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"Donor and Recipient" Dental Practices

Early in my career, I realized my best referral source wasn’t the direct response mailers, new resident programs, care-to-share programs, signage, or even location.  To my surprise, it was the Orthodontist and two other GP Dental practices down the street.  In a town of 19,000 people, 35 miles north of Dallas, we were getting 15-20 new patients per month from our competitors.  How could that be?  Why would so many patients in a town where everyone knew one another, decide to leave their long time dental practice to come to the new kid on the block.  Maybe what I had been taught in dental school wasn’t true: “Patientswill bond to your dental practice for life”.  In fact, Fortune magazine found that 87% of patients will change their Physician (MD) for a $5 difference in fee.  Is it any surprise that they would leave a dentist for money, lack of concern, inconvenient hours, poor location, lack of competence, or a single bad experience?  Welcome to the era of “Donor and Recipient” Dental Practices.  Fail to inspire your patients, and you will see them seek treatment elsewhere.  Make every step of the patient experience perfect except for the last one, and they’regone.  Patients today vote with their feet.  If you are seeing the backs of their heads, you are doing it wrong.

Dental Truth #1:  There is no way to get better at giving patients what they don’t want.

The worst thing you could ever do is push treatment on patients without happily giving them what they want.  Let that small fact elude you (giving patients what they want), and you will find yourself on the fast track to a mediocre,unfulfilling career.   Fact:  If you are not growing, then you are not meeting your patient’s needs.  If you cannot inspire your patients or if you are not growing, then you become the “Donor” practice for your area.  Take a moment and see if you can name a practice in your area that is a “Donor” practice.  If you can’t think of one, then it’s probably you.  The “Donor” practice has no idea that they are having this effect on their patients.  They are usually clueless.  It is always the poor economy, terrible location, poor dental IQ, or inability to find and keep quality staff that is blamed for lack of growth.  At Summit, we expect our client’s practices to grow regardless of the economy, and they do.  The “Recipient”practice quietly grows, inspiring their patients to refer everyone they know.

Here are the symptoms of a “Donor” practice.

  • Increase in Cancellations and No-Shows (goal would be less than 10%).  You are not convenient, and did not sound caring and compassionate over the phone.  Poor hours, days and fees (Consumerism) create such a hassle to get into your practicethat patients make an appointment never intending to keep it.
  • Few or no Direct Referrals (Goal:  60% minimally).   This is the one black or white symptom.   Few referrals spell disaster.
  • Patients want second opinions.  This is often the result of being too assertive, instead of having a balanced case presentation.  If you want the treatment more than the patient, you have crossed the line.  There should be no selling in dentistry.  Give them what they want and tell them what they need.
  • Marketing Driven:  You spend a greater and greater portion of your income on external marketing in order to maintain your numbers.  Good practices (Recipient) do not need to market and poor practices (Donor) should not market.  Spendingmoney and time on marketing when you have few internal referrals spells disaster.  You will just have more patientsleaving faster, and telling everyone they know to stay away.  Don’t look for an external solution to an internal problem.  Close your back door first, then open the front.
  • Patients say they cannot afford your treatment plans.  You must keep comparables comparable when it comes to fees.  Stay in the 80-85thpercentile for your area.  Always give the patient what they want first, then, work at giving them what they need.
  • High staff turnover.  Our office was fortunate to average over 14.5 years of tenure for each employee.  High turn-over is a symptom of lack of leadership and poor business systems.  Get it right and the patients and staff will stay.  If your patients see a different face every 6 months, they will wonder why.(Actually, they will assume the problem is you).
  • Assisted Hygiene.  Assisted hygiene can work to ramp up the hygiene department, but make sure you have the right assistant in that role.  It should be the best assistant in the office.   Maybe even the one you can’t work without.   If done incorrectly,   you will see fewer patients following thru with treatment plans because of a lack of trust that was oncecreated by your hygienist spending the time to adequately explain treatment and discovering what the patient wants.  I have seen few offices that do assisted hygiene well.
  • Poor Financial Arrangements.  The largest and most used health care patient financing company is not the best just because they pay the ADA hundreds of thousands of dollars a year to receive their endorsement.  Add Wells Fargo, Chase, and others to your options and watch the acceptance rate soar.


How to Fix Donor Practices

  1. Routing slips:  These can be produced by most dental software and allow you to track each patient through the office.  Somewhere along the way you will find a point at which they do not proceed to the next step. Identify this point and you can correct the system or staff member and eliminate the blockage.  Failure to identify it will lead to“Donor Doomsday”.
  2. Exit Interviews:  Whether it is with a staff member that does not work out, or a patient who goes down the street, you can benefit by taking the time to call and find out why.   Great leaders find the problem and deal with it immediately.
  3. Comment Cards:  These anonymous cards allow you to discover potential problems with every patient you see.  Email me ([email protected]) and I will send you one.  Assume that if one patient mentions a problem, there are 100 more patients who were silent and felt the same way.  96% of patients will leave without saying anything if they are dissatisfied.  Learn about and deal with the problem and most will stay.
  4. Create a system for CA/NS:  Email me and I will send you our cancellation and no-show system we used for over 30 years.  We will include a call sheet and purge sheet to help bump up your daily production and lower your overhead.
  5. Record and monitor the calls in and out of the office.  The number one piece of technology in your office is the telephone.  If the staff members answering the phone do not come across as caring and compassionate, the patient will likely never show up.  If the patient does actually come in, the job of convincing them to trust you and follow through with treatment is much more difficult.


Spend the time to create great systems and inspire your patients and staff, and there is no limit to practice growth.

If this has hit a nerve, if you are stalled or feel you have reached a plateau and cannot get to the next level, give me a call at 972-523-4660 or email me at [email protected] and let me set up a time todiscuss and analyze your situation and give you some answers to your problems.  No cost, no obligation, nothing to lose — so call or email today.