The man who can smash your associates’ glass ceiling

by Business growth, Industry trends, Leadership, Movers and shakers, Workshop

Michael Sernik is a one man global revolution in dentist-patient communication. His technique goes to the heart of what usually frustrates serious practice growth: the limited ability of associates to break through an average daily yield (ADY) of around £3k. The Sernik System For Big Case Dentistry is anathema to all the dental sales courses you’ve ever been on, and it looks like the way to ensure your associates are driving your business growth, rather than your business carrying your associates. We’ve invited Michael to run his workshop in the UK and Ireland in May and wanted to give him the opportunity of explaining it here first. 

First, Michael, why is the era of the cruisy associate lifestyle over? 

All you have to do is look at the number of dentists graduating and the population. There are more associates, more practices and more groups. If you have more dentists per capita prices go down. The corollary is that now as a principal I’d be looking for an associate who can grow my practice but I’d be nervous of them putting pressure on my patients. If an associate is too pushy even a 80% conversion rate means 20% of patients have a negative experience and may post negative reviews. That can cause a lot of damage to a business. 

You want ambitious dentists but they need to be skilled. They must know how not to make a patient feel like they’re being sold to. If you’ve got a lazy associate who you ask to gross more without the appropriate training, he or she may be able to put on the screws, but now they’ll do damage. It all boils down to having communication skills. This issue is getting worse not better because of the numbers. It’s competitive out there and you need a system of corporate consistency that’s obvious and simple to stick to. But this isn’t obvious if you haven’t been trained — it’s not just out of another sales book. I’m pleased to be launching the Sernik System For Big Case Dentistry course in Europe in partnership with Fine Company, who I believe uniquely understand the challenges ahead for owners and their associates in the 2020s.

Walk us through your principles of anti-sales psychology 

To generalise, there are two types of patient. One is responding to an offer, which may be focusing on a particular element like the fee or the quality of service. This patient is in a sense already sold because they’re telling you what they want. You could always rely on this as your sole method of growing — it means you’re spending a lot on marketing but, then, if the ROI is there, who cares, right? The second type of patient is a regular coming in for their check up. They come in hoping there’s nothing wrong. They feel compelled to attend. They don’t have a particular problem.  

Most dental disease is chronic, and most treatments that dentists do are not for acute pain or obvious problems. It’s gum disease, pockets getting worse or bleeding, which could be masking other problems. The teeth could be loosening or there may be hard tissue problems around the roots that could become terminal. It’s the same with old, failing fillings: by the time there is pain it’s probably cracked and infection has entered the nerve. 

So if most treatment is for chronic painless conditions, there’s a ton of work there. If a dentist is struggling to get permission to treat these chronic conditions, that’s a communications challenge. How do you get a patient to want treatment for a problem that’s not hurting them? You can point out that they have a pocket or require a crown, but if they feel they haven’t got a need they will assume you are upselling.

If the patient isn’t concerned about their dental health needs at this point (which is quite normal) and treatment looks expensive, they won’t want it. If they agree to treatment they may see no obvious benefit, experience buyer’s remorse, and leave a negative review on your website or on social media. Most practices rely on positive reviews for new patient traffic because most patients going to a new dentist will look them up. Even one negative review can be a deal killer. So right at the beginning we must be careful about making sure that whatever communications we’re using, the patient never misinterprets what is normal good quality diagnostics. 

So how should you talk to a patient?

Patients hate being sold to. But if you want training on how to get a patient to say yes you won’t have to look far. The problem is that when a healthcare professional has a pecuniary interest in selling treatments it creates a toxic environment. We need a technique that prevents us from looking like we’re selling, and that’s what my course is about. My approach uses negative psychology so that at the end of a conversation it’s the patient pushing for treatment, not the clinician. If you’ve eliminated any potential of being rejected by your patient and receiving a negative review from them, you’ve come a long way. It means your technique is effective and powerful — that’s what my course is about.

Are you in effect removing the ‘dental health advocate’ role? 

I’m always a little bit reticent to talk about ethics, but this is the truth: if you are completely ethical and aren’t trying to sell your patient anything, and you are basically allowing the logic of what needs to happen to rule, you make yourself neutral. Counterintuitively, the more you appear to care the more this can cause a negative reaction from the patient. The person who cares the most should be the patient.  

Of course the clinician should care, but if we care more than the patient then often they are repelled and feel like we’re pretending. One has to take a neutral emotional position through the whole process. Allow your patient to know that essentially this is their problem, and it will be their solution. It’s their choice, it’s really up to them. That encourages the patient to own the problem. We want that, we want to let them feel they understand it, with no interference from us. It gives them a strong sense of responsibility and control if they feel like it’s dumped on their lap. The more you show them the problem and explain it the more it can hurt you.

What kind of attitude does a typical high grossing associate display? 

If you have a strong drive to get patients to buy, that will come through in the way you talk. Instead, be like an independent assessor with no interest in what the patient chooses. The metric we should be using for success is not “does the patient buy?” but “do they understand the consequences of their condition completely?” That shifts everything away from you.

Support them in understanding the damaging result of their condition. Once they understand they either will or will not want treatment. That’s their choice, so your goal is actually quite modest: to make sure they understand your diagnosis. Rather than simply asking them if they understand, ask them to tell you what you were talking about, and listen to them describe their condition and its implications. That’s your objective, and it ends at that point. I do have further techniques of going through treatment choices, which encourages patients to want the best treatment, but it all starts with the patient perceiving their need. 

Is this a unique approach? 

Yes. The truth is, of all the other stuff you see, it’s either a generic customer satisfaction or customer courtesy approach: smile, be nice, establish eye contact, repeat what the patient says, all motherhood stuff, which is fine, and you can pull it out of a million sales books, and it’s not irrelevant, but it’s common and not unique to dentistry. They are generic customer service skills that you hear whenever you have contact with customer service people. 

That’s not wrong but often it won’t change your results in dentistry. Dentistry is somewhat unique because when someone goes into a store they are usually an interested consumer, looking at prices and options. Dental patients aren’t consumers in that sense, they’re hoping nothing happens, and they’re suspicious. It’s a uniquely sensitive sales situation because they’re there at gunpoint — that’s what makes dentistry different.

Why is there a need for this approach in the UK, and why now? 

I know more and more dentists are looking for ways to increase their work rate, and frankly by having these skills you can be very effective very quickly. Speed is always important in efficiency and these techniques don’t take longer. You can hit all the right buttons even in a practice where there is time pressure. The real challenge for owners is the big ADY differential between the newest associates and the experienced ones. Communication is the root cause of different incomes, whereas clinical skills are actually quite easy to top up. This is a communications challenge and while doing more clinical courses is the norm for junior associates and it is useful, it typically isn’t addressing that discrepancy of income. 

Is this course for the whole team?

The most common regret from owners is “I should have brought everybody”. I’ve heard that a million times. They have difficulty explaining it to their associates. A lot of dentists don’t like to be coached by other dentists in their practice. When a third party consultant is involved it feels like everyone can listen, but when one person in a company is pushing people around it doesn’t work well, and it’s hard to pass these valuable messages on.

Will you be mentioning your Channel D product on this course?

Yes, the rationale being that every big case a dentist ever did started with a conversation. Assuming it’s more advantageous if the patient is the one starting the conversation about big treatments, and assuming that many patients don’t know much about big treatments, and don’t know why bad teeth aren’t just a cosmetic issue, Channel D is a cost effective tool that can be part of this process. 

The product is a series of short, silent animations to have playing in your waiting room and surgeries. They’re designed to provoke questions. If you’ve got 20 people in your waiting room looking at these videos each day and 10% of them respond with a comment or question, that’s 500 conversations a year. And these conversations could trigger referrals because your patient might talk to their friends and family about what they learned. This is the original viral marketing and it can turn into a ton of work. Work comes from conversations. If you’re relying on the patient to make a self diagnosis, this starts the process, and that’s what Channel D is designed to do. 

How did you develop this philosophy?

It came out of years of clinical dentistry, a process of trial and error. I owned a practice in the UK in the 1970s and then grew practices in Australia in the days when advertising was illegal. Over many years the system started to develop. I wanted the patient to want treatment more than I wanted them to have it because that’s what worked. When I became partner in a practice management company I looked at ways of being able to communicate and didn’t like any of the courses I was seeing; they were all essentially sales courses. I knew my system worked, but to run a course I needed to create the theory as to why it worked. So I started to codify my system, working backwards from practice to theory. 

I noticed that many dentists who run courses are taking sales techniques that are generalised, they could be selling cars or TVs. The problem was the ubiquity of this — sales training is the most common form of corporate training. Any company worth its salt is doing it. Good companies know customer service is everything. Yet when anyone is exposed to these kinds of closing techniques in dentistry they immediately know it and they hate it. I became sensitive to wanting to create something that worked and was far away from looking like sales. It was an iterative process. 

The Sernik System For Big Case Dentistry comes to Europe for the first time in September 2020.

 11th September, London, Browns Covent Garden

14th September, Bristol, Marriott Hotel, City centre

16th September, Dublin , Clayton Hotel, Leopardstown

Book tickets at:

CPD learning agenda (8.30am-5pm)
1. To master a communications system that causes the patient to recognise their clinical condition.
2. To have the patient understand the impact of their condition.
3. To have the patient take psychological ownership of their condition.
4. Offering choices in a strategic sequence that will tend to skew the patient’s decision to want the ideal long-term treatment.
5. The patient will never feel sales pressure.


“It’s a uniquely sensitive sales situation because they’re there at gunpoint — that’s what makes dentistry different.”

Michael Sernik, The Sernik System For Big Case Dentistry

Author: Zac Fine