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10.03.08 Issue #343 Forward This Newsletter To A Colleague

Nancy Caudill
Senior Consultant
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Should You Clean the NP On The First Visit?

Dr. Sandra Crisp—Case Study #429

Dr. Crisp contacted McKenzie Management asking how all the other dental offices handle the patient question, “Will I get my teeth cleaned on my first visit?”

Dr. Crisp’s Practice Facts:

  • 5-year old general family practice
  • State-of-the-art equipment and latest decor
  • Several competing general dental offices within a 5-mile radius
  • 1 hygienist working 3 days a week
  • 15 New Comprehensive Exam Patients a month

Notable Concerns:

  • Office is only retaining 64% of new patients
  • Needs 25+ new Comprehensive Patients a month for practice growth
  • No tracking of incoming phone inquiries

Systems must be put into place to reduce the loss of Dr. Crisp’s patient base in order to grow the practice. With 60–85% of restorative treatment coming from the hygiene recall exams, the more exams that are performed means the more treatment is diagnosed!

“I need to make an appointment to get my teeth cleaned!”

After consulting with Dr. Crisp’s Schedule Coordinator, it was determined that most of the new non-emergency patients call and make the above statement. The next thing they ask is usually, Are you taking new patients?(It still is amazing that patients ask this question. What dental office that is running a business is NOT taking new patients?)

It was also discovered that in Dr. Crisp’s office, the office policy is that even if new patients want their teeth cleaned, they can’t get their teeth cleaned. They must visit the doctor first and then re-appoint for their professional cleaning, or maybe for scaling and root planing!

Tracking Inquiries
The Schedule Coordinator had no idea of exactly how many potential patients were calling and not scheduling because new patient telephone slips were not completed to determine the number of inquiries versus the number of patients scheduled versus the number of appointments kept.

It was possible to review the computerized appointment book and see the number of “new patient” appointments that were broken or canceled, because they were either left on the schedule or placed in the Unscheduled Folder. Dr. Crisp was losing 15 to 20 potential new patients per month who were not keeping their appointments or who were canceling and not rescheduling. Something wasn’t working!

Why do patients want their teeth cleaned?

  • Feeling “fuzzy”—to remove plaque and stains
  • Weddings, graduations or other big events
  • Embarrassment from a “yellow” look
  • Bad breath
  • Bleeding and sore gums
  • Use insurance benefits

There are obviously many reasons why a potential patient elects to pick up the phone and make that call. There are just as many reasons why they choose the office to make the call to. When you tell a caller that your “office policy” states that you don’t clean teeth on the first visit, are you giving them what they want? The answer is no.

Give the patient what they want!

Dentistry is about relationships and patients elect with whom they want to make relationships. Dr. Crisp was making it too difficult for patients to accept and KEEP their appointments with her because they weren’t really getting what they wanted. From the number of broken new patient appointments, it was obvious that Dr. Crisp’s approach was not working. The new potential patient would call around and find another dentist that would give them what they wanted—a cleaning.

Dr. Crisp has a beautiful office with friendly and well-informed team members to support her. Unfortunately, not enough people in her community have an opportunity to experience it because of the office policy. Patient retention is poor because there are no systems in place to retain the patients that she does have.

It was recommended that the following system be implemented for new patient appointments:

  • See all new patients within 1 week for excellent customer service and to avoid “no shows.” If patients don’t have X-rays and their insurance won’t pay for another FMX, take them as a courtesy, because the doctor needs them for diagnosis.
  • Schedule 30 to 60 minutes with the doctor/assistant for information-gathering and treatment recommendations. The time spent with the doctor for evaluation and treatment recommendations must be exclusive time with no other patients waiting. Complex treatment plan options will need to be rescheduled in order to have time for presentation by doctor or Treatment Coordinator.
Schedule next 60 minutes with the hygienist for assessment and possible professional cleaning, as well as sharing videos, study models and other educational tools with the patient.

Six months later, new patient numbers were up 50%. Patient retention increased to 85% and additional hygiene days were being considered. Barriers were lowered that made it difficult for patients to make appointments, such as requesting X-rays from their previous dentist. Patients don’t want to confront their other dentist for X-rays. They want to quickly disappear and hope that no one will notice!

Keep your door open to potential new patients and help them walk in. Then be sure that you have systems in place so they don’t disappear without YOU noticing!

If you would like more information on how McKenzie's Practice Enrichment Programs can help you IMPLEMENT proven strategies, email

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