Revenues Evaporating? Do This.
It's dry out there. In some parts of the country, this summer looks to be serving up one of the worst droughts in decades. Water restrictions are being put into place and crops are cooking as the nation continues to bake under the summer sun. Many dental practices are feeling the effect of a drought of their own - this one being a lack of patients. Patients are cancelling, they don't show up, they are late, and tempers among the team are running hot as a sun-scorched summer day. The doctor is pacing. The hygienist is wringing her hands. The business staff are ready to wave down cars in the street to get bodies in the chairs.
Increased patient cancellations and no-shows is a trend that we see across the country. Not in every region - but in many - practices are experiencing difficulty keeping schedules full. Certainly, the economy is a factor, but before you hang your head in hopeless resignation that there is nothing you can do about it, read on. With appropriate systems, patient no-shows and cancellations can be dramatically reduced regardless of today's ever fluctuating economic whims.
First step, pay attention to what staff are saying to patients. This is critical because, as I have noted countless times, patients look to the clinical and business teams for cues. If there is the slightest indication that the appointment can be delayed or is not necessary or if the messages are mixed, patients will take that as their signal to promptly exit and get back to you when they feel like it.
Here's a common scenario in many practices: A well-intentioned Scheduling Coordinator is trying to schedule a recall visit for the patient who is due to return in six months. The patient has absolutely no idea what her schedule is going to be then and prefers to wait. The Scheduling Coordinator is trying to be helpful to both the patient and the practice and explains that if the patient doesn't book the appointment, she may not get one because the practice always books six months out for hygiene appointments.
“Let’s just get you on the schedule. If you can’t make it when the time comes, just call and we’ll reschedule it then,” says the Scheduling Coordinator. In effect, she is contradicting herself, and the patient is puzzled. First the patient must be scheduled because the appointments are filling up quickly, and it’s going to be practically catastrophic if the patient doesn’t schedule now. Then the Scheduling Coordinator indicates it’s really no problem to cancel if the patient discovers the time won’t work. Mixed messages defeat the purpose, and the purpose is to have patients in the chair.
If it is clear that a patient prefers not to book an appointment six months in advance, do not pre-schedule. Rather, tell the patient that s/he will receive a notification two-to-four weeks in advance of the date s/he is due for his/her professional cleaning/periodontal maintenance appointment. Then direct the patient to call the office and schedule the appointment when s/he receives the notice.
Dental teams have long operated under the illusion that six month scheduling would guarantee a full schedule. Certainly, this approach works for some patients who have an established history of keeping their appointments, but to insist on six-month scheduling for patients who have clearly indicated that this doesn't fit their busy, unpredictable lifestyles only exacerbates the problem of cancellations and no-shows.
Knowing what to say and what not to say to patients is only part of the solution to reducing this vexing practice problem. Next, evaluate the various methods of patient/practice communication, specifically those related to appointment confirmations. It is essential that practices contact patients using the communication tools patients prefer, including text messaging, email, postal service, cell phone, business phone, home phone, and in some cases a combination of those. While text messaging and email appointment confirmation have grown in popularity, it's critical that business staff ensure the patient receives the message sent and responds.
Simply sending a text message or an email to a patient reminding them of the appointment is NOT a confirmation. The patient must respond to the message acknowledging receipt and indicating if they plan to keep the appointment. If the patient does not respond to the text and/or email message, the practice must have an established protocol for following-up by phone to make contact with the patient.
Next week, killing time or filling time?
For more information on this topic, visit my blog: The Lighter Side.
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The Funnel Theory in Dental Business
The funnel theory in marketing refers to building a large database of prospects that with follow-up will “funnel” down to be buyers of services and products. Dental practices, as with most small businesses, do little or no follow-up with their customers. The store door opens and the waiting game begins for customers to show up. If we imagine the dental office as an open store without appointments, where patients walk in during store hours and are accommodated according to their needs and your ability to serve them, how would the schedule look? If the dental office operated this way, what would you do to attract new patients?
Lately the schedules in many dental practices have open time - and not entirely due to cancellations and no-shows. The challenge to create a profitable schedule every day requires focus and a commitment of time. In order for the funnel theory to work, a large volume of prospective patients must be created. In dentistry, this is referred to as the active patient list. In practices that have relied on word of mouth to grow, it is wise to see that other tactics need to be in place to stimulate growth. Think of the following as ways to fill up your funnel - or as the “lucky seven.”
1. Increase Contact with Potentially New Patients
2. Update or Create an Effective Website
3. Record All Prospective Patients in your Database
4. Maintain your Relationships
6. Excellent Customer Service
7. Building Trust Builds Loyalty
Need help with growing your practice? McKenzie Management has the marketing tools to increase new patients and help you to retain your current patients. From business training programs for your staff to internal and external marketing plans, McKenzie Management is here to help you.
How to Schedule New Patients Effectively
A new patient wants to get his/her teeth cleaned and is scheduled with the hygienist for 90 minutes. The doctor then visits the new patient in the hygiene chair, along with the hygienist. So - what is wrong with this picture?
First, I am going to assume that your state's dental guidelines assert that all patients must be diagnosed by the doctor regarding the necessity of radiographs, what kind are needed in order to make a diagnosis, and then necessary radiographs are to be prescribed by the doctor. In order to accomplish this, the doctor must sit down with the patient and perform an oral evaluation. How many times does your assistant take an x-ray(s) before you ever see the patient? Probably many times. Instead, the patient should see the doctor first, either in their chair or in the hygiene room for an introduction. They should receive a view of the medical history, and an oral evaluation of the purpose of prescribing necessary radiographs.
Hygiene or Doctor Side?
In this scenario, the preliminary fact-finding steps are already completed by the assistant, and the doctor and the treatment plan can be proposed at that time. Some dentists, however, prefer not to evaluate the teeth if they are “dirty”, as it makes it harder to make a diagnosis. The use of other diagnostic equipment is also difficult to impossible since the occlusal surfaces are not free of plaque.
The second option is to schedule the patient on the hygiene side and allow 20-30 minutes for the doctor to spend with the patient for their consultation. Keep in mind, however, that the doctor still must come in and perform their initial oral evaluation in order to prescribe the radiographs, as well as make a diagnosis regarding the patient's periodontal tissue. The hygienist will then proceed to complete her fact-finding tasks such as using the intra-oral camera, intra-oral digital photos, and periodontal charting. If the doctor has given the green light for her to perform a professional cleaning, she can proceed with that step until the doctor returns to complete the comprehensive exam and prepare the treatment plan.
If the patient has periodontal disease, the patient must be informed and educated regarding how to treat and control the disease. A debridement could be performed if the calculus prohibits the completion of a successful periodontal chart. At that point, the patient is scheduled for their next visit, depending on the treatment plan by the doctor.
The big question is always the same - what to do if the patient is periodontally involved? The practice should have a protocol that is followed by the hygienists regarding how to proceed with a patient that is diagnosed with periodontal disease.
Do I Block for Time on the Doctor's Side?
Develop a plan with your team to better manage the scheduling of your new hygiene patients. Determine what will work best for you, but have a plan. Simply scheduling them with the hygienist and leaving your patient at some point while you conduct this longer and more complex exam is not efficient. Keep in mind that “children” don’t need as much time. Determine at what ages various times are needed and when blocking on the doctor’s side is not necessary if the patient is scheduled on the hygienist’s side. This is especially true for children.
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