The Paradox of choice in dentistry

Would you like a shop where you can choose just between Coke and Pepsi?

Would you prefer more choices or fewer ?!? the intuitive answer is always one : MORE !  and , for the same reason ,  business owner run behind this idea offering several variations  of a product trying to meet the expectations of different kind of customers..yet is there a threshold to the amount of choices  or not? 

A very famous experiment at Columbia university evaluated the effect of choice on a simple product : fruit jams . 

They organized two different kind of selling : in one just 6 flavors , in the other 24 …4 times more . 

Intuitively you expect that the larger assortment would attract more people and sell more product.

Yet data are counterintuitive . 

The larger assortment attracted 50% more people but , the amount of buyers was scarce .Just 3% bought something .

The smaller assortment instead sold to 30% of potential customers . …10 times more !

Too many choices can create more indecision , friction ; the customer got  lost pondering options, maybe he get away  trying to decide  thinking to come back later ..but often he doesn’t.

There is a threshold in the number of choices and in every field this changes. 

For Jams is clear that 24 is worst than 6 but in dentistry ?!?

I see many colleagues following the golden rule to “inform “ the patient  on his/her  situation trying to explain advantages and disadvantages  of every treatment plan …

We know that the amount of possible treatment plan in dentistry , especially in complex cases is wide…removable or fixed ? bone regeneration or short implants ? Connective tissue graft or just some  composite on some recessions ? on and on …we can spend so much time describing pro and cons of each treatment …and , last but not least , do we wanna talk about the economical side of the treatment ?!? we can move from  a cheap removable treatment to a complex and expensive rehabilitation . 

In dentistry , moreover , i realized that the dentist and the patient play a sort of Killer game . The dentist starts to explain the different plans highlighting pro and cons , the patient has some problems understanding exactly the meaning of these pro and cons so he start placing some questions . But more questions lead to  a bigger amount of other informations , other pro and cons.

Complexity raise , comprehension doesn’t.

In the Barry Schwartz book “ the paradox of choice “  this approach has been tested in the field of salesman . The result is that the information oriented approach increases the likelihood of refusal up to 50% .

Much more effective is instead the prescriptive approach where the patient/customer is guided toward a specific solution that has worked in a  very similar situation 

Using this approach the results are stunning , this increases the likeliness of purchasing ease by 82%  and also drops the probability of buyer remorse by 37%.

It’s a win win scenario of managed in an ethic way .

The patient is driven in a comfortable way to a solution without the hassle to feel the weight of decisions in fields where he has zero expertise.

The dentist raise his acceptance ability  but at a cost . 

The weight of responsibility is shifted on us . 

I started using this approach long ago , after reading books and testing different approaches  with patients. 

In my office I can guarantee that this approach works much better but we have to change completely our approach.

We have to learn how to interview the patient , we have to learn how to listen at the patient , we have to learn how to understand the person behind  failing teeth  or missing ones…and  we have to accept the weight of being responsible for the choice .

Giving choices to people is easier …we don’t choose , they do . 

Giving one solution , they don’t choose , we do …and we can do mistakes also , and we have no one to blame apart ourselves . 

In the past I was not sure how to move between these two approaches , sometimes I was trying to combine them .

With time , yet , I realized that using the first approach most of the patients were deciding just on an emotional basis …some were accepting , by default , the most expensive treatment  ( believing this was the best ) . Some , confused , afraid to make a mistake , were deciding the cheapest one or they were just saying the most hated words : Thank you doctor , i will decide in the next day and will let you know.

I realized that in this unbalanced relation we doctors have with patients using the first approach the number of mistakes was much higher .

The second approach  was , eventually , more precise .

So I started removing PLAN a , PLAN b , PLAN c , I started trying getting really interested at the  person in front of me and I started being easier and essential in my communication regarding dental details and spending more time on relational /behavioural /time  needs and expectations.

And , again , I learned that everything in life is not absolute . Every thing we meet in our life has a correct measure …not too little , not too much . 

Not enough choices is a problem like too many choices . 

Not enough freedom is a problems like too much freedom , leading to what se wee nowadays in modern countries where the excess of freedom , paradoxically , has brought a sense of losing social and familiar connections  and has  created more loneliness and depression than ever.

Not doing mistakes is  a problem like doing too many .

Everything has a balance .

Life can only  be understood backwards , but it must be lived forwards.

P.s. if you’re still struggling deciding which prosthetic technique choose , I will solve your problem 🙂 Just have a look at my brand new “in person “ course in Syracuse about vertical prep!

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