3.29.13 Issue #577 info@mckenziemgmt.com 1-877-777-6151 Forward This Newsletter

New Patients More! Better! Best!
By Sally McKenzie, CEO

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... And you already have them. Yes, you already have them. These are the patients who already like you and trust you. They offer huge potential. But you are looking at them through the same old tired lens. Some of your best “new” patients are your existing patients. 

Case in point: In 2008, at the dawn of the Great Recession and well before the worst of it hit, “Dr. Brown” was ready to sell his Texas practice. It wasn’t growing and hadn’t been for some time. He was losing money. New mailto:info@mckenziemgmt.com patients had all but completely disappeared. In a last ditch effort to salvage his practice and his career, he invested in a few continuing education opportunities. He learned how to perform some new procedures. He learned how to effectively present treatment plans. And he learned how to deliver a truly excellent new patient experience. The only problem, Dr. Brown didn’t have any new patients. But that didn’t stop him. He decided that in his practice every patient coming in for an appointment – any appointment – would be treated like a new patient. 

The results were huge. Treatment acceptance exploded, and the referrals cascaded into Dr. Brown’s practice. Within one year, he had to hire an associate to keep up with demand – and that was at the height of the recession. Best of all, he was passionate about his profession once again.

Oftentimes, dentists are so concerned about numbers of new patients, they lose sight of the potential that existing patients offer. Current patients are, well, just patients. They are no longer “special” and they know it, but dental teams are often oblivious to the fact that they are treating these bread and butter patients like yesterday’s leftovers.

Remember this: 80% of dental practices are losing more patients than they are gaining new patients. Doctors and dental teams in practice after practice are utterly convinced that long-term patients will remain loyal and simply keep returning. “I have had many of my patients for 15-20 years,” you profess. At least you think you still have them. You assume that if a patient has come to your practice for a few years they will keep returning. Yet rarely do you actually check the numbers to confirm your perceptions. Nor do you think you need to do anything special to keep them returning.

Doctors and dental teams also falsely assume that these patients are well aware of the services the practice provides. “We have brochures in all of the treatment rooms. Patients know all about our services.” You have wallpaper in your treatment rooms too, and patients are more likely to notice your wallpaper than your brochures. And if they do spot those handy pamphlets that could educate them about adult ortho, veneers, whitening options and the like, they assume they don’t need the services or would not be candidates for the treatments because you have not suggested it to them. You have not handed them a sliver of information or bothered to mention that you now offer adult ortho and would be happy to talk to them further about how it might be an option for them to consider. You haven’t conducted a comprehensive exam on existing patients in years. You haven’t talked to them about the exciting continuing education programs you’ve attended recently or the amazing advancements in dental materials and treatment options available today.

Practices spend enormous amounts of time, energy, and revenues trying to win new patients, yet existing patients merely mark the hours on the schedule. They are seldom given a second thought. How often do we hear advertisements offering a special deal or promotion for new customers, new patients, new clients. What about the long-term, loyal customers? They are routinely taken for granted, which is why these special promotions are effective.

The customer that is taken for granted in Dr. Joe’s practice likes the idea of being treated to something special at Dr. Sue’s practice, so she leaves Dr. Joe’s practice, reasoning that while she likes Dr. Joe well enough, he’s getting older and maybe Dr. Sue’s practice really is better. After all, she has a special whitening product she’s offering. Of course, so does Dr. Joe, but his practice never seems to get around to talking to patients about it – unless they are new patients, that is.

Make your patients feel “new” every time they walk in your office.

Next week, how well “connected” is your practice?   

For more information on this topic, visit my blog: The Lighter Side

Interested in speaking to me about your practice concerns? Email sallymck@mckenziemgmt.com
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Belle DuCharme, CDPMA
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5 Critical Considerations Before Building a Dental Practice
By Belle DuCharme, CDPMA

Dear Belle,

I just found a great space for my new dental practice. It is near my home and in a medical/dental building which I think is better than a strip mall location. I am just stuck on whether to sacrifice reception room space for a fourth treatment room. What do you think? 

Dr. Newbie, Office Anywhere, USA

Dear Dr. Newbie, 

The excitement of opening your own practice and the “build it, they will come” romance needs to be quieted to some real time considerations. Here are a few questions to ask yourself:

1. Did you complete a business plan prior to choosing this location? In this business plan would be your vision statement for practice success. The vision is about you and what your “perfect day” schedule is - as far as services and products you wish to provide to patients. Do you want to treat children? Do you want to treat the underserved in your community? Do you want to do endodontic therapy and oral surgery in your general practice? Will you be providing oral or IV sedation? Will you be employing a hygienist at once or further down the road? The vision of your practice also includes where you see yourself in six months, one year and five years from now. This vision helps you to establish goals for the practice growth. If your desire is to hire an associate as soon as the patient base is at 1,400 patients because your vision is to work only three days a week, then this will have a bearing on the number of treatment rooms you will be plumbing. If you want your practice to be mainly children and later add an orthodontist, then you must include in your design a larger reception room and restrooms away from treatment areas, quiet rooms and more treatment rooms. 

2. The location of the practice is critical for success. Some doctors have the drive and the personality to be successful anywhere they decide to open shop, but for the majority the location needs careful thought and advice from experts such as McKenzie Management. A detailed report of the demographics and the psychographics of the community around the practice site is a must before making a decision on whether to purchase in the area. Do you really want to practice close to your home? You will be running into patients when shopping, dining or going to movies. This has to be a comfort zone for you. If your practice is in a strip mall or shopping complex, you will have higher visibility and “walk-in” patients. Some patients like the convenience of seeing the dentist and shopping for groceries in the same morning. If you are in a medical/dental complex, make sure there is plenty of parking available in your lease and check out the signage requirements. Visibility can be an issue in buildings that forbid signage.

3. Start-up costs and operational costs for the new practice must be estimated as realistically as possible. Careful planning and management of the start-up monies and the complete understanding of where the money will be going is critical to getting the practice up and running and profitable as quickly as possible. Included in these costs are the marketing expenses necessary to get a new practice up and running. 

4. Marketing and visibility in the community is a do-or-die commitment. In the Community Overview Report of demographics, the competition is addressed at length.  Is your practice area already saturated with dentists? Is the opportunity to do the kind of dentistry you are envisioning a demand in the area? How will you set yourself apart from other general dentists in the area? If you are a specialist, who else is offering the same services in the area? What are they not doing that you could do for your patients?  Marketing is everything and everyday and never stops. You will need a plan of action for marketing both internally and externally.

5. Human resources will tax even the most prepared of new doctors. What will you have to pay in staff salaries? What benefits do you have to offer, if any? How do you find and hire great employees and how do they look and act? An Employee Policy Manual is necessary to prevent difficult situations such as wrongful termination suits.  Again, this is an area that calls for expert consulting advice.

Dr. Newbie, there is so much to consider…and realize you do not have to do this alone.  McKenzie Management provides programs for Practice Start-Up and Practice Acquisition. Call us today at (877) 777-6151 and we will guide you to achieving the practice of your dreams.

If you would like more information on McKenzie Management’sTraining Programs  to improve the performance of your team, email training@mckenziemgmt.com

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Nancy Caudill
Senior Consultant
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The Perfect New Patient Exam
By Nancy Caudill

Step 1 - The Introduction (10 minutes)
Your assistant, Sue, seats the patient - sitting “eyeball to eyeball” with him in her dental chair. She makes an opening rapport-building statement, such as: “Mr. Brown, we are so pleased to have you here today. I see that you were referred by Mrs. Smith. We just love her. I promise that we will take just as good care of you as we do her! Dr. Smith asks that we have a baseline blood pressure reading for all our new patients. Is that okay?”

Keep in mind, it’s usually required by your state board that before a clinical team member can take any radiographs, they must be “prescribed” by you, the dentist. Your goal is to briefly introduce yourself to the new patient as soon as possible after your assistant has seated the patient, review the medical and dental history, and take a quick tour in the patient’s mouth to accurately prescribe the radiographs you need to make a complete diagnosis and treatment plan. Prior to your arrival, your assistant can be taking digital photos if you find them helpful, as well as intra-oral photos.

Step 2 - Radiographs (10 minutes)
Sue will now proceed to obtain the prescribed x-rays.

Step 3 - Soft and Hard Tissue Exam (10 minutes)
The order in which you conduct your exam is a personal preference. Remember to inform the patient that you are “performing an oral cancer exam, looking and feeling for lumps and bumps that are not normal.” This is added value to the appointment. The soft tissue exam would include TMJ evaluation, periodontal charting, etc. As you conduct your periodontal charting, explain to the patient that low numbers are good and high numbers 4 and above are signs of possible infection and disease. Then call out the probing depths to your assistant, as well as bleeding, etc. This helps the patient to “co-diagnose” their own health.

Consider having the doctor and assistant chart the existing restorations together. This is much quicker for the assistant, and also gives you an opportunity to brag on the patient’s previous treatment, as well as start preparing yourself for your diagnoses and treatment planning. (#1 is missing, #2 has a beautiful porcelain crown, #3 has an old silver filling with a crack on the distal-buccal, etc.)

Step 4 - Treatment Planning (10 minutes)
If your practice is chartless, treatment planning can be entered directly into the patient’s digital chart if your assistant is proficient. If not, she/he should write it down on the back of the routing form as you call out the treatment and it can be entered by the business team. It is more about being efficient than it is what “should be.” Your assistant will start entering the recommended treatment as you go through the mouth. (#3 will need a porcelain crown due to the large crack on the distal-buccal cusp, #6 will require an MO 2-surface white filling due to a cavity, etc.)

Step 5 - Visit #1 (10 minutes)
This is the important step. You have presented all the recommended treatment to the patient and it is charted. You decide where you want to start with the patient. Upper, lower, right or left? “Put out the fires first” is usually the first plan of action. At this point, the key is not to spend 30-60 minutes discussing ALL of their options. Discuss their options on the area that you want to start in. (Crown vs. filling vs. extraction vs. bridge, etc). Help the patient make a decision for their next visit based on your clinical review.  It is not mandatory at this time that you discuss the option for 8 veneers, orthodontic appliances and a sleep apnea appliance, unless this happens to be the patient’s chief concern.

In other words, eat the elephant one bite at a time to avoid your patient from running through the jungle and out the front door. Help guide them through the process, explaining that when they return for their next visit, you will discuss what area they would like to address next.

This scenario was 50 minutes. You determine how long it will take you. Keep in mind that you may have a difficult case that will need time to prepare and review with the patient. In that case, gather your information, discuss with the patient what they are expecting, and schedule them back for a consultation. Maybe it can be combined with something that is needed that is not extensive, like a filling. Don’t feel that you need to present 4 options to the patient that will take preparation and time at this appointment. It will be apparent to the patient that their dental needs are complex.

Keep in mind that the patient only really listens to the first 5 minutes of what you say, so keep it short and to the point. Ask questions to confirm that they understand their next visit. Bid them good-bye until you see them again soon. Sue reviews the recommended treatment for the next visit and then escorts the patient to the hygienist, briefly reviews with her the doctor’s findings for the next visit, indicates that there was no evidence of gum disease and dismisses herself. All in less than an hour!

If you would like more information on how McKenzie's Consulting Coaching Programs can help you IMPLEMENT proven strategies, email info@mckenziemgmt.com

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