. The Dental Industry – Scarcity or Abundance in the Marketplace?

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Second Opinion Scarcity vs. Abundance: What’s True for Dentistry?

Are you competing with the dentist down the street?

November 2006

Fred Joyal, CEO & Co-founder of 1-800-DENTIST, shares his insights on the best way to focus your marketing energy.

My experience in business is that there are two ways of looking at things. You either see your opportunities in the marketplace as abundant or scarce. This is more than just a personality trait, like seeing the glass half-empty versus half-full. It's how you look at the business world in general and how that affects your assessment of the industry you're in. Dentistry is without doubt an industry of abundance for these two reasons: half the population doesn't have a dentist, and the vast majority of the population either doesn't value dentistry or truly doesn't understand what dentistry can offer. As someone whose business is finding new patients for dentists, I have a unique window into the mindset of the public. And from my perspective, dentistry is the most under-utilized and under-marketed service in the country.

Unfortunately, many dentists operate with the belief that there is a scarcity of patients and of opportunity. After all, it's easy to fall into the scarcity trap. As you struggle to keep your business growing rather than shrinking, sometimes you can't help but feel that economic forces are working against you.

I've heard from dentists who are worried about a practice opening up down the street, or another office doing print ads or mailers in their neighborhood. And they're concerned about losing their patients to these practices. But the simple fact is, unless you're doing something terribly wrong, you'll lose more patients from people moving away than you will from some other doctor "stealing" them. (Quick stat: according to the Census Bureau, each year 16-percent of the population moves, and eight-percent move farther than a county away.)

Here's the basic principle: people have almost as much fear about finding a new dentist as they do going to the dentist. In other words, they are not likely to change dentists unless they really have to change dentists. And most likely, they'll stop going to one dentist and wait years before finding another. So, you're more likely to lose patients to avoidance than to another dental practice. And losing patients is more likely to happen because of something you do (or don't do) than as a result of some other practice attracting them with a discount or promotion.

Other than moving away, the two most likely reasons a patient would leave your practice are that: 1) you didn't offer something they wanted, such as evening appointments or laser dentistry, or 2) that they simply didn't have any idea that you offer what they're looking for. Face it, your patients don't know what you do offer. Reason number one is something you should be able to fix either with additional training or new equipment, and reason number two is simply a perception problem - a result of a lack of communication with your patient base, which is not unusual in a dental practice. In other words, these reasons for losing patients have nothing to do with the marketplace and are fully within your control. All you have to do to hold onto your patients is consistently remind them that you care by sharing information about the wide variety of services offered in your practice.

This isn't true for most other businesses, simply because their marketplace is not abundant. Yours is. According to American Dental Association figures, 50-percent of the population doesn't see a dentist on a regular basis and 30-percent have no dentist of record at all. What service or industry in America has such under-utilization? In the car business, everyone already has a car. They spend all their time and advertising dollars trying to get people to buy a new one, preferably one of theirs. Supermarkets are busy trying to attract business from their competition, because everyone has to buy food from somewhere. This is the reality for almost every business in America. Their new customers have to come from the competition.

Dentistry is the opposite. Everybody has a mouth (I was going to say everyone has teeth, but we know that isn't true!). And yet nowhere near everyone has a dentist. So there are literally tens of millions of potential patients that you don't have to take away from anyone else's practice. They're just out there, waiting for someone to explain to them why they should take care of their teeth and gums.

And here's level two of my premise: I would estimate that of the 50-percent of the population who sees a dentist fairly regularly, more than half of them are getting crown-a-year dentistry (i.e., what the insurance will pay for), rather than what the patient really needs to have a healthy mouth. We're talking literally billions of dollars in production not even diagnosed, never mind presented.

Now, some dentists complain about competition from "discount dentists." Let me just say that there is no worse patient, no less loyal patient, than the one who came to you because you were the cheapest dentist, or the one who left you because someone else was cheaper. Why even bother with this person? They don't value their own health. They think dentistry is a commodity, and they look for the lowest bidder. Let them go because discount dentistry is also the lowest profit dentistry. You only have so many chairside hours in a day, so make the most of them. That means doing all your procedures profitably on willing patients.

Another delicious aspect of the abundance of potential patients is that most of them are operating with older notions of a dental practice. Very often these impressions are from childhood, when fear and pain are exaggerated in a child's mind. It's not so much that these people are terrified of a dental visit. But their childhood memories are just enough of a deterrent to keep them from getting around to making an appointment. So the opportunity here is to introduce them to modern dentistry. From simple things like better administration of local anesthesia to IV sedation, and a host of great new technologies that make the dental experience more comfortable, if you can take someone with a negative expectation and give them a positive experience, you will make a lasting impression.

There is scarcity in one aspect of dentistry: awareness. People don't really know what their dentist can do for them. What's worse, they don't know how significant dentistry can be to their appearance - and to their overall health. The real tragedy is that virtually no one is telling them - certainly not on the level of all the other industries out there with billion-dollar ad campaigns convincing consumers to spend their money (The average American sees 6,000 advertising messages each day!). We need to be advertising in dentistry, and we need to do a lot more than we're already doing to penetrate the consciousness of the American public and raise dental health as a priority.

Unfortunately, most of the dental-related advertising out there comes from the big consumer product advertisers, e.g. toothpaste companies, which often unintentionally reinforces the average consumer's misguided belief that with the right toothpaste, brushing is enough to keep their teeth in shape. Unfortunately, half the population believes this because they want to believe that it's that easy. Well, it's time that people begin to understand the value of healthy dentition, to learn about the (what should be obvious) connection between their oral health and their overall health. If we all advertise more, then more dentistry will get done on a greater proportion of the population. This industry is an $80 billion a year industry that can and should be twice that.

Now, a segment of the dentist population keeps saying that advertising dentistry is unprofessional, or that it denigrates the profession. And yet that ratio of 50-percent dental avoiders remains unchanged. Why? Because of the fact that no one in dentistry is promoting or educating the public about dentistry. It's that simple. If we want more patients, we have to change the consumer's consciousness.

Another comment I hear from time to time is that "selling" patients on comprehensive care is bad. My personal opinion is that selling something good isn't bad. Selling something bad, or something people don't need, certainly isn't professional. That's where it's important for our conscience to guide us and to treat each patient as we would want to be treated. But remember that we constantly "sell" as a part of our everyday lives. For example, talking your son into going to college isn't bad, is it? But it can be quite a sell job. So, if you don't like calling this aspect of your job "selling," call it "facilitating treatment acceptance." But realize that people need you to explain their treatment options; patients are not going to ask for comprehensive care because they don't even know what that means.

Another scarcity myth is that there are too many dentists. Hardly! We're probably short a few thousand. Are there too many on your block or in your building? Probably not. At 450 Sutter in San Francisco, there are roughly 600 dentists in that building alone! And you can bet they're all doing pretty well - or they wouldn't be able to pay their exorbitant downtown San Francisco rent. So don't worry about the practice across the street, or the cosmetic practice advertising in the local magazine. There are more than enough patients for everyone.

Insurance plans change, you say, and people leave because we don't accept their insurance. What can you do? The first step is communication. Help them to understand that dental insurance is simply a benefit plan with negotiated rates for a set number of procedures and that it covers just a small portion of what would be considered ideal care. In other words, they shouldn't confuse it with their medical insurance. Remember, most people hate to change dentists. I'm sure you have patients who have moved away and still drive an hour or more to see you. And our experience is that in order to go to a dentist who is held in high esteem, many people will go out of their insurance network and pay the full fee. So don't let your patients leave because their insurance changed or because you no longer accept their plan. Give them the opportunity to remain in your practice as a fee-for-service patient, and explain to them that most of their dental needs won't be covered by insurance anyway. If they appreciate the value and the personal care that you give, they will be very reluctant to go back out into the great unknown and begin looking for a new dentist just to save a few bucks on their prophys.

Now, the final argument is that the patients floating around without a dental practice to call home are not "good" patients. They have "low dental IQs." They "don't value dentistry." I counter that mindset with this: people who don't have a dentist are naturally avoiders or procrastinators. They haven't seen a dentist in years, sometimes many years. But not necessarily because they can't afford it. Many of them are afraid, and others simply haven't seen the value because their constant neglect has never caused a perceivable problem - until now. Hey, enamel is tough, so tooth decay can be a very gradual process. And it can take years of neglect for infected gums to cause noticeable pain. But in my view, these "neglecters" are walking around with thousands of dollars of restorative dentistry waiting to be done in their mouths. So invite them to your practice. Go out and find them wherever you can. Realistically, half the population isn't broke. They all find the money to gas up their SUVs and to buy cell phones for their eight-year-olds. They just haven't budgeted a penny toward dental care. If you give them a positive experience of dentistry and help them understand why optimum oral health should be a priority, they also will find the money to take care of their teeth and gums as they should.

With the attitude of abundance, you've got limitless opportunity in your profession and in your office. That can be a little scary because there's no one you can point the finger at but yourself. But it should be exciting too. Because like it or not, you've picked the most abundant profession in America.

Editor's Note: To discuss your thoughts on the "scarcity myth," visit Dentaltown.com: Message Boards >> Dentaltown Magazine >> 2006 >> November 2006 >> Scarcity vs. Abundance

Fred Joyal is the CEO & Co-Founder of Futuredontics Inc., the company behind the 1-800-DENTIST cooperative external marketing program and the new internal marketing program, Patient Activator. He is the company's TV spokesperson and is a regular industry lecturer on topics including patient loyalty, practice marketing and branding, patient acquisition and the public's perception of dentistry. Fred sits on the board of directors for both The Children's Dental Center and The National Children's Dental Foundation. He can be reached at fjoyal@1800dentist.com or 310-215-6400.