Turning the world upside down – a new way of approaching the new patient examination

shutterstock_244572790Andrew Hepburn, Primespeak business manager for Software of Excellence, explains how Primespeak is changing the way dentists practise.

Every now and again a new way of thinking causes a paradigm shift that realigns the way people think. Often pioneers of these techniques are thought of as being wacky or misguided, but if the theory they espouse is tenable, it soon takes hold and can eventually come to define normality.

One such movement is Primespeak, which is a new concept in patient communication, one founded in psychology and the nuances of patient behaviour, which incorporates a whole new way of thinking about how to communicate with patients in an ethical way, but one that encourages treatment uptake.


In a profession where ‘selling’ is often considered a dirty word, dentists face a dilemma in aligning their ethical status with the need to sell treatments and make profit. Primespeak is a philosophy that teaches dentists how to reconcile these two conflicting aspects.

Traditional sales techniques more often than not fail in dentistry because in sales it’s often a question of numbers, ie can you convert enough leads to sales? But this simply isn’t the case in the healthcare professions, and dentists have a duty of care to do their best for every patient, not simply those who choose or can afford the optimum treatment plan.

The essence of Primespeak is to encourage patients to take responsibility for their dental problems, deepening their concerns rather than simply being the supplier of solutions.

Although professional recommendation is clearly the remit of the dentist, treatment is always the patient’s choice and the role of the dentist is to communicate the options and, importantly, the consequences of not having treatment.


Primespeak’s objectives are threefold:

  1. Make the patient aware of their oral health and the damaging results of existing conditions. This generates concern in the mind of the patient and forces them to take ownership of their dental problems
  2. The patient has to fully understand the treatment options and acknowledge that the choice of treatment is their decision – this ensures that patients feel they are in control of the situation
  3. The patient must feel supported and respected regardless of the treatment they choose, which creates a sense of loyalty to the dentist and the practice.

As professionals, dentists should concentrate on the above areas and in so doing they will fulfil their ethical duty.

New patient examination

Traditional new patient examination
Traditional new patient examination

Primespeak’s focus is primarily on the new patient examination as it regards this as a key influencer in creating a loyal and returning patient. Body language, eye contact (or the lack of it), interaction and objections are all factors that need to be addressed if the new patient examination is to be a successful ‘first date.’ Failure to meet the expectations of a new patient at this first face-to-face meeting means you run the risk of the patient sharing their bad experience, and these days sharing is likely to take place, not within a small group of close-knit friends and family, but with a wide network of friends and acquaintances via social media.

Primespeak new patient exam
Primespeak new patient exam

Primespeak turns the traditional new patient examination protocol on its head, by focusing more time on the pre-clinical discussion than on the final consultation element. The philosophy is that if the pre-clinical discussion is conducted in the right way you can pre-empt issues and barriers before they occur and in this way by the time the consultation takes place the patient is already well on their way to making their choice.

In the words of Rita McCollum from Smile Dental Care and an attendee on Primespeak’s November course held in London: ‘This course turns the traditional dental examination on its head! The result of which eliminates the risk of undertreatment and it empowers both the patient and the team.’

‘Devastated that I could not have done this course 32 years ago. Elated that I have done Primespeak now; if you only do one course over the next year make it Primespeak!’ – Peter Silver, Dentist, Jersey Dental Care.

The pre-clinical discussion provides an opportunity to ‘scatter seeds’, which the patient can pick up and start to consider subliminally whilst the examination itself is taking place. The conventional new patient examination is an information driven approach during which the onus is on the clinician to find out what the patient needs. This is a process of education, recommendation and overcoming barriers. In contrast a Primespeak new patient examination is concerned with building trust and confidence, exposing existing conditions and deepening awareness and concern.

The pre-clinical discussion is used to build trust and rapport, dentists are encouraged to be curious and ask questions in such a way that shifts control of the discussion from the dentist, where it lies in traditional pre-clinical discussions, to the patient.

Adopting Primespeak methodology requires a change of mindset by the dentist and the acceptance of some actions, which on the face of it could be considered counter intuitive. Using a combination of metaphors and patient-friendly language, dentists who have attended the Primespeak course are now using the techniques to diffuse patient objections and encourage treatment uptake in their practices.

Software of Excellence, in partnership with Prime Practice, is running regular events in 2016. For more information visit www.softwareofexcellence.com.

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