OM Ep. 183 - How to Increase Orthodontic Case Acceptance in 2026: Conversion Tips for Treatment Coordinators & Practice Owners

About this Podcast

Case acceptance is one of the biggest challenges facing orthodontic practices in 2026. In this episode of Ortho Marketing, host Dean Steinman is joined by Shelley Bostrom, founder and owner of Align My Practice to break down what’s really causing patients to walk away and how to fix it. Shelley shares practical, real-world strategies to help treatment coordinators and practice owners improve conversions, from structuring consultations more effectively to creating clear next steps and stronger follow-up systems. If your practice is generating leads but struggling to turn them into starts, this episode is packed with actionable insights to help you close more cases and stop leaving revenue on the table.

What You’ll Learn:

  • The 3 required outcomes every patient should leave a consultation with (yes today, scheduled, or follow-up commitment)
  • Why patients leave without starting treatment — and how to prevent it
  • How to guide conversations using assumptive language and stronger communication
  • The importance of asking the right questions to personalize the consultation
  • Proven follow-up strategies, including a multi-touch approach over time
  • Why authentic conversations outperform scripted sales approaches

Episode Transcript:

Shelley Bostrom

Hi everyone, Shelley here with Align My Practice. Today's podcast with Dean at Orthomarketing is all about conversion. Make sure to tune in so that you can empower your treatment coordinator to get conversion at 80%.

Dean Steinman

Well, hello everybody out there in podcast land. It's Dean Steinman from Author Marketing and guess what? We are back with another podcast for you. Welcome, welcome, welcome. Hope everybody is having a terrific day. And we have one of our my favorite favorite people in the whole world back again for another podcast to join us. I have the beautiful, incredible, lovely, talented Shelley Bostrom here from Align My Practice to talk a little bit about conversions, guys. We're And so Shelley, welcome back. How are you?

Shelley Bostrom

Dean? I'm so fantastic. It's so great to uh chat with you again. And I remember all of your deanisms.

Dean Steinman

So, I appreciate it. I'm glad I have a deanism there. So, thank you.

All right, so we're going to jump right in. All right, so we're going to talk a little bit about conversions. All right, plain and simple. That's the number one thing that practice has to think about now. All right, it's early 2026, you know, and you got I'm sure if you just look at your numbers, guys, 2025 might have been, if you're lucky, up a couple of points. Most practices were flat or even down. So what's the reason why? All right, number one reason why is conversions. You, you know, you probably are seeing some leads, but then from there, are they showing up? And are and once they're showing up, are you letting them leave? So Shelly, let's talk about the three main reasons that somebody just will leave that seat.

All right? Because you once we get that's somebody's butt in the seat I like to say don't let them leave guys unless they have no teeth okay or they have no money but besides that let's talk about the three reasons that somebody will will not start and then let's talk about how to respond to that.

Shelley Bostrom

Yeah. Gosh. So I think the main, the main reason I know you mentioned three but really the main reason if a if a patient after the consultation is over and they leave without a next step. So well back up a little bit. So whenever I'm working with my TC's I make sure it as part of their system that patient doesn't leave until there are one of three statuses. They are either yes today. That doesn't mean a same day start where we're slapping braces on the teeth. It's a same day commitment because a same day commitment which is basically signing a contract making an initial payment that is at a 98.6% conversion. So a itty itty bitty percentage of those patients are going to call back tomorrow and go I changed my mind. I would like a refund for my initial payment.

So that is that is really your first you know your priority uh status. Your second status is a scheduled record. So, this is the patient who they didn't give you money. They're still really motivated. We need to use that assuming language mindset and guide the patient into saying, "You know what? No problem. Tell you what, you're busy. We're really busy. Let me save this appointment for you. I know you love Wednesdays at 4 PM. Let's just save it. Let me put you down. You want to come in next Wednesday or the Wednesday after." I'm not asking them if they want to. If we gave them everything they want out of this consultation and we gave them a great experience out of them, we did our job. Then why wouldn't they want to schedule? So then you're going to move forward with that.

Dean Steinman

Okay.

Shelley Bostrom

Your third status is if those didn't work, you can't have an open-ended I'll call you, you call me. We need to have a very firm call to action, which is I'm gonna follow up with you. Do you want me to call you the end of this week or beginning of next week? I'm not gonna just leave it open-ended. And then you need to get that commitment from them. You need to open your calendar together. You need to choose the day and the window of time that you're going to follow up with them.

Don't put the ball in the patient's court. You are the treatment coordinator. This is your room, your house, your patient. So, it is your responsibility to make that next step connection. And then you're going to give them an appointment card. And the appointment card is going to be agreed upon by both of you. I'm going to call you on Friday between the hours of 2 and 5. I can't wait to chat with you again. If you need me between now and then, call me. And you're going to give them an appointment card. By doing that, you're going to have a lot less chance of them ghosting you. as a treatment coordinator, you know, if the patient leaves without a firm appointment and you got to add them to your pending list and we're going to be chasing them and you're going to get ghosted because they're not ready to make that choice yet. Um, you're going to be a lot less ghosted if you get the commitment from them in advance.

Dean Steinman

All right. So while they're doing that, you know, how do they you Yeah. educate a TC to get better at sales because it's a sales job.

Shelley Bostrom

Right?

Dean Steinman

You know, so how would you, you know, besides obviously they bring you in and to teach them how to how to do it, but you know, what's one thing that a doctor could do today?

Shelley Bostrom

Yeah.

Dean Steinman

Yeah. To help his T get a little bit better. You know, to go from 50 to 55, 60 to 62 could be a difference maker. You know,

Shelley Bostrom

you need to be converting at least at 80%. So,

Dean Steinman

okay. Wow. Okay. All right.

Shelley Bostrom

The way that that happens. Have you Dean seen um the wolf of Wolf of Wall?

Dean Steinman

Of course. Of course. Right.

Shelley Bostrom

The you know famous line of sell this

Dean Steinman

sell me this pen.

Shelley Bostrom

So, we need to know what kind of pen this patient wants. We cannot as as treatment coordinators, and I know that you you definitely said it. Treatment coordinators are salespeople. Absolutely. They often don't want to be called a salesperson, but it's okay. We need to own that role. But we need to remember that these patients researched you, called you, scheduled, showed up. They are sitting in your chair. They really want to be sold. Moms are the busy decision makers. They don't want to go to three consultations. They really don't. They would love to have you check all their boxes, have a great experience, have their child have a great experience. So, as a treatment coordinator and as a doctor, the way that you're going to crush this treatment presentation is you need to ask a lot of questions beforehand. So, I teach my TC's to be a good detective, a good sooth. One of my favorite books is um Dr. Robert Chaldini's principle of influence and he talks

Dean Steinman

many times right

Shelley Bostrom

a bungler a smuggler or a sleuth a bungler is someone who you're just bungling all the information and you don't know what to do with it and you're selling everybody the same pen smuggler is someone who the patient's giving you information and you're just smuggling it you're keeping it within you are not putting it to work a Luth is the smart treatment coordinator. You're asking all the right questions. You are truly listening and then you're applying that information to your presentation. Whether you're the doctor or you're the treatment coordinator. So like if a patient says, "I'm just here because of this space or this tooth sits higher than that tooth or you know, this tooth overlaps that tooth." The doctor needs to make sure to, you know, review the records, give the treatment plan, go over all the diagnostics, make or her recommendation, but if he or she doesn't say, and you know what, I know that canine tooth is bugging you, I got you. We're going to level that out as part of this treatment plan because the patient wants to know that you hear what their goals are. you hear what their concerns are and you're applying that, you know, it's not a it's not a oneandone. You're not going to treat every patient the same way. So, a lot of of your success with this is you have to ask questions from the moment they call your office,

Dean Steinman

right?

Shelley Bostrom

You have to start planting seeds and asking questions. So, you just check all the boxes for them and then the treatment truly tells itself.

Dean Steinman

Okay.

How much realistically should the doctor be involved in the TC process?

Shelley Bostrom

Yeah. Um less than 10 minutes.

Dean Steinman

Okay. So, so how all right so let's take back percentage wise. So if it how long it you know is the appointment 60 minutes 20 minutes 40 minutes. So to be in for two 5% 20% you know.

Shelley Bostrom

So I like a 60-minute new patient consultation.

Dean Steinman

Okay.

Shelley Bostrom

There's really like five parts to that. So, we've got the initial greeting, we've got the records, we've got the meet and greet, um we're you're being a great detective and sleuth, then we've got the doctor portion and then doctor get in and out. So, if we had a 60 minute consultation, I like the doctor in at the 30 minute mark. So that allows you to do your greeting, your welcome tour, the whole red carpet,

Dean Steinman

right?

Shelley Bostrom

Service treatment. Um, doing all your records, getting them uploaded. Dr. Reviews records is in at the 30 minute mark, out definitely before that 45 minute mark. And then that way the treatment coordinator has a a solid 15 minutes to reiterate doctor's treatment plan and then go over financials and get them scheduled same day.

Dean Steinman

Got it. All right. Next question. Say to somebody just they still just can't close them and blah blah blah. I'll let you know. I have to talk to so and so. Let's talk about next steps. Follow up there. I How long should they wait? It's kind of like you date. You have a first date. How long should you wait before you you follow up and call a second one? So, how long should then that should they be following up? How and how often and in what manner?

Shelley Bostrom

Yes, such good questions, Dean. Um, so I like the first followup to be a confirmed phone call. Remember, it's agreed upon by you and the patient. And I like three days unless they flat out tell you, "I'm going out of town. I'm on vacation. I need to do X Y and Z and you can call me back later. But I like to immediately lead into that three days. So if the consultation is in the beginning of the week, try to get it in on a Thursday or Friday. If at the end of the week, beginning of the following week. Um and then as and and like I said, the chances of them answering are going to skyrocket once you get that commitment. So my goal is that you're not going to get ghosted for following up forever. Um my recommendations as far as frequency of followup is I have a um nine touch points over nine months and you had asked about the method of communication. I do it all because not everybody has the same preferred method of communication. So it's a combination of phone calls, text messages, emails, and then my kind of Hail Mary at the end are a couple of good oldfashioned snail mail letters.

Dean Steinman

Okay.

Shelley Bostrom

because you don't know. You know, I a lot of people love texting. I don't love texting. I'm an email girl. It's probably my age, but I like email. And so, you don't know unless you flat out ask them what is your preferred method of communication. Um, I recommend mixing it up and then what sticks.

Dean Steinman

I'm the same way when it comes to our marketing is, you know, we I want to have as many different call to actions as possible for for at least for the initial communication there. Um because you don't know what how you know less and less and less people are picking up the phone you know and you know and and if you realize but caller ID is gone now so when so when a call comes through it comes through is just as a phone number

I don't know about you but I probably have a hundred voicemails I don't check my my phone anymore because it's because unless I know somebody's already in my contacts so text email and even now you should be doing you know reaching people through DMs. you know, because they people are checking their Instagram more than they're checking their their texts, you know, so you got to do it multiple multiple ways. Um, so, you know, and I love that nine times in nine days, you know, from the flip side, I'm at eight times in eight days per guy in order for from the initial, you know, lead coming through.

Shelley Bostrom

Yeah.

Dean Steinman

Um, you know, here's something that I don't know if I if I updated you or told you about it. Um, but you know, obviously, you know, from at Hero Marketing, we handle all of the the new patient inquiries of practices now. So, we answer the calls, we respond to the book to the the emails, we respond to the forms, we book them on the calendars. And last month, 58% of the appointments that we booked for practices took four or more touch points to get them in. Now I, I don't know of one practice that does it in-house that reaches out somebody more than more than two or three times. So, you know, so can you afford to lose 60% of your new business by not just having a process in place? You know,

Shelley Bostrom

Everybody needs you, Dean. Everybody needs you because you're right the the the team that is in the practice if you are in a busy thriving practice and you've got you know patients coming and going and you have to give them a great you know wonderful patient experience just on the first visit but really throughout their entire patient journey having a like lifeline partner like you who can help them get these leads in there because you know marketing is an investment and I think you said it before you know why why invest in marketing if you're not going to be able through

Dean Steinman

right

Shelley Bostrom

you gota one they need to answer the phones two they need to answer the phones correctly and so many offices

Dean Steinman

now

Shelley Bostrom

revenue on the table because nobody's answering their phones and if they are, they're bad at it

Dean Steinman

yeah terrible at it so it's it's it's it's bad you know when they have to do it right away speed to lead the first practice that responds to a lead, gets them in. That's it. Plain and simple. 85% chance of getting them in.

Shelley Bostrom

Yeah.

Dean Steinman

If you you the first one, you have to do it within two minutes, you know, and that's what we that's what we're doing now for a lot of practices there. So, um, you know, and so quickly in closing here, if you had to give somebody one bit of advice today, all right, that practice should do, a doctor should do today that could potentially help with his conversions, what do what should you have him do or her do?

Shelley Bostrom

Call Dean at Ortho Marketing. Um,

Dean Steinman

thanks.

Shelley Bostrom

So, the one thing that you can take away is you need to remember that I I want your patient I want it to be more of a conversation with them and not a script. So, I like scripting frameworks to help treatment coordinators and really all team members within the practice know understand why they're having these conversations,

Dean Steinman

right?

Shelley Bostrom

I get away from the scripting because patients want you to be authentic and genuine. So, you need to have conversations with them, find out what they want. Hey, when you're thinking about orthodontic treatment, are you thinking more of clear aligniners, metal braces, or clear braces?

Dean Steinman

Right?

Shelley Bostrom

Such a simple question. Why go through the whole spiel of, you know, we've got all these different modalities if like why talk about braces if they came in here because they want to have aligners. Great. You're a great candidate for for clear aligners.

Let's talk through what that looks like. So, it's just customizing that relationship and that conversation and getting away from this like, you know, scripting that sounds the same for everybody.

Dean Steinman

That's why I tell everybody, don't jump into the AI world yet, okay? Eventually, you're going to have to, but it has to be a human conversation to start. Then you could use AI as the the whipped cream on the Sunday, but you're you're the ice cream. You need to make sure that you're a human person first and then you could, you know, you know, work work with that afterwards to because things aren't are not going always straight. There are different questions to be asked and answered. So, you need to adapt to it accordingly there. So,

Shelley Bostrom

100% sure.

Dean Steinman

That's great. So, Kelly, once again, thanks so much for these tips. This is awesome. I love having you on and shameless plug time. If somebody obviously and everybody out there, guys, you need help. You know, you're great at changing people's lives. Give them the smile that they want and that you could deliver. Work with an expert who could help your staff be better at what they do. And take take advice, you know, adapt. So, Shelley, go ahead. Walk away. What's the best way for somebody to reach you?

Shelley Bostrom

A thank you so much, Dean. It was a great great great day today. Um, I'm everywhere, friends. You guys can find me anywhere. So, again, Shelley Boston with Align My Practice. I've got a gorgeous website. Um, thank you to my friends at Ortho Marketing. Um, but I'm I'm all over. I'm on Facebook, Instagram, LinkedIn, YouTube. You can you can find me. Not hard to find. Thank you.

Dean Steinman

She's easy to find and she's great to work with. So guys, reach out to Shel if you need help and which I'm sure most people do because I don't know anybody that's that's doing 100% closing out there yet. So you know she can help and Shelly bless you. Thanks so much for joining. Appreciate it. And everybody in Podcast Lamb, thank you for being loyal for watching us, listening to us and uh being a fan. Love you. So everybody be happy, be smart, be safe, and keep smiling. Thank you.

Don’t Stop Here

VIEW MORE EPISODES

Contact Us

"*" indicates required fields