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Authors: Dr. Howard Farran

Nobody has customers “for life.” If a hygienist works 40 hours a week, 50 weeks a year, that’s 2,000 hours. With that time, she can do twice-yearly cleanings on a thousand patients. And if the average new-patient flow at a dental office is only 25 patients per month, that should mean that every 40 months—just over three years—the office should need to add another full-time hygienist. (See chart to the right.) So this dentist opens up and has a hygienist getting 25 new patients a month … and a year later you come back, and the practice still has only one hygienist, working two days a week. You come back 40 months later, and there should be another hygienist … another 40 months, another hygienist … until 10 years later when you come back to the practice, do the math and go, “Where are your four full-time hygienists?” Dentist: “Oh, we only have one, and she works three days a week.”

Me: “Well, what are you doing?” Dentist: “I spent money on advertising—I’m always getting new patients.” I’ve never met a dentist who isn’t focused on getting new patients. When you’ve lived in the same town for 40 years and gained 25 new patients a month, you’ve had 12,000 new patients. At the end of 40 years, you should have six full-time hygienists working 40 hours a week, 50 weeks a year. But instead, what does that doc have? One hygienist, still working three days a week.

Formula for hygienist hours/year: 40 hours/week, 50 weeks/year = 2,000 hours 2,000 hours, divided by two (since each patient is seen twice a year), equals 1,000 hours per year, per full-time hygienist. Now, divide those 1,000 hours by the number of new patients you have per month to see how many months (or years) it will take before you should add another full-time hygienist.

“Dam” straight advice Dentists don’t blink at spending 3 percent on marketing and advertising, but why do we always want new patients until we die? Why don’t we spend part of that money on patient loyalty? Think of the Hoover Dam. It was created by capturing an inflow of just a tiny bit of water and letting none of it escape. It accumulates, and eventually there’s a lake that’s so big you can’t even swim across it.

It’s time to close the floodgates, and aim for keeping patients for life. Start tracking every time a patient asks for something: Why is she leaving and not coming back? Ask, and she might answer, “Well, I wanted evening appointments.” Or Saturday appointments. Or you didn’t take his insurance, or you couldn’t put him to sleep for the procedure, or you didn’t have nitrous oxide. Stop that trickle—emulate the Hoover Dam.

When you look at the dental market, you see that half of it lives in fear of the dentist. If I tell a patient he needs a root canal, half of his questions are about money, and the other half are fear. “How much is that? Will my insurance cover it? I don’t get paid until Friday.” We answer that the insurance will pay 80 percent, so he can just make a few payments and it’ll be a hundred bucks … and then he asks, “Can you knock me out?” But, when someone goes on Dentaltown and posts that the “wand” is a pain-free injection where no one feels a shot, the first thing a dentist says in response will be, “I’m not paying $2,000 for that!” No, but you’ll pay 3 percent on marketing for years.

Special treatment

The most impactful thing I’ve ever heard at a lecture is when someone asked, “Why won’t dentists spend 4 percent on patient loyalty, but they’ll drop their fees 40 percent to take some new PPO?” SmartPractice’s whole thing is, “Before you drop your fee 40 percent to take that PPO, we have all this stuff for patient loyalty.” But dentists don’t want to buy patient loyalty; they want to buy Facebook ads and direct mail campaigns and targeted advertising. Maybe you should take your advertising budget and use half to hunt for new blood and half to improve patient loyalty. My ex-wife cried every time the cheesy doctor sent

her roses after she had a baby. He probably wasn’t even the one who put in the order—it was probably someone in marketing—but his name was on the card and my ex-wife loved it.

You have your wisdom teeth pulled only once. Did the dentist call the patient after? Did you do anything to help get patient loyalty? Patients might not remember exactly what you did, but they’ll always remember how you made them feel. Patients will remember their wisdom tooth removal because it’s their only one—dentists, on the other hand, are completely immune to all that. I’ve pulled a thousand sets of wisdom teeth. It’s not special to me—but it is to our patients, and what are we doing for them?

Show your gratitude In the market, everyone talks about the “new patient experience.” The most common new patient experience is spending 20 minutes in the waiting room. The No. 1 return on investment is an extra operatory, because if your new patient is waiting when you don’t have a chair ready, that’s a bad experience. If I’m waiting out in the lobby, I’m seething. But if you move me into an operatory and do a little something, and say, “We need to let this anesthetic set for (however long the dentist is running late),” that’s occupied time, and the patient isn’t angry. How about a bigger way to show your appreciation?

When I fluoridated Phoenix in 1989, my staff wanted to throw a party at a local rec center and invite all my patients. I thought it was crazy, but I swear I think they all showed up. Tom Mattern, a Townie dentist with a practice in Chandler, Arizona, rented a theater and showed a free movie, thinking maybe some patients would show up—and the attendance was so big, the theater was standing room only! I know a dentist in Kansas who swears to methat lots of old people have nothing to do on New Year’s Eve, so for 30 years he’s been renting an entire nightclub and throwing a New Year’s party. He thinks it’s his No. 1 thing, because when you’re a loser with nowhere to go, you’ll keep your dentist so you have at least one rocking-hot party to go to each year! At my practice, the largest number of referrals is still word-of-mouth from other patients. That’s what everyone should be focusing on: Keeping the current patient base happy, because they’re still the No. 1 source of new patients.

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