Is This Blunder Costing You Thousands of Patients?
I recently had a conversation with Dr. John. Like many dentists over the last several months, he’s experienced some challenging times. But one thing that Dr. John firmly believes is that his practice is not losing patients. He is living in a fantasy. But Dr. John, a sole practitioner, is not alone in his delusions; he is like 78% of the 128,000 general dentists in the United States. The vast majority of solo practitioner practices are losing more patients than they are bringing in, and many of them scoff at such a notion. Holes in the schedule: “it’s the weather.” Lower production: “it’s the economy.” Fewer hygiene days needed: “it’s the hygienist.” And the excuses go on - seldom will they acknowledge that they are losing patients.
We work with doctors every day who have been in practice for 15 to 30 years yet can’t quite explain why they are still solo practitioners. Some dentists have had 2,000 to 3,000 people come through their offices and never return. The harsh reality is that you are losing more patients out the backdoor than you are gaining new patients coming in the front door. Dentists commonly believe that patient records in the computer or in the files constitute active patients. In actuality, only those patients that have been in the practice for a hygiene recall appointment in the past 12 months can be counted as active patients. The recall system, or lack thereof, is a huge factor in patient attrition.
Yes, patient retention will vary from practice to practice, but it’s essential that you understand where yours falls. The loss of non-retained recall patients per month cannot be anymore than 50% of the 00150’s or new patients per month.
Patient retention is measured monthly by taking the recall patients due for the month and dividing into the recall patients treated for the month. So, at the first of the month you run a recall report of patients due for the month. At the end of the month, you will generate a production report and total the amount of perio maintenance plus periodic exams which should equal the amount of recall patients treated for the month. Remember, a hygiene patient who receives a quadrant of root planing is not a recall patient.
Next, take a good hard look at recall. It is the most important system in the practice for ensuring patient retention - and it’s also the most ignored system in the practice. How do you know if your recall system is weak? Look at the number of hygiene days. If they haven’t increased in the past 12 months, the practice is losing patients. In addition, the schedule has open time slots, however the schedule looks full because the practice schedules patients six months out. Moreover, no one on the business team is responsible for ensuring that the hygiene schedule isn’t riddled with holes or following-up with past-due patients.
Too many dental teams take it for granted that the patient will return, but when they don’t, no one follows up with them to get them back on the schedule. Pre-scheduling three and four month recall is reasonably effective. But the six month recalls are not. It is essential that if you pre-schedule patients six months in advance you educate the patients, and the business staff must follow-up with patients on the phone. Too often, it’s the follow-up that falls down.
In addition, when the patient is in the chair, communication between the doctor, hygienist and patient must reinforce the need for ongoing care. Most patients don’t think they need to go to the dentist every six months, and many dental teams are not particularly effective in convincing patients otherwise. It’s not uncommon for the dental team to refer to the hygiene appointment as a routine checkup, thereby trivializing the importance of care delivered and confirming the patient’s misperceptions.
An effective recall system includes other key components as well. The practice should be actively educating the patients. Professional recall notices should be used. The patient can be involved in the recall process by personally addressing the envelope that they will receive in the mail with their recall information and informational brochures. A business employee needs to follow up with patients to ensure that they will keep their recall appointments. In addition, the hygienist should be scheduled to meet specific production goals and there should be no more than .5 openings in the schedule on any given day.
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