The Profitable Dentist
August 2007
By Fred Joyal
CEO & Co-Founder of 1-800-DENTIST®

When was the last time you took a really close look at your patient database? If it has been a while, I am almost positive many of your records could be outdated. Most dentists concern themselves with how many new patients are coming in the front door, rather than determining why they leave. At 1-800-DENTIST, we receive calls from people looking for a dentist 24 hours a day. The majority of these callers don't currently have a dentist, while others are just looking for someone new - and they tell us why. After working with hundreds of practices, and interacting with thousands of patients, here are the primary reasons why practices lose patients:

#1 They move away. According to the U.S. Postal Service, roughly 14% of the American population moves or changes addresses annually. More importantly, 8% move out of their current county-which means they probably aren't going to retain the same dentist. So, in a large city, you can expect to lose 8-10% of your patients every year. Do you even know when that happens? Usually you find out when the patient, or their new dentist, asks for their dental records. Problem is, they usually wait 3 or 4 years before finding a new dentist, unless they have children. What are you doing to stem that ebb tide?

#2 Your practice doesn't offer what they want. They've heard about Invisalign®, lasers, one-day restorations with CEREC® machines, or they saw ZOOM!® whitening on Extreme Makeover®-the problem is that you don't offer these things. So they go somewhere else to get it.

#3 They don't know what you do. You may have done 600 hours of C.E. learning to do cosmetics. Perhaps you offer I.V. sedation and Lumineers®. But this doesn't make a difference unless they know that you do. Don't assume that you or your staff may have told them or that they know because you have brochures available in the waiting room. The reality is that patients spend most of their time in your office looking at the ceiling. So unless it's written there, your patients most likely haven't read about it. More importantly, telling people one time what you do is not effective. Most patients are only listening if it's something that matters to them right at that moment. Effective practice marketing means repeatedly telling your patients about the services your practice offers and the benefits of those services.  

I've heard dentists mention having a long time patient show up for an appointment with a full set of veneers, When asked why they went elsewhere for the procedure, the story is always the same: They saw an ad for a great cosmetic dentist. When the dentist explains that he does veneers also, the patient says, "Oh, but cosmetics is the other dentist's specialty!" Now their original dentist gets to do prophys on that smile for the next 20 years. Communicate what you do to your patients repeatedly because it is your greatest resource for increased production.

#4 They don't understand why you're so expensive. This just means that they don't value what you do and that no one is building the value of the dentistry in their mind. They just get a bill. Remember, 80% of what you do in dentistry is elective. One of the most common complaints we've heard from the public is about fees for dental care. Let's face it, most people don't understand what good quality dentistry costs. They'll say, "He charged me $1,000 for a root canal!" And we'll calmly explain that that cost is around the going rate. This generally helps because in the end, people don't want to be taken advantage of, and all they need is to have the cost fully explained. Cost is one of the main reasons why people avoid the dentist in the first place. They think it's expensive (and insurance doesn't pay for it, they lament!) and all they're paying for is discomfort. Many believe that six-month recall is a myth created by the ADA. The truth is, in order to bring patients into comprehensive care, they have to appreciate the value of what you do. This means your staff, office environment, technology and you as the doctor have to communicate to the patient why they should value the care you provide.

#5 Their insurance changed, and you don't take it. There's not much you can do about that, right? At 1-800-DENTIST, we ask consumers if they are willing to go out of their plan for the right dentist, and often they will. People want good dentistry, not necessarily the cheapest. For those patients who are contemplating leaving because of an insurance plan change, let them know you would still like to treat them even though they're on a closed plan. Hopefully they will find value in the relationship and some will stay. Others will come back when they don't like the care they've gotten somewhere else.

#6 They are embarrassed about how long they've put off their recall. This may seem strange, but people feel uncomfortable about being chided for neglecting their exams and cleanings. Some people would rather go to an entirely new dentist rather than face a dentist they've avoided for a long time. Don't make your patients feel guilty. Let them know you're there to treat them when they are ready, and ask how you can make it more convenient for them.

#7 They don't think you care. Many patients think you don't care about them personally. It's very easy to get caught up in the clinical side of what you're doing and very often your staff is multi-tasking and doesn't pay proper attention to the patient. It only takes a moment to let your patient know that you understand their fear and their discomfort and suddenly they feel cared for. They don't expect dentistry to feel good, which is all the more reason to take the time to acknowledge what they're going through. Otherwise you're just telling them that all they represent is income to you. And no one likes feeling that way.

Successful practices make their highest priority ensuring their patients know they care. This can often take as little as a minute of your time, or your staff's time, asking about their kids, telling a joke or sharing a story. My dentist was doing a rather long and unpleasant crown restoration on me and right in the middle he stopped and said, "Why don't we let your mouth calm down a little bit since we've been doing a lot of work here? So, what's new?" After two minutes of talking, he resumed and completed the treatment. Instantly, he showed how much he cared about my comfort. With a little effort, it can take only a few minutes to turn someone into a long-term patient.

The simple solution most often is communication, the kind of interaction that shows patients that they are in a relationship with you about their lifelong oral health. Show them you care, relate to them, equip your office with the latest technology and for goodness sake, tell them what you do. Getting new patients is tough enough. It's worth the effort to keep them.