james, Author at The McAnally Selling System

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So far james has created 3065 blog entries.

Keep the Dental Financial Conversation Off the Doctor

james2026-06-16T00:00:00-04:00

Why should the financial conversation happen away from the doctor? Because the doctor in the room changes the conversation, and not for the better. When you stack the clinical authority and the money talk into one visit, the patient feels squeezed from two directions, and that pressure pushes them toward no. Hand the financial visit to the front office. The financial coordinator, the treatment planner, whoever owns it. That person can talk fees, options, and timing without the patient feeling like the doctor is standing over them waiting for a yes. It also frees your chair time, your most expensive asset. [...]

Keep the Dental Financial Conversation Off the Doctorjames2026-06-16T00:00:00-04:00

The Cost of Skipping Case Presentation Steps With Patients

james2026-06-16T00:00:00-04:00

Why is it a mistake to jump straight to case presentation with existing patients? Because you are guessing at what they know, and you are usually wrong. With patients who have been around a while, the temptation is to skip the early steps and go straight to presenting the case. That is how good dentists bomb out. The patient has forgotten the specifics, their clinical picture may have shifted, and you walk in talking like they remember a conversation from two years ago. They do not. Skipping steps with a familiar patient makes no more sense than skipping the exam. Run [...]

The Cost of Skipping Case Presentation Steps With Patientsjames2026-06-16T00:00:00-04:00

Should You Apply the Exam Fee to Dental Treatment?

james2026-06-16T00:00:00-04:00

Should I credit the exam fee a patient already paid toward their treatment? Yes, and patients love it. They have already shown up and paid for a film and an exam. When you apply that money to the next step, they feel like they are not paying twice for the same thing. To them it reads as a discount, and that small piece of goodwill nudges them toward the next yes. This is basic reciprocity. You give a little, they feel obligated to move forward a little. It costs you almost nothing because the money is already in your account, and [...]

Should You Apply the Exam Fee to Dental Treatment?james2026-06-16T00:00:00-04:00

Dental Patient Triage by Complexity, Pain, Cost

james2026-06-16T00:00:00-04:00

What does triage by complexity, pain, and cost mean for new patients? With an emergency or regular new patient you are really doing two kinds of triage at once. Problem triage, the clinical one you already do, and sales triage, which decides what pathway that patient follows in the practice. You sort on three things: complexity, pain, and cost. Pain sets the first move, because if they hurt you fix that first. Complexity tells you whether this is a single-tooth problem or something that deserves a complete evaluation. And cost is what actually splits the road. Below a fee level you [...]

Dental Patient Triage by Complexity, Pain, Costjames2026-06-16T00:00:00-04:00

Reciprocity and Liking in Dental Case Acceptance

james2026-06-16T00:00:00-04:00

Do reciprocity and likability really matter in dental case acceptance? They matter more than most dentists will admit. Reciprocity, liking, and even appearance run underneath every consultation whether you plan for them or not. Give the patient something real first, your time, your attention, a genuinely useful explanation, and they lean toward saying yes. Be someone they actually like and trust, and the clinical recommendation lands softer. This is not manipulation. It is being aware that people decide with the relationship as much as the X-rays. The mistake is pretending it doesn't apply to you because you are a clinician. It [...]

Reciprocity and Liking in Dental Case Acceptancejames2026-06-16T00:00:00-04:00

What Is Risk-Based Treatment Planning in Dentistry

james2026-06-16T00:00:00-04:00

What is risk-based treatment planning in dentistry? It is planning around what is likely to go wrong, not just what is wrong today. Instead of cataloguing existing holes, you assess the patient across categories of risk. Functional risk, decay and caries, periodontal risk in both hard and soft tissue, and esthetic risk. From a single snapshot of a mouth, and the experience of having seen thousands of them, you can forecast what is probably coming for this person over the long term. That changes the whole conversation. You are no longer fixing one tooth, you are protecting a future. It is [...]

What Is Risk-Based Treatment Planning in Dentistryjames2026-06-16T00:00:00-04:00

When Patient Demands Should Raise Your Fee

james2026-06-16T00:00:00-04:00

Can patient behavior and demands raise the fee on a case? They should, and you are within your rights to let them. Not every factor that drives a fee is clinical. A patient who needs it fast, who can only be seen on one specific day, who can only sit twenty minutes before needing a break, who has a long list of personal wants and demands, all of that costs you. It costs scheduling flexibility, chair time, and stress on your team. Those non-clinical realities belong in the fee conversation, not absorbed silently while you quietly resent it. Put patient behaviors [...]

When Patient Demands Should Raise Your Feejames2026-06-16T00:00:00-04:00

How a Specialist Wins More Referral Cases

james2026-06-16T00:00:00-04:00

As a specialist, how can I get more big cases from my referring doctors? Teach your top referrers how to refer correctly. Most general dentists do not know how, and that is not their fault, nobody showed them. Pick your top five or top ten referring offices and invest real time, energy, and shoe leather teaching them to spot and hand off the right cases. One of the strongest moves is to pay the tuition for a top referring practice to learn proper selling alongside you. Think about the cases that come back as a byproduct. That single investment beats any [...]

How a Specialist Wins More Referral Casesjames2026-06-16T00:00:00-04:00

Why Patient Motivation Questions Matter at Every Visit

james2026-06-16T00:00:00-04:00

Why do I keep re-asking patients what motivates them at every visit? Because the real reason a patient wants treatment rarely comes out the first time you ask, and it is the most valuable thing you can learn. At the complete physical I ask again, what do you want to see different in yourself? This is my last clean chance to surface the pain that is actually driving them, before I commit to a plan. People hold back. They give you the safe answer first, then the true one once they trust you. If you only ask once you build your [...]

Why Patient Motivation Questions Matter at Every Visitjames2026-06-16T00:00:00-04:00

Using Old Smile Photos in Cosmetic Case Planning

james2026-06-16T00:00:00-04:00

Why do I ask cosmetic patients for an old graduation or wedding photo? Because it tells me what they are really chasing, and it puts expectations on the table early. I ask for a photo from graduation, high school or college, or from a first marriage. There is a running joke, with truth in it, that people smile more in the first marriage photo than the later ones. What I am after is whether they want to return to a smile they used to have, or reach for one they never had. That distinction shapes the whole anterior esthetics conversation. With [...]

Using Old Smile Photos in Cosmetic Case Planningjames2026-06-16T00:00:00-04:00

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