Decoding patient decision making

decoding patient decision making

Derek Uittenbroek considers some of the influences on patient decision making and reveals how teams can navigate biases and financing to ensure informed decisions for optimal care.

In dentistry, patient decisions impact outcomes – in clinical results and profitability. But what influences this process, and how can dental professionals help patients confidently make informed choices? What empowers patients to confidently cross the line and embark on a treatment journey?

Quality dental care relies on successful communication. The expectation of teams to share clear and accurate information that patients can understand before, during and after treatment is embedded in the General Dental Council’s Standards for the Dental Team.

What factors affect decision making?

Helping patients appreciate the evidence that supports a particular procedure will help guide them. Patients may need help comprehending the necessity or urgency of specific treatments, especially if they are not experiencing pain or symptoms. Without clear understanding, they might postpone or ignore necessary procedures. Providing education about the importance of timely treatment and the potential consequences of delaying care can be impactful.

Costs are, of course, a consideration and not so easy to overcome. Patients may hesitate due to financial constraints. Even with insurance, payments or uncovered procedures can be a barrier. Some treatments might require multiple appointments or longer sessions, which can be challenging for individuals with busy schedules or those who find it hard to take time off work or have other commitments.

And then there are those who will delay treatments due to a tendency to procrastinate or because they hope issues will resolve themselves. Addressing these hurdles will involve open communication between the practice team and the patient, including explaining all treatment options thoroughly and discussing financial alternatives or payment plans.

Deviation from reality

However, cognitive biases are also at play here. These unconscious decision-making processes are systematic patterns of deviation from rationality in judgement. They stem from the brain’s attempt to simplify information processing and can manifest in various forms. These biases influence how information is perceived, how events are interpreted and how patients make choices. Understanding them can help teams become more aware of decision-making processes and potentially mitigate their impact on patient judgements.

How might these biases manifest within the dental environment?

  • Anchoring bias – imagine a patient receiving an initial high-cost dental treatment estimate. They might latch onto this figure, perceiving the procedure as unreasonably expensive, potentially deterring them from pursuing it further despite more affordable alternatives
  • Confirmation bias – when contemplating cosmetic dental work, a patient might actively seek information that confirms their belief that such procedures are excessively costly. They might prioritise stories or reviews that align with this belief while dismissing accounts that suggest otherwise
  • Status quo bias – some patients might resist dental procedures due to their fear of change, especially if they perceive the cost as a burden. They might prefer sticking to their current dental status rather than considering a potentially beneficial but unfamiliar procedure
  • Loss aversion – patients might overly focus on the potential financial losses associated with dental procedures. Concerns about not achieving desired outcomes or encountering unexpected expenses might dissuade them from pursuing treatments despite potential benefits
  • Hindsight bias – after opting out of dental treatment due to cost concerns, patients might retrospectively believe they foresaw the high expenses or adverse outcomes, reinforcing their decision to avoid the procedure
  • Availability heuristic – patients might recall stories or anecdotes of acquaintances who faced financial difficulties post-dental procedures, influencing their perception of the procedure’s risks and costs
  • Social proof – people tend to look to others for guidance and validation. Suppose someone perceives that people in their real world or social media circles have stories of financial struggles or dissatisfaction with their procedures. In that case, it can create a perception that these issues are common.

Behaviour change

These biases can impact how patients perceive the costs and benefits of dental procedures. By understanding these influences, dental teams can look to implement behaviour change.

Educating the team about cognitive biases and their potential impact is an excellent place to start. Awareness is the first step towards recognising and addressing biases effectively.

Review treatment plans regularly to identify instances where biases might have influenced decisions and embrace shared decision-making to ensure patient preferences are considered, thereby reducing these biases throughout any treatment journey.

Financial obstacles

In addition to these non-tangible factors, genuine financial obstacles can play a significant role in patient decision making. The availability of funds holds a substantial sway in shaping patient conversions, and dental practices should consider implementing policies or strategies to provide support. This could involve offering financing options, creating packages or discounts, or working with finance providers to cover specific procedures.

Traditional financing solutions are limited in their scope, leaving both patients and dental practice owners unsatisfied. Practices may look to offer a buy now, pay later (BNPL) model reminiscent of retail financing. However, from a business perspective, BNPL schemes in healthcare may raise ethical concerns.

Alternatively, practices may wish to consider offering their own finance scheme. But it is worth noting that without Financial Conduct Authority (FCA) registration, the maximum loan amount for in-house financing is restricted. They cannot offer longer-term financing options beyond the 12-month threshold. This potentially limits patient access to lengthier or more complex treatments.

Third-party financial partners

Partnering with third-party financing companies to provide financing payment plans offers another solution. But, while financing with 0% interest can make high-end treatments more accessible, most lenders require practices to pay an interest rate subsidy. This can be a substantial financial burden. Hidden costs can considerably impact profits, challenging a robust bottom line.

Practice owners should, therefore, understand the financial complexities of traditional financing solutions and single-lender finance companies. Taking the time to look at all options will reap benefits in the long term.

With the right financing partner, such as one that offers a panel of lenders instead of just one, dental practices can provide patients with affordable and convenient payment plans that facilitate more extensive treatment plans. Partnering with an ethical financing platform can eliminate the need for practices to become FCA-authorised.

Look for companies that add value, too. For example, marketing support through customisable materials, practice-branded web pages, website widgets for finance eligibility checks and signage for waiting rooms and reception areas.


Cognitive biases significantly influence patient choices, steering decision-making towards overestimated financial risks and a fixation on potential losses. But, with a critical focus on recognising and addressing cognitive biases to ensure optimal patient care, teams can surmount these obstacles to treatment.

In an ever-evolving landscape of dentistry, there is always room to grow. Adapting to meet patients’ shifting needs remains paramount. In the current economic climate, offering patients flexibility in terms of financially accessing high-value treatment is also essential.

Open communication alongside accessible financing solutions is pivotal in dismantling barriers and opening the door to a diverse clientele while maintaining a steady cash flow.

Follow on Instagram to keep up with all the latest dental news and trends.

Get the most out of your membership by subscribing to Dentistry CPD
  • Access 600+ hours of verified CPD courses
  • Includes all GDC recommended topics
  • Powerful CPD tracking tools included
Register for webinar
Add to calendar