain, you might say something like, “You’re in a really good position right now. We’ve got time to study the information we’ve gathered and to learn about your preferences. The doctor will want to go over all the information we’ve gathered today and spend time thinking about your oral health circumstances and options. If you decide later to have treatment, you will be fully informed about your options so you can make the decision that is right for you.”

Shared Values as the Basis

When we discover shared values in conversation, there is a powerful connection between us and the patient. If a patient mentions a filling has lasted for decades, you might say something like, “It seems to me that you like to have your dentistry last as long as possible?” And if the patient says yes, you might say, “Excellent, we’ll take that into consideration when we think about options for you.” Give them opportunities for discovering together with you what is most important to them.

The foundation you intentionally build on compassion, mutual trust, and shared values will enable you to expand conversations you have with patients about insurance and the cost of care. You will be able to assure them you will do whatever you can to make the dentistry they value affordable for them.

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Mary Osborne RDH

Mary is known internationally as a writer and speaker on patient care and communication. Her writing has been acclaimed in respected print and online publications. She is widely known at dental meetings in the U.S., Canada, and Europe as a knowledgeable and dynamic speaker. Her passion for dentistry inspires individuals and groups to bring the best of themselves to their work, and to fully embrace the difference they make in the lives of those they serve.