Most of the country is headed toward an expedited method of collecting tolls on our roadways. In the Northeast it's the EZ Pass system. From a business perspective it sounds like a perfect plan. Move vehicles through the toll booths in a faster, more efficient manner, collect the tolls through the drivers' credit cards and have fewer employees doing the work. Let's look at how it benefits the roadway authority.

You have the funds deposited electronically. No cash to be embezzled or stolen from the workers. The traffic moves through the toll booths faster, which keeps the motorists happy. Fewer employees are needed to collect and process that money. Moving away from cash is better for so many reasons. So, if it's such a good system, why are the non-EZ Pass lanes so crowded that they spill over into the EZ Pass lanes and cause a back log there as well?

That's a tough question to answer. A few years ago, they made EZ Pass car tags available just about everywhere. You could get one in any convenience store and it would be linked up to your credit card on the spot. What could be easier? Well, something was hindering people from getting them. I refrain from using the words "buying them" because they were available for free. You just paid as you went. No hassle, no charge, no wait at the toll booth. Yet the program was falling flat on its face.

So, next move. Give everyone a credit on their EZ Pass account for $25 just for getting on board with the program. Then to sweeten the deal a little more, just about every toll was reduced for EZ Pass users. People are funny. Even this great deal had very few takers. So, with the EZ Pass authorities scratching their heads, they are left with nowhere to turn. The system is working, just not as well as they would have liked.

In our offices we all have issues like this. We go to a new class and get all gung ho on a new procedure only to find that we have very few people accepting treatment. Where does the problem lie?

Generally, it's with our inability to show the patient the need and therefore the value in what we are proposing. Sometimes it's that we are so enthusiastic it comes off as the hard sell and people get put off. Or maybe it's our inability to present the situation and treatment in layman's terms and we confuse the patient too much. We need to educate our patients so well that they will end up seeing the need before we even stop talking. That, in a nutshell, is the key to case presentation. Education in terminology which is fully understood, followed by an "aha" moment, and then best thing ever: co-diagnosis. If many patients are avoiding treatment, then we simply failed to educate.

Surely, there are some patients who will never commit. Much like those motorists that think the EZ Pass system is put in place to track their movements. We can't make everyone see the need that we see. Perhaps the EZ Pass authorities failed to very simply teach people how the system works. I can think of so many TV commercials featuring the famous rabbit and the turtle, where the turtle wins because he has EZ pass. Educate, educate, educate. That is the answer.